Dec
28
2024

Anti-Inflammatory Diets Improve Inflammation

By | diet, fiber, fish oil, food, Health, Inflammation, meat, Mortality, Nutrition, olive oil, omega-3 fatty acids, polyunsaturated oil, Processed food, processed meat, red meat

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A CNN review article noted that anti-inflammatory diets improve inflammation. This is important for medical conditions that also have inflammation attached to it. For instance, rheumatoid arthritis, diabetes or chronic kidney disease all carry inflammation with them. But according to a 2019 study more than 50% of all deaths stem from chronic inflammatory conditions.

Here is a more complete list of what type of clinical conditions are associated with chronic inflammation:

  • cardiovascular disease, such as heart disease and stroke
  • obesity
  • cancer
  • chronic obstructive pulmonary disease
  • asthma and allergies
  • diabetes
  • chronic kidney disease
  • chronic pain — for example, from some sources of back pain, headache disorders, arthritis and other joint conditions
  • non-alcoholic fatty liver disease
  • autoimmune diseases, such as rheumatoid arthritis, lupus, ulcerative colitis, and Crohn’s disease
  • depression
  • neurodegenerative conditions, such as Alzheimer’s disease

Some people may have two or more of these chronic diseases at the same time. This increases the risk of death. This is even more of a reason to follow an anti-inflammatory diet.

Anti-inflammatory diet

The CNN article suggests that an anti-inflammatory diet has the potential to reduce inflammatory cytokines. This is important and can also improve symptoms of chronic inflammatory diseases. A large study was conducted in 2021, which showed that people on an anti-inflammatory diet had a lower probability to get complications.  Anti-inflammatory diets protected them from heart attacks, strokes, coronary heart disease and more.

Here are the ingredients of an anti-inflammatory diet

Why are anti-inflammatory diets so healthy? It is because they are rich in fiber, omega-3 fatty acids, antioxidants, polyphenols, vitamins, and unsaturated fats can have anti-inflammatory effects. Fruit options can include:

  • apples
  • fruits with stones or pips, such as peaches, plums, apricots, and cherries
  • grapes
  • citrus fruits such as oranges, lemons, limes, and grapefruit
  • pomegranates

Vegetables are high in fiber and other important vitamins and nutrients. Include a variety of colors of vegetables in your daily diet. Options can include:

  • green leafy vegetables, such as spinach, kale, radicchio, and arugula
  • cruciferous vegetables, such as broccoli, cauliflower, cabbage, and brussels sprouts
  • tomatoes
  • root vegetables, such as turnips, beets, radishes, and onions
  • potatoes
  • sweet potatoes

Whole and cracked grains are another source of fiber.

Nuts and seeds

Nuts and seeds contain polyphenols, which can have an anti-inflammatory effect. Nuts and seeds can include almonds, peanuts, cashews, hazelnuts, flaxseeds, sesame seeds, chia seeds, sunflower seeds, and pumpkin seeds.

Healthy oils

Vegetable oil like olive oil are important for cooking and for salad dressings.

Fish

Fish that is high in fatty acids and omega-3s can be important in an anti-inflammatory diet. These fish varieties can include salmon, tuna, sardines, and mackerel.

Herbs and spices

Some herbs and spices may have anti-inflammatory effects, as they can be high in phenols and antioxidants. These include clove, sage, oregano, cinnamon, rosemary, turmeric, black pepper, and ginger, among other options.

What to avoid

Highly processed foods like hamburgers, french fries, cakes and others must be removed from your food list. They are associated with heart attacks, strokes and cancer. In addition, the following food component must be avoided, if you value your life.

  • Refined carbohydrates: This can include products made with white flour, such as white bread, pasta, breakfast cereals, and pastries.
  • Trans fats: These can include foods labeled as having partially hydrogenated oils in them. Examples include baked goods such as cakes, pies, and frozen pizzas, as well as fried foods such as donuts or fries.
  • Some saturated fats: red meat, chicken with the skin on, milk, cheese, and cream contain high levels of certain saturated fats that promote inflammation.
  • Sugar: Sugary foods or foods with a high glycemic index can be inflammatory. Examples can include sugary drinks and sodas, sugary cereals, and candy.
  • Red meat and processed meat: This can include beef, lamb, goat, and pork meat, as well as processed hot dogs and sausages, among others. These meats have an association with colorectal cancer.
  • Certain spreads and cooking fats: Some fats such as margarine, shortening, and lard can be inflammatory.
Anti-Inflammatory Diets Improve Inflammation

Anti-Inflammatory Diets Improve Inflammation

Conclusion

You hear bad things about chronic inflammation and premature deaths. What you may not have heard a lot yet is that anti-inflammatory diets actually can safe lives. Above I have listed the most common inflammatory diseases. I also described the ingredients of an anti-inflammatory diet. With this diet researchers found that cardiovascular disease was reduced by 38%, strokes were reduced by 28%. It is not that difficult to adopt a healthy anti-inflammatory diet. Keep trans fats and highly processed foods away. Eat more vegetables, fish and avoid red meats. Add some nuts and cold pressed extra virgin olive oil. Good health will thank you for this diet change.

Jun
15
2019

Replacing Part Of Red Meat With Fish Shows Health Benefits

By | diet, fish oil, Health, heart attack, Nutrition, omega-3 fatty acids

A Danish study has shown that replacing part of red meat with fish shows health benefits.

The research was done by a PhD student and pointed out that men above the age of 50 were particularly benefitting from fish substituting part of red meat in their diet. Women in the childbearing age also benefitted greatly. On this diet pregnant women as well as the unborn children become healthier.

Risk versus benefit analysis

Sofie Theresa Thomsen, the PhD student who conducted this study did risk-benefit assessments regarding partial substitution of beef with low-mercury fish. Red and processed meat contains saturated fat, which is added to the other saturated fat in the Danish diet. Red meat and processed meats have been associated with colorectal cancer and some other cancers. But red meat also contains beneficial iron. In contrast, fish contains a lot of omega-3 fatty acids that are anti-inflammatory and also contains vitamin D. But one has to be careful about methylmercury content in fish. I reviewed fish, mercury contamination and the benefits in this link.

In her calculations Sofie Theresa Thomsen replaced 350 grams of beef per week with 350 grams of low-mercury fish per week.

If all the Danish households would do this partial beef/fish exchange, the Danes would gain 7,000 healthy years of life annually. This includes, among other health conditions, the prevention of 170 deaths from coronary heart disease.

What kind of fish can you eat?

As the link above shows, there are low, medium and high methylmercury contaminated fish. The higher the fish is in the predator chain, the higher the methylmercury content. This is of particular concern for pregnant women as mercury is toxic for the fetal brain tissue. But they consume low mercury fish and shellfish, like mackerel, herring, wild salmon, shrimps or clams, pregnant women benefit greatly from the beef/fish exchange. Tuna is too high in methylmercury to be included in the beef/fish exchange. If you were to include tuna in this, you would experience a health loss.

Vitamin D and iron

The study showed further that a partial exchange of beef by fish would reduce the number of Danes who are vitamin D deficient. The 350 grams of fish per week are sufficient to significantly raise the vitamin D blood level. Conversely, replacing a part of the beef intake with fish does not cause iron deficiency problems.

Who benefits most from replacing part of red meat by fish?

Sofie Theresa Thomsen asked who would benefit most from such a beef/fish exchange diet.

On the one hand it is the older than 50 year male population who is at a significant risk of developing heart attacks. The fatty fish with omega-3 fatty acids reverses some of the plaque in the arteries and keeps coronary arteries open. This prevents heart attacks and strokes.

On the other hand pregnant women and their children benefit greatly from the beef/fish exchange diet. The women will feel more energy and their offspring will have healthy brains.

Replacing Part Of Red Meat With Fish Shows Health Benefits

Replacing Part Of Red Meat With Fish Shows Health Benefits

Conclusion

A study from Denmark analyzed what happens when a person exchanges 350 grams of beef with low mercury fish or shellfish per week. The conclusion was that Danes would gain 7,000 healthy years of life annually. Among these is the prevention of 170 deaths from coronary heart disease. But the most lives saved would be among men older than 50 years due to heart attack and stroke prevention. Pregnant women are also benefitting tremendously, not only for themselves, but for their children. The fish needs to be low mercury fish, as mentioned above, as mercury is a central nervous system toxin. Tuna is too high in mercury.

I have cut out red meat and meat products from my diet since 2015, when the WHO came out with the statement that red meat causes colorectal cancer. As a result I eat a lot more low mercury seafood and shellfish.

Jan
28
2017

Cardiovascular Disease And Inflammation

By | Cardiovascular disease, Diabetes, Fitness, heart attack, Heart Disease, High Blood Pressure, Inflammation, lifestyle, mitochondria, Nutrition, Obesity, sugar

Dr. Mark Houston talked about cardiovascular disease and inflammation – “the evil twins”. He presented this lecture at the 24th Annual World Congress on Anti-Aging Medicine (Dec. 9-11, 2016) in Las Vegas. Dr. Houston is an associate clinical professor of medicine at the Vanderbilt University Medical School in Nashville, TN 37232.

New thinking about cardiovascular disease and inflammation

Dr. Houston pointed out that the old thinking about cardiovascular disease is defunct, needs replacing and, of course, that the new thinking needs to take its place. Specifically, here are a number of points regarding the new thinking.

  1. Coronary heart disease and congestive heart failure are diseases of inflammation. In the same fashion, oxidative stress, vascular immune dysfunction and dysfunction of the mitochondria are also part of them.
  2. Moreover, in the past it was difficult to reduce these cardiovascular diseases. In contrast, with the new thinking there are now new treatment approaches that help cure cardiovascular disease.
  3. On the whole, the development of heart disease has a long history. First, endothelial dysfunction predates coronary artery disease by many years. Second, the next step is vascular smooth muscle dysfunction. Finally, inflammation develops and structural changes occur in the small and larger blood vessels with atheromatous deposits (plaques) and final occlusion, at which point you get a heart attack.

New approach to the old problem of plugged coronary arteries

Canadian physician Sir William Osler has already stated more than 100 years ago “A man is as old as his blood vessels”. In the first place, the old thesis was that cholesterol would lead to deposits that close coronary blood vessels and cause heart attacks. Dr. Houston called this the “cholesterol-centric “ approach. In reality, the truth is that with conventional blood tests you are missing 50% of all the high-risk patients that are going to develop heart attacks. They are missing the ones that have chronic inflammation, but normal cholesterol levels.

Coronary artery damage from cholesterol elevation versus inflammation

What was not common knowledge in the past was that oxidative stress associated with normal aging can also lead to chronic low-grade inflammation. This oxidative stress leads to mitochondrial DNA changes. Associated with it are biochemical changes that cause chronic inflammation, which in turn will affect the lining of the arteries. The literature describes a metabolic change that known as metabolic syndrome. It leads to high blood pressure, hardening of the arteries and eventually heart attacks and strokes. Accordingly, the key today is to include in screening tests all parameters that will predict who is at risk to develop a heart attack or not.

Blood tests to screen for cardiovascular disease and inflammation

The physician should check blood tests and health history for dyslipidemia, high blood pressure (hypertension), hyperglycemia, smoking, diabetes, homocysteinemia, obesity etc. Also, patients with high GGTP (gamma-glutamyl transferase) levels in the blood are more at risk to develop diabetes. This in turn leads to inflammation of the arterial wall and heart attacks. There are 25 top risk factors that account for all causes of heart attacks.

Briefly, apart from the 7 factors already mentioned above the physician wants to check for high uric acid levels (hyperuricemia), kidney disease, high clotting factors (fibrinogen levels), elevated iron levels, trans fatty acid levels, omega-3 fatty acid levels and omega-6 to omega-3 ratio, low dietary potassium and magnesium intake with high sodium intake, increased high sensitivity C reactive protein level (hs CRP measuring inflammation).

Further high risk factors for coronary artery disease

The list to test for cardiovascular disease risk continues with blood tests for vascular immune dysfunction and increased oxidative stress, lack of sleep, lack of exercise, subclinical low thyroid levels, hormonal imbalances for both genders, chronic infections, low vitamin D and K levels, high heavy metals and environmental pollutants.

The speaker stated that he includes a hormone profile and vitamin D levels. He does biochemical tests to check for mitochondrial defects. Micronutrients are also checked as cardiovascular patients often have many nutritional deficiencies coupled with cardiovascular factors. Inflammation is monitored through testing the levels of C-reactive protein (CRP).

The Rasmussen score

In order to assess the risk of a patient Dr. Cohen, a cardiologist has developed the Rasmussen score, which is more accurate than the Framingham score.

The following tests are performed on the patient: computerized arterial pulse waveform analysis (medical imaging), blood pressure at rest and following exercise and left ventricular wall of the heart by echocardiography. Further tests include urine test for microalbuminuria, B-type natriuretic peptide (BNP, a measure of congestive heart failure), retinal score based on fundoscopy, intima-media thickness (IMT, measured by ultrasound on the carotid artery) and electrocardiogram recording (EKG).

Here is what the Rasmussen score means:

  • With a disease score of 0 to 2: likely no heart attack in the next 6 years
  • The disease score is 3 to 5: 5% likely cardiovascular events in the next 6 years
  • Disease score > 6: 15% likely cardiovascular events in the next 6 years

Non-intervention tests to measure cardiovascular health

1. The ENDOPAT test

With this test the brachial artery is occluded with a blood pressure cuff for 5 minutes. Endothelial dysfunction is measured as increased signal amplitude. A pre- and post occlusion index is calculated based on flow-mediated dilatation. The values are interpreted as follows: an index of 1.67 has a sensitivity of 82% and specificity of 77% to predict coronary endothelial dysfunction correctly. It also correlates to a future risk for coronary heart disease, congestive heart disease and high blood pressure.

2. The VC Profile

This test measures the elasticity of the arteries. There is a C1 index that measures the elasticity of the medium and smaller vessels and the C1 index, which measures elasticity of the larger arteries and the aorta. The smaller the numbers are, the less elastic the arterial walls.

3.The Corus CAD score

This is a genetically based blood test. The score can be between 0 and 40. If the score is 40, there is a risk of 68% that there is a major blockage in one or more coronary arteries.

4. Coronary artery calcification

The CAC score correlates very well with major event like a heart attack. There is a risk of between 6- and 35-fold depending how high the CAC score is. The key is not to wait until you have calcification in your coronary arteries, but work on prevention.

Treatment of cardiovascular disease and inflammation

When the doctor treats heart disease, all of the underlying problems require treatment as well. It starts with good nutrition like a DASH diet or the Mediterranean diet.

Next anti-inflammatory and other supplements are added: curcumin 500 mg to 1000 mg twice a day, pomegranate juice ¼ cup twice per day, chelated magnesium 500 mg twice per day, aged garlic 1200 mg once daily, taurine 3 grams twice per day, CoQ-10 300 mg twice per day and D-ribose 5 grams three times per day. This type of supplementation helps for chest pain associated with angina. On top of this metabolic cardiology program the regular cardiac medicines are also used.

Additional supplements used in the metabolic cardiology program may be resveratrol 500 mg twice per day, quercetin 500 mg twice per day, omega-3 fatty acid 5 grams per day, vitamin K2 (MK 7) 100-500 micrograms per day and MK4 1000 micrograms per day. In addition he gives 1000 mg of vitamin C twice per day. This program helps in plaque stabilization and reversal and reduction of coronary artery calcification.

Case study showing the effect of metabolic cardiology program

Here is a case study where Dr. Houston treated a heart patient. He was a white male, first treated for congestive heart failure as a result of a heart attack in June 2005. Initially his ejection fraction was 15-20%. His medications were: digoxin 0.25 mg once daily, metoprolol 50 mg twice per day, ramipril 10 mg twice per day, spironolactone 25 mg twice per day and torsemide 20 mg once daily. These medications remained in place, but the patients followed the metabolic cardiology program in addition. Here are the results of his ejection fraction (EF) values after he was started on the metabolic program:

  • Initial measurement: EF15-20%. Marked shortness of breath on exertion.
  • 3 months: EF 20-25%. He reported improved symptoms.
  • 6 months: EF 25-30%. He said that he had now minimal symptoms.
  • 12 months: EF 40%. He had no more symptoms.
  • 24 months: EF 50%. He reported: “I feel normal and great”.
  • 5 years: EF 55%. He said” I feel the best in years”.

A normal value for an ejection fraction is 55% to 70%.

Cardiovascular Disease And Inflammation

Cardiovascular Disease And Inflammation

Conclusion

Testing for heart disease risk has become a lot more sophisticated than in the past, and the tests have opened up a window to early intervention. Metabolic cardiology is a new faculty of cardiology that assists in the reversal and stabilization of heart disease. It will help high blood pressure patients and stabilizes diabetes, which would otherwise have deleterious effects on heart disease. Metabolic cardiology improves angina patients. It also prevents restenosis of stented coronary arteries. As shown in one clinical example reduced ejection fractions with congestive heart failure will improve. The metabolic cardiology program achieved all of these improvements.

As usual, prevention is more powerful than conventional treatment later. To give your cardiac health a good start, don’t forget to cut out sugar, exercise regularly and follow a sensible diet.

Feb
28
2015

A Low Fat Diet is Not Protective Of Heart Attacks

By | Diabetes, heart attack, Heart Disease, lifestyle, Mortality, Nutrition, Obesity

This article is about the fact that a low fat diet is not protective of heart attacks. The British Medical Journal (BMJ Publishing Group, James J DiNicolantonio) published a critical editorial review regarding the lack of science behind the low fat diet guidelines. The low fat guidelines became law  in 1977 in the US and in 1983 in England. The devastating fact was that it was based only on a study of 2467 men (not a single female included) and there was no evidence of lower heart attacks in the low fat diet group when compared to the normal diet control. Yet the guidelines were the cause of the obesity and diabetes epidemic that followed causing heart attacks and strokes. February, the month where we think about heart disease  is the appropriate month to discuss the findings of this British Medical Journal article that exposes it all.

No significant difference between control group and low fat diet group

The BMJ Publishing Group re-traced all of the data that were available at the time of the decision in 1977. There were six clinical trials (with randomization) that had a mean duration of 5.4±3.5 years where the researchers compared low fat diets to normal diets. They found that the authorities who wrote the dietary recommendations for a low fat diet should have come to the conclusion that there was no statistical difference between the experimental group and the control group. The summary of the present re-analysis of the studies that were available to the US government in 1977 and to the UK government in 1983 was as follows: “There was no statistically significant relationship between dietary interventions and all-cause mortality.”

The researchers noted that the all cause mortality was identical in the experimental group and the control group (370 deaths in both groups). There was no significant difference of coronary heart disease (CHD) between the low fat diet group and the control group.

Low fat diet recommendations based on false data

There was no statistically significant difference in deaths from CHD (heart attacks). The reductions in mean serum cholesterol levels were significantly higher in the intervention groups; however, this did not result in measurable differences in mortality from CHD or all-cause mortality.

What is troublesome is that the six studies with randomization were the basis of all of these observations.  The studies included only 2467 men, but there was not a single woman in the trial. Yet the researchers recommended the diet for both men and women alike.

The authors concluded “It seems incomprehensible that dietary advice was introduced for 220 million Americans and 56 million UK citizens given the contrary results from a small number of unhealthy men”.

Political mistakes introducing low fat diets

Dr. Robert Olson of St Louis University warned Senator George McGovern that the studies did not support the dietary recommendations the Senator was about to announce. To this objection Senator McGovern replied: “Senators don’t have the luxury that the research scientist does of waiting until every last shred of evidence is in”.

There was very good evidence that dietary changes (low fat diet) will not change the rate of heart attacks and strokes. Yet the government committees in the US and in Great Britain did not consider this evidence. Other publications have examined the consequences of replacing saturated fats with carbohydrates in the recommended low fat diets.

Sugar is the problem in low fat diets

The researchers made the following observations regarding low fat diets:

  1. In processed foods low fat diet meant that more sugar was added to bring the saturated fat content down. This has detrimental effects on insulin sensitivity and causes type 2 diabetes on the long-term. In these patients there is an increase of small LDL particles and triglycerides, while there is a reduction of HDL. Blood clot markers increase, weight increases causing obesity. Polyunsaturated fats of the omega-6 type (including oils from corn, soybean, safflower and cottonseed) replaced saturated fats.
  2. However, randomized controlled trials showed the following. When omega-6 polyunsaturated fats (without simultaneously increasing omega-3 fatty acids) replaced trans-fats and saturated fats, there was an increase of death rates from heart attacks and strokes.
  3. The Anti-Coronary Club trial showed that more people died from heart attacks when saturated fat was replaced by polyunsaturated fat.
  4. The reason for the heart attack causing omega-6-fatty acids (from polyunsaturated fats) has been worked out in several research papers between 2006 and 2012 (cited in this link): they cause inflammation, cause cancer, weaken the immune system, lower the protective HDL cholesterol and increase the susceptibility of LDL cholesterol to be oxidized.
  5. When polyunsaturated fatty acids (omega-6) replaced saturated fat there was more breast cancer and prostate cancer.

Low fat diets don’t work

This review stated that there was a lack of data that low fat diets help prevent heart attacks and strokes. We have now clinical trials that numbered 347 747 participants. These trials showed that increased fat intake did not cause heart attacks. The Women’s Health Initiative included 48, 835 postmenopausal women. It showed that a low fat diet did not reduce cancer. It also did not prevent heart attacks or strokes. All of this supports what has been summarized before in a critical review regarding “The Oiling of America“.

Low Fat Diet Not Protective Of Heart Attacks

Low Fat Diet Not Protective Of Heart Attacks

Conclusion

Enjoy saturated fat as it does not cause you harm. Cut out omega-6 fatty acids like oils from corn, soybean, safflower and cottonseed. Use virgin olive oil or coconut oil instead. Take regular supplements of omega-3 fatty acid (marine derived) to balance natural omega-6 fatty acids in turkey or chicken meat. You can eat cheese and enjoy nuts. But in the US buy organic or imported cheeses from Canada or Europe. In Canada and Europe bovine growth hormone is illegal.

It is most important to avoid sugar, honey and high fructose corn syrup. These all oxidize LDL cholesterol, which is the pre-stage for hardening of the arteries. The oxidized LDL cholesterol is part of the plaques of arteries and leads to strokes and heart attacks. This also means that you must avoid all processed foods that contain sugar and high fructose corn syrup (read labels).

It is not that difficult to follow such diet recommendations as my wife and I have done this since 2001. We use stevia to replace sugar for sweetening (no calories, no effect on insulin). Do what’s good for your body!

Nov
30
2013

Statins Can Hurt The Consumer

By | Anti-aging medicine, Arthritis, Diabetes, Fitness, heart attack, Heart Disease, High Blood Pressure, Hormones, kidney disease, Nutrition, Obesity, Prevention, Stroke, Vitamins and supplements, Weight loss

Lovastatin (Mevacor, from Merck) was the first statin drug approved by the FDA in 1987 as a cholesterol-lowering drug in the US. It made history in helping high-risk heart attack patients reduce their cholesterol levels and has helped safe many lives. But with the detection around 2002 that heart disease is an inflammatory disease, and that measuring the C-reactive protein with a blood test was a better than measuring cholesterol levels in predicting who would be at risk for developing a heart attack, the landscape has changed. Lifestyle changes have also been shown to be very effective in reducing cholesterol, C-reactive protein and triglyceride levels. In fact, lifestyle changes will reduce the risk for heart attacks and strokes. The newest flurry of activity with calls for putting more people on statins makes me suspicious that there could be a misrepresentation of the facts.

In this blog I am analyzing the literature to get to the bottom of the facts on reducing risk for heart attacks and strokes. I also come to my own conclusion.

Facts about cholesterol

Cholesterol is a waxy substance that is part of the cell walls and plays a vital role in our metabolism. Liver cell membranes, for instance contain about 30% cholesterol. However, most of the cholesterol in our body comes from metabolism, 20 to 25% from the liver, the rest in the gut, adrenal glands and the reproductive organs, and also from the brain (the myelin sheaths contain a lot of cholesterol). 50% of the body’s cholesterol is recycled through bile salts and reabsorption of cholesterol in the gut (called the enterohepatic pathway).

Cholesterol is vital for cell function, for insulation of nerve fibers (myelin sheaths) and for synthesis of our steroid hormones (sex hormones and vitamin D3, which  is now considered to be a hormone). The medical establishment took most of the information regarding heart attack and stroke prevention from the ongoing Framingham study. This clearly pointed to the importance of lowering the LDL cholesterol fraction (the “bad” cholesterol) and maintaining or increasing the HDL fraction (the “good” cholesterol). When it was realized that concentrating only on lowering cholesterol missed 50% of all heart attacks that researchers refocused and found the missing link, namely inflammation. Inflammation is at the cause of heart attacks and strokes, high cholesterol and lipids were only secondary phenomena. Ref. 2 points out that a comprehensive approach to treating a patient with high cholesterol should involve a combination of treatments aimed at the underlying risk factors for heart disease or stroke in a particular patient. This involves sophisticated blood tests where a metabolic derangement can be pinpointed. It should include measuring cholesterol fractions, lipids, the C-reactive protein, hormone levels and more.

Statins Can Hurt The Consumer

Statins Can Hurt The Consumer

How the traditional thinking about cholesterol has changed

The Framingham study has provided the basis for the drug industry to produce statins until about 2002 when our thinking about cholesterol being the culprit for causing heart attacks has forever changed. Subsequently further research showed that other factors like inflammation of the blood vessels, the metabolic syndrome associated with obesity and lack of exercise were also to blame for causing heart attacks and strokes. Recently more details have come to light, which point to multiple causes like the consumption of too much sugar, too much trans fats, too much salt and eating too much over processed convenience food.  We end up gaining weight, develop the metabolic syndrome and inflammation of arteries (including the coronary arteries of the heart and the brain vessels). It is the lack of nitric oxide in the lining of the arteries, which combined with inflammatory substances from visceral fat are responsible for hardening of the arteries as the ultimate consequence of faulty nutrition and lack of exercise. We also know that oxidized LDL, particularly the very low-density lipoproteins (VLDL), will release free radicals and damage the arterial walls. CoQ-10 is a supplement, which is known to counteract this. One important test that had developed out of the Framingham study is the “ratio of total cholesterol to HDL cholesterol”, which is used by cardiologists to determine the risk of coronary artery disease. The average risk of this ratio for Americans is 5.0 for males and 4.4 for females. The ideal ratio to strive for is  the “1/2 average risk” ratio of 3.4 for males and 3.3 for women (Ref.2). A fit, slim person who eats a low carb, normal fat diet (modified Mediterranean diet) will often have a ratio of only 3.0, well below the 1/2 average risk. The moment you introduce grains in your diet (cereals, bread, pasta) your liver will convert carbs into LDL cholesterol, while HDL cholesterol will drop resulting in a high risk ratio of above 5.0 (often 7 or 8 or more). The LDL will get oxidized and is deposited into your arteries setting you up for coming down with a heart attack or stroke down the road.

How do statins work?

The statins are a group of drugs that inhibit an enzyme, called the hydroxymethylglutaryl–Coenzyme A (HMG-CoA), which leads to a lowering of cholesterol, specifically a fraction known as the LDL cholesterol. The success story of lovastatin (Mevacor) led to a flurry of new HMG-CoA reductase inhibitors (cholesterol lowering drugs) such as fluvastatin (Lescol), pravastatin (Pravachol), simvastatin (Zocor), atorvastatin (Lipitor), and rosuvastatin (Crestor) in the late 1980’s and the 1990’s. Collectively it is now a 26 billion industry in annual sales.

Later investigations showed that there were other mechanisms by which statins helped, namely they were found to decrease the inflammatory reaction, which can be measured by lowering of the C-reactive protein. However, there are significant side effects in about 1 to 3% of people who take this medication, particularly an inflammation of liver cells (evident from elevation of liver enzymes) and a myopathy, which is a painful muscle condition (Ref. 1). This latter fact, which can occur in as many as 33% of the population at large (particularly the exercise minded) has limited the use of statins in competitive athletes where myopathies can occur in as many as 75% of athletes treated with statins (Ref.2). The reason for that is that the muscles of athletes cannot keep up with the demands put on them when they are kept in check by the HMG-CoA reductase inhibitors. On the other hand statins have prevented heart attacks and deaths from heart attacks and strokes in about 25% to 35% of patients treated with them as many clinical trials have shown (Ref.1), but simple supplements that have no side effects can do the same or do even better (see below).

The lack of cholesterol synthesis by the body’s cells when statins are given, leads to an expression of more LDL receptors on the cell surfaces. LDL binds to these receptors and enters the cells, which removes the circulating high risk LDL fraction of cholesterol from the blood thus causing a drop in LDL cholesterol. All of the side effects of statins (pull down to side effects in this link) can be explained as a result of the slow-down of organ functions (brain, muscles, gut, adrenal glands, etc.) as cholesterol synthesis is reduced.

New information from the Framingham Heart Study

So far everything I said made sense. But when I came across Ref. 4 I noticed that there was a bombshell of new information from another follow-up study of the Framingham Heart Study (Ref. 5) that did not fit in with the latest marketing drive of the statin manufacturers. In this study from 2005 Boston researchers had studied the outcomes of 789 men and 1105 women over a period of 16 to 18 years with respect to cognitive function. Participants were divided into total cholesterol groups that showed levels that were desirable (less than 200), borderline (200 to 239) or high (above 240). The astounding results were that higher cognitive functioning as documented in multiple cognitive tests in these three groups showed the best performance in the group with the highest cholesterol and the worst cognitive test outcomes in the lowest cholesterol group, quite opposite of what was expected.

Another important piece of research (April 2013) comes from Spain where doctors followed a group of 7447 patients with a high cardiovascular risk who were put on a Mediterranean diet with olive oil, a Mediterranean diet with nuts or a regular diet. The end point was death from heart attack or stroke. After 4.8 years the study had to be interrupted as the Mediterranean groups showed a significant survival advantage over the group on a regular diet.

Ref. 4 cited literature evidence that statins cause a 48% increased risk in postmenopausal women who take statins to develop diabetes. It also cites compelling evidence that diabetes patients are twice as likely to develop Alzheimer’s disease within 15 years and are 1.75 times more likely to develop any kind of dementia in the same time period.

Dr. Seneff from the Computer Science and Artificial Intelligence Laboratory at MIT explains in great detail that statins effectively reduce cholesterol synthesis in the liver, which in turn starves the brain of one of its main nutrients explaining why patient develop Alzheimer’s disease and dementia as a result of statin treatment.

So, the lessons to be learnt from these clinical trials are that you want to offer your brain enough cholesterol and healthy fat to have a normal metabolism. Fortunately, what’s good for your heart is also good for your brain. Conversely avoid statins, if you can and try alternatives first. Ref. 4 explains that for years the experts had the wrong theory that low fat/high carb was what would be good for your heart and brain, but the opposite is true: what is good for your heart and brain is a high healthy fats/low refined carb diet.

Make sure that with your blood tests that fasting insulin is low (no insulin resistance), that the ratio of total cholesterol to HDL cholesterol is less than 3.4 (low risk for heart attacks or strokes) and that the hemoglobin A1C level is low (4.8 to 5.6%, ideally less than 4.5%), which means you are not diabetic.

How alternative treatment can save you from heart attacks

Lifestyle treatment through dietary intervention, moderate exercise, and weight loss has been somewhat neglected by mainstream medicine, but is now recognized in regular textbooks of medicine as first-line treatment (Ref. 3). Most patients can lower LDL cholesterol by 10 to 15% through a change in diet. High-risk patients with established heart disease (narrowing of coronary arteries) require a drop of 30 to 60% of LDL cholesterol; this high-risk patient group may need an addition of a statin. In patients with metabolic syndrome or diabetes high triglycerides are often present and will respond to decreased intake of simple sugars, alcohol, and calories (Ref.3). Total calorie intake should be adjusted according to what the weight is when weighed every day with the goal of reducing the weight when overweight or obese, but maintaining the weight when it is in the normal body mass index range (BMI of 20 to 25). The total fat intake should be around 25%-35% of the total calorie intake. Specifically, saturated fat needs to be less than 7% of total calories, polyunsaturated fat up to 10% of total calories and monounsaturated fat up to 20% of total calories. Healthy fats according to Ref. 4 are extra-virgin olive oil, organic butter, almond milk, avocados, olives, nuts, nut butters and cheese ( except for blue cheeses). Other healthy fats are sesame oil, coconut oil, and the oils found in seeds like flaxseed, sunflower seeds, pumpkin seeds and chia seeds. Note that trans-fats (such as in margarine and baked goods) are a “no-no” as it causes free radicals in your body, which would accelerate the hardening of your arteries. Complex carbohydrates from vegetables and fruit are the main source of total calories providing 50%-60% of the total calories. Fiber intake needs to be 20-30 grams per day. Protein intake should be about 15% of total calories. Fat should provide 25% to 35% of the total calories per day. Cholesterol intake should be less than 200 mg per day. You may want to consider the use of plant sterols (2 grams per day) to enhance LDL cholesterol lowering. Physical activity from moderate exercise should expend at least 200 kcal per day (better 300 kcal).

Which supplements prevent heart attacks and strokes?

There are several nutrients that have been shown to be powerful preventers of heart attacks and strokes. I will review them briefly here (based on Ref. 2):

1. Coenzyme Q10 (CoQ10): The cells lining the arteries are only working well when their mitochondria are working properly producing chemical energy in form of ATP. CoQ10 is an important component of the mitochondrial metabolism; it is also the only fat soluble antioxidant that gets absorbed into the LDL particles where it protects these from oxidation. Statins suppress CoQ10 synthesis, so patients on statins need to take CoQ10 supplements daily to counteract this. However, anybody who is healthy now should take CoQ10 as a daily supplement for prevention. I take 400 mg per day.

2. Vitamin E (tocopherols): this fat soluble vitamin is an antioxidant and has been praised in the past as being heart supportive, was subsequently bad-mouthed by some conservative physicians, but lately has been resurrected. It turns out that there are 8 different types of tocopherols, with the alpha tocopherol being the most known, but gamma tocopherol is the one you want to make sure you are also getting with your balanced vitamin E supplement every day as this is the one that is a powerful anti-inflammatory. Simply ask staff at your health food store for a vitamin E supplement with gamma tocopherol in it. Take 400 IU per day (of the mix).

3. Curcumin: This is a powerful heart and brain protector combining three different mechanisms in one; it is reducing oxidative stress, is an anti-inflammatory and counters the process that threatens to destroy the lining of the arteries. One study on healthy volunteers showed a reduction of 33% in lipid oxidation, a 12% reduction of total cholesterol and an increase of 29% of the protective HDL cholesterol when 500 mg of curcumin was taken only for 7 days (Ref.2). This is the daily dose I would recommend for prevention of heart attacks and strokes.

4. Polyphenols: Flavonoids are the largest group among the polyphenols contained in such common foods as vegetables, fruits, tea, coffee, chocolate and wine.  Over 130 studies have been done on humans showing improvement of the lining of the arteries (endothelial functioning) and lowering of blood pressure. Polyphenol consumption has been associated with a lower risk of mortality from heart attacks. Eat a Mediterranean type diet or a DASH diet and you will automatically get enough polyphenols with your food. However, resveratrol, the powerful red wine polyphenol warrants a separate daily supplementation as it prevents LDL oxidation in humans (Ref.2). Take about 250 mg of it daily.

5. Niacin/nicotinic acid: This supplement comes as “flush-free niacin” and also as extended release niacin; it can raise the beneficial HDL cholesterol by 30 to 35% when higher doses of 2.25 grams per day are used. In a metaanalysis of 7 studies it has been shown to significantly reduce heart attacks and transient ischemic attacks (precursor syndrome before developing a stroke). Niacin can change the small particle LDL into a large particle size LDL, which is less dangerous. Niacin has also been shown to reduce oxidation of LDL, which stops the atherosclerotic process. For a healthy person 500 mg per day of flush-free niacin is adequate.

6. Fish oil (omega-3-fatty acids): Because heart attacks are due to an inflammatory process and high LDL cholesterol is thought to be only a secondary phenomenon, it is very important to have this additional tool of an important anti-inflammatory supplement. In the past it was still safe to eat fish fairly frequently per week. But with mercury, radioactive iodine from Japan’s leaking reactor and carcinogenic PBC’s all congregating in the ocean waters, it is no longer safe to consume fish in large quantities. The remedy to this situation is molecularly distilled (or pharmaceutically pure) EPA/DHA supplements. EPA stands for eicosapentaenoic acid or omega-3 fatty acid. DHA is the acronym for docosahexaenoic acid. Fish oil supplements at a dosage of 3.35 grams per day of EPA plus DHA were shown to reduce triglycerides by up to 40%, equally to Lipitor or even more effective, but without the statin side effects. The amount of the dangerous small dense LDL is also being reduced with fish oil. Fish oil supplements have reduced the mortality from heart attacks and strokes and led to a higher survival from non-fatal heart attacks. At the same time these preventative fish oil doses will also treat and prevent arthritis.

7. Other useful supplements: Soluble fiber from psyllium, pectin, beta-glucans and others have been shown in clinical trials to reduce LDL cholesterol by binding bile salts in the gut (interrupting the enterohepatic pathway). Plant sterols (usually sold as sterol esters) are recognized by the FDA as reducing the risk of coronary heart disease, if taken in high enough amounts (2.4 grams of sterol esters per day). There are other useful supplements like artichoke extract, pomegranate, soy protein, Indian gooseberry (amla), garlic and pantethine (vitamin B5) that have been proven to be of benefit in terms of prevention of heart attacks and strokes. It would be too lengthy to get into more details here.

Conclusion

Recently there was a review in a medical journal that demonstrated that clinical guidelines (in this case for clinical guidelines for lowering cholesterol) erred 40% of the times when measured against scientific tests as this link explains. When it comes to saving lives by preventing heart attacks and strokes, what is needed is a multifactorial approach that treats the multifactorial causes of cardiovascular disease. Just pushing for treating more people with statins as Big Pharma is attempting to do is not addressing the fact that cholesterol is needed for our metabolism and the synthesis of our hormones. It is much superior to use a combination of different approaches that overlap and thus potentiate each other in their effects excluding statins first. Exercise creates more nitric oxide production by the lining of the arteries, which opens up arteries and prevents spasms. A proper diet with as many of the proven vitamins and other support factors will control inflammation and oxidation of LDL cholesterol particles as explained. This will prevent heart attacks and strokes as has been shown in many clinical trials. Only patients who come from families with genetically high cholesterol or high triglycerides and those patients who had heart attacks and strokes should be exposed to statins as they are at a higher risk of developing a heart attack or stroke. They need all of the help they can get in addition to the lifestyle factors mentioned. Most other patients and the public at large will do quite well without statins (no side effects of diabetes, Alzheimer’s and muscle pains). And, yes, a diet high in healthy fats, but low in refined carbs is what your brain and heart need (the opposite of what you have thought, see Ref. 4).

More information about side-effects of statins (acute pancreatitis): https://www.askdrray.com/pancreatitis-can-occur-with-statin-use/

Lower cholesterol with Mediterranean diet: http://nethealthbook.com/news/mediterranean-diet-benefits-us-workers/

 

References

1. Bonow: Braunwald’s Heart Disease – A Textbook of Cardiovascular Medicine, 9th ed. © 2011 Saunders.

2. Life Extension: Disease Prevention and Treatment, Fifth edition. 130 Evidence-Based Protocols to Combat the Diseases of Aging. © 2013

3. Melmed: Williams Textbook of Endocrinology, 12th ed. © 2011 Saunders.

4. David Perlmutter, MD: “Grain Brain. The Surprising Truth About Wheat, Carbs, And Sugar-Your Brain’s Silent Killers.” Little, Brown and Company, New York, 2013.

5. http://www.psychosomaticmedicine.org/content/67/1/24.full.pdf

Last edited Nov. 7, 2014

Apr
01
2007

Red Meat Linked To Heart Disease In Diabetics

By | Diabetes, Heart Disease, Nutrition

Red meat is one of the sources of protein, but doctors from the Harvard School of Public Health reporting in the January edition of Diabetes Care, that a type 2 diabetes diet should be lean in red meat.

Type 2 diabetics are at risk for subsequent coronary heart disease (CHD), and intake of iron rich food was significantly associated with a greater risk of fatal CHD. The results come from a prospective study of 6,161 women from the Nurses’ Health Study. All of these patients reported a diagnosis of adult onset diabetes, and they were followed between 1980 through 2000, which amounts to an impressive 54,455 person-years follow-up. Attention was paid to the food questionnaires, which were monitored for the consumption of iron and red meat such as beef, pork or lamb as a main dish, also for the use of beef in roast beef sandwiches and mixed dishes, hamburger, hot dog, processed meat and bacon. Note was also taken of other nutrients such as seafood and poultry.
Women with diabetes who ate the most iron in the form of heme found in red meats had a 50% increased risk of total coronary heart disease as compared to those with the lowest intake. The risk ratio with women was more obvious in post menopause when compared with pre menopause.

Red Meat Linked To Heart Disease In Diabetics

Red Meat Linked To Heart Disease In Diabetics

While lean beef may be a good protein food to the average population, type 2 diabetics might choose to cut back on red meat and processed red meat sources and replace it with a heart-friendlier choice. Fresh seafood, rich in omega -3 fatty acids, would rank high on the list of a healthy eating plan.

Reference: The Medical Post, February 20, 2007, page21

Last edited December 5, 2012

Feb
01
2007

Lycopene Benefits Backed By Science

By | Cancer, Diabetes, Health, Heart Disease, Nutrition, Osteoporosis

Lately a lot of attention has been directed to the health benefits of vegetables and fruit. Vitamin C has long been an accepted household term, and nobody questions the benefits. Newer buzz words are the terms “bioflavonoids” and “antioxidants”. Some products are aggressively marketed extolling the above named beneficial substances, but often the consumer is left mildly bewildered by exaggerated claims. Often the sale prices of these miracle foods are as lofty as the bold statements that go along with them.
For any shopper it is important to know that some of the most beneficial foods are not high priced items, but very common staples. Take tomatoes, for instance. They are a significant source for the substance lycopene, which lately has received a lot of attention. Lycopene and its dietary sources as well as its benefits have been researched world wide, and the results are now in. It is responsible for the red color in fruit or vegetables, such as tomatoes, and its isomeric form 5-cis-lycopene is the most stable form having the highest antioxidant properties. Common dietary sources are tomatoes, watermelons, pink guava, pink grapefruit, papaya, apricot and other fruit. In the Western diet tomato-based foods account for about 85% of dietary sources of Lycopene. Studies have shown that lycopene is more efficiently absorbed from processed tomato products compared to raw tomatoes. Once it is absorbed it is distributed throughout the body. The highest levels showed up in the testes, the adrenal glands, prostate, breast and liver.
Research going back to 1995 showed an inverse relationship between the consumption of tomatoes and the risk of prostate cancer. A follow up publication in 1999 showed that the same inverse relation of lycopene intake and cancer also included breast, cervical, ovarian, liver and other organ sites. Further studies have followed these initial publications, and the great majority of them suggest that an increased intake of lycopene showed an association with a significant reduction in the risk of many cancers.
Coronary heart disease and lycopene benefits were also examined. The strongest population based evidence comes from a multi center case control study in Europe (EURAMIC). 662 Cases and 717 controls were recruited from 10 different European countries, and there was a significant relationship between levels of lycopene in fatty tissue and the risk of myocardial infarction. Lower lycopene levels were associated with a higher risk of heart attacks.Lycopene was also shown to decrease levels of oxidized LDL (LDL or low density lipoprotein is known as the “bad” cholesterol). Another small study showed that lycopene was reducing total cholesterol levels and as a result was lowering the risk of coronary heart disease (CHD).
The list of benefits does not end here: the dietary oxidant reduces oxidative stress and levels of bone turnover markers, meaning that it may contribute to the bone health, especially reducing the risk of osteoporosis in postmenopausal women.

Lycopene Benefits Backed By Science

Lycopene Benefits Backed By Science

For people with mild hypertension (high blood pressure), consumption of lycopene resulted in significant reductions of systolic and diastolic blood pressures.
Infertility in males was significantly helped by lycopene intake. In a study infertile man received 8 mg lycopene per day in capsule form. Laboratory tests confirmed an increased sperm density along with functional sperm concentration and mobility. This treatment protocol with lycopene supplementation resulted in a success rate of 36% pregnancies in their partners.
Pregnant women with pre-eclampsia who were treated with lycopene supplement significantly improved, which was shown by decreased diastolic blood pressure, the reduction of pre-eclampsia and a decrease of intrauterine growth retardation, resulting in a healthier mother and baby.
Future research is pending surrounding lycopene in metabolic and inflammatory diseases and in its role of possibly preventing neurodegenerative diseases such as Alzheimer’s disease. Other inflammatory conditions such as arthritis and emphysema will likely also be shown to benefit from lycopene. Preliminary data has already indicated this.
The Food and Drug Administration (FDA) of USA has recently approved lycopene as a safe “natural coloring agent” and a Generally Recognized as a Safe (GRAS) component. The Department of Nutritional Sciences , Faculty of Medicine, University of Toronto, c/o Dr. A.V. Rao et al. who completed this meta analysis of the recent literature have recommended that we all consume a regular daily lycopene dose in our food and supplements as part of our diet for good health.

More info about lycopene and prostate cancer: http://nethealthbook.com/news/lycopene-reduces-prostate-cancer-risk/

Reference: The Whitehall-Robins Report, December 2006, Volume 15, No.4

Last edited November 2, 2014