Dec
05
2020

Mother’s Lifestyle Predicts Heart Attack Risk for Offsprings

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

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

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

Set-up of the study

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

Risk factors for cardiovascular disease

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

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

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

Findings of the study

Here are the findings of the study.

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

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

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

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

Discussion

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

Mother’s Lifestyle Predicts Heart Attack Risk for Offsprings

Mother’s Lifestyle Predicts Heart Attack Risk for Offsprings

Conclusion

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

Risk management of cardiovascular risks

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

Dec
08
2018

Not Exercising Is More Risky For You Than Smoking

By | Cancer, Cardiovascular disease, Diabetes, exercise, Fitness, heart attack, Mortality, Nutrition, Prevention, Smoking, Stroke

A new study showed that not exercising is more risky for you than smoking. We all know that smoking puts you at risk to get a heart attack or a stroke. It can also cause lung cancer and other cancers. So, hearing that not exercising is even more risky than smoking comes as a shocker.

The study

Dr. Wael Jaber, a cardiologist at the Cleveland Clinic was the senior cardiologist of this study. It was based on 122,007 patients who underwent tests using an exercise treadmill test at the Cleveland Clinic. This took place between the beginning of January 1991 and the end of December 2014. The end point in the study was all-cause mortality. The question in the study was whether exercise and fitness were lowering the risk of mortality. The result showed that 12% of the study group had the lowest exercise rate. This sedentary group had a mortality rate that was 500% higher than the top exercise performers. Compared to someone who exercises regularly the sedate group that hardly exercises still had a 390% higher death rate.

No ceiling of the benefit of exercise

What was astounding to the researchers was the fact that there was no ceiling of the benefit of exercise. The ultra fit group still had a super low mortality rate, lower than the next higher fitness group. Age did not matter either. Whether you were 40 or 80, the more you exercised, the lower your mortality rate was.

Comments about the study

Jaber said: “Being unfit on a treadmill or in an exercise stress test has a worse prognosis than being hypertensive, being diabetic or being a current smoker. We’ve never seen something as pronounced as this and as objective as this.” He went on to say: “If you compare the risk of sitting versus the highest performing on the exercise test, the risk is about three times higher than smoking.”

A sports medicine physician, Dr.Jordan Metzl who was not part of the study, said: “Cardiovascular disease and diabetes are the most expensive diseases in the United States. We spend more than $200 billion per year treating these diseases and their complications. Rather than pay huge sums for disease treatment, we should be encouraging our patients and communities to be active and exercise daily.”

Other studies showing that not exercising is associated with a high mortality rate

 

The STABILITY trial

This trial was based on 15,486 patients with heart disease and found that even 10 minutes of exercise per day reduced mortality. They compared the death rate of people engaging in 10 minutes of a brisk walk with a group who did not exercise at all. The brisk walkers had a 33% lower death rate than the group who was entirely sedentary.

A lack of exercise causes a lot of chronic diseases

This review article mentions that a number of chronic diseases were related to sedentary lifestyle. Major diseases like heart attacks, strokes, arthritis, depression and anxiety and others were clearly much more common in people who were more sedentary than those who were exercising regularly.

Poor lifestyle in general causes diseases

Lifestyle, in particular regular exercises, a healthy diet and NOT smoking has a profound positive effect on our health. In one study researchers showed that 79% of major diseases including heart attacks and strokes could be prevented with a healthy lifestyle. I reviewed this in this blog.

High blood pressure reduced by regular exercise

This 2017 study from Brazil has examined the effects of regular exercise on high blood pressure patients. They came to the conclusion that regular exercise can be as powerful as blood pressure lowering medication. Both bring down systolic and diastolic blood pressure. Even complications of previously untreated high blood pressure will be reversed with regular exercise while medication will not have this positive effect. Controlling high blood pressure with regular exercise will prevent diseases like heart attacks and strokes and the associated mortality.

Regular exercise and diet change to prevent type 2 diabetes

In this 2015 study the researchers noted that a combination of adopting a healthy diet and regular exercise could lead to weight loss. This was shown to prevent type 2 diabetes. The authors question why such a lifestyle change was not more widely taught to people to prevent cardiovascular diseases and diabetes.

Not Exercising Is More Risky For You Than Smoking

Not Exercising Is More Risky For You Than Smoking

Conclusion

The medical profession knows for a long time that regular exercise is good for your health. But there always was a concern that perhaps too much exercise may be hazardous. A 2018 study from the Cleveland Clinic followed 122,007 patients for 14 years. All patients underwent an exercise treadmill test as a baseline. The end point was mortality during the 14 years of follow-up. The results made clear that there was no upper limit of exercise. Patients who were exercising the most still had a lower mortality than those who exercised less.

Sessile patients

But perhaps the most impressive result was that sessile patients who did hardly any or no exercise had the highest mortality. Their mortality was higher than that of smokers who exercised a little bit. If you want to avoid getting a heart attack, a stroke, diabetes or many types of cancer, exercise regularly, don’t smoke and eat a Mediterranean type diet. Regular exercise can reduce cardiovascular disease by 79%. And since the Cleveland study we know that more exercise is even better as the top athletes had the lowest mortality.

Apr
21
2018

3 Cups Of Coffee Stop Clogged Arteries

By | coffee, heart attack, Heart Disease, Mortality, Stroke

There is a new coffee study that says 3 cups of coffee stop clogged arteries. The study appeared in the Journal of the American Heart Association on March 24, 2018. It was part of the cross sectional Brazilian Longitudinal Study of Adult Health. This study took place from August 2008 to December 2010. It followed 15,105 civil servants, aged 35 to 74 years. They were living in 6 Brazilian cities (Belo Horizonte, Porto Alegre, Rio de Janeiro, Salvador, São Paulo, and Vitoria). The final study sample comprised 4426 individuals who underwent CAC measurements.

CAC score

CAC stands for “coronary artery calcium”. Other tests in the past have shown that CAC is a very sensitive test that quantitates the calcification status of coronary arteries. The CAC score is also known as Agatston score. It also predicts how likely it is that a person with a high CAC count will develop a heart attack down the road. A score of 100 or less is considered to be a low risk for developing a heart attack later in life. If the score is between 100 and 400, it is a moderate risk. A score of more than 400 ranks as a high risk to develop a heart attack.

Study design

Upon entering the study the participants had an extensive entrance exam and interview. Part of this was a nutritional and lifestyle questionnaire. This told the examiners whether the patients were smokers or not. Their age ranged between 35 and 74 years. Participants took a CAC test. 4426 individuals who underwent CAC measurements became part of the study. The participants’ blood pressure and body weight were additional measurements.

Results of the study

There was a negative correlation between the amount of coffee consumed on a daily basis and the CAC score. Specifically, the following observation emerged regarding daily coffee consumption and the risk of a higher than 100 CAC score.

  • Less than 1 cup per day: odds ratio 0.85
  • 1 to 3 cups per day: odds ratio 0.73
  • More than 3 cups per day: odds ratio 0.33

These results show clearly that there is an inverse relationship between coffee consumption and risk of developing coronary artery hardening. Those who consume 3 or more cups of coffee have a lower coronary artery disease risk.

The risk to develop coronary artery calcification in coffee drinkers (3 or more cups) is 67% lower. The comparison group are non-coffee drinkers.

Discussion of the results

The research paper from Brazil compares their results with many other research facilities and concludes that others had very similar conclusions. For instance, a 2014 publication pointed out that consuming more than 5 cups of coffee per day had no association with heart disease and did not cause any increased mortality.

The 2015–2020 Dietary Guidelines for Americans recommends consuming 3 to 5 cups of coffee per day, which reduces the risk of getting diabetes type 2 or cardiovascular disease.

Korean study using CAC scores

One other relevant Korean study that involved 25,138 participants is also of note. The participants consumed 3 to 5 cups of coffee per day. They also underwent CAC tests. The coffee drinkers had a 41% lesser prevalence of CAC score in comparison to non-coffee consuming controls. The authors of the present study said that the Korean study was comparable to their own findings.

Comparison of study to previous literature

Mortality data and coffee consumption

In a large Harvard study that I discussed on Nov. 18, 2017 the end point was mortality data. There too, was a dose response curve. With 3 to 5 cups of decaffeinated or regular coffee there was a reduction of death rates by 15%. Less coffee consumption produced less reduction of mortality.

Stroke data and coffee consumption

In another review on March 4, 2013 I reviewed a 10-yer study that looked at the effect of 1 to 2 cups of coffee per day in 32,600 women. There was a 25-32% reduction of strokes compared to non-coffee or tea consuming controls. I also reviewed a Finnish study that consisted of 29,133 smokers (smoking 5 cigarettes a day) aged 50 to 69 who were stroke free when entering the study. It ended in 1993 and the study had lasted for at least 5 years. Drinking two cups of black tea or 8 cups of coffee reduced the stroke risk by 21 to 23%.

Stroke mortality and coffee consumption

In the Annals of Internal Medicine (June 17, 2008) researchers have found that coffee consumption can be beneficial to reduce stroke mortality. A study using the data from 41,736 male and 86,214 female subjects is quite informative. Researchers followed these people over 18 years in the male group and over 24 years in the female group. The risk of all-cause mortality decreased significantly with increasing coffee consumption in the male as well as in the female group. Men had a relative risk reduction of 20% in comparison to those with the lowest level of coffee consumption. Women with intermediate to high consumption of coffee had a relative risk reduction of 10% to 30 % when compared to the group that drank less than 1 cup of coffee per day. The end point here was risk of death from stroke.

3 Cups Of Coffee Stop Clogged Arteries

3 Cups Of Coffee Stop Clogged Arteries

Conclusion

Coffee has a number of anti-oxidant bioflavonoids that help increase survival. The main study reviewed measured the effects of coffee consumption by calcium scores of the coronary arteries. This is a specific way to look at the relative risk to come down with a heart attack in the future. Other ways to measure the beneficial effect of coffee are mortality as the end point, stroke or stroke mortality. I have reviewed some studies that used all of these end points. It is interesting to observe that consumption of 3 to 5 cups of coffee has such a beneficial effect. It does not matter whether it is regular or decaffeinated coffee. Both have the identical effect. This has been shown by a recent Harvard study.

Coffee and tea make you live longer

Coffee keeps the arteries open for longer, if we consume 3 to 5 cups of coffee per day. This allows our brain to think longer and allows our heart to beat for many more years. It is time to stop the research and to apply what was found: 3 to 5 cups of coffee per day. If tea is what you prefer, you are in luck. Everything I said about coffee also applies for green and black tea. There is one word of caution. Using copious amounts of sugar in your coffee or tea will most likely cancel some or all of the benefits. Cream and sugar-laced Frappuccino or Chai Lattes are calorie bombs and not conducive to good health. I use stevia instead of sugar to sweeten my coffee.

Feb
25
2017

Heart Health Improves With Hormone Replacement

By | Alzheimer’s disease, andropause, Anti-aging medicine, Cardiovascular disease, Diabetes, Health, heart attack, Heart Disease, High Blood Pressure, Hormones, Inflammation, Menopause, mitochondria, Mortality, Obesity, Prevention, prostate cancer, stress, Stress management, Stroke

Dr. Pamela Smith gave a lecture in December 2016 showing that heart health improves with hormone replacement. Her talk was part of the 24th Annual World Congress on Anti-Aging Medicine (Dec. 9 to Dec. 11, 2016) in Las Vegas, which I attended. The title of the talk was: “Heart health: The Importance of Hormonal Balance for Men and Women”. Her keynote lecture contained 255 slides. I am only presenting a factual summary of the pertinent points here.

1. Estrogen

First of all, estrogens are the main female hormones in women that protects them from heart attacks.

Observations regarding risk of heart attacks

  1. Women have a lower risk of heart attacks before menopause compared to men of the same age.
  2. Heart attack rates go up significantly after menopause.
  3. Estrogen replacement therapy may reduce the risk of heart attacks by 50% for postmenopausal women.

Lipid profile after menopause

There is an elevation of LDL cholesterol, total cholesterol and triglycerides as well as lower HDL cholesterol levels. All of this causes a higher risk of heart attacks for postmenopausal women. Estrogen replacement therapy increases the large VLDL particles, decreases LDL levels and raises HDL-2. Postmenopausal women who do estrogen replacement therapy (ERT) are helping to reduce their heart attack rates.

Difference between oral and transdermal estrogen replacement

The liver metabolizes estrogen taken by mouth. This reduces the protective effect on the cardiovascular system. In contrast, transdermal estrogen (from commercial estrogen patches or from bioidentical estrogen creams) has a higher cardioprotective effect. The liver does not metabolize transdermal estrogen. Dr. Smith explained using many slides how estrogen prevents heart attacks. Apart from lipid lowering effects there are protective effects to the lining of the arteries. In addition there are metabolic processes in heart cells and mitochondria that benefit from estrogens. The end result is that postmenopausal women who replace estrogen will outlive men by about 10 years. The production of Premarin involved pregnant mares. In other words, it is not human estrogen and it does not fit the human estrogen receptors. Also the liver metabolizes estrogen taken as tablet form, which loses a lot of the beneficial effects that you get from transdermal estrogen. 

How can you document the beneficial effects of estrogen replacement?

  1. Carotid intima measurements in postmenopausal women on ERT show a consistent reduction in thickness compared to controls.
  2. Postmenopausal women on ERT reduce their physical and emotional stress response compared to postmenopausal women without ERT.
  3. Hormone replacement therapy in postmenopausal women reduces blood pressure. Measurements showed this effect to be due to a reduction of angiotensin converting enzyme (ACE) by 20%. This is the equivalent of treating a woman with an ACE inhibitor without the side effects of these pills.
  4. Coronary calcification scores were lower in postmenopausal women on ERT than a control group without ERT. These calcification scores correlate with the risk for heart attacks.
  5. Oral estrogen replacement leads to proinflammatory metabolites from the liver metabolism of estrogen. No proinflammatory metabolites occur in the blood of women using transdermal estrogen. The anti-inflammatory effect of transdermal estrogen is another mechanism that prevents heart attacks.
  6. Postmenopausal women on ERT had no increased risk of heart attacks or venous thromboembolism (clots in veins). Menopausal women without ERT have a risk of 40% of dying from a heart attack. Their risk of developing breast cancer is 5.5%, the risk of dying from breast cancer is about 1%. There was an increase of venous thromboembolism in women who took oral estrogen.
  7. Estrogen has antiarrhythmic effects stabilizing the heart rhythm. Dr. Smith said that in the future intravenous estrogen might be used to prevent serious arrhythmias following heart attacks.

Estrogen levels in males

Males require a small amount of estrogens to maintain their memory, for bone maturation and regulation of bone resorption. But they also need small amounts of estrogen for their normal lipid metabolism.

However, if the estrogen levels are too high as is the case in an obese, elderly man, there is an increased risk of heart disease. Factors that lead to increased estrogen levels in an older man are: increased aromatase activity in fatty tissue, overuse of alcohol and a change in liver metabolism, zinc deficiency, ingestion of estrogen-containing foods and environmental estrogens (also called xenoestrogens).

2. Progesterone

Furthermore, progesterone is the second most important female hormone, the importance of which has been neglected in the past. Progesterone is significantly different from the progestin medroxyprogesterone (MPA). MPA was the oral progestin that was responsible for heart attacks and blood clots in the Women’s Health Initiative. MPA increases smooth muscle cell proliferation. This in turn causes hardening of the coronary arteries. In contrast, progesterone inhibits smooth muscle cell proliferation, which prevents heart attacks. Progesterone also lowers blood pressure and elevates HDL cholesterol, but MPA does not.

Progesterone in males

In a small study Depo-Provera was given to males for 17 days. Blood tests showed a lowering of triglycerides, LDL cholesterol and Apo A-1.

3. Testosterone

Finally, testosterone is the third sex hormone that is present in women. In men it is the main hormone, but women benefit from just a small amounts of it for libido, clarity of thought and muscle endurance.

Testosterone replacement in women

Testosterone in women does not only increase their sex drive, but also relaxes the coronary arteries in women who were testosterone deficient. This allows more blood flow to the heart. In postmenopausal women testosterone replacement lowered lipoprotein (a) levels up to 65%. The physician replaces first with bioidentical estrogen; only then does he consider replacing missing testosterone in women. Otherwise testosterone alone can cause heart attacks in women.

Elevated testosterone in women with PCOS

Women with polycystic ovary syndrome (PCOS) can have increased testosterone levels when they go through premenopause or menopause.

Women with PCOS are at a higher risk to develop diabetes, heart disease and high blood pressure. 50% of women with PCOS have insulin resistance. 70% of women with PCOS in the US have lipid abnormalities in their blood.

Elevated testosterone levels in the blood can lower the protective HDL cholesterol and increase homocysteine levels. Both can cause heart attacks.

Women with PCOS have a 4-fold risk of developing high blood pressure.

Testosterone replacement in males

A 2010 study showed that low testosterone levels in males were predictive of higher mortality due to heart attacks and cancer. Low testosterone ca cause high blood pressure, heart failure and increased risk of cardiovascular deaths. There was a higher incidence of deaths from heart attacks when testosterone levels were low compared to men with normal testosterone levels.

Low testosterone can cause diabetes and metabolic syndrome, which in turn can cause heart attacks.

It is important that men with low testosterone get testosterone replacement therapy.

DHT (Dihydrotestosterone)

DHT is much more potent than testosterone. Conversion of testosterone leads to DHT via the enzyme 5-alpha-reductase. While testosterone can be aromatized into estrogen, DHT cannot. Some men have elevated levels of DHT. This leads to a risk of heart attacks, prostate enlargement and hair loss of the scalp.

Andropause treatment

Only about 5% of men in andropause with low testosterone levels receive testosterone replacement in the US. This may be due to rumors that testosterone may cause prostate cancer or liver cancer. The patient or the physician may be reluctant to treat with testosterone. Researchers sh0wed that bioidentical testosterone does not cause any harm. It is safe to use testosterone cream transdermally. It does not cause prostate cancer or benign prostatic hypertrophy.

An increase of 6-nmol/L-serum testosterone was associated with a 19% drop in all-cause mortality.

Testosterone helps build up new blood vessels after a heart attack. Testosterone replacement increases coronary blood flow in patients with coronary artery disease. Another effect of testosterone is the decrease of inflammation. Inflammation is an important component of cardiovascular disease.

Testosterone replacement improves exercise capacity, insulin resistance and muscle performance (including the heart muscle).

Apart from the beneficial effect of testosterone on the heart it is also beneficial for the brain. Testosterone treatment prevents Alzheimer’s disease in older men by preventing beta amyloid precursor protein production.

4. DHEA

The adrenal glands produce the hormone dehydroepiandrosterone (DHEA). It is a precursor for male and female sex hormones, but has actions on its own. It supports muscle strength. Postmenopausal women had a higher mortality from heart disease when their DHEA blood levels were low.

Similar studies in men showed the same results. Congestive heart failure patients of both sexes had more severe disease the lower the DHEA levels were. Other studies have used DHEA supplementation in heart patients, congestive heart failure patients and patients with diabetes to show that clinical symptoms improved.

5. Melatonin

Low levels of melatonin have been demonstrated in patients with heart disease. Melatonin inhibits platelet aggregation and suppresses nighttime sympathetic activity (epinephrine and norepinephrine). Sympathetic activity damages the lining of coronary arteries. Melatonin reduces hypoxia in patients with ischemic stroke or ischemic heart disease. Lower nocturnal melatonin levels are associated with higher adverse effects following a heart attack. Among these are recurrent heart attacks, congestive heart failure or death. Melatonin widens blood vessels, is a free radical scavenger and inhibits oxidation of LDL cholesterol. Melatonin reduces inflammation following a heart attack. This can be measured using the C-reactive protein.

In patients who had angioplasties done for blocked coronary arteries intravenous melatonin decreased CRP, reduced tissue damage, decreased various irregular heart beat patterns and allowed damaged heart tissue to recover.

6. Thyroid hormones

It has been known for more than 100 years that dysfunction of the thyroid leads to heart disease. Hypothyroidism can cause heart attacks, hardening of the coronary arteries and congestive heart failure. Lesser-known connections to hypothyroidism are congestive heart failure, depression, fibromyalgia, ankylosing spondylitis and insulin resistance. Some cases of attention deficit hyperactivity disorder (ADHD) with low thyroid levels may successfully respond to thyroid replacement.

Thyroid hormones improve lipids in the blood, improve arterial stiffness and improve cardiac remodeling following a heart attack. Thyroid hormones help with the repair of the injured heart muscle. They also work directly on the heart muscle helping it to contract more efficiently. Lower thyroid stimulating hormone (TSH) values and higher T3 and T4 thyroid hormone levels lead to improved insulin sensitivity, higher HDL values (= protective cholesterol) and overall better functioning of the lining of the arteries.

Dr. Smith said that thyroid replacement should achieve that

  • TSH is below 2.0, but above the lower limit of normal
  • Free T3 should be dead center of normal or slightly above
  • Free T4 should be dead center of normal or slightly above

Most patients with hypothyroidism require replacement of both T3 and T4 (like with the use of Armour thyroid pills).

7. Cortisol

Cortisol is the only human hormone that increases with age. All other hormones drop off to lower values with age. The adrenal glands manufacture cortisol. With stress cortisol is rising, but when stress is over, it is supposed to come down to normal levels. Many people today are constantly overstressed, so their adrenal glands are often chronically over stimulated. This can lead to a lack of progesterone. It also causes a lack of functional thyroid hormones as they get bound and are less active. When women have decreased estradiol in menopause there is a decline in norepinephrine production, production of serotonin, dopamine and acetylcholine. Women with this experience depression, lack of drive and slower thought processes.

Heart Health Improves With Hormone Replacement

Heart Health Improves With Hormone Replacement

Conclusion

Seven major hormones have been reviewed here that all have a bearing on the risk of developing a heart attack. It is important that these hormones are balanced, so they can work with each other. Hormones can be compared to a team that works together and is responsible for our health. If one or several of the team players are ineffective, our health will suffer. For this reason hormone replacement is crucial.

Hormone effects on heart muscle

Hormones have effects on mitochondria of the heart muscles cells. They stabilize the heart rhythm as in the case of estradiol. But they can also strengthen the heart muscle directly through DHEA and estrogens in women and DHEA and testosterone in men. Thyroid hormones are another supportive force for the heart. Physicians can  use them therapeutically in chronic heart failure patients. When people age, their hormone glands will produce less hormones, but blood tests will show this. Replacing hormones that are missing can add years of active life. Taking care of the symphony of hormones means you are taking care of your most important organ, the heart!

Nov
10
2015

Sugary Soda Drinks Make You Sick

By | Alzheimer’s disease, Cancer, Cardiovascular disease, heart attack, Heart Disease, Inflammation, Nutrition, Stroke

Dr. Frank Hu and colleagues have recently re-examined the old question of whether sugary soda drinks make you sick. They usually contain high fructose corn syrup, a mixture of 55% fructose and 45% glucose. This sugar mix can be found in sugary soda drinks as well as in many processed foods like fruit spreads. Dr. Hu’s publication is listed in PubMed , but details can be found in this summary.

The study found that one or two cans of sugary soda drinks per day lead to

  • As high as a 26 percent greater risk of developing type 2 diabetes,
  • A 35 percent greater risk of heart attack or fatal heart disease, and
  • A 16 percent increased risk of stroke.

Difference in metabolism between fructose and glucose

The study also found that there is a difference of how glucose, the main sugar that the body uses for energy is metabolized versus fructose from high fructose corn syrup or the breakdown of table sugar, a disaccharide consisting of glucose and fructose combined as one molecule. Glucose gets directly absorbed from the gut into the blood circulation and with the help of insulin gets further absorbed directly into body cells. In contrast the liver metabolizes fructose into triglycerides, which can cause fatty liver disease and insulin resistance. Fructose also raises the bad cholesterol (LDL cholesterol). This in turn is a risk factor for developing diabetes, heart attacks and strokes.

It is fructose in sugary drinks and processed foods that are largely responsible for weight gain, metabolic syndrome, diabetes and cardiovascular disease.

The newest finding: heart failure can also be caused by high fructose corn syrup

A study in Sweden has recently shown that sugary drinks can cause heart failure. Researchers followed 4200 Swedish men for 12 years in regard to their food habits. The study found that the men who drank at least two sweetened drinks per day had a 23% higher risk of developing heart failure. Dr. Susanna Larsson, a co-author of the study, said: “The takeaway message is that people who regularly consume sweetened beverages should consider limiting their consumption to reduce their risk of heart failure”. Heart failure affects nearly 6 million Americans. It develops either on its own in persons with inadequately treated high blood pressure or in people who had a previous heart attack. It is a condition, which disables the heart to effectively pump enough blood with nutrients and oxygen into the tissues.

Symptoms of heart failure

People who develop this condition feel the symptoms: they get short of breath with minimal activity. They also may wake up short of breath in the middle of the night. It is a miserable life, as people with heart failure experience severe restrictions in their daily activities. Even walking a flight of stairs becomes a struggle or even an impossible task. Total disability is the next step. The key is prevention: do not use high fructose corn syrup, and stay away from sugar in any form; instead use stevia to sweeten your food when needed.

Be careful how you replace saturated fatty acids

Dr. Frank Hu has also participated in a study that spanned over 24 to 30 years and examined the replacement of saturated fat with polyunsaturated fatty acids (PUFA), monounsaturated fatty acids and whole grain carbohydrates. The study involved 84,628 women (Nurses’ Health Study, 1980 to 2010), and 42,908 men (Health Professionals Follow-up Study, 1986 to 2010). Detailed questionnaires assessed the diet every 4 years. 7,667 cases of cardiovascular disease (CHD) occurred during the long observation times. Compared to controls that did not change their diet with respect to saturated fatty acid intake, those who replaced with PUFA had 25% less CHD, those who replaced with monounsaturated fatty acids had 15% less CHD and those who replaced saturated fatty intake with whole grains had 9% less CHD. A subgroup that had replaced saturated fatty acid intake with carbohydrates from refined starches/added sugars ended up with a 10% increase of CHD.

Cutting fructose out of diet lowers cholesterol and weight

A new study by Dr. Robert Lustig and colleagues from the University of California, San Francisco showed on 43 children that a change of diet reducing dietary sugar from 28% to 10% and replacing it with other complex carbohydrates led to a significant reduction in triglycerides, cholesterol and blood pressure.

The nucleus accumbens in the brain is the reward center for addictions

The fructose stimulus was taken away, which stimulates a part in the brain, called nucleus accumbens, where the reward center is located. This is the reason why the more sugar you take in, the more addicted to sugar you become. Not surprisingly when physicians changed the diet, there were internal signs of improving with regard to blood tests. But physically the children also showed weight loss just within 10 days as their total calorie intake had reduced. There is another observation with regard to fructose metabolism. Normally after a meal there is suppression of ghrelin, the hunger hormone. But when you drink a sugary drink with fructose in it, there is no suppression of ghrelin. The result is that you do not feel satisfied and you keep on consuming fructose containing drinks resulting in weight gain.

Sugary Soda Drinks Make You Sick

Sugary Soda Drinks Make You Sick

Conclusion

What we eat matters in terms of long-term consequences. This is certainly true for refined sugar intake. Don’t lull yourself into the belief that honey is “healthy”. Even though it is a natural product, your body treats it according to its chemical composition. It is sugar, and unfortunately it will get you into health problems naturally. Even the fashionable agave syrup contains largely fructose: again, this is bad news for your health! No matter what type of sugar you choose, the long-term consequences have haunting qualities. Consequences of sugar intake are weight gain, diabetes, heart attacks and strokes. You will agree that is not worth to take any of these risks just to satisfy a sweet tooth.

Alternatives to sugar

Biting into a crisp, sweet apple is enjoyable and has never harmed anybody. Eating a small helping of fruit salad to top off a meal can be a delicious finale to dinner. If you need a sweetener, it is better for you to use the plant-derived stevia, which is available as a powder or a liquid. Smallest quantities are adequately sweetening foods. Stevia has no calories and none of the consequences of sugar: you’ll enjoy the sweetness without the bitter aftereffects of tooth decay or heart disease!

Sep
25
2015

Testosterone

By | Alzheimer’s disease, andropause, Anti-aging medicine, Cancer, Cardiovascular disease, fractures, heart attack, Hormones, Men's Health, Osteoporosis, Prevention, Stroke

One of the driving hormones in a man is testosterone. We also know that with age this hormone level falls. The lesser known fact is the importance of monitoring testosterone levels in aging males. This way they have the choice of intervening with the aging process. Here are the facts about the male hormone and about replacement of it when it is low. I will also discuss the anxieties of the medical profession to deal with this. Some feel uncomfortable about hormone replacements.

Androgen receptors contained in key tissues

Androgen receptors are situated in the key organs like the brain, heart, muscles, bones, kidneys, fat cells, genitals, hair follicles and skin. They respond to all male hormones, called androgens, like testosterone, dihydrotestosterone (DHT) and DHEA. DHT is produced by metabolizing testosterone with the help of an enzyme, called 5α-reductase in the adrenal glands. This is responsible for hair loss in males and some females. There is a genetic factor for this. It is important that the man continues to have all tissues stimulated by his male hormones when he ages or the key organs mentioned are going to suffer.

A lack of the male hormone as the man ages (around 55 to 65) leads to a slowdown in thinking, osteoporosis in the bones, muscle atrophy (melting in of muscle tissue), and a lack of sex drive. Mood swings can turn the male into the “grumpy old man”. The skin gets thinned and is more brittle.

Animal experiments have shown that the development of fatty streaks in blood vessels happens at a higher rate in castrated animals. The more encouraging finding in these animals is the fact that this condition is reversible by replacement of the male hormone. In healthy males of a younger age all organs are working well. The problems starts when males age and the hormone regulation in the brain slows down, which ultimately leads to andropause in males, the equivalent of menopause in women. When the physician replaces testosterone in an aging man who has low testosterone levels, the stimulation of androgen receptors in key organs, which I mentioned before return organ function to normal.

Reluctance of physicians to prescribe testosterone

In the past medical students were taught that testosterone is causing prostate cancer. This was based on old observations by Dr. Huggins, a Canadian born surgeon who practiced in Chicago, that orchiectomy improved the survival of advanced prostate cancer patients by a small percentage. Dr. Lee pointed out that Dr. Huggins neglected to realize that testicles make both the male hormone and small amounts of estrogen.

History of hormone ablation therapy for prostate cancer

When an orchiectomy was done (because of the belief that the male hormone production was the culprit) inadvertently the real cause of prostate cancer (an estrogen surplus) was also removed thus improving the survival of these patients somewhat. Nowadays we have more sophisticated testing methods. Dr. Abraham Morgentaler (Ref. 1) has compiled a lot of evidence about the importance of testosterone in men. He proved, based on a lot more modern references that it is not testosterone that is the cause of prostate cancer. We know now that estrogen dominance is responsible for prostate cancer and that this develops as stated above because of the low testosterone and low progesterone during the male menopause (also called “andropause”).

Rebuttal of Dr. Huggins’ research

Dr. Morgentaler, a urologist from Harvard University has taken prostate cancer patients and put them on testosterone. To his and everyone else’s surprise testosterone treated prostate cancer patients improved, their prostate cancer either disappeared or become much less aggressive, which can be measured with the Gleason score based on its microscopic appearance. The result was that they did better, not worse on male hormone replacement.

Older physicians still hold on to the belief that testosterone would make prostate cancer worse

Unfortunately the history of male hormone production, orchiectomy and prostate cancer as explained led to confusion among the medical profession. We now know that testosterone is innocent with respect to prostate cancer, testicular cancer or any other cancer. But some of the old-timers among the physicians doggedly hold on to their false belief from the past. If a man asks one of these physicians for testosterone replacement he may not only be told that he/she could not do that, but will also receive a tirade of false statements about testosterone.

No blood clots with male hormone replacement

We dealt with the myth of prostate cancer that is not related to treatment with the male hormone. There is another myth that older physicians often cite: that testosterone would supposedly be causing blood clots. At the University of Texas Medical Branch at Galveston (Texas, USA) a large study was done involving 30,572 men, ages 40 years and older. All had venous thromboembolism and received an anticoagulant drug or an intravascular vena cava filter following their diagnosis. Because they also had a low testosterone level physicians gave them testosterone replacement therapy. In addition, they followed them and monitored them for further venous thromboembolism. None were found in any of the men. The conclusion of the investigators was that filling a testosterone prescription was not associated with any clotting condition.

Aging and testosterone

A longitudinal study showed that testosterone has been declining in the male population over a period of 20 years. Partially there is a relationship to aging. Otherwise estrogen-like substances or xenoestrogens, which are environmental factors, contribute to it as well. Although age is a factor, there is so much variation from man to man, that it is best to just measure testosterone and determine whether the mail hormone level is above or below 500 ng/dL. This seems to be the most reliable indicator in determining whether a man needs hormone replacement, apart from symptoms due to testosterone loss. These are: increased risks for prostate problems and/or cancer, cardiovascular disease, loss of bone density, a rise in cholesterol and urinary dysfunction. Dr. Randolph describes this in detail and also discusses who needs bioidentical testosterone replacement.

The aging male and hormone replacement

A New England Journal of Medicine study from September 2013 explained that apart from testosterone the male body needs a small amount of estradiol, the female hormone. The enzyme aromatase within the fatty tissue achieves this. But the physician must prescribe testosterone replacement as the bioidentical testosterone, so that a small amount of it converts into estradiol by the action of aromatase. Synthetic male hormone compounds with chemical side chains do not provide this small estrogen metabolism.

After a review of the hard facts about prostate cancer risk, it is now clear that older men get prostate cancer because testosterone in their blood is low and their body weight elevation. The extra fat converts androgens by the aromatase into estradiol. This leads to estrogen dominance. This causes breast cancer and uterine cancer in women, prostate cancer in men. When the total testosterone level in a man is lower than 500 ng/dL it is a sign that he needs male hormones to protect his prostate from prostate cancer.

Cardiovascular disease and testosterone

The cardiovascular system has a lot of androgen receptors on its cell surfaces. It is important that the man continues to have the proper stimulus from androgenic hormones (testosterone, dihydrotestosterone and DHEA). This will allow him to have proper contractility of heart cells. It will also allow for relaxation of smooth muscle cells in the arteries to control blood pressure. With a lack of male hormones there is hardening of the arteries, loss of muscle cells in the heart muscle and increase of blood pressure. So far researchers have only noticed an association of low testosterone with diabetes, high blood pressure and heart attacks. It has not been proven that it is the cause (so webmd.com says). But careful replacement with bioidentical testosterone helps patients to get rid of their symptoms, have the energy to exercise and feel better.

Is it safe to replace missing hormones in a male?

Long-term studies have already shown that hormone replacement saves lives, but the medical profession is slow to accept this (Ref.1). Here is a link that explains this a bit further.

If a man who is low in male hormones wonders whether it would be worthwhile to go on testosterone therapy, here is the clear answer: would you like to have a 47% lowered risk of dying, a reduction of 18% in heart attacks and 30% reduction in the risk for a stroke? This is what a 14-year follow-up study published in the European Heart Journal in August, 2015 found.

The same is true for cardiovascular disease as stated above: if the total testosterone level in a man is lower than 500 ng/dL it is a sign that he needs testosterone replacement therapy to protect his cardiovascular system to prevent heart attacks and strokes.

Loss of bone density with a lack of testosterone

Older men can get osteoporosis, which can lead to compression fractures in the spine. In addition fractures can also occur in the hip, the ankle or wrist. Current thinking is that with the lack of male hormones there is also a lack of estradiol via the aromatase pathway in fatty tissue. This small amount of estradiol is able to prevent osteoporosis all his life until testosterone drops with older age. Once again it is important to monitor his male hormone level and replace with bioidentical testosterone when it is lower than 500 ng/dL.

Rise in cholesterol

With obesity there is a metabolic change, called metabolic syndrome. This leads to an elevation of LDL cholesterol, which is a direct risk for hardening of the arteries. In an obese older man with low male hormones there is a double risk. First, there is the low testosterone and secondly the metabolic syndrome, if he is overweight or obese. As a result the heart attack and stroke rates in obese men with low testosterone are much higher. In obese men with normal male hormone levels there are less heart attacks and strokes. Men with obesity need to lose weight by changing their diet to healthier eating habits and starting a regular exercise program with swimming and walking. At the same time those with a testosterone level of lower than 500 ng/dL should have bioidentical testosterone replacement.

Urinary dysfunction

A hyperactive bladder, dribbling, hesitancy and leaking bladder can all be part of male hormone deficiency. But this is not that easy to diagnose. A full consultation by a urologist may be necessary to assess various other causes that could hide behind these symptoms. Part of the work-up though is to measure the total testosterone level and replace what is missing.

Alzheimer’s disease

Alzheimer’s disease can be due to a lack of male hormones. It is therefore important to measure the total testosterone level in a man. If it is lower than 500 ng/dL, as mentioned before , it means he needs male hormone replacement therapy. This will prevent Alzheimer’s disease.

Burnout

According to Dr. Thierry Hertoghe, an endocrinologist from Belgium, there are several hormones that can be missing in a person with burnout: a lack of cortisol, thyroid, growth hormone, testosterone/estrogen, progesterone and oxytocin. The middle-aged manager with burnout would have other hormones missing apart from testosterone. The physician needs to order blood tests to measure whether other hormones are missing. Whatever is low needs replacement with bioidentical hormones.

Some details regarding testosterone measurements and delivery

The deeper you delve into male hormone replacement, the more details there are to consider. First, there is a sex hormone-binding globulin that is mostly produced by the liver and circulating in the blood. It is like a storage form of testosterone and only 1 to 2% of the total testosterone is unbound. This is called the free or bioavailable testosterone. Some physicians measure just that portion of testosterone.

Hormone replacement in a man

Second, when it comes to replacement of testosterone in a man who is deficient for testosterone, there are several delivery systems, which some people find a little confusing. There are testosterone gels with less than optimal absorption. Another application are creams that compounding pharmacies provide. The patient absorbs these creams usually quite well. But some men do not absorb either creams or gels. They need testosterone injections or testosterone pellets. The goal is to replace testosterone in a manner that there is a fairly equal amount of testosterone available circulating in the blood at all times. Some men achieve that only with testosterone pellets, others with testosterone cypionate injections. For this reason blood test that determine the levels of free testosterone are necessary at intervals of about 3 months.

Testosterone

Testosterone

Conclusion

Testosterone is a key hormone in the male that requires monitoring, particularly when he is aging. A knowledgeable physician or naturopath needs to take a careful history of his symptoms. If blood tests show that the total testosterone is less than 500 ng/dL the physician needs to replace with bioidentical testosterone.

 

References

Ref.1: Dr. Abraham Morgentaler: “Testosterone for Life – recharge your vitality, sex drive, and overall health” McGraw-Hill, 2009

May
02
2015

Healthy Olive Oil

By | Diabetes, heart attack, High Blood Pressure, Mortality, Nutrition, Prevention, Stroke

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

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

How polyphenols in olive oil work for you

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

Endothelial function

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

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

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

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

Lowering blood pressure

In a study on 23 hypertensive patients it was shown as far back as in 2000 that extra virgin olive oil over 6 months allowed physicians to reduce high blood pressure medications by 48%. When the study was crossed over, the reverse was the case for the control group on sunflower oil that had no such effect before.

Based on what was said about endothelial function above, it is easy to understand that the polyphenols of olive oil released nitric oxide, which is known to lower blood pressure. This is an important finding as high blood pressure is a known risk factor for the development of hardening of the coronary arteries leading to heart attacks, congestive heart failure, but also stroke. Regular intake of 2 tablespoons of extra virgin olive oil often will reverse high blood pressure and restore normal endothelial function.

Preventing heart attacks and strokes

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

Healthy Olive Oil

Healthy Olive Oil

Conclusion

It is a simple fact that incorporating 2 tablespoons of virgin olive oil in your daily food intake will definitely have all of the beneficial effects described above. It is readily available, is inexpensive and very effective. It is also not difficult to work into your eating routine: add olive oil and vinegar or lemon juice to your salads, and cook with olive oil. If you have not totaled 30 grams (2 tablespoons), then make up the difference by eating an extra teaspoon full of olive oil. This is not all! You need to cut down on processed foods as they are made with the wrong oils, such as safflower oil, corn oil, soybean oil and others. These are usually omega-6 containing oils that cause heart attacks and strokes. They are cheap oils use by food processors, and they are not doing anything for your health!

I would suggest that you read more about the powerful role of prevention that extra virgin olive oil has in our diet. Buy it and stick to it as a new healthy lifestyle habit. Two tablespoons a day is the weapon against disease!

Reference:

Ref.1. Current Medical Diagnosis and Treatment 2015, chapter 10 Heart Disease. By Thomas M. Bashore, MD; Christopher B. Granger, MD; Kevin Jackson, MD; Manesh R. Patel, MD: Heart Disease. Lange, 2015.

Dec
06
2014

Regrets Following Holiday Foods

By | Abdominal Pain, Angina, gout, heart attack, High Blood Pressure, Nutrition

Countless blogs have been written about gaining pounds with holiday food. This is not my topic in this blog. I am looking at the medical evidence of what is happening to our bodies, some of which is permanent. I like to focus on the gallbladder, blood pressure, heart function and gout. I will provide little clinical vignettes that make my points clear.

Gallbladder disease

Many patients are unaware that their gallbladder has developed stones that accumulate over several years, perhaps even several decades. But, if infection sets in there is an acute flare-up of gallbladder pain, which can be excruciating. Also, when one of the stones is transported into the gallbladder duct, there is a sudden colicky pain similar to labor pains. In cases where the migrating stone blocks the common bile duct, the patient can get jaundiced and the pancreatic juice can get backed up leading to an acute pancreatitis.

What does that have to do with overindulging during a Thanksgiving meal? Fatty sauces, ham, and gravy can all lead to more cholesterol deposits in the gallbladder and make stones larger. Add to this a rich dessert with ice cream and a dollop of whipped cream and you’ve got yourself a fairly fatty feast. So, this one fatty meal can make a difference by bringing on symptoms of a previously undiagnosed condition, and you spend hours in an emergency room of a hospital.

The scenario could look like this case:

Fred is a 40-year-old teacher, somewhat overweight who enjoyed a holiday meal at his parent’s place for Thanksgiving. His health has been good with no surgeries. Following the turkey dinner, which he enjoyed he noticed right upper abdominal pain, and he started to vomit. As the pain did not improve, his parents called an ambulance that brought him to a hospital. The emergency physician said that he was concerned about Fred’s gallbladder. He ordered a CT scan and this showed multiple stones with one of the stones being stuck in the cystic duct. Despite pain medication and bed rest the situation did not resolve (the stone did not pass). A surgeon was called in and a laparoscopic cholecystectomy was performed. Fred recovered within only 3 days and could return to teaching. The fatty food of the Thanksgiving dinner was only the tip of the iceberg in this case. The fact that there have been many pre-existing gallbladder stones tells us that this patient had the chronic habit to eat foods with too much fat and cholesterol.

High blood pressure

Extra salt intake leads to an elevation of blood pressure. If a person has borderline high blood pressure, the extra salt intake from holiday meals can get the blood pressure out of control and this in turn can cause a stroke (typically a hemorrhagic stroke) or is a strain to the heart leading to a heart attack or to congestive heart failure.

Janice is a 50-year-old janitor who has had problems with borderline high blood pressure readings. Normally her blood pressure was 140 over 90, and when she watched her salt intake it would go down to 125 over 80. She bought a blood pressure monitoring device, just so she could measure her own blood pressure at home. Following the Thanksgiving turkey dinner she noticed that she developed fullness in her head and a headache and her face looked flushed. She took her blood pressure with a reading of 160 over 100. It had never been that high. When she saw her doctor he asked her what she had for Thanksgiving dinner: they sat together with friends and had potato chips with dip and drank some red wine with it. Next for the meal she enjoyed the roasted, brined turkey and ham. Yes, she did add some more salt to the mashed potatoes too.

The doctor found her blood pressure to be 165 over 100. He explained to her that she needs to go on a DASH diet, which is low in salt. He also started her on blood pressure pills. Here is another link for a low salt diet.

Heart attack following turkey dinner

When working as an intern in teaching hospitals of McMaster University of Hamilton/Ont. during my training in 1975 to 1978 I noticed a strange correlation between holidays like Thanksgiving and Christmas and intensive care unit admissions with acute heart attacks. Later a formal study was published that there is indeed such a correlation between consuming a big meal with fat, salt and refined carbohydrates and the development of a heart attack.

This likely does not develop without prior silent conditions of high triglycerides, high cholesterol and insulin resistance leading to inflammatory substances circulating in the blood. The C-reactive protein is one of the substances that has emerged as a useful monitoring device and a fasting insulin level. Both should be low or the person is at a higher risk of developing a heart attack.

Add to this a festive, large meal and you got troubles at your hand like in the next case:

Joan is a 62-year-old high school principal who developed chest pain within 2 hours of having enjoyed her Christmas dinner. She was known to have high cholesterol levels for about 5 years and she had been taking statins for 4 years as diet alone could not control it. But she loved food in general and was about 20 pounds overweight. The doctor had discussed exercise with her, but she felt too busy doing other things. Now all of this came back to her as she was recovering in a hospital bed from an emergency stent procedure. They had to insert two stents to overcome narrowing of the coronary arteries. She was now pain free and felt that she needed to do something about her lifestyle. She would see a dietician and record her weights daily. She wanted to loose 20 pounds and yes, she wanted to start mild exercise when her doctor allowed it and gradually build it up to a maintenance program.

Regrets Following Holiday Foods (Gout Patient)

Regrets Following Holiday Foods (Gout Patient)

Gout attack following rich meal

It is known since the Middle Ages that feasting on a large meal of beef combined with lots of beer or wine can cause a gout attack. Gout at this time was known as a disease of the affluent. The poor obviously could not afford big feasts. Today we know that purines are the end product of meats and this gets excreted in the kidneys. However, alcohol prevents the purines to be excreted in the urine so that uric acid levels exceed a certain limit beyond which uric acid crystals are precipitated in soft tissues like around joints, which is very painful.

The following case will illustrate this:

Carl, a 45-year-old sales person suddenly developed excruciating pain and swelling in his left big toe. He went to the emergency room of the closest hospital. After some tests he was told that he had come down with acute gout. His blood tests showed a high uric acid level and biopsy samples from the left toes also revealed uric acid crystals. With the help of colchicine and allopurinol things turned back to normal within 3 days.

The gout episode occurred just 4 hours after his holiday meal consisting of a few beers and copious amounts of turkey meat. He also seems to be addicted to soft drinks which are sweetened with high fructose corn syrup which he consumes freely all day long.

It is known that sugar from soft drinks make a person 85% more prone to develop gout than a person who uses diet drinks or water.

Here is a diet sheet for Carl to prevent his next gout attack.

Conclusion

Who would have thought in the past that food could be a dangerous substance with the potential of making us sick? But this is exactly what I wanted to point out in this blog. Of course, it does not stop at holidays where we tend to eat more of what we normally eat. It pays dividends watching what we consume even in the days between feasts. For instance a DASH diet is a good idea for those of us who may have developed borderline high blood pressure. Avoiding excessive red meat is a good idea for prevention of heart attacks and strokes, as your cholesterol stays lower. Avoiding soft drinks with sugar and fructose is good prevention for avoiding obesity, cancer, heart attacks and strokes. Get the greens going (vegetables, salads etc.) to live longer without disabilities.

Last edited Dec. 6, 2014

Oct
24
2014

TACT Study Proves Effectiveness of Chelation

By | Angina, Heart Disease, Mortality, Stroke

Even though the Trial to Assess Chelation Therapy (TACT Study) has been published in March 2013 (Ref. 1), it still needs to make its way into the common public knowledge. The National Institute of Health was noticing an “alarming 68% increase” of chelation therapy between 2002 and 2007. These patients had problems with previous heart attacks and others had angina due to coronary artery disease, so they sought relief through intravenous chelation treatments. The purpose of the TACT study was to see whether chelation treatments with EDTA were safe and whether they would show any benefits when compared to a placebo group.

TACT study design

A total of 1708 patients were randomized into two groups, 869 treated with EDTA chelation therapy and 869 in treated with placebo infusions of normal saline/dextrose. Treatments were blinded (nobody knew what was given in the intravenous). 134 research sites in Canada and the US were involved in this trial including the Mayo Clinic. Patients had to be at least 50 years old, but the average age was 65 years. They had all a prior heart attack, but not less than 6 weeks before enrolment; on average they did have their heart attack 4.6 years before enrolment. Participants had to quit smoking at least 3 months before entering into the study and if they had revascularization procedures (bypass surgeries or stents), this had to be done more than 6 months in the past.

31% of the study population had diabetes. 83% had revascularization procedures done in the past. The majority of patients were taking heart medications (72% beta blockers, 73% statins to lower cholesterol and 84% aspirin to thin the blood).

65% completed 40 infusions, 76% completed at least 30 infusions.

The chelation infusion was the standard infusion usually used in chelation clinics, namely containing EDTA (the chelating agent), salts and vitamins as indicated in this Mayo clinic summary report. The follow-up period was for 4 years. There was a drop-out of 30% for various reasons and 17% refused their consent to carry on in the study.

TACT Study Proves Effectiveness Of Chelation

TACT Study Proves Effectiveness Of Chelation

Results of the TACT study

Overall mortality in the chelation group was down 2.8% versus the placebo group. Heart attacks in the chelation group were down 19.5%; strokes down 20% and hospitalization rates were down 28.6% when compared to the values of the placebo group.

Diabetic patients (the subgroup of 31%) appear to have greater benefits from chelation treatments than the non-diabetic ones. The diabetic group benefitted by 39% with regard to risk reduction (strokes, heart attacks, mortality) versus the non-diabetic chelation group (only a 4% reduction).

Perhaps as important as the results of the effect of the chelation study versus the placebo group was the fact that the side-effect profile was indistinguishable between the two groups. This establishes for the first time that chelation therapy is safe and that it also has beneficial effects.

It is interesting that when the results of the TACT Study were announced at the 2012 American Heart Association meeting in Los Angeles, the majority of cardiologists did not believe the results (that chelation was effective); instead they were looking for alternative explanations to explain the effect and suggested that this study needed to be repeated again.

What are the benefits of chelation therapy?

Originally EDTA was used to treat children with lead poisoning in Germany. However, workers who were exposed to lead containing paints in various industries also were described to have improve significantly with EDTA chelation (see this chelation history link).

In the 1990’s environmental concerns about heavy metal poisoning of the earth atmosphere came more into the forefront. This 2007 paper reports about heavy metal poisoning in detail.

A new concern for those who like organic food is the use of copper sulfate by organic food growers to spray against fungal and bacterial growth on crop as copper sulfate is one of the 5 chemicals used in organic agriculture approved by the USDA.

Those who consume organic foods may inadvertently expose themselves to copper in their system. This will reduce zinc levels as zinc naturally counterbalances the effects of elevated copper levels. But normal zinc levels are needed for normal body function, particularly in males.

As I have explained in this blog before, chelation therapy and several other methods can detoxify the body. Pollution continues to play havoc with our system and we need to consider taking steps to counteract that. In this blog I explained that we live in a toxic world and I mentioned several steps we can take to counteract this including chelation therapy. Particularly heavy metals like lead, mercury, cadmium and copper will be reduced in the blood by intravenous EDTA chelation treatments.

Conclusion

I felt that I should take some time explaining the carefully conducted TACT Study that was a randomized double blind, government sponsored study examining the effects of chelation treatments. It showed that there were significant improvements in terms of cardiovascular recovery, but it also showed that it was entirely non-toxic. Chelation should be done by an American College for Advancement in Medicine (ACAM) certified practitioner to ensure that you get the same chelation treatment as described in the TACT Study. People with heart conditions will need 30 to 40 treatments (usually 1 week apart) to improve. However, a person with a normal heart who considers detoxification will only need 10 treatments initially (twice per week or weekly), then one every three months for maintenance. We all reside on the same planet and are exposed to ongoing pollution and food toxicity. Due to this reality the topic of chelation and detoxification is worth some serious consideration not only for patients with heart health issues.

More information about vitamins and detoxification: http://nethealthbook.com/health-nutrition-and-fitness/nutrition/vitamins-minerals-supplements/

Reference: 1. J. American Medical Association (March 27, 2013, Vol. 309, No. 12)

Last edited Nov. 8, 2014

May
21
2014

Forty Percent Of Premature Deaths Can Be Prevented

By | Cancer, Diabetes, Fitness, Health, heart attack, Heart Disease, High Blood Pressure, Lung Disease, Nutrition, Obesity, Prevention, Stroke, Vitamins and supplements

A new report from the CDC (Center of Disease Control) in the US has revealed that up to 40% of premature deaths could be prevented by simple lifestyle changes. As this link shows every year about 900,000 premature deaths occur in the US, which are due to 5 major diseases that in the opinion of the CDC can be prevented by 20 to 40%. Here are the diseases that kill: cancer, heart disease, COPD/emphysema, stroke and accidents/injuries. These conditions were responsible for 63% of all deaths in the US in 2010.

Let’s discuss each of these conditions and how one could lower the risk of dying from them.

1. Cancer:

The Framingham Heart Study has shown that smoking and cancer are closely related. Smokers who quit can significantly reduce their risk of getting cancer. We also know that exercise and prophylactic supplements like fish oil and vitamin D3 have cancer preventative effects.

Antioxidant supplementation that included beta-carotene, vitamin A, vitamin C, and vitamin E daily or on alternate days for 1 to 12 years, along with selenium supplementation reduced the incidence of cancer of the esophagus, colon, pancreas, stomach or the liver. Insulin resistance due to sugar and starch overconsumption is causing cancer, particularly breast cancer, colorectal cancer and endometrial cancer. I have discussed this in a recent blog.

Pollution has been linked to increased lung cancer risks as discussed here.

2. Heart disease:

Heart disease can be caused by several factors in combination. Lifestyle issues are important: Smokers need to quit smoking as the Framingham Heart Study has shown more than fifty years ago that smoking causes heart attacks. Obesity and diabetes also contribute significantly to the risk of heart disease. Often these are connected to faulty nutrition, which is another lifestyle issue that comes to mind when too much sugar and starchy foods are taken in; your liver will convert these into fatty acids, triglycerides and elevated, oxidized LDL cholesterol, which gets deposited under the lining of the arteries. A lack of exercise adds to this problem as a lack of exercise lowers the protective HDL cholesterol and fat is deposited under the lining of the arteries. Start exercising and your protective HDL cholesterol will rise, your total cholesterol to HDL ratio will lower to healthier levels and your risk for hardening of the arteries and for getting a heart attack will fall. If you have diabetes, it is important that you manage your blood sugars well; this means that if you inject insulin, you want the blood sugar tests to be within the normal range and the hemoglobin A1C values to be below 5.5%. Poorly controlled diabetes is an important cause of heart attacks and strokes. High blood pressure is also an important cause of developing heart attacks and strokes. It is important to control your blood pressure by taking blood pressure lowering pills and also by exercising regularly. Exercise seems to send a signal to relax the blood vessels thus lowering the blood pressure, which in turn prevents heart attacks.

Forty Percent Of Premature Deaths Can Be Prevented

Forty Percent Of Premature Deaths Can Be Prevented

 

3. COPD/emphysema:

Chronic obstructive pulmonary disease (COPD) or emphysema is mostly caused by chronic exposure to cigarette smoke from smoking. The earlier you can quit, the better your chances that your breathing will not be the limiting factor when you age. But it is also important to avoid exposure to other noxious gases, such as from welding and from exposure to pollution. This may involve a decision to move to a less polluted area. Or it might involve a job retraining. Those who are suffering from COPD can be helped to a certain extent by a portable oxygen tank with nasal prongs.

4. Stroke:

As mentioned before, quitting smoking, controlling high blood pressure and controlling blood sugar, if you suffer from diabetes have been shown to stabilize your blood vessels including the ones that supply your brain. The key is to prevent hardening of the arteries by a healthy lifestyle. Exercising and keeping your weight under a body mass index of 25.0 have been shown to be effective stroke prevention. Healthy nutrition as indicated above under “heart disease” is equally important for stroke prevention. Go green (eat more vegetables, consume more green smoothies), cut down grains, sugar and starchy foods and you will live longer without strokes and heart attacks. Remember, what’s good for your heart is good for your brain!

5. Unintentional accidents/injuries:

Wearing helmets when bicycling, wearing seat belts when driving in a car, avoiding risky behaviors are all measures that save lives. One factor stands out in all of this: if you drink too much, you run the risk of being involved in unintentional accidents or injuries. People may not like to hear this, but your brain lacks the natural inhibitory impulses when you are under the influence of alcohol, so you become more daring and you may not pay attention for the split second that could have prevented an injury or accident. People react very differently to alcohol. Some people feel inebriated after only ½ a glass of wine or beer whereas others can drink more before they make mistakes. The best is to be sober when you drive, ski, use power tools or walk in traffic. Even climbing ladders requires a clear mind!

Conclusion:

As the CDC said 20 to 40% of premature deaths (deaths that occurred before the age of 80) could have been prevented, if the above-mentioned recommendations were followed. Let me rephrase this: 180,000 to 360,000 premature deaths every year in the US before the age of 80 could have been prevented! Curative medicine cannot help with these statistics as a heart attack or stroke has happened when it has struck you. Cancer and end stage lung disease are similar conditions that you are suddenly faced with when they occur and unintentional accidents just seem to happen. This is where the importance of prevention can be seen, because these little baby steps every day are adding up to something formidable, a force to be reckoned with. Be part of the solution, think prevention!

More information on:

1. Cancer mortality: http://nethealthbook.com/cancer-overview/overview/cancer-mortality-rate/

2. Higher vitamin D3 intake lowers mortality from heart attacks, strokes, cancer, fractures due to osteoporosis: http://nethealthbook.com/news/higher-vitamin-d-levels-associated-lower-risk-mortality/

Last edited Nov. 8, 2014