Oct
12
2024

Cardiovascular Risk Markers Predict Heart Attacks and Strokes

By | blood test, Cardiovascular disease, cholesterol, diet, fasting mimicking diet, Fitness, heart attack, Heart Disease, Mortality, Stroke, Weight loss

An article in The New England Journal of Medicine stated that cardiovascular risk markers predict heart attacks and strokes. A summary of this study was also published by NBC News.

30-year follow-up of the Women’s Health Study

This is based on a 30-year follow-up study of the Women’s Health Study. In the beginning of the study all women had blood tests taken. In the beginning none of the women had cardiovascular disease.  The blood tests were LDL cholesterol, lipoprotein(a) and high-sensitivity C-reactive protein (CRP). When either of these markers was high at the beginning of the clinical trial, it turns out that 30 years later the person either was dead from cardiovascular disease or had a heart attack or stroke.

More details of the study

In the beginning of the study 27,939 initially healthy U.S. women had 3 of the mentioned blood tests taken. If only one of them was elevated, there was a risk in the next 30 years to get a myocardial infarction, coronary revascularization, stroke, or death from cardiovascular causes. The initial age of the patients was 54.7 years. During the next 30 years of follow-up 3662 cardiovascular events took place. Hazard ratios for the primary end point in a comparison of the top with the bottom quintile were calculated. The following hazard ratios were derived:

  • 70-fold for high-sensitivity CRP
  • 36 for LDL cholesterol
  • 33 for lipoprotein(a)

Each biomarker showed an independent contribution to the overall risk. The risk of developing cardiovascular disease was highest when all three biomarkers were elevated.

Traditional risk calculation

Cardiologists calculated risk for cardiovascular events by the traditional 10-year estimates of risk. The authors suggest that physicians should do screening blood tests with these three biomarkers. If any of the biomarkers is elevated, measures to reduce cardiovascular risk should be initiated. This will be very effective to prevent cardiovascular events for the next 30 years.

Be proactive, prevent heart disease

As we get older, many people develop elevations of high-sensitivity CRP, LDL cholesterol and lipoprotein (a). But don’t wait for this to happen. Here are 9 steps you  can follow to prevent it.

  • Maintain a healthy weight
  • Quit smoking
  • Choose good nutrition
  • Be physically active
  • Treat hypertension adequately
  • Manage diabetes, if you have it
  • Stress management
  • Limit alcohol intake
  • Get enough sleep

Comments to the steps you can take to prevent cardiovascular disease

The ideal body mass index is between 21.0 and 22.0. I found that the fasting mimicking diet helps me to stay in that BMI range. Good nutrition eliminates red meat and emphasizes vegetables and salads. Fish, lean chicken and turkey meat are healthy. Avoid all processed meats like sausages. Watch your calorie intake to keep your body mass index stable. In addition, avoid excessive salt and sugar intake. Avoid highly processed carbohydrates and processed food. Eliminate fried fast food, chips and baked goods from your diet as they contain trans fats. Trans fats cause hardening of the arteries.

Aim to get 30 to 60 minutes of daily activity. Do two or more strength training sessions a week. This raises the protective HDL cholesterol and prevents cardiovascular disease. Excessive alcohol intake leads to cardiovascular disease and high blood pressure. Limit your alcohol intake, if you find it hard to eliminate it altogether.

Cardiovascular Risk Markers Predict Heart Attacks and Strokes

Cardiovascular Risk Markers Predict Heart Attacks and Strokes

Conclusion

A unique 30-year follow-up study of the Women’s Health Study identified three risk factors that a doctor can be determin from a blood sample. They predict whether a person will develop cardiovascular disease 30 years down the road. The three risk factors are high-sensitivity CRP, LDL cholesterol and lipoprotein (a). The best approach to prevention of heart disease is to adopt the approach of the Mayo Clinic described above. It comes down to the basics of good nutrition, regular exercise, maintaining a healthy weight, limiting excessive alcohol intake and stress management.

Aug
08
2020

Poor Diets Threaten Americans and Cause Diseases

By | alcohol, Alzheimer’s disease, Cardiovascular disease, diet, exercise, fish oil, Fitness, food, heart attack, Hormones, lifestyle, Lung Disease, Nutrition, Obesity, polyunsaturated oil, Smoking, Stroke, sugar

A new Federal Nutrition Research Advisory Group stated that poor diets threaten Americans and cause diseases. More than 500,000 people in the US are dying every year because of poor nutrition. 46% of adults have unhealthy diets; but children have even more, namely 56%. In 1979 the US healthcare cost was 6.9% of the gross domestic product. Compare this to 2018 when the US healthcare cost was 17.7% of the gross domestic product.

The Federal Nutrition Research Advisory Group states: “Poor diets lead to a harsh cycle of lower academic achievement in school, lost productivity at work, increased chronic disease risk, increased out-of-pocket health costs, and poverty for the most vulnerable Americans.”

You can improve your diet quality 

When you start cutting out junk food and other processed foods, the quality of your food intake is improving. Eat more vegetables, and fruit. Eat wild salmon, which provides omega-3 fatty acids. Do not consume vegetable oils like soybean oil, canola oil, safflower oil, corn oil and grapeseed oil. They all contain omega-6 fatty acids. Omega-6 fatty acids are essential fatty acids and they convert mainly into energy. But the problem is that our western diet contains too many omega-6 fatty acids. Omega-6 fatty acids can convert into arachidonic acid, which causes inflammation. This in turn can cause heart attacks and strokes on the one hand and arthritis on the other. Use cold-pressed extra virgin olive oil instead for cooking and on salads.

How does poor quality food affect your health?

Researchers are aware of trans fats causing Alzheimer’s disease, heart attacks and strokes for a long time. They increase the bad LDL cholesterol, decrease the good HDL cholesterol. Rancid oils contain free radicals that oxidize LDL cholesterol and attack the lining of your arteries through small dense LDL cholesterol. The FDA has started to initiate steps in 2015 to make the use of trans-fats in the food industry illegal. Completion of this in the US occurs in early 2020.

Japanese trans-fat study (Alzheimer’s disease)

This Japanese study followed 1,628 Japanese community residents (men and women) for about 10 years. Researchers used the typical trans fatty acid, elaidic acid to monitor the accumulation of trans fats in patients. This is possible with a simple blood test, which serves as a marker for industrial trans fats. 377 participants developed dementia (247 Alzheimer’s disease and 102 vascular dementia). Based on the blood elaidic acid levels earlier in the study individuals with higher trans-fat levels were more likely to develop Alzheimer’s disease as the study progressed. Patients whose trans-fat blood levels were in the higher range were 50% to 75% more likely to develop Alzheimer’s disease or dementia.

Diseases caused by poor lifestyle habits

It is important to review the diseases that shorten life expectancy due to having poor lifestyle habits. Note that it is not only your dietary habits that determine this, but in addition, several lifestyle factors.

Cardiovascular disease

Smoking, lack of regular exercise and poor eating habits result in being overweight or developing obesity. All of these are risks with LDL cholesterol elevation and HDL cholesterol lowering that leads to heart attacks and strokes. Here is a study that shows how life is shortened after a heart attack. It is clear from this how important it is to give up all of the poor lifestyle habits to avoid this from happening.

Cancer

90% of lung cancers are the result of cigarette smoking. Heavy drinking can contribute and also lead to cancer of the liver, esophageal cancer, cancer of mouth and throat and cancer of the breasts in women. In addition, consuming too much alcohol causes cancer of the colon and rectum in both sexes.

Diabetes

There are a variety of risk factors causing diabetes. Obesity, a lack of exercise, a bad diet with too much carbohydrates and the aging process are what contributes to the development of type 2 diabetes.

We see again that it is largely lifestyle issues that drive the onset of this disease. People who have developed diabetes need to control their blood sugar very closely to avoid complications of diabetes. This includes making healthier choices.

Otherwise complications of diabetes are diabetic nephropathy, blindness from macular degeneration of the cornea, heart attacks, stroke and diabetic neuropathy. In addition, vascular complications also include artery occlusions in the lower extremities with frequent foot or below knee amputations.

Chronic diseases

Often chronic diseases develop when there is generalized development of inflammation. COPD, chronic kidney disease and arthritis are examples of such conditions. In addition, Alzheimer’s disease, arthritis, asthma, Crohn’s disease, cystic fibrosis and diabetes belong into this category. All of these chronic diseases have in common that cytokines produce inflammation in the body. This keeps the chronic disease going and makes it more difficult to cure. When the person with a chronic disease makes poor lifestyle choices, the inflammation just becomes more chronic.

Smoking is one of the factors that makes chronic inflammation more chronic. Having a body mass index above 25.0 (being overweight) and above 30.0 (obesity) also creates more inflammation in the body. Excessive alcohol intake damages body cells and releases free radicals. These in turn cause inflammation and make the chronic disease more difficult to treat. An unhealthy diet tends to raise the bad LDL cholesterol, introduces pesticides and other chemicals into your system and adds to chronic inflammation. Finally, a lack of exercise is not contributing to a healthy circulation and lowers the protective HDL cholesterol, paving the way for heart attacks and strokes.

Poor Diets Threaten Americans and Cause Diseases

Poor Diets Threaten Americans and Cause Diseases

Conclusion

A new Federal Nutrition Research Advisory Group has been formed, which noted that many Americans follow very poor diets. 46% of adults in the US have unhealthy diets; but children have even more poor diets, namely 56%. This is of concern, because in time this causes a variety of diseases discussed here. Instead of just treating the symptoms of these diseases, it is important to improve the diet people are on, which prevents the development of these diseases. A well-balanced diet not only prevents diseases, it also leads to longevity and healthy aging without Alzheimer’s disease. Take care of what you eat, and be sure it is healthy!

Part of this text was published before here.

Jun
29
2019

Both White Meat And Red Meat Elevate Cholesterol

By | Cancer, Cardiovascular disease, diet, food, heart attack, Nutrition, Stroke

A study from the American Journal of Clinical Nutrition showed that both white meat and red meat elevate cholesterol. This was a randomized controlled clinical trial. Many observational studies in the past showed that red meat consumption could elevated LDL cholesterol values and this increased cardiovascular disease. Many study authors have recommended to get away from the dangers from red meat by switching to white meat from poultry .

However, this study pursued this question in more detail. It questions whether it is true that white meat is safer from a cardiovascular risk point of view. It also studies the effects on cardiovascular risk when switching to vegetable protein (vegan or vegetarian diets). In addition, the researchers assessed the effects of low or high saturated fat on LDL cholesterol levels.

Design of the study

Researchers from the Children’s Hospital Oakland Research Institute, Oakland, CA conducted the study. They rotated participants through three different diets for 4 weeks each with a washout period of 2 to 7 weeks in between where they ate their usual foods. The diets were as follows. The first tract consisted of food with high-saturated fatty acids (high SFA): red meat; white meat and non-meat. The second tract contained low-saturated fatty acids (low SFA): red meat, white meat and non-meat. The researchers determined the cardiovascular risk of these 6 diets by measuring triglyceride levels, LDL cholesterol levels apo B levels ad additional factors.

Results of the study

LDL cholesterol: 2.64 mmol/L for red meat, high SFA; 2.61 for white meat, high SFA; 2.46 for non-meat, high SFA.

The LDL cholesterol values for red meat, low SFA were 2.35; for white meat, low SFA were 2.38 and for non-meat, low SFA were 2.22.

The message from this part of the trial is that it did not matter whether you ate red meat or white meat, the LDL cholesterol was still high, particularly when combined with high saturated fatty acids. Lean cuts of red meat and of chicken (no skin) result in lower LDL cholesterol readings. The very best LDL cholesterol results came from non-meat protein like vegetables. This was particularly so when the vegetables contained only low-saturated fatty acids.

There were many more results in the study, but it would be inappropriate to list them all for this overview here. For those interested in it, here is the link where more detail is discussed. Here is a blog where I discussed how to lower cholesterol.

Discussion of the study that found that both white meat and red meat elevate cholesterol

For years physicians have recommended to exchange some of the red meat (beef, pork and lamb) with white chicken or white turkey meat. This was based on poorly designed observational studies. Now the investigators of a randomized controlled clinical trial have shown that the old assumptions were incorrect. White meat raises LDL cholesterol just as much as red meat does. But protein from vegan or vegetarian diets lowers LDL cholesterol significantly. In addition the effect of saturated fatty acids raises LDL cholesterol significantly in all of the different diets. The researchers pointed out that L-Carnitine from red meat is metabolized by gut bacteria into trimethylamine-N-oxide (TMAO). This is a substance that has two effects on the body: it causes increased atherosclerosis (hardening of arteries) and also causes cancer of the colon.

Both White Meat And Red Meat Elevate Cholesterol

Both White Meat And Red Meat Elevate Cholesterol

Conclusion

This randomized clinical trial clearly showed that red meat and white meat cause the same elevation of LDL cholesterol and other cardiovascular risk factors. In contrast non-meat protein from a vegetarian or vegan diet lowers cholesterol. Also, high-saturated fatty acid food elevated cholesterol while low-saturated fatty acid food lowers cholesterol. For this reason, choose the leanest cut, if you eat red or white meat. Don’t be afraid to have a meatless day once or more often during the week. It will help you to equilibrate your cholesterol level. Keep in mind that your gut bacteria metabolize red meat into trimethylamine-N-oxide (TMAO). This is a substance that has two effects on the body: it causes increased atherosclerosis (hardening of arteries) and also causes cancer of the colon. For this reason keep your red meat consumption low, which prevents colon cancer, heart attacks and strokes.

May
19
2018

What lowers LDL cholesterol?

By | blood test, Cardiovascular disease, cholesterol, exercise, fish oil, Fitness, food, heart attack, Heart Disease, Inflammation, Nutrition, Smoking, Stroke, Vitamins and supplements

Many times we hear terms like LDL and HDL cholesterol , but what lowers LDL cholesterol? We have to go back to a time when the ongoing Framingham Heart Study wanted to find out what caused a heart attack or a stroke. In the 1960’s scientists found out that cigarette smoking increased heart attack risk and also blood cholesterol. Then in the 1980’s the news came out that HDL (high density lipoproteins) reduced the risk of heart disease. Eventually several research institutions agreed that LDL (low density lipoproteins) was the culprit for causing plaque deposits in arteries. This caused heart attacks and strokes. LDL is often referred to as the “bad” cholesterol.

Clarification of HDL and LDL cholesterol

Recently a review article asked the question: “What is the difference between HDL and LDL cholesterol?”

Below I will review what LDL and HDL cholesterol do in our system. I will also mention normal values for blood tests. This will help you to understand your own blood test results. Then I will review what you can do to lower LDL cholesterol and to increase HDL cholesterol.

The function of LDL and HDL cholesterol

Total cholesterol in the blood contains LDL cholesterol, small dense LDL cholesterol and HDL cholesterol. The small dense LDL cholesterol is more dangerous than LDL cholesterol. It infiltrates the lining of the arterial walls aggressively. A normal LDL level is less than 100 mg/dL. When triglycerides, another form of lipid is high in the blood, LDL cholesterol forms a lot more small dense LDL cholesterol. This is the case in diabetics or in obese people. It is the reason why they are very vulnerable to develop heart attacks and strokes. The optimal range for triglycerides is less than 80 mg/dL.

HDL cholesterol is protective from hardening of the arteries and protects you from heart attacks or strokes. HDL dissolves LDL cholesterol, brings it to the liver, and the liver excretes it into bile. You want to have more than 60 mg/dL of HDL cholesterol in your blood.

Cholesterol math

The total cholesterol conventionally is calculated like this:

LDL cholesterol + HDL cholesterol + (triglyceride/5) = Total cholesterol

You see that the small dense LDL is not part of it here, but high triglyceride levels would increase the total cholesterol value as the inclusion of 20% of triglycerides in this equation compensates for this.

There is also a ratio of total cholesterol to HDL cholesterol that is important. This ratio should be below 3.4 for both women and men. This is also known as the ½ average risk for a heart attack or stroke. If your value is equal to that or below, you are in a very low risk category to get a heart attack or stroke.

Now I will deal with the question: what lowers LDL cholesterol?

What lowers LDL cholesterol?

Now we need to review what can be done to lower an LDL cholesterol which is too high. Don’t tell me that you want to take one of the statin drugs. These drugs have serious side effects and are only indicated for the most serious cases of high cholesterol values.

Most common measures to reduce LDL cholesterol

  • Cut out red meat

    First of all, cutting out red meat (like beef, pork and sausages) to an absolute minimum, for instance once per week or less is important. The reason is that these meats have more cholesterol in them and also more saturated fats than any other foods. Compare that to poultry, fish and vegetables like beans, which are healthy food sources.

  • Eliminate trans fats

    Furthermore, we need to eliminate trans fats as they are causing heart attacks. There is an important difference between ruminant trans fats and artificial trans fats. Ruminant trans fats have been part of the human diet for millennia like milk fat and fat from cows that are on pasture or lamb. Milk products for instance contain fat with 2-5% natural trans fats. 3-9 % of the fat in beef and lamb consists of natural trans fats. Studies have shown that the body is able to handle these natural trans fats, and heart attacks are not more frequent in people eating moderate amounts of these products including butter from cows that graze on pasture.

  • Artificial trans fats

    Quite the opposite is true for artificial trans fats in margarine that comes from vegetable oil. Avoid bakery items like sweet pieces or muffins and other products that contain hydrogenated oils. Read labels! Use olive oil or coconut oil, but avoid vegetable oils like corn oil, safflower oil or grape seed oil to get away from trans fats and unstable oils that turn rancid. Rancid oils contain free radicals that oxidize LDL cholesterol and attack the lining of your arteries through small dense LDL cholesterol.

  • Cut out sugar and starchy foods

    Another important item is to cut out sugar and starchy foods because these will raise your LDL cholesterol and triglycerides, which also leads to hardening of your arteries. Starchy foods are broken down by pancreatic juices into sugar, which enters your blood stream, causing an outpouring of insulin from the pancreas. When the short-term storage of sugar as glycogen is exhausted in muscle and liver tissue, the liver has to process any surplus of sugar that is still there. The end results are triglycerides and LDL cholesterol. Unfortunately the protective HDL cholesterol does not reach higher levels, when the LDL cholesterol is increased. A persistent diet of high-refined carbs will increase the risk for heart attacks and strokes. It follows from this that we are all better off cutting out sugar and starchy foods from our food intake as it will reduce LDL cholesterol and small dense LDL cholesterol.

  • Increase your soluble fiber intake

    Increase your soluble fiber intake by eating vegetables, oats and oat bran, lentils, fruits and beans. Why does this decrease LDL cholesterol? The liver tries to eliminate too much cholesterol by binding it to bile salts and excreting it into your small bowel. But the last part of the small bowel reabsorbs some of these bile salts, and from there they return to the liver. This is called the enterohepatic pathway of bile salts. Soluble fiber intake binds those bile salts and prevents re-absorption in the enterohepatic pathway, eliminating cholesterol safely in stool. Clinical trials have also shown that soluble fiber from psyllium, pectin, beta-glucans and others reduce LDL cholesterol by binding bile salts in the gut (interrupting the enterohepatic pathway).

  • Plant sterols and fiber supplements

    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 are beneficial in terms of prevention of heart attacks and strokes. It would be too lengthy to get into more details here.

  • Take a whey protein supplement

    There are two major milk proteins, whey and casein. Only whey protein binds to total and LDL cholesterol, lowering both. It is available in health food stores. Follow the package insert of the whey product for dosing.

  • Increase your omega-3 fatty acid intake

    Omega-3 fats naturally present in fish oils and nuts. They increase the amount of circulating HDL cholesterol, which binds the bad LDL cholesterol. Go ahead and eat salmon, herring and mackerel as well as walnuts, ground flaxseeds and almonds. You can also take molecularly distilled (or pharmaceutically pure) EPA/DHA supplements. This pure form of fish oil is free of mercury and other heavy metals. EPA stands for eicosapentaenoic acid or omega-3 fatty acid. DHA is the acronym for docosahexaenoic acid, an important supplement for the brain. Tests have shown that fish oil supplements at a dosage of 3.35 grams per day of EPA plus DHA reduce triglycerides by up to 40%, equally to Lipitor, but without the statin side effects. The end result: your total cholesterol/HDL ratio decreases, as does the risk for heart attacks and strokes. Here is a review of other oils in your diet.

Measures that will increase HDL cholesterol 

  • Eat foods with anthocyanin

    In a 24-week study with diabetic people HDL levels rose by 19% when food was eaten that was rich in anthocyanin. This consisted of eggplant, purple corn, red cabbage, blueberries and blackberries. The advantage of raising the HDL cholesterol level is that the total cholesterol to HDL ratio decreases, which lowers the risk for heart attacks and strokes.

  • Exercising regularly

    Exercising will increase your HDL cholesterol, which again decreases the ratio of total cholesterol to HDL cholesterol. This number should be between 1 and 3.5, the lower, the better.

  • Take a supplement called Ubiquinol, or Co-Q-10

    Adults above the age of 60 need 400 mg once daily, younger people need between 200 mg and 300 mg daily. Co-Q-10 prevents oxidation of LDL cholesterol, which would aggressively attack the arterial walls causing hardening of the arteries. What causes oxidation of cholesterol? The answer is clear: fried foods like french fries or deep fried chicken will lead to oxidation; other culprits are margarine, commercially baked goods and cigarette smoking.

  • Calcium and vitamin D3

    Recently a study on postmenopausal and overweight or obese women found that supplements of calcium combined with vitamin D3 lowered cholesterol.

  • Polyphenols

    Flavonoids are the largest group among the polyphenols in such common foods as vegetables, fruits, tea, coffee, chocolate and wine. Over 130 studies on humans have shown improvement of the lining of the arteries (endothelial functioning) and lowering of blood pressure. Polyphenol consumption has a connection to 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.1). Take about 250 mg of resveratrol daily.

  • 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 patients take higher doses of 2.25 grams per day. In a metaanalysis of 7 studies researchers found a significant reduction of heart attacks and transient ischemic attacks. These are precursor syndromes before developing a stroke. Niacin can change the small particle LDL into a large particle size LDL, which is less dangerous. Niacin also reduces oxidation of LDL, which stops the atherosclerotic process. For a healthy person 500 mg per day of flush-free niacin is adequate.

  • Curcumin

    This is a powerful heart and brain protector combining three different mechanisms in one. It is reducing oxidative stress. But it is  also an anti-inflammatory. In addition it counters the process that threatens to destroy the lining of the arteries. One study on healthy volunteers showed reduction of 33% in lipid oxidation, a 12% reduction of total cholesterol and an increase of 29% of the protective HDL cholesterol when patients took 500 mg of curcumin for only 7 days (Ref.1). This is the daily dose I would recommend for prevention of heart attacks and strokes.

  • Vitamin E (tocopherols)

    This fat-soluble vitamin is an antioxidant and in the past health practitioners knew about its use as being heart supportive. Strangely enough some conservative physicians bad-mouthed this vitamin. In the meantime health practitioners have returned to using the vitamin. It turns out that there are 8 different types of tocopherols, with the alpha tocopherol being the best-known, but you also want to be sure that you are getting gamma tocopherol with your balanced vitamin E supplement every day. Newer research has shown that tocotrienol is more powerful than tocopherols. I take 125 mg of tocotrienols daily.

What lowers LDL cholesterol?

What lowers LDL cholesterol?

Conclusion

Over the years cardiovascular researchers have accumulated knowledge about supplements that will reduce LDL cholesterol or increase HDL cholesterol. It has practical value: you can look at your own lab results and choose what fits your situation best. You should always make these decisions together with your health care provider. None of the methods reviewed here have any serious side effects. On the other hand statins, as I have reviewed in the link provided, do have significant side effects. Keep in mind that cholesterol is a normal body component that our body needs to make human cell walls. But we do not need to smoke (stopping it lowers LDL cholesterol). We need regular exercise (increases HDL cholesterol). Keep your cholesterol and triglyceride values within the normal ranges that I listed and as a result you will do well in terms of preventing heart attacks and strokes!

Jan
20
2018

Lower Cholesterol

By | cholesterol, exercise, fiber, fish oil, heart attack, Heart Disease, olive oil, Prevention, Smoking, Vitamins and supplements

When your cholesterol is high, what can you do to lower cholesterol? First, there is the bad cholesterol, called LDL cholesterol that should not be too high. Furthermore, there is the good cholesterol, called HDL cholesterol that you want to be to higher to protect you from hardening of the arteries. LDL cholesterol finds its way into plaques of arteries, and later calcification occurs. HDL cholesterol does the opposite; it dissolves LDL cholesterol and brings it to the liver.

Food contributes only to a small portion to the increases of your LDL cholesterol (the bad cholesterol) in the blood. The minor part of the body’s cholesterol stems directly the refined carbs and trans fats from your diet. Here are a number of steps that will protect your heart from LDL cholesterol.

1. Cut out red meat

Cutting out red meat (like beef, pork and sausages) to an absolute minimum, for instance once per week or less is important. The reason is that these meats have more cholesterol in them and also more saturated fats than any other foods. Compare that to poultry, fish and vegetables like beans, which are healthy food sources.

2. Eliminate trans fats

We need to eliminate trans fats as they are causing heart attacks. There is an important difference between ruminant trans fats and artificial trans fats. Ruminant trans fats have been part of the human diet for millennia like milk fat and fat from cows that are on pasture and lamb. Milk products for instance contain fat with 2-5% natural trans fats. 3-9 % of the fat in beef and lamb consists of natural trans fats. Studies have shown that the body is able to handle these natural trans fats and heart attacks are not more frequent in people eating moderate amounts of these products including butter from cows that graze on pasture.

Artificial trans fats

Quite the opposite is true for artificial trans fats in margarine that comes from vegetable oil. Avoid bakery items like sweet pieces or muffins and other products that contain hydrogenated oils. Read labels! Use olive oil or coconut oil, but avoid vegetable oils like corn oil, safflower oil or grape seed oil to get away from trans fats and unstable oils that turn rancid. Rancid oils contain free radicals that oxidize LDL cholesterol and attack the lining of your arteries.

3. Cut out sugar and starchy foods

You need to cut out sugar and starchy foods because these will raise your LDL cholesterol and triglycerides, which also leads to hardening of your arteries. This is an important observation. Starchy foods are broken down by  pancreatic juices into sugar, which enters your blood stream, causing an outpouring of insulin from the pancreas. When the short-term storage of sugar as glycogen is exhausted in muscle and liver tissue, the liver has to process any surplus of sugar that is still there. The end results are triglycerides and LDL cholesterol. Unfortunately the protective HDL cholesterol does not reach higher levels, when the LDL cholesterol is increased. A persistent diet of high-refined carbs will increase the risk for heart attacks and strokes. It follows from this that we are all better off cutting out sugar and starchy foods from our food intake.

4. Increase your soluble fiber intake

Increase your soluble fiber intake by eating vegetables, oats and oat bran, lentils, fruits and beans. Why does this decrease LDL cholesterol? The liver tries to eliminate too much cholesterol by binding it to bile salts and excreting it into your small bowel. But the last part of the small bowel reabsorbs some of these bile salts , and from there they return to the liver. This is called the enterohepatic pathway of bile salts. Soluble fiber intake binds those bile salts and prevents re-absorption in the enterohepatic pathway, eliminating cholesterol safely in stool. 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 and fiber supplements

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 are beneficial in terms of prevention of heart attacks and strokes. It would be too lengthy to get into more details here.

5. Take a whey protein supplement

There are two major milk proteins, whey and casein. Only whey protein binds to total and LDL cholesterol, lowering both. It is available in health food stores. Follow the package insert of the whey product for dosing.

6. Increase your omega-3 fatty acid intake

Omega-3 fats are healthy fats naturally present in fish oils and nuts. They increase the amount of circulating HDL cholesterol, which binds the bad LDL cholesterol. Go ahead and eat salmon, herring and mackerel as well as walnuts, ground flaxseeds and almonds. You can also take molecularly distilled (or pharmaceutically pure) EPA/DHA supplements. This pure form of fish oil is free of mercury and other heavy metals. EPA stands for eicosapentaenoic acid or omega-3 fatty acid. DHA is the acronym for docosahexaenoic acid, an important supplement for the brain. Tests have shown that fish oil supplements at a dosage of 3.35 grams per day of EPA plus DHA reduce triglycerides by up to 40%, equally to Lipitor or even more effective, but without the statin side effects. The end result is that your total cholesterol/HDL ratio decreases. This reduces the risk for heart attacks and strokes.

7. Eat foods with anthocyanin

In a 24-week study with diabetic people HDL levels rose by 19% when food was eaten that was rich in anthocyanin. This consisted of eggplant, purple corn, red cabbage, blueberries and blackberries. The advantage of raising the HDL cholesterol level is that the total cholesterol to HDL ratio decreases, which lowers the risk for heart attacks and strokes.

8. Exercising regularly

Exercising will increase your HDL cholesterol, which again decreases the ratio of total cholesterol to HDL cholesterol. This number should be between 1 and 3.5, the lower, the better.

9. Take a supplement called Ubiquinol, or Co-Q-10

Adults above the age of 60 need 400 mg once daily, younger people need between 200 mg and 300 mg daily. Co-Q-10 prevents oxidation of LDL cholesterol, which would aggressively attack the arterial walls causing hardening of the arteries. What causes oxidation of cholesterol? The answer is clear: fried foods like french fries or deep fried chicken will lead to oxidation; other culprits are margarine, commercially baked goods and cigarette smoking.

10. Calcium and vitamin D3

Recently a study on postmenopausal and overweight or obese women found that supplements of calcium combined with vitamin D3 lowered cholesterol.

11. Polyphenols

Flavonoids are the largest group among the polyphenols  in such common foods as vegetables, fruits, tea, coffee, chocolate and wine. Over 130 studies on humans have shown improvement of the lining of the arteries (endothelial functioning) and lowering of blood pressure. Polyphenol consumption has a connection  to 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.1). Take about 250 mg of resveratrol daily.

12. 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 patients take higher doses of 2.25 grams per day. In a metaanalysis of 7 studies researchers found a significant reduction of 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 also reduces oxidation of LDL, which stops the atherosclerotic process. For a healthy person 500 mg per day of flush-free niacin is adequate.

13. 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 reduction of 33% in lipid oxidation, a 12% reduction of total cholesterol and an increase of 29% of the protective HDL cholesterol when patients took 500 mg of curcumin for only 7 days (Ref.1). This is the daily dose I would recommend for prevention of heart attacks and strokes.

14. Vitamin E (tocopherols)

This fat soluble vitamin is an antioxidant and in the past knew about its use as being heart supportive. Strangely enough some conservative physicians bad-mouthed this vitamin. In the meantime health practitioners have returned to using the vitamin. It turns out that there are 8 different types of tocopherols, with the alpha tocopherol being the best-known, but you also want to be sure that you are getting gamma tocopherol with your balanced vitamin E supplement every day. It remains 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).

Lower Cholesterol

Lower Cholesterol

Conclusion

There is a lot you can do to control your cholesterol level by changing your diet, shedding some pounds, exercising and quitting smoking. All this will contribute to lower cholesterol. This will have a beneficial, long-term effect regarding prevention of heart attacks and strokes. In addition there are specific supplements and vitamins, which prevent heart attacks and strokes as well. With these measures the majority of people with high LDL cholesterol can change their cholesterol levels without taking statins. Statins have serious side effects like Alzheimer’s disease and a painful muscle condition called rhabdomyolysis. None of the other measures described here have any such side effect. Even if you chose to only concentrate on a few of these 14 points to lower cholesterol there will be significant improvements in your LDL and HDL cholesterol levels, when you ask your doctor to order these blood tests.

More info: https://www.askdrray.com/statins-can-hurt-the-consumer/

References

Ref. 1: Life Extension: Disease Prevention and Treatment, Fifth edition. 130 Evidence-Based Protocols to Combat the Diseases of Aging. © 2013

 

Sep
16
2017

Healthy Oils For A Healthy Body

By | coconut oil, fish oil, Inflammation, olive oil, omega-3 fatty acids, polyunsaturated oil

Healthy oils for a healthy body? Quite frequently the news are full of articles that want to inform you what fat or oil to eat. At the end the consumer often faces information overload and confusion.

Here I am reviewing what we know about the various oils.

1. Coconut oil not as good as it was thought

This review article pointed out that coconut oil does elevate the bad cholesterol, called LDL cholesterol. This is not a desirable effect, as it can lead to heart disease and possibly heart attacks. On the other hand coconut oil also elevates HDL cholesterol, the good cholesterol that mobilizes LDL cholesterol. The article points out that coconut oil may be a better choice than butter. Butter does not elevate HDL cholesterol to offset the effects of LDL cholesterol. Researchers felt that the occasional use of coconut oil instead of butter would be justifiable. But they advised strongly against the daily use of coconut oil. Instead they recommended olive oil, canola or soybean oil, along with nuts and seeds, as your primary fats. I agree with olive oil, but have concerns about canola or soybean oil, as I explain it later in this article.

Dr. Andrew Weil reviewed coconut oil in Self Healing August 2014. He said that the effect on cardiovascular health remains largely unclear. He is not aware of any “study that has shown using coconut oil leads to significant weight loss”. It is basically a thumbs down assessment for coconut oil. You may want to use it occasionally for baking or a special Thai food meal.

Let’s remember that the long-lived populations such as in Okinawa and others never used coconut oil.

2. Polyunsaturated fatty acids used in processed food

A news release in 2016 describes new FDA food guidelines. They recommend that saturated fat should not exceed 10% of the total daily caloric intake, but there are still different opinions: some studies show that saturated fat may not be responsible for hardening of the arteries. Other studies have shown that breast cancer is more common in persons who consume more saturated fat .

In the 1980’s the news came out that saturated fats would be bad for arteries. At that time there was a switch to polyunsaturated fatty acids. These consist of safflower oil, canola oil, sunflower seed oil, corn oil, soybean oil and grape seed oil.

However, the irony is that these vegetable oils were highly unstable and lead to oxidation causing heart disease and cancer.

In contrast olive oil is a much more stable oil. And long-lived populations in the Mediterranean seem to be the proof, that it is a healthy fat source for them and for us.

Personally I have cut out polyunsaturated fatty acids out of my food and I suggest you do the same. We know now that polyunsaturated fatty acids lead to inflammation via the arachidonic acid pathway. This can cause gout, arthritis, diabetes, and inflammation of the arteries with subsequent clots causing heart attacks and strokes. I don’t need all of these diseases, I am doing fine without polyunsaturated fatty acids.

3. Omega-6 to omega-3 ratio

The cell membrane consists of two lipid layers at a specific ratio of omega-6 essential fatty acids and omega-3 essential fatty acids. It also contains triglycerides, phospholipids and protein. Safflower oil, canola oil, sunflower seed oil, corn oil, soybean oil and grape seed oil are mostly omega-6 fatty acids and the type of polyunsaturated fatty acids that prevail in processed foods. With the consumption of too much processed food the body has a problem constructing cell memranes. When you compare the metabolism of omega-6 fatty acids with that of omega-3 fatty acids, there is a fundamental difference. The linoleic acid of omega-6 fatty acids metabolizes into arachidonic acid, which causes pro-inflammatory mediators, PGE2 and LTB4. On the other hand with omega-3 fatty acids alpha-linolenic acid (ALA) is metabolized into EPA, DHA and the anti-inflammatory mediators PGE3 and LTB5.

Disbalanced omega-6 to omega-3 ratio

It is easy to understand why a surplus of omega-6 fatty acids from processed foods will disbalance the omega-6 to omega-3 ratio. This ratio should be 1:1 to 3:1, but many Americans’ omega-6 to omega-3 ratio is 6:1 to 18:1. Omega-6-fatty acids cause arthritis, heart disease and strokes. Be particularly careful in avoiding soybean oil, which is the most popular oil in the last few decades to foul up the omega-6 to omega-3 ratio through processed foods. Read labels to avoid soybean oil and other omega-6 fatty acids.

When it comes to balancing omega-3 and omega-6 fatty acids in your diet, be aware that nutritional balancing can help you restore the ideal omega-6 to omega-3 ratio of 1:1 to 3:1. An easy way is to simply cut out processed foods as much as possible. Supplement with molecularly distilled fish oil capsules to add more omega-3 fatty acids into your food intake.

4. Fish oil

What we learned from this is the importance of fish oil as a supply of omega-3 fatty acids. But nuts also supply us with omega-3 fatty acids. Eating fish three times per week is another way to get enough fish oil on board. There is a word of caution. Our oceans are so contaminated with mercury that you want to be careful and eat only fish low in mercury content. Avoid swordfish, tuna fish or grouper.

But wild salmon and mackerel are fish low in mercury and safe to eat. I would recommend that you eat seafood at least three times per week to have a good source of omega-3 fatty acid. In addition I would also recommend you take omega-3 supplements. I take it in the form of molecularly distilled high potency omega-3. I take 2 capsules twice a day. In addition I take 750 mg of krill oil once per day, another source of molecularly distilled marine omega-3 supplement.

5. Cold pressed virgin olive oil

Organic olive oil contains monounsaturated fatty acids that are neutral in terms of effects on the cardiovascular system. But it also contains a lot of polyphenols and among these in particular hydroxytyrosol that lower blood pressure and protects you from hardening of the arteries. This likely is the main reason why the Mediterranean diet is so healthy, apart from its emphasis on vegetables, which further makes it desirable. 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.

Only two tablespoons of 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 plaque.

Effects of olive oil

Olive oil has been shown to lower blood pressure and prevents heart attacks and strokes.

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 plaque from arteries more efficiently than the regular, cheaper olive oil. You should use mainly olive oil for your regular cooking. Cold pressed, virgin olive oil is more expensive than the regular olive oil, but this is what has been proven to enhance health and to prolong life, if you consume it regularly.

Healthy Oils For A Healthy Body

Healthy Oils For A Healthy Body

Conclusion

Sometimes it is useful to think about what fats you are consuming. We tend to eat too many omega-6 fatty acids from processed foods. These are polyunsaturated fatty acids found in safflower oil, canola oil, sunflower seed oil, corn oil, soybean oil and grape seed oil. Food merchants use these polyunsaturated fatty acids to have a longer shelf life of their products. But the more omega-6 fatty acids we consume, the higher the omega-6 to omega-3 ratio gets. This leads to inflammation in the body and the arteries. It causes heart attacks, strokes and other illnesses. Years ago I cut polyunsaturated fatty acids out of my food intake. Instead I use organic cold pressed extra virgin olive oil. It is full of polyphenols (and among these in particular hydroxytyrosol). It lowers blood pressure and prevents heart attacks and strokes. I am not convinced that the hype around coconut oil can be verified. At this point I would suggest only occasional use of it.

You need to eat fish three times per week and other seafood as a source of omega-3 fatty acids. This is important to keep your omega-6 to omega-3 ratio well balanced. I also take fish oil supplements regularly like krill oil once daily and fish oil capsules twice a day. You can buy these molecularly distilled to ensure they are mercury contamination free.

Dec
19
2015

Beer Belly Bad News

By | alcohol, andropause, Cardiovascular disease, heart attack, Heart Disease, Hormones, Inflammation, lifestyle, Mortality, Nutrition, Stroke, Weight loss

You heard the expression “beer belly”, but now we learn “beer belly bad news”. It is an unflattering term for increased abdominal girth, especially in males. It is quite often that this picture is found in middle-aged men who consume more beer than what is good for them, but they may also mill around the hot dog stands at the ball game instead of being physically active. Any leftover calories are stored as belly fat, which protrudes their stomach as if they were pregnant.

There is a big difference between belly fat and body fat. Belly fat is metabolically much more active. Body fat is more sessile. So, it is the belly fat we need to do something about as this has been shown to be associated with heart attacks, strokes and diabetes.

 

Abdominal girth to hip ratio instead of BMI

Originally it was thought that excessive weight would best be measured with the body mass index (BMI). But subsequently it was shown that athletes with well-developed muscles could have BMI’s that were in the overweight (between 25.0 and 30.0) or even obese category (more than 30.0). Also, some people with heavy bones can have excessive BMI values despite them being normal based on other measurements. The new measurement is the old fashioned abdominal girth to hip ratio.

Weight gain leads to metabolic syndrome

You measure the abdominal girth, the hip girth and divide the abdominal girth by the hip girth. Normally this should be 80% (=0.8) or less for women and 90% (=0.9) or less for men. But a person with a beer belly will have ratios of 1.2 or 1.5.

If you take blood tests of that person you would also find elevated triglycerides, lowered HDL cholesterol (the protective cholesterol) and elevated LDL cholesterol (the bad cholesterol). In addition, we know from studies that often the insulin level is elevated in the sense of hyperinsulinism. In fact that person has often the metabolic syndrome, which is a characteristic change of the metabolism in an obese person. The blood is thicker with clotting factors floating around, there are inflammatory kinins that circulate and these factors work together on causing hardening of the arteries.

Why is a beer belly dangerous?

There are not only cardiovascular risk on the long-term causing heart attacks and strokes down the road. There is a danger of fat deposits in the liver, called fatty liver disease.

In time this can turn into liver cirrhosis and in some cases develop into liver cancer. Because belly fat causes inflammation in the system including in the lining of the blood vessels, this can in time also affect the immune system, weakening it and eventually allowing cancer to develop. Common cancers that are associated with obesity are breast cancer, ovarian cancer and uterine cancer in women, prostate cancer in men and pancreas and colon cancer in both sexes.

Estrogen from aromatase in beer bellies

In men beer bellies produce a lot of estrogen, the female hormone. This is so because fat tissue contains the enzyme aromatase that metabolizes male hormones into estrogen. Estrogen in men is only good in traces, but when the body produces it massively, it will counter testosterone production and will cause heart attacks and strokes.

What can you do about a beer belly?

We need to understand how beer bellies develop. One of the sources of fat from beer bellies is the consumption of foods that contain a lot of fructose. Food manufacturers have been diligent in mixing high fructose corn syrup into sugary drinks and into a myriad of processed foods.

Sugar itself can only be processed and stored until the glycogen stores in the liver and the muscles are filled. The liver metabolizes a surplus of sugar into triglycerides and LDL cholesterol. This is also the case for any fructose that comes from metabolized sucrose (table sugar) and from the high fructose corn syrup popular with the food processing industry. One problem is that fructose can only be processed by the liver, while glucose gets directly taken up by cells with the help of insulin.

German obesity wave after WWII in the 1960’s

The surplus of fructose metabolizes into triglycerides and LDL cholesterol before the body stores it as fat in fat cells. Unfortunately a lot of the fat will end up between your guts, in the liver as fatty liver and in the beer belly, a metabolically more active form of fat.

The sad part is that in the 1960’s I have seen the German economic wonder (“Wirtschaftswunder”) where many mid fifty to mid sixty business men died as a result of obesity and subsequent heart attacks and strokes. At that time Germans who were starving during World War II lived it up. This was in the late fifties and 1960’s. They ate whatever they could: cakes, fatty cheeses, whipped cream, fatty foods like pork roasts and beef.

Unhealthy hydrogenated fats, starchy food and sugar caused beer bellies

They also consumed loads of bread, buns, pasta and sugar. Margarine also became popular with its hydrogenated fatty acids that also contained free radicals. The end result was that they gained weight, did not exercise and developed their beer bellies.

In the 1980’s the school of thought was that saturated fatty acids  were responsible for heart attacks, strokes and obesity.  A low fat/high carb diet became popular and continued to steadily increase. Sure, the hydrogenated fatty acids did not help and should be cut out. But the bigger problem was the consumption of high fructose corn syrup and over-consumption of high glycemic-index carbohydrates.

Steps of how to get rid of the beer belly

Here is the solution of what to do get rid of the beer belly.

Eliminate sugar and high fructose from diet

Remove sugar and high fructose corn syrup from your diet.

Remove empty starches from your diet

The second effective step is to cut out as many empty starches that you can cut out like white rice, bread, sweets, cookies, cakes, ice cream and pasta. Starchy foods metabolize in the gut into sugar, which causes an insulin response. The extra insulin is responsible for developing inflammation in the arteries, which eventually leads to heart attacks and strokes.

Regular exercise

Exercise on a regular basis. This will produce HDL cholesterol, the protective cholesterol, which balances LDL cholesterol.

Rebalance your food intake

Perhaps the most important step is to rebalance your food intake. With this I mean that you replace high glycemic-index carbs with low glycemic-index carbs. This means you will eat a lot of salads, steamed vegetables, and fruit. This gives you a lot of extra fiber, which your system needs to slow down the rate of sugar absorption. It also  helps you to lower LDL cholesterol and detoxify your body in the gut where fiber binds toxins.

Moderate your alcohol intake

If you are heavily into alcoholic drinks, this is another source of refined carbohydrates. They metabolize into LDL cholesterol, triglycerides and can cause fatty liver disease and liver cirrhosis. A moderate consumption of alcohol (one drink for women per day and two drinks for men per day) lowers the risk of heart attacks and strokes, while excessive alcohol intake increases the risk.

Bioidentical hormone replacement

Bioidentical hormone replacement may be something you have not heard about. But if you are a woman above the age of 40 or a man above the age of 50 chances are that you need some hormone tests. As a male, your natural hormone production from your testicles or adrenal glands is likely not keeping up.  As a woman, your ovaries or adrenal glands are no longer keeping up with the demand of regular life. Part of the aging process is that the production of our sex hormones slows down. It does so shortly before menopause in women and shortly before andropause in men.

Lack of function of key organs in menopause and andropause

This will not only manifest itself in hot flashes and sleep disturbance in women. Men experience erectile dysfunction and grumpiness. Eventually this leads to a lack of energy production in the heart, the brain and other organ systems. When these organs have sex hormone receptors, but circulating sex hormones are missing, they cannot function optimally.

Lack of hormones causes heart attacks, strokes and cancer

A lack of hormones translates into yet another cause of heart attacks, strokes and certain cancers. This is an area where conventional medicine disagrees with anti-aging medicine. Years in general practice have taught me that heart attacks, strokes, colorectal cancer and pancreatic cancer happen more often when hormones are missing in both sexes. Cancer of the breasts, uterus and ovaries and prostate cancer are more common when sex hormones are missing. These cancers occur when natural sex hormone production declined.

On the other hand, with bioidentical hormone replacement the metabolism of all cells will return to normal. With this the likelihood of not developing all these illnesses at an earlier time is diminishing as well. It is not a panacea for eternal life, but it will add significant longevity. And with this comes the knowledge that you will not get premature disabilities, which is what we all need.

Beer Belly Bad News

Beer Belly Bad News

Conclusion

We need to assess our food intake habits and cut out the items that contribute to the beer belly. Next we need to ask ourselves what other change in lifestyle we require.  Think about anything to improve our body shape and our energy metabolism. Life is too precious to just throw away years of fruitful living in our golden retirement years. Work on these factors in midlife or even in younger years and you will enjoy disease-free aging.

Jul
11
2015

Experiments On Humans With New Statin Drugs?

By | heart attack, lifestyle, Nutrition, Stroke

This article is about experiments on humans with new statin drugs. The FDA released new statin drugs for use on a high-risk segment of the population with genetically high cholesterol. This has the name familial hypercholesterolemia and runs in families. There was a fast track for these drugs strictly to treat a high-risk population. There was a completion of smaller trials, but the the FDA expects the results of larger trials only for 2017. This leaves the uncomfortable question, whether physicians should prescribe these newer statins despite the lack of completion of proper trials.  In other words, are we doing experiments on humans with the new statin drugs, when the final word regarding their safety is not out.

Introduction

There was a news release about this story. There are a number of new super cholesterol lowering drugs. Physicians administer them by injection. They reduce the LDL cholesterol fraction. Oxidation of LDL is what causes hardening of the arteries very quickly. What made the news right now is Amgen’s drug, evolocumab and Sanofi and Regeneron Pharmaceuticals’ drug, alirocumab. The traditional thinking is that when you lower the bad LDL cholesterol you would save the patient from heart attacks and strokes. I have blogged about the cholesterol story and statins in November 2013 pointing out that statins can hurt the consumer. One concerning side effect of statin therapy is myopathy, a painful muscle disorder where statins have to be discontinued.

We need to be cautious about simplifying cholesterol blood results

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, 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).

LDL delivers cholesterol to vital organs

LDL cholesterol is actually an important cholesterol fraction that the body uses as transport molecule to all vital organs like the heart, the skeletal muscles and the brain to replace lipids in cell membranes. It is inappropriate to label LDL cholesterol as the “bad cholesterol”. This is an oversimplification.

The assumption in the recent past was that LDL requires a reduction to prevent heart attacks and strokes. But strictly concentrating on this could hurt patients because vital organs require enough nutrients to replace their cell membranes. Without cell membranes there is no life!

Some details about what causes heart attacks and strokes

I like to explain how heart attacks and strokes develop. At the center of the problem is how hardening of the arteries develops. In the 1990’s and in the next decade, from 2000 to 2010 detailed research into this has been completed. It has shown that free radicals have a lot to do with hardening of the arteries. There is not one single cause, but a combination of multiple factors that cause hardening of the arteries. One of the key facts is that people in civilized countries consume too much sugar and starchy food. The digestive process of the gut metabolizes starch into sugar, which the blood absorbs. In response to all this sugar the pancreas secretes an overload of insulin every day.

High insulin levels cause inflammation

The high insulin levels cause inflammation, which releases a number of aggressive molecules that attack the lining of the arteries. Sugar also oxidizes the LDL cholesterol and the HDL cholesterol, which makes the LDL cholesterol more aggressive as it now reacts like a free radical. Macrophages take up the oxidized LDL cholesterol; they turn into fat-laden foam cells, which in turn burrow themselves under the lining of the arteries. Normally the HDL cholesterol incorporates oxidized LDL cholesterol and brings this to the liver for further processing. However, sugar oxidizes HDL itself and it loses its protective function. The end result is that there is an acceleration of the hardening of the arteries and when this reaches a critical point, a heart attack or stroke can occur.

We need to rethink how to prevent heart attacks and strokes

What struck me with the FDA decision is that they seem to doggedly hold on to the hypothesis that heart attacks and strokes develop from LDL cholesterol that is too high. If this were the case, statins would have worked wonders in terms of preventing heart attacks and strokes, yet the number one killer is still hardening of the arteries. What I wrote in my blog in November 2013 is still true.

The solution to preventing heart attacks and strokes may not be attractive to some, but it is found in a proper diet and exercise.

These points are important

  1. We need to cut out sugar and starchy foods. This includes grains. Kellogg’s and cohorts won’t be happy nor will be your friendly baker or the bakery department in your supermarket.
  2. A Mediterranean diet is now the gold standard and adding olive oil and nuts to it will be even more effective in reducing mortality from heart attacks and strokes.
  3. Exercise has been proven to elevate HDL cholesterol significantly, so why not do less sitting and do more moving? When you cut out sugar and starchy foods, HDL is fully functioning and this keeps the LDL cholesterol honest. This means that only LDL without oxidation reaches the vital organs for membrane exchange work, while HDL removes LDL with oxidation like a sponge and inactivates it in the liver.

Misleading statin trials without diet changes

This is all: a three-point approach with no statins and no super statins. Big Pharma does not like this, but the three-point approach was proven to be effective for several years (Ref. 1, 2 and 3).

What I find particularly concerning is the fact that most of the super statin trials will only come out with the full results in 2017. We witness that the FDA has approved these new super statins to be used on the most vulnerable people (familial hypercholesterolemia) on top of regular statins. I fail to see how vital organs can function, if the diet is not changed.

CoQ-10 is essential as a co-factor

It also disturbs me that the average physician does not recommend CoQ-10 as a supplement to counter at least some of the side-effects of statins and super statins. There was no such recommendation. I feel that the FDA allows patients with familial hypercholesterolemia to be subjected to a human experiment of this nature. They are receiving drugs that we do not fully know yet. After 2017 we will know whether they have reduced heart attack and stroke rates or not.

Experiments On Humans With New Statin Drugs?

Experiments On Humans With New Statin Drugs?

Conclusion

I remember very well from the 1980’s what the suggestions were treating patients with high cholesterol. Cholesterol-lowering drug guidelines told practicing physicians to first assess the patient’s diet and exercise status. If modifying these lifestyle factors were ineffective, we would then only be using the statin drugs to lower cholesterol levels. In the meantime the scenario has changed and experienced a complete reversal in terms of diets. The high carb /low fat diet has been replaced with the low carb/medium fat Mediterranean diet, which by itself can be very effective in reducing LDL cholesterol. Recently research has shown that adding olive oil and nuts can lower mortality from heart attacks and strokes even more. It seems that the FDA is completely ignoring all this research.

History teaches us

I think that physicians and patients alike would do well to remember the following. It all started with the introduction of sugar, starchy foods and processed foods into the civilized world about 100 years ago. This caused an increase of heart attacks and strokes because of the processes explained above. The real solution is the 3-point program suggested above. This will likely solve 80% to 90% of all cases of hardening of the arteries causing strokes and heart attacks. Physicians treated the rest cautiously with cholesterol lowering drugs, like the statins; however, there is no room for human experiments.

More info on arteriosclerosis (hardening of arteries).

References

1. Dr. Steven Masley, MD: “The 30-day Heart Tune-Up – A Breakthrough Medical Plan to Prevent and Reverse Heart Disease”, Center Street, A Division of Hachette Book Group Inc. New York, Boston, Nashville, USA © 2014

2. 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.

3. William Davis, MD: “Wheat Belly Cookbook. 150 Recipes to Help You Lose the Wheat, Lose the Weight, and Find Your Path Back to Health”. Harper Collins Publishers LTD., Toronto, Canada, 2012.

Oct
04
2014

The Problem Are Sugar And Starchy Foods

By | Cancer, heart attack, Heart Disease, Nutrition, Stroke

Fareed Zacharia interviewed Chief Medical Correspondent Sanjay Gupta on CNN on Sept. 10, 2014 regarding why sugar is worse than fat.

I like to explain why it is important to rethink the issues of fat, cholesterol, sugar, starchy foods, longevity, prevention of cardiovascular diseases (strokes, heart attacks) and cancer.

I have blogged about this many times before, but perhaps an overview regarding these issues would be in order.

The Framingham Heart Study indicated first that too much cholesterol in our system was a problem leading to heart attacks and strokes (Ref. 3). As more research was done, the reasons for this have become clearer.

1.Liver metabolism

The liver plays a major role in the metabolism of glucose. Digestion of refined starchy foods starts in the mouth where amylase from the saliva digests the surface of the pasta or white bread you eat. The stomach carries on with this process and the job is finished in the small intestine with the help of pancreatic enzymes (Ref.1). This digestive process is so efficient that within 20 to 30 minutes all of the refined carbs from pasta, donuts and bread appear as sugar in the blood stream. The portal vein system that collects the nutrients from the gut delivers all sugar straight to the liver where it is reassembled into glucagon as the storage form in the liver and skeletal muscles. This would all be good, would we have periods of fasting in between our sugar consumption. Periods of famine are no longer part of modern civilization, but consumerism is. Most of the processed food contains sugar and this leads to excess sugar uptake, which has to be processed by our liver. The end result is production of LDL cholesterol, oxidization of LDL cholesterol by sugar and in the process the production of VLDL (=very low-density lipoproteins) that leads directly to deposits in the arterial walls and clogging of arteries. Triglycerides are also produced, which leads to fat deposits (the cause of the obesity wave all around us).

2. Where does the fat that we see around us come from?

In the past we thought that it was from too much saturated fat and cholesterol in the food that would have caused the accumulation of fat and cholesterol in the body. Now we know that this was an over-simplification. In fact more cholesterol and fat comes from metabolized sugar and with a slight time delay also from starchy foods.

Sugar and starchy foods (like pasta, white rice, white bread, potatoes, grapes, honey etc.) get metabolized by your liver into LDL cholesterol, triglycerides, and fat. This does not mean that you should not pay attention to the total fat content and the quality of fats you eat.

3. The finer points about subfractions of cholesterol

You have heard many times about the good (HDL) and the bad (LDL) cholesterol. Sugar and refined starches do not only lead to the production of LDL cholesterol, but also to oxidized LDL cholesterol, which is very aggressive (VLDL=very low-density lipoproteins) leading directly to deposits in the arterial walls and to clogging of arteries. Your doctor can order a detailed lipid profile test, if you belong into a higher risk group to determine your VLDL level.

It may surprise you to read that many of the foods that were demonized in the past 2 to 3 decades like whole eggs; unprocessed grass-fed red meat, coconut oil etc. are now seen to be good for you.

But there are provisos: supplement with molecularly distilled omega-3 fatty acids, have enough vitamin D3, vitamin K2 and calcium in your diet or supplement with these. This will make sure that calcium will leave the blood stream (not lead to arteriosclerosis) and enter into the bones where it is needed for healthy bone structure. The anti-inflammatory effect of vitamin D3 and of the omega-3 fatty acids will prevent arthritis, strokes, heart attacks and cancer.

The Problem Are Sugar And Starchy Foods

The Problem Are Sugar And Starchy Foods

4. Four major conditions causing heart attacks and strokes

According to Ref. 2 only 4 conditions have been proven over the years to lead to serious hardening of arteries causing strokes and heart attacks: dyslipidemia (high triglycerides, high LDL cholesterol and VLDL), hypertension, cigarette smoking, and/or diabetes (Ref. 3). What has not been appreciated until recently is the fact that sugar and refined starchy foods metabolized by the liver are the culprits in causing plaque in arteries as the oxidized LDL cholesterol is aggressively invading the arterial wall and is inflammatory. A total cholesterol level greater than 5.2 mmol/L (200 mg/dL) has been shown to be associated with increased heart attacks and strokes. Ref. 2 also points out that dietary changes; days of fasting and weight loss have all been shown to stabilize and reduce plaque lesions and reduce heart attacks and strokes. It is the rupture of unstable plaques that lead to attraction of platelets and thrombus formation. It is this localized thrombosis that leads to the closure of coronary arteries or brain vessels causing heart attacks and strokes. According to Ref. 2 there are 9 factors that determine whether we get a stroke or heart attack, the four factors mentioned above (dyslipidemia, hypertension, cigarette smoking, diabetes) and abdominal obesity, lack of physical activity, low daily fruit and vegetable consumption, alcohol overconsumption, and a psychosocial risk. This latter factor includes any kind of chronic stress like interpersonal stress at work or home, depression, financial stress, major life events like marriage, death, divorce, and lack of control. Counseling is useful for support regarding psychosocial risk factors. It is significant to note that according to Ref. 2 several studies have shown that 90% of heart attacks and strokes can be prevented by paying attention to these 9 risk factors. Managing stress effectively and seeking professional help for psychosocial difficulties as well as avoiding the  physical health risks will contribute to good allover health.

Conclusion

Where does this leave us? For decades we have been told that saturated fats and cholesterol in our diet were the culprits and we replaced them with sugar that is part of a low-fat diet. We need to pay attention to the glycemic index and cut out high glycemic foods. However, it is OK to eat some carbs from the medium glycemic food list and most of our carbs from the low glycemic food list. With regard to fat it is important to consume only the healthy fats including omega-3 fatty acids. By taking care of the 4 major causes of heart attacks and strokes and also attending to the additional minor contributors mentioned above you will be able to eliminate 90% of the cardiovascular events. As you change these things you will also prevent many cancers as you changed the body metabolism and chronic inflammation has been taken care of as well as I pointed out in several blogs before. Finally, pay attention to stress management. The body and mind work together.

I have discussed all of these items in detail in my book as well (Ref. 3).

More information on high density and low density carbs: http://nethealthbook.com/health-nutrition-and-fitness/nutrition/carbohydrates/

References:

1.Townsend: Sabiston Textbook of Surgery, 19th ed.,Copyright 2012 Saunders.

2.Melmed: Williams Textbook of Endocrinology, 12th ed.,Copyright 2011 Saunders.

3. Dr. R. Schilling: “A Survivor’s Guide to Successful Aging“. Paperback through Amazon.com, 2014.

Last edited Nov. 8, 2014

Apr
05
2014

Yes, There Are Healthy Sugar Substitutes

By | Cancer, Diabetes, Heart Disease, Nutrition, Obesity, Prevention, Weight loss

It is true that sweets are not good for you because they lead to fat accumulation and to diabetes. I explain how this works later in this blog. But who says you cannot sweeten your life with healthy ingredients? Not all sugar substitutes are the same; some are awful, some are in between and one is good (see below).

General information why sweets and starches are bad for you:

There is a triple whammy from sweets that you don’t really want:

a) First, sugar gets absorbed really fast through the gut wall and arrives in your blood stream within 15 to 20 minutes. Starches can be just as powerful in terms of blood sugar surges, but it takes perhaps 30 to 40 minutes for the peak of blood sugar to occur. The end result is the same: whether you load up with a pizza, a doughnut or drink a large, sugar-loaded soda drink, your pancreas reacts the same way. It produces a lot of extra insulin to bring the blood sugar level down. When you do this day after day your pancreas gets used to overproducing insulin and you develop insulin resistance meaning that your insulin receptors that are on every cell surface get tired and become less sensitive to insulin. Due to insulin resistance the muscle cells and the liver cells do not take up sugar (in the form of glucose) as easily as before.

b) Second, because excess sugar cannot be stored as glycogen (the storage form of glucose in the liver and the muscles), the liver converts excess glucose into triglycerides and oxidized fatty acids get taken up by white blood cells called macrophages. These attach to the inner lining of the arteries and lead to atheromatous plaques, the first stage of hardening of the arteries.

c) Third, glucose is an oxidizing agent that will oxidize LDL cholesterol. This makes the LDL particles much denser and forms the so-called very dense LDL lipoprotein fraction (VDLDL) that can be detected in special blood tests (Ref.1).

Not surprisingly people who consume sugar, sweets, soft drinks and starches on a regular basis will have very dense LDL particles (=VDLDL, also called “pattern B-LDL”). The treatment for this is to quit sugar and starchy foods.

I have explained in more detail what sugar does in this blog.

Yes, There Are Healthy Sugar Substitutes

Yes, There Are Healthy Sugar Substitutes

The food industry’s answer to low carb diet drinks and low sugar foods:

Many years back the food industry decided to offer alternative diet drinks that would not contain sugar, but instead have aspartame in it.

Dr. Blaylock has researched excitotoxins like MSG and aspartame (NutraSweet) and urges you in this link to abandon both. I agree with him. But while we are at it, don’t take other artificial sweeteners like sodium cyclamate in Canada (Sweet’N Low). Are you thinking of taking sucralose (Splenda) instead? Think again. What the industry seems to have forgotten is that it was originally developed as an insecticide. This website states that sucralose was actually discovered while trying to create a new insecticide. A researcher tasted it and found it exceedingly sweet. I have done the experiment myself in Hawaii where small ants are ubiquitous. I thought I take a package of Splenda from a coffee shop and do the experiment: In the beginning the ants were reluctant to eat it, but after a few hours they came and took it in. One day later there were only shrivelled up dead ants left in the area where Splenda had been sprinkled. Proof enough for me that Splenda was developed as an insecticide!

In the Splenda marketing scheme they decided to first introduce Splenda gradually into diabetic foods as a sweetener, then later sell it to the public at large. Don’t fall for it. It was a side product of insecticide research, and insecticides have the undesirable quality of being xenoestrogens, which block estrogen receptors in women. As a result of that estrogen can no longer access the body cells, including the heart. The final consequence for a woman is a higher risk for cardio-vascular disease. This can cause heart attacks, strokes and cancer. In men estrogen-blocking xenoestrogens can cause breast growth and cause erectile dysfunction.

The natural sweeteners:

One wonders why the food industry did not choose healthy sweeteners like stevia that has been used for decades in Japan and South America.

Other sweeteners like xylitol, sorbitol, maltitol, mannitol, glycerol, and lactitol are sugar alcohols. Contrary to what many believe they have calories, but much less than sugar, so they are perceived as “safe” as a dietary supplement for weight loss. These alcoholic sugar compounds still produce partial LDL oxidization; interfere with weight loss and still lead to a certain insulin response.  Stevia, a natural sweetener from a leaf of South America is safer and without any calories.

The key is that stevia will not oxidize your LDL cholesterol and will not cause a hyperinsulinism response following a meal. It is metabolically neutral. It is the ideal sweetener for people who desire to lose some weight. It is also safe as it is no excitotoxin. The FDA has recognized stevia as “generally recognized as safe” (GRAS).

What about fructose, agave syrup, honey, brown rice malt syrup, fruit juice concentrates, refined fructose, maple syrup?

The problem is that they are all sugars, which cause a full insulin response leading to obesity, diabetes and hardening of the arteries. This causes heart attacks and strokes. These natural sugar products also oxidize LDL cholesterol, which initiates plaque formation as discussed above; this is the first step leading to hardening of the arteries. It took the medical profession 30 years of observing that a low fat/high carb diet makes us fat and causes heart attacks, leads to strokes and causes diabetes. Let’s not make the mistake of trusting the food industry and mindlessly swallow so-called natural other sugars and sugar substitutes like xylitol, sorbitol, maltitol, mannitol, glycerol, and lactitol. You may want to chew the odd gum with xylitol, as this will prevent cavities in your teeth. But otherwise it is much safer to just stick to Stevia to sweeten your tea, coffee or food. There are brands that are less bitter than regular stevia products, like stevia from New Roots in Canada and stevia from KAL in the US (no, this is not a commercial, it is based on my own observations).

Conclusion:

Sugar is an emotional topic that can get people caught up in heated discussions. The sugar industry and the sugar substitute industry have also powerful lobby groups that provide the Internet and the popular press with conflicting stories to convince you to buy their product. This blog was meant as a no-nonsense guide to get you removed from the high-risk group of candidates for heart attacks, strokes or diabetes. Let’s not forget the metabolism behind the various sugars and starchy foods described above, which I have explained in more detail in my recently published book (Ref.2). Forget the emotions of severing yourself from your favorite fix and stick to a tiny amount of stevia that can replace the familiar sweet taste that you have become accustomed to from childhood onward. At least this is what I do. The only alternative would be to take the plunge and cut out any sweet substance altogether, which I am not prepared to do. If you can do it, by all means go ahead.

More information on carbohydrates: http://nethealthbook.com/health-nutrition-and-fitness/nutrition/carbohydrates/

 

Reference:

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

2. Dr. Ray Schilling: “A Survivor’s Guide to Successful Aging“, Amazon.com, 2014

Last edited Nov. 7, 2014