Cardiovascular Disease – In the News – Part 2

by Judith A. DeCava, C.N.C., L.N.C.

Scientific studies aren’t always what they seem. For example, a recent study seemed to show that eating a high-fat meal is more stressful to the heart and blood vessels than a low-fat meal. Researchers looked at how the hearts and blood vessels of 30 undergraduate students (aged 18 to 25) reacted to psychological stress after they ate either a high-fat meal or a low-fat meal. It was concluded that eating a high-fat meal increased cardiovascular reactivity to stress. Did the study prove this? Not really.

It’s all in the details. The high-fat meal was a McDonald’s breakfast of 2 hash brown patties, a Sausage McMuffin and an Egg McMuffin. The low-fat meal consisted of Kellogg’s Frosted Flakes, skim milk, Source fat-free yogurt, a Kellogg’s Fruit Loops fruit bar, and Sunny Delight orange juice. Yuk on both counts! Neither meal was nutritionally sound. Both meals contained ingredients that could adversely affect the cardiovascular system. The only thing the study proved was that trans fats, other altered fats and denatured proteins place more stress on the cardiovascular system than do refined carbohydrates. The high-fat meal was simply a bit worse than the high-refined carb meal. [i]

FOOD AND NUTRIENT FINDINGS

Foods and nutrients affect the blood vessels and heart. They can prevent and help or cause and worsen problems. Fruits and vegetables are good for your heart and blood vessels. No surprise? Ah, but now there are scientific studies that prove it! A multiyear study of more than 100,000 people showed that the more fruits and vegetables people ate, the less their cardiovascular risk. An analysis of 9 studies involving a total of 91,379 men and 129,701 women showed that fruit and vegetable consumption lowered the risk of heart disease. Researchers are looking at hundreds of plant nutrients and ingredients from fruits, vegetables, tea, wine, nuts, seeds, herbs, and spices. Many of these components are lower in patients with cardiovascular disease than those without it.

Vitamin C complex is one of the most important nutrients needed to support the strength, integrity, and flexibility of blood vessel walls and heart muscle function. Researchers in the Netherlands found that a higher level of ascorbic acid, a part of the vitamin C complex that “marks” fruit and vegetable intake, was associated with lower risks for vascular disease. Ascorbic acid is the protective “shell” for more functional parts of vitamin C complex. It’s been known for over 30 years that a deficiency of vitamin C is one of the causes of high cholesterol levels. Vitamin C is needed to improve gallbladder function so fats and cholesterol can be properly processed. It helps raise HDL levels, prevent premature rancidity of fats, and supports the inflammation and repair processes.

Whole grains have cardioprotective benefits. Many nutrients and phytochemicals in whole grains are low or absent in refined grains—like vitamin E complex, many minerals, folate and other B vitamins. Overweight people with elevated cholesterol and blood pressure were instructed to substitute whole grains for refined grains for 5 weeks. Their blood pressure dropped and, even though they were eating an average of 100 more calories a day than the American Heart Association diet they were on before, they still lost an average of 2.2 pounds. Another study found that men who ate the most whole grains had an 18% to 30% lower risk of heart disease compared with those who ate the least. Women with atherosclerosis who ate more whole grains fared better than those who ate less.

Various nuts—walnuts, almonds, macadamia, pine, whatever—do more than a standard low-fat diet to reduce the risks of cardiovascular disease and help maintain healthy tissues. Seeds—sunflower, sesame, flax, pumpkin, etc.—also show cardioprotective effects.

Medicinal plants—“herbs” to most of us—have beneficial effects for preventing and treating heart disease. Included are German chamomile, plantain leaf, peppermint, yarrow, St. John’s wort, nettles, and many others. Cayenne stimulates the heart and circulatory system; it can help lower blood pressure, reduce angina, and smooth out arrhythmias. Cilantro has been used in traditional medicines to relax muscles and enhance proper fat uptake and breakdown. Garlic can lower blood pressure, increase blood flow, inhibit blood clot formation, protect against LDL oxidation, decrease artery wall thickening, improve artery wall cell health, and decrease the effects of atherosclerosis. Garlic got some bad press because it didn’t lower the so-called “bad” LDL cholesterol. But it has the documented ability to inhibit and even reverse buildup of plaque in the arteries. That’s more significant than lowering LDL! Hawthorn has long been used for angina; inadequate valve function; palpitations; inflammation of heart muscle, valves, lining, or membrane coverings; rapid heart rate; cardiac nerve pain; and rheumatism of the heart. Studies have shown that it can reduce blood pressure and anxiety, decrease heart rate, improve cardiac pressure, reduce abnormal heart rhythms, and improve circulation.

For a while it was thought that soy protein in items like veggie burgers and soy milk could lower blood cholesterol and thus lower the chance of developing heart disease. But the evidence is “much weaker” than previously believed.

Omega-3 fatty acids are consistently linked with decreases in risks of developing cardio-vascular disease or dying from it. Studies have found anywhere from a 30% to an 80% reduced risk. Low levels of omega-3s are linked to increases in risk. For one thing, omega-3s enhance blood flow by relaxing open the arteries. A large clinical trial in Japan found omega-3s to be a “promising treatment for prevention of major coronary events.” Analyses of studies indicate that omega-3s should be consumed to help prevent cardiovascular disease, treat cardiovascular disease after a heart attack, and prevent a second heart attack. Wild fatty fish; grass-fed beef; poultry or pork from naturally-raised animals; eggs from free-range chickens or ducks; leafy green vegetables; flaxseeds; walnuts; and some seaweeds are good sources. So is cod liver oil which can lower triglycerides, overcome arrhythmias, and reduce the chances of dying from a heart attack. It may make the difference between walking out of a hospital after a heart attack and being carried out in a body bag. It works much better than a defibrillator in lowering death rate. As Dr Sherry Rogers says, “You can electrocute a heart all you want, but you are not going to bring it back to life if it doesn’t have the right chemistry.”

GLA (gamma linoleic acid), an omega-6 fat, may increase artery wall strength and lower cholesterol, triglyceride, LDL and VLDL (so-called “very bad”) cholesterol levels. GLA is found in green leafy vegetables, and borage, black currant seed or evening primrose oils.

Calcium regulates many cellular processes that function abnormally in people with cardio-vascular disease. Both low and high calcium levels may occur. When calcium and vitamin D intake is low, calcium can shift from the bone to soft tissue and from outside to inside cells. This shows up as “excess” calcium when there is really a deficit. Calcium is used like cement in blood vessel walls to reinforce them when they’re weak (hardening of the arteries). Then calcium is blamed for causing problems when it may actually be preventing a crisis! Supplementing with calcium also decreases total and LDL cholesterol.

A deficiency of magnesium increases risk for cardiovascular disease, heart attack, and sudden cardiac death. People having a heart attack are often deficient. Magnesium helps to relax and dilate arteries, improve oxygen delivery, and alleviate arrhythmias. It can reduce angina and coronary “events.” Unfortunately, large doses of separated magnesium have been used like a drug after heart attacks have occurred. This can cause imbalances that adversely affect the cardiovascular system, so this drug-like use is controversial.

Potassium is protective too. In one study, cardiovascular death was 41% lower in people getting potassium. Other studies have shown that increasing potassium intake lowers blood pressure in people with hypertension and reduces incidence of stroke. Potassium enhances heart muscle metabolism and regulates blood pressure, preventing both high and low pressure. Very low selenium (a part of vitamin E complex) can increase heart disease risk. Adequate intake may improve blood fluidity. Low levels of zinc are often found in people who have heart attacks. The susceptibility of blood vessel linings to damage by bad fats (trans fats, refined oils) may increase with low levels of zinc. But taking large amounts of separated zinc can disturb blood fat levels. This may be due to low copper levels caused by taking too much zinc. Real food does not cause such imbalances.

People fed a diet low in copper have increases in LDL and decreases in HDL cholesterol. These changes reverse after they get copper. High serum copper may up the risk for heart attack, but the serum may not reflect copper intake or organ levels. Animal experiments show that high serum copper may actually mean low intake. Inadequate chromium increases risk for artherosclerosis. High intake of iron has been blamed for increased incidence of heart attacks, but this seems mostly due to taking large amounts of non-food iron in supplements or ‘fortified’ foods, not from real foods. Also, taking large amounts of ascorbic acid abnormally increases iron absorption.

Vitamins C and E complexes work together to protect artery walls. But using parts—like d-alpha tocopherol rather than whole vitamin E complex—doesn’t show benefits. Vitamin C complex is needed for vitamin E to function effectively. Vitamins B1 (thiamine) and B2 (riboflavin) improve relaxation and opening of blood vessels. B6 (pyridoxine) helps reduce blood pressure. Other B vitamins and nutrients like calcium, potassium, boron and zinc may strengthen and promote flexibility in artery walls and heart muscle while improving nerve function. Vitamin K—as in green vegetables—is now thought to contribute to heart health, helping to slow hardening of the arteries. Most Americans don’t consume enough.

People with low blood levels of carotenes such as lutein and zeaxanthin may be at greater risk for coronary artery disease. Egg yolks, yellow corn, kale, spinach, romaine lettuce, broccoli, kiwi, and Brussels sprouts are some good sources.

Coenzyme-Q10, found in most natural whole foods in small amounts and manufactured by healthy cells, may improve heart muscle performance, lower blood pressure (if high), and prevent breakdown of LDL (accused of causing atherosclerosis). Co-Q10 supports energy production in all cells and has “a remarkable affinity to protect heart cells that are deficient in oxygen.” Co-Q10 ignites the spark that generates ATP, the main source of cellular energy. When blood flow to the heart is reduced, oxygen needed for producing energy is also reduced—it’s called ischemia. When this happens, ATP production goes down and may remain so for a long time. Co-Q10 is needed to spark the production of ATP. Guess where Co-Q10 was first found and identified? In beef heart. Glandular (heart) supplements may thus be a wonderful source.

The brain needs glucose (blood sugar) to make energy, but the heart needs—guess what?—fats! More than 60% of the energy of the heart comes from burning fats. L-carnitine is like a train that shuttles in the fatty acids that are burned as fuel in the “energy factories” (mitochondria) of heart cells. Most muscle cells have about 250 mitochondria, but the heart has about 5,000, all needing to be ‘fed’! Fatty acids are essential for energy and L-carnitine is necessary to burn those fats efficiently. The best source of L-carnitine is mutton, followed by beef, pork, and lamb.

D-ribose is a complex sugar that begins the process of ATP (energy) production. It is the carbohydrate part of DNA and RNA (ribonucleic acid), B2 (riboflavin), and is core to the production of many essential metabolic compounds. It occurs naturally in all living cells, including raw whole foods.

Cells inside blood vessels release nitric oxide (NO) which helps blood vessels to relax, to stay flexible, and boost blood flow. Some people make less NO as they age. When there isn’t enough, blood vessels may constrict and become less flexible, contributing to angina, high blood pressure, and inflammation (susceptibility to injury). An amino acid, arginine, is used to make NO, so there are many arginine supplements on the market from candy bars and drinks to tablets and capsules. But the benefits of these supplements are uncertain. “Increased amounts of isolated amino acids can create imbalances with other amino acids and thus have adverse effects.” A recent study raised questions like why there was a small increase in the death rate of people who had had heart attacks and were given arginine supplements. Taking large amounts of arginine by itself can result in production of a very unstable NO that could cause problems. Gamma-tocopherol—a part of vitamin E complex absent from most “vitamin E” supplements—scavenges such unstable compounds. But taking alpha-tocopherol (the “vitamin E” of most supplements) could cause a deficit of gamma-tocopherol, reversing the hoped-for benefits of L-arginine. There’s a better way! Nutrients “function in the body as a team”—and that’s the way they appear in real foods. Nuts, dairy products, poultry, and fish are among the foods rich in arginine. Other foods such as leafy greens, whole grains, red wine, dark chocolate, and omega-3 fats also raise NO and/or help maintain blood vessel health. Exercise helps restore NO production too.

SUPPLEMENTS THAT FAIL

Several studies have shown that other supplements fail to help cardiovascular disease. For example, although folate and vitamins B12 and B6 are needed to lower homocysteine (considered a risk factor for heart disease and stroke) separated, manufactured versions don’t work very well! In two recent studies, people who took the chemical vitamins had a decrease in blood levels of homocysteine, but no decrease in heart attacks or stroke or death from cardiovascular disease. In one study, the risk was actually slightly higher than it was for people taking a placebo. The synthetic vitamins performed more as drugs, lowering homocysteine, but they didn’t get to the underlying causes. Manufactured imitation parts can’t give the cells the nutrients found in real food.

An analysis of multiple studies looked at the effect of isolated, synthetic folic acid on the risk of cardiovascular disease. The vitamin decreased homocysteine concentration, but had no effect on risk for cardiovascular disease or all-cause death. A group of doctors suggested that homocysteine is a marker for disease rather than an independent risk factor. Put another way, high homocysteine is probably an effect, not a cause.

Vitamin E—at least its former definition as d-alpha tocopherol—has been “tested” in many studies with “mostly null results.” A study that looked at d-alpha tocopherol and ascorbic acid (so-called “vitamin C”)—both separated parts—showed that they did not offset the progression of hardening of the arteries. Yet people with diets rich in vitamin E complex—the real deal in whole grains, unrefined oils, green vegetables, egg yolk, liver, etc.—appear to enjoy protection from cardiovascular disease.

Other unnatural un-nutrients, when studied, also don’t seem to work. Whether synthetic beta-carotene, folic acid, B12, B6, vitamins A, E, and C; inorganic minerals (those not in food-form)—they don’t help prevent or slow the progression of cardiovascular disease. Healthful foods which include these same nutrients in their collective natural ensembles do offer protection. Authentic, functioning, integrated complexes in real foods work! [ii]

CHANGE IS SLOW

In the OmniHeart trial, participants ate “a healthy, fruit-and-vegetable-rich diet” three ways. One group ate more protein (mostly from fish, poultry, beans, and tofu), one group ate more fat (mostly from olive or canola oil or nuts), and one group ate more carbohydrates (mostly desserts and other refined carbs). The higher-protein and higher-fat diets won over the higher-carb diet as far as cardiovascular disease risk. The researchers were surprised. We weren’t. The extra refined sugars in the high-carb diet were no doubt detrimental.

Another surprise from the study was that both the higher-protein and higher-carb diets lowered HDL (so-called “good”) cholesterol—the one we’re told should be high. But HDL stayed steady on the higher-fat diet. Oh dear. Does this mean that more protein is as bad as refined carbs because it lowers “good” cholesterol? Well, “experts aren’t certain that a drop in HDL is always bad.” What? “Some populations with low HDL levels have no heart disease,” says Lawrence Appel of Johns Hopkins School of Medicine. “HDL is so complex that we try to base our advice to the public on LDL and blood pressure.” And: “We still saw a substantial net reduction in overall heart disease risk on the higher-protein diet.” Wait a minute! We’ve been told that our HDL level should be high, but now we’re informed that low HDL is okay, that it doesn’t mean you’ll develop heart disease. HDL is “complex.” Isn’t LDL “complex” too? What next? Maybe LDL doesn’t have to be low.

A review of 1,214 studies found no evidence to support the idea that ultra low LDL (70 mg/dL or lower) is a good thing. Too low LDL is linked to depression and anxiety, messes with serotonin and other things in the brain. Okay, since total cholesterol was deemed less important than believed, then the ratio between HDL and LDL was supposed to be most important. Now HDL doesn’t have to be as high as thought, and LDL shouldn’t be too low, so the ratio between HDL and LDL can’t be that important either. Could it be that the whole cholesterol thing is not really a big problem?

“Together, the data suggest that blood cholesterol is not a major determinant of mortality in patients with heart diseases.” Evidently, only “certain categories of patients” need to lower blood cholesterol. Many factors contribute to heart disease. And individuals are all different. “In my opinion,” says Michel De Lorgeril, MD, “no biochemical marker [like cholesterol] can actually give a good idea of the risk of heart attack at the individual level.” Instead, a doctor should learn as much as possible about a person’s history and lifestyle as well as dietary habits—“because dietary habits are the main risk factor…”

Even so, statins—cholesterol-lowering drugs—are recommended for 36 million Americans, “most of whom do not yet have but are estimated to be at moderately elevated risk of developing coronary heart disease.” Three-quarters of those taking statins don’t have any evidence of cardiovascular disease. The current guidelines for these drugs are based on the assumption that cardiovascular risk is a continuum—an inevitable progression that leads to disaster (like a heart attack or stroke). It’s also based on the assumption that cardiovascular risk can be accurately predicted. Both assumptions are far from being proved. Same goes for the assumption that increased blood cholesterol causes heart disease. How cholesterol and blood fats are processed in the body “is very complex and not completely understood,” and there is no consensus on which changes in cholesterol or blood fats “are most relevant.” Sigh. Add to this the bad side effects of statins!

One thing that can raise cholesterol levels is Teflon, as in your sauté pan. As Teflon levels slowly accumulate in the body, they damage genes such as those involved in processing fats, leading to high cholesterol that resists treatment, even by drugs. Apparently, the only way to fix it is to get the Teflon out of your body. Isn’t it ironic that people use non-stick Teflon cookware so they can use less fat to keep their cholesterol levels down? [iii]

A supplement protocol that supports the heart and blood vessels may include:

Just Before Two Meals: After Two Meals: After One Meal:
2 Cardio-Plus (break in mouth)
2 Vasculin (break in mouth)
1 Cataplex C (break in mouth)
1 Cyruta-Plus (break in mouth)
1 SP Green Food
1 Tuna Omega-3 Oil
1 Hawthorn (MediHerb)
1 Garlic capsule

[i] Fabijana Jakulj, Dristin Zernicke, et al, J Nutr, Apr 2007, 137(4):935-9.
[ii] Tufts Univ Health & Nutr Lttr, Feb 2005, 22(12):1-2 & Apr 2005, 23(2):1-2 & May 2005, 23(3 suppl):1-4; FJ He, CA Nowson, et al, J Hum Hypertension, 19 Apr 2007, Epub ahead of print; L Dauchet, P Amouyel, et al, J Nutr, Oct 2006, 136(10):2588-93; J Lin, KM Rexrode, et al, Am J Epidemiol, 22 Mar 2007, Epub ahead of print; K Fassbender, D Lutjohann, et al, Atherosclerosis, 28 Nov 2006, Epub ahead of print; Sherry Rogers, Total Wellness, Jan 2007:4 & May 2007:5 & June 2007:1; P Mink, C Scrafford, et al, Am J Clin Nutr, Mar 2007, 85(3):895-909; KD Ahuja, IK Robertson, et al, Eur J Clin Nutr, 23 Aug 2006, cited in Second Opin, Feb 2007, 17(2):4; Gina Nick, Townsend Lttr, Feb/Mar 2007:65-6; SM Boekholdt & MC Meuwese, Br J Nutr, 2006, 96(3):516-22; KM Behall, DJ Scholfield, et al, J Am Diet Assoc, 2006, 106(9):1445-9; What Doctors Don’t Tell You, Sept 2006, 17(6):4, citing Ann Intern Med, 2006, 145:1-11; Clinical Pearls, 8 Aug 2006:9-10, citing C Lidebjer, P Leanderson, et al, 2006; D Martirosyan, M Belyavski, et al, HerbalGram, Spring 2005, 66:68-9; Mark Blumenthal, HerbalGram, May-Jul 2007, 74:6; R DeCaterina, A Zampolli, et al, Am J Clin Nutr, Feb 2006, 83(2 suppl):421S-6S; TL Halton, WC Willett, et al, N Engl J Med, 2006, 355(19):1991-2002; L Gillen, LC Tapsell, et al, J Am Diet Assoc, 2005, 105:1087-96; DB Panagiotakos & C Pitsavos, Intern J Cardiolog, 2005, 102(3):403-9; B Walser, RM Giordano, et al, Eur J Appl Physiol, 2006, 97(3):347-54; R Jarvinen, P Knekt, et al, Br J Nutr, 2006, 95(4):824-9; WS Harris, KJ Reid, et al, Am J Cardiology, 2007, 99(2):154-8; G Zhao, PM Kris-Etherton, et al, Am J Clin Nutr, 2007, 85(2):385-91; C Adams, HealthKeepers, Spring 2005, 7(2):8-13; M Yokoyama, H Origaso, et al, Lancet, 31 Mar 2007, 369(9567): 1090-8; UC Berkeley Wellness Lttr, Mar 2005, 21(6):4; BS Kendler, J Cardiovasc Nurs, 2006, 21(1):9-16; Richard A Passwater, Interview with Dr. Stephen Sinatra, Whole Foods Mag, Part 1 Feb 2004, Part 2 Mar 2004, Part 3 Apr 2004 Part 6 Aug 2004:3; Fred L Crane, Whole Foods Mag, Part 1 of interview, VitaSearch, Epub May 2007; Melvyn Werbach, Townsend Lttr D&P, Part 1, Feb/Mar 2006, 271/272:147-8, Part 2, Apr 2006, 273:115-6; S Hughes & S Samman, J Am Coll Nutr, 2006, 25(4):285-91; Maret Traber, Am J Clin Nutr, Jan 2007, 85(1 suppl):293S-9S; R Abdulad, H Koyama, et al, Biol Trace Elem Res, 2006, 112(1):87-96; S Arora, A Lidor, et al, Ann Vasc Surg, 2006, 20(5):653-8; C von Schacky & WS Harris, Cardiovascular Res, 2007, 73(2):310-15; Robert Rowan, Sec Opin, Oct 2006, 16(10):8; Alan Gaby, Townsend Lttr, Nov 2006, 280:45, citing HY Chang, et al, Am J Clin Nutr, 2006, 83:1289-96; Environmental Nutr, Oct 2006, 29(10:12; Alan Gaby, Townsend Lttr, June 2006, 275:27-8; SP Schulman, et al, JAMA, 2006, 295:58-64; Julian Whitaker, Health & Healing, Jun 2007, 17(6):7-8.
[iii] Heart Outcomes Prevention Evaluation (HOPE) 2 Investigatiors, N Eng J Med, 2006, 354:1567-77; KH Bonna, I Njolstad, et al, N Eng J Med, 2006, 354:1578-88; LA Bazzano, K Reynolds, et al, JAMA, 2006, 296(22):2720-6; F Dentali, M Gianni, & W Ageno, JAMA, 11 Apr 2007, 297(14):1549-50; Altern & Complem Ther, Apr 2006, 12(2):54; Meir Stampfer, Erick Rimm, & Walter Willett, Lancet, 15 Apr 2006, 367(9518):1237-8; Y Arad, LA Spadaro, et al, J Am Coll Cardiol, 5 July 2005, 46(1):166-72; GD Smith, S Ebrahim, Lancet, 12 Nov 2005, 366(9498):1679-81; J Bleys, E Miller III, et al, Am J Clin Nutr, Oct 2006, 84(4):880-7; D McCormick, Am J Clin Nutr, Oct 2006, 84(4):680-1; Michel DeLorgeril, interview by K Hamilton, VitaSearch, Epub 12 March 2007; J Abramson & JM Wright, Lancet, 20 Jan 2007, 369(9557): 168-9; Peter L Zock, Am J Clin Nutr, Feb 2007, 85(2):331-2; Sherry Rogers, Total Wellness, May 2007:6.

© 2007, Judith A. DeCava

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