Dec
08
2018

Not Exercising Is More Risky For You Than Smoking

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

The study

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

No ceiling of the benefit of exercise

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

Comments about the study

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

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

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

 

The STABILITY trial

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

A lack of exercise causes a lot of chronic diseases

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

Poor lifestyle in general causes diseases

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

High blood pressure reduced by regular exercise

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

Regular exercise and diet change to prevent type 2 diabetes

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

Not Exercising Is More Risky For You Than Smoking

Not Exercising Is More Risky For You Than Smoking

Conclusion

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

Sessile patients

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

Oct
27
2018

Four Diseases Cause Most Of The Deaths

Four diseases cause most of the deaths around the world: cancer, cardiovascular disease, chronic respiratory diseases and diabetes. This story is the news right now. 50% of the 193 UN member states that signed a treaty in 2015 are falling short of their promise. They wanted to reduce premature deaths from these diseases by 2030. But this is not happening as this story shows.

I like to review these 4 key diseases and what we can do ourselves about eliminating them. We cannot afford to wait for things to happen on a national level. Rather we need to go to the grass roots of every country and change the risk factors that cause these 4 diseases.

Cancer

First, cancer is a disease of older people, unless strong genetic factors are present. In this case even children can get leukemia, brain tumors and osteogenic sarcoma. In older people DNA mutations and DNA breaks happen more often as we age. On the other hand, if we diagnose cancer in stage 1 or 2 (in the early stages), it is quite often curable.

Oncoblot test, a cancer screening test

Probably one of the less known new criteria is the fact that there is a very sensitive cancer blood test, called the Oncoblot test (released about 4 years ago by the FDA). The latest screening test that came out of the human genome project is called the Oncoblot test. It screens for 25 of the most common cancers. And it is screening for ENOX2 proteins from cancer cells. It is a 1000 USD test in the US that health plans will not cover, but it will screen for more than 25 different common cancers 6 to 8 years before they would otherwise become clinically manifest.

If you discover cancer with this early blood test and you treat it right away, you have a good chance to live a few years longer. You may come down with another cancer down the road, but treat it early again, and you will still have a better life expectancy. Remember: four diseases cause most of the deaths, cancer is one of them!

Cardiovascular disease

Furthermore, people develop cardiovascular disease from poor eating habits and a lack of regular exercise. There are a few percentage points of people with familiar high cholesterol. These people need to see their family doctor for a prescription to lower cholesterol. But the majority of people will do well by changing their diet into a Mediterranean diet; lose weight until their body mass index reaches a value of 21 to 24. With this diet it is important to cut out all refined sugar and starchy foods. Regular exercise in a gym will also prevent hardening of the arteries. Chelation therapy has been shown in this study to help reduce hardening of arteries.

Diabetes patients have accelerated hardening of the arteries

We know from diabetic patients who have accelerated hardening of the arteries how devastating cardiovascular disease can be. Heart attacks, strokes, kidney failure, amputations of the lower leg and blindness are just some examples. Even patients who do not have diabetes can get these complications at an older age. The key is to think preventatively, change the diet, exercise regularly and you will lower all those risks. Remember: four diseases cause most of the deaths; cardiovascular diseases belong to that group and are a major player.

Chronic respiratory diseases

There are different reasons why a person may develop chronic respiratory disease. A common disease is chronic obstructive pulmonary disease (COPD). COPD often has a link to smoking heavily as a younger person. This is where the damage to the lung tissue has started. Exposure to cigarette smoke leads to loss of elastic tissue in the bronchial tubes. The lungs have a difficult time to exhale to get rid of the CO2. The end result is that your breaths are shallow and you can’t get enough oxygen, because the lung is already filled with air.

Asthma and COPD

Another disease is asthma. Nowadays physicians can treat this condition well with a corticosteroid inhaler and salbutamol. Salbutamol dilates the airways by relaxing the muscles of the bronchial tubes. The corticosteroid keeps the lining of the bronchial tubes thin, so that the air can move in and out of the lung.

If asthma is not treated properly there can be permanent damage to the airways and the clinical picture would look similar to COPD.

With end-stage COPD patients the only therapy the physician can offer is continuous oxygen flow treatment. With power failures these machines that supply oxygen will stop working. People need to make provisions to have a back-up generator. Again, we need to remember: four diseases cause most of the deaths. Chronic respiratory diseases belong to them.

Diabetes

Patients with type-2 diabetes (Type 2 DM) are usually older than 30 years of age.

That’s why they are called “mature onset diabetes” or “adult onset diabetes”. For several decades a patient may “incubate” diabetes and have one or more of the diabetes risk factors, such as high blood pressure, obesity, high cholesterol or high triglycerides, but have normal blood sugars.

Physicians have followed patients like this for several decades in the well known Framingham Heart Study and found that a high percentage of them do come down with type-2 diabetes later in life. In the past this time of incubation was termed “pre-diabetes”. Now we call it “syndrome of insulin resistance” or “metabolic syndrome”. Diabetes belongs to the group of diseases that are associated with chronic inflammation in the body.

Causes of type-2 diabetes

Type-2 diabetes often associates with other endocrinological diseases such as Cushing’s syndrome (an adrenal gland hyperactivity) or acromegaly (increased growth hormone production). In these diseases other hormones are tilting the hormone balance by counteracting insulin thus leading to a relative shortfall of insulin, which is another cause for type-2 diabetes. There is confusion among scientists regarding possible genetic reasons for type-2 diabetes. The environment or weight gain may trigger various genetic loci that exist. The syndrome of insulin resistance has shown some connections between hypertension, obesity and type-2 diabetes.

Death in diabetics usually comes from a heart attack, a massive stroke, but it may also come from systemic infections, called sepsis. Dr. Taylor from Newcastle University showed on 30 volunteers that 43% of diabetics could be cured by a diet of 600-700 calories for 8 weeks. The medical literature also knows that regular exercise is beneficial for diabetics. It cannot be overstressed that four diseases cause most of the deaths; diabetes belongs to them and is a major player.

Four Diseases Cause Most Of The Deaths

Four Diseases Cause Most Of The Deaths

Conclusion

Four diseases cause most of the deaths. They were the cause of death for several years. They are cancer, cardiovascular disease, chronic respiratory diseases and diabetes. The secret is to minimize the impact of each of these diseases. You can prevent chronic respiratory diseases by stopping to smoke and treating asthma properly. To treat cancer successfully one needs to diagnose it early and remove it surgically. With cardiovascular disease chelation therapy has shown a difference. Otherwise a regular exercise program and a Mediterranean diet, which has anti-inflammatory qualities, will help. Dr. Taylor from Newcastle University demonstrated that he can treat diabetes with a low calorie diet. Each one of us has a responsibility to do something about our diagnosed condition. We cannot wait for magic cures. We need to do what has known benefits. Hopefully with these short hints will help you to improve your health.

Sep
22
2018

The Best Foods For Your Heart

In the following I will describe 16 foods, which are the best foods for your heart. I will also comment as to why I believe they are best. This review is based on this article in “Medical News Today”.

But I have added many other comments to it.

Heart disease is still the number 1 killer. We need to change what we eat.

Vegetables

The regular intake of green leaf vegetables and cruciferous vegetables (broccoli, cauliflower and cabbage) has an association with the  preservation of cognitive function. In the Nurses’ Health Study starting in 1984 women were asked about their usual intake of a specified portion of food items, including 15 fruits and 28 vegetables. At a later date, between 1995 and 2001, researchers decided to ask the oldest participants (70 years and older) to participate in a cognitive function study. Two years later researchers repeated these tests.The main finding of the study is that women with the highest intake of green, leafy vegetables had the least decline in their cognitive function. The vegetable lovers, who consumed five serving of cruciferous vegetables, like broccoli, cabbage and cauliflower had less decline in their cognitive function. On the other hand the highest decline showed up in the group that averaged only 2 servings per week.

Asparagus

Asparagus is a source of fiber, folate, multiple vitamins and chromium. Chromium enhances the function of insulin to transport sugar into cells. Asparagus contains glutathione, a powerful antioxidant that neutralizes free radicals and carcinogens. It is said to help prevent lung cancers, larynx cancer, and bone, breast and colon cancers.

Berries

Berries like strawberries, raspberries, blackberries and blueberries are full of bioflavonoids. These are antioxidants, which prevent cardiovascular disease.

It is the anthocyanines, which prevent oxidation of LDL cholesterol. Berries also have bioflavonoids and reduce lipid formation in the blood. Berries contain fiber, folate, iron, calcium, vitamin A, and vitamin C.

Broccoli

This fiber rich vegetable helps to prevent hardening of the arteries. Broccoli and kale likely have preventative effects against colon cancer.

Chickpeas, beans, peas and lentils

Legumes or pulses are a great way to consume plant-derived protein. People who are on vegan diets should be eating them for a protein source. They also contain lots of fiber, vitamins and minerals. We know that they lower cholesterol, which prevents heart disease. Other healthy nutrients they contain are bioflavonoids, which have antioxidant properties and help prevent cardiovascular disease.

Dark chocolate

This is a food rich in antioxidants. Dark chocolate is chocolate with more than 70% cocoa content. Please note: “milk chocolate” is nothing better than candy and devoid of any health benefits. Dark chocolate increases the protective HDL cholesterol and prevents oxidation of LDL cholesterol. It is said to prevent atherosclerosis (hardening of the arteries). Don’t exceed eating 1 to 2 oz. per day, as chocolate has some sugar in it and the fat content would be detrimental with higher consumption.

Chia seeds and flaxseeds

Chia seeds and flaxseeds are rich in omega-3 fatty acids in the form of α-linolenic acid (ALA). ALA reduces LDL cholesterol and it dissolves plaque in the arteries. ALA also reduces blood pressure to a certain degree. All of this helps reduce cardiovascular disease (heart attacks and strokes). Note that flaxseeds must be ground to powder to release the nutrients from its tough shell. Both chia and flaxseeds can be used as an egg replacement in vegan cooking.

Fish high in omega-3s

Omega-3 fatty acids are abundantly present in fish. It has plaque-reducing properties and also reduces the risk for abnormal heart beats. Overall this means less cardiovascular disease. The American Heart Association recommends a 3.5 oz. serving of fatty fish (salmon, mackerel, lake trout, herring or sardines) twice per week.

Coffee

A Brazilian study from 2018 showed that drinking 3 cups of coffee a day would stop coronary artery calcification. Many other studies have shown reduced mortality from heart attacks and strokes with increased coffee intake.

Green tea

Green tea is known to reduce blood pressure slightly and to reduce cholesterol. Both effects are beneficial for the cardiovascular system (prevents heart attacks and strokes). Green tea also prevents many cancers. Whatever we know about coffee consumption seems to also be true for green tea consumption.

Nuts

Nuts contain healthy fatty acids (omega-3). But they also contain fiber, protein, minerals, vitamins and antioxidants. Use them in desserts, in salads and as a quick food on the go. They are definitely healthier than protein bars.

Liver

Liver is one of the nutrient rich foods. It is rich in iron, phosphorus, vitamin A, folate, vitamin B12 and biotin.

Oatmeal

Oatmeal is rich in soluble fiber. It has been shown to lower LDL cholesterol and total cholesterol. This is important for prevention of heart disease.

Red wine (may be)

The bioflavonoids of red grapes have been the subject of much research. There is a dose-response curve showing a protective effect with regard to heart attacks and strokes with the consumption of  1 to 3 glasses of red wine per day. But unfortunately there is also a dose-response curve with respect to alcohol consumption and cancer causation. Personally, I take resveratrol from the health food store, 500 mg daily and consume white wine or red wine very rarely.

Tomatoes

There are a number of beneficial phytochemicals in tomatoes. Carotenoids like lycopene, lutein, zeaxanthine and beta-carotenes are helping to prevent prostate cancer and colon cancer. Potassium and folate are cardioprotective.

Spinach

Eating spinach regularly will provide you with magnesium, iron and bioflavonoids. Magnesium is good for a regular heart rhythm. The other nutrients are good for skin, bone and hair health.

Discussion

I have reviewed why these 16 foods are the best foods for your heart. We have seen that many foods that are rich in antioxidants are also cancer preventative. People who eat a Mediterranean diet will get these 16 foods, because their meals are balanced with nutrients. But if you eat a hamburger or a pizza you will not get balanced nutrients. The more one-sided your food intake, the more dangerous your lifestyle becomes. This is the problem with the Standard American diet (“SAD”). You need all of the components of the 16 foods described here. Junk food won’t do, as it consists only of empty calories.

The Best Foods For Your Heart

The Best Foods For Your Heart

Conclusion

It is useful to review healthy foods as was done above. Now it is a matter of including them in your daily food intake. If this is overwhelming you, start with baby steps. One or two healthy foods here or there are a good start. Increase this until you cover all the 16 foods mentioned. The more balanced your food intake is, the more antioxidant vitamins you will get. And the more heart disease and cancer prevention you will experience.

Apart from good, balanced nutrition we also need regular exercise for heart disease and cancer prevention. Go to a gym, go for a walk, climb some stairs. Get away from the computer and television. Together with best foods for your heart this will keep you healthier for longer.

Aug
25
2018

The Downside Of Living To 100

A review article has examined longevity and reviewed the downside of living to 100. In their 80’s about 10% of the population live in nursing homes, but among centenarians 55% are residing in nursing homes. They are often very lonely, as their social circles have shrunk as they aged.

Common diseases of older people

Osteoarthritis makes it difficult for people to get around, it causes chronic pain and it can also be the reason for falls. In 1990 there were 213.4 cases of osteoarthritis per 100,000. 26 years later, in 2016 there were 232.1 cases of osteoarthritis per 100,000 people.

Chronic obstructive pulmonary disease (COPD) has been falling, because less people smoke cigarettes now. Statistics show 1667 cases of COPD per 100,000 in 1990, but only 945 cases of COPD per 100,000 in 2016.

Diarrhea and common infections have dropped sharply from 8951 per 100,000 in 1990 to 3276 per 100,000 in 2016.

What other common diseases do older people get?

There are a number of common diseases that affect the elderly.

Osteoarthritis

Osteoarthritis of the hips and the knees are common, but it can affect every joint in the body. In the end stage knee replacements or hip replacements may be necessary. But before a total knee replacement or total hip replacement can even come into consideration, the person’s heart needs a thorough checkup to ensure that it is safe for the patient to undergo surgery under a general anesthetic.

Heart disease

Older people often have heart disease.

When coronary arteries are narrowed, heart attacks occur. Cardiologists can place stents, so that previously narrowed coronary arteries receive normal blood flow. Following such a procedure the patient may live for another 10 to 15 years.

There are also heart valve calcifications. The aortic valve is particularly endangered. A heart surgeon may be able to replace a diseased aortic valve by a porcine valve.

The nervous system of the heart transmits electrical signals from the sinus node to the muscle fibers, which can get diseased. Heart rhythm problems may necessitate the insertion of a pacemaker.

Finally, the heart may enlarge, but pump less blood than before. This condition is congestive heart failure. The 5-year survival for this condition is only 50.4%. Unfortunately there is very little the doctor can do for patients like this.

Cancer

The older we get, the more DNA mutations we accumulate. At one point cancer develops. If the diagnosis happens at an early stage there is a good chance that surgery can remove a cancerous growth, and the patient survives. But there are cancers that are notoriously difficult to recognize in the early stages. These are: cancer of the pancreas, kidney cancer, stomach cancer and certain types of leukemias.

Respiratory diseases

Those who smoked earlier in life may develop chronic obstructive pulmonary disease (COPD). It is a chronically disabling lung disorder. Often these individuals have to carry an oxygen tank with them wherever they go. The 5-year survival rate for people with COPD is 40 to 70%.

Osteoporosis

Osteoporosis is a disease where the bone is brittle. Spontaneous bone fractures can occur at the wrists, the upper thigh bone (femoral fractures) or in the vertebral bones. Women in menopause are hormone deficient and this contributes to calcium depletion of the bones. Lately research has shown that vitamin K2 and vitamin D3 are necessary for a normal calcium metabolism. Briefly, 200 micrograms of vitamin K2 and 5000 IU of vitamin D3 every day are the necessary dosage that the body can absorb calcium from the gut, eliminate it from the blood vessels and deposit it into the bone. Calcium is present in milk products and milk. If a person does not consume enough milk products a supplement of 1000 mg of calcium daily does make sense.

Alzheimer’s

The older we get, the more likely it is an onset of Alzheimer’s or dementia. Between the ages of 90 to 94 there is a yearly increase of Alzheimer’s of 12.7% per year. The group from age 95 to 99 years has a yearly increase of Alzheimer’s of 21.2% per year. Persons aged 100 years and older have an increase of Alzheimer’s by 40.7% per year. What this means is that essentially there is a doubling of Alzheimer’s every 5.5 years. We do not have all of the answers why this is happening and why Alzheimer’s develops. But we do know that diabetics are more likely to develop Alzheimer’s. High blood sugar levels and high insulin levels seem to lead to the precipitation of the tau protein in the brain, which causes Alzheimer’s.

Diabetes

When diabetes is not well controlled, there is accelerated hardening of the arteries. This can cause heart attacks and strokes. Longstanding diabetes can affect the kidneys (diabetic nephropathy, kidney damage) and can lead to hardening of the leg arteries. Often the only treatment left is a below knee amputation. Blindness from uncontrolled diabetes is common and pain from diabetic neuropathy as well.

Diabetics have an average life expectancy of 77 to 81 years. However, if they pay attention to their blood sugars and manage their diabetes closely they can live past the age of 85.

Falls and balance problems

As people age, their balance organ is not functioning as well. Also, people with high blood pressure medication may have postural hypotensive episodes that can lead to falls.

There may be a lack of cognitive functioning and misjudging of steps, ledges and irregularities in the floor. When a person has brittle bones from osteoporosis and they fall, a hip fracture is very common. At a higher age surgery for a hip fracture is dangerous. It can have a mortality of 50%.

Obesity

A person with obesity has a life expectancy that is 10 years less than a person without obesity. The reason for this is that with obesity This is so, because the risk of heart attacks, strokes, cancer, arthritis and diabetes is increased.

Depression

Older people often get depressed. It even has its own name: involutional depression. People can get into a state of mind, where they think negatively. Depressed people feel that they have nothing to live for. They lost friends; they are shut in because they can’t drive a car any more. This type of depression needs treatment by a psychologist or psychiatrist. The danger of leaving depression untreated is that the person may get suicidal. In older people depression is often precipitated by physical health problems.

Oral health

When teeth are not looked after, gingivitis and periodontitis can develop. Infected gums can shed bacteria into the blood and this can affect the heart valves. Endocarditis, the infection of heart valves, is a cardiological emergency. Prolonged antibiotic therapy is necessary to overcome this condition.

Poverty

Poverty has real consequences. The aging person may not have access to the optimal medical care facility because of a lack of funds. But even at a younger age there is evidence that people are healthier when they are wealthier.

Shingles

Older people often get shingles, even if they had chickenpox or shingles as a child. This is evidence that the immune system is getting weaker. Shingles in an older person should alarm the treating physician that there could be an underlying cancer. Due to that knowledge a cancer-screening tests should be part of the medical exam. In addition, a varicella vaccine should be offered to the patient to build up immunity.

The Downside Of Living To 100

The Downside Of Living To 100

Conclusion

Living to 100 is often glorified in the press. Maybe you have seen a 90-year old jogger completing a marathon, or you saw an 85-year old couple ballroom dancing. But what they don’t show you is what I summarized here, the less glamorous things about living to 100. You may get a heart attack or a stroke. Osteoarthritis may affect you how you walk. Congestive heart failure may make you get short of breath when you walk upstairs. Then there are various cancer types that are difficult to diagnose early.

If you have smoked in the past, you may suffer from chronic obstructive pulmonary disease (COPD), which leaves you breathless.

Other illnesses

Osteoporosis can lead to spontaneous fractures. Because the bone has a lack of calcium, this is difficult to treat and takes a long time to heal.

Alzheimer’s is ever so much more common when you approach the year 100. There are other medical conditions you can get: obesity, diabetes and depression. When you get shingles for the second time, it may mean that your immune system is getting weak and a cancer-screening test should be done.

There are some downsides when you approach the age of 100.

Know your risks and be vigilant

You may keep your physician busy checking out various age-related illnesses, but more importantly, get regular check-ups and tests. Any condition is easier to treat with an earlier diagnosis! The message for anybody reading this is very simple. Prevention through healthy living is something you can actively pursue. Keep your body and your mind busy. Enjoy time with friends and family instead of living a solitary existence. See the glass that is half full instead of viewing it as half empty. Stick to a healthy diet. Knowing all the risks is not a scare but a call to being vigilant. Knowledge is powerful and will help you to enjoy your golden years feeling well and happy.

May
19
2018

What lowers LDL cholesterol?

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. 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).

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!

Apr
14
2018

Where Does Fat Go With Weight loss?

People often wonder where does fat go with weight loss? This question recently came up in a CNN conversation.  The answer was originally researched by Dr. Ruben Meerman and Professor Andrew Brown.

Dr. Meerman is an assistant scientist at the University of New South Wales and author of “Big Fat Myths: When You Lose Weight, Where Does the Fat Go?” Professor Brown is the head of the School of Biotechnology and Biomolecular Sciences at the same university.

When you lose 1 kilogram of fat, where does fat go with weight loss?

The interesting answer to this question is that fat gets metabolized. Dr, Meerman and Prof. Brown pointed out that originally Leifson et al. answered this question who used heavy oxygen and found out that this was metabolized into heavy water.

Technically these experiments are fairly complex, but they allow the researchers to see exactly where the body incorporates these chemicals and where they end up with breakdown of fat. The BMJ paper describes that the breakdown of 1 kg of fat follows the following pattern: It breaks down into 0.84 kg of CO2 (carbon dioxide) and 0.16 kg of H2O (water). In other words, the lungs are the primary organs that get rid of fat and the kidneys excrete the water. There is a bit of extra energy in this chemical reaction as well, which dissipates through the skin and through exhaled air.

What did health professionals think where the fat would go?

The health professionals were doctors, dieticians and personal trainers. About 65% of them thought fat would evaporate into energy/heat. About 10% thought fat would end up in the feces. 5% thought fat would turn into muscle. Another 5% thought fat would turn into sweat or urine. 8% were correct that fat would become CO2 and H2O. 7% said they did not know.

The chemistry of fat deposits and metabolizing fat

The body deposited triglycerides from the liver metabolism of sugar and fatty acids into fat cells and stored them as oleate (C18H34O2), palmitate (C16H32O2), and linoleate (C18H32O2). Part of this are many chemical reactions, including a number of enzymes. These fatty acids form esters and turn into gigantic molecules with this chemical formula: C55H104O6. The BMJ paper further says that an overall chemical description of metabolized fat would look like this:

C55H104O6+78O2→55CO2+52H2O+energy. In plain English it means that 1 molecule of fat ester (from fat storage) is metabolized together with 78 molecules of oxygen. This results in 55 molecules of carbon dioxide, 52 molecules of water and energy.

Fat turns into carbon dioxide and water

Based on this chemical reaction a calculation of the breakdown of fat into carbon dioxide and water was possible. The surprising result is that 84% of fat becomes carbon dioxide and only 16% of fat becomes water. We exhale the carbon dioxide from our lungs and it is mostly the kidneys that excrete the water. People who lose weight are aware that they have to urinate more often. But they do not notice that they get rid of a lot of carbon dioxide, as this is a subtle process.

Some observations from the fasting mimicking diet

The fasting mimicking diet (FMD) was at the center of the most recent anti-aging conference in Las Vegas I attended. This was the 25th Annual World Congress on Anti-Aging Medicine in Las Vegas, Dec. 14-16, 2017. Late in December 2017 I started 5 days of FMD and have just completed my 4th round of it (FMD is done 5 days out of each month). My main interest in doing this is to prevent heart attacks and strokes and I like the idea of stimulating telomeres for anti-aging and increasing stem cell production. See more details under this link.

Personal experience of fasting mimicking diet

I keep meticulous records of my body measurements using daily body composition scales, which I record in a booklet. Between March 23, 2018 and March 28 I lost 1.5 kg from 64.8 kg to 63.3 kg. Fat composition was reduced from 14.1% to 12.2%. Visceral fat was reduced from 6% to 5%. My muscle percentage rose from 38.1% to 39.1%. The basic metabolic rate was 1471 Calories on March 23 and went down to 1449 Calories on March 28. My body mass index went from 22.0 to 21.5.

I definitely noticed the frequent urination, something I had noticed in the past in 2001 when I lost 50 pounds over 3 months. Of course it is understandable when you reduce your daily calorie intake to 600 Calories per day that you will lose this amount of weight. People have different metabolisms. It may be that you won’t lose as much as I did.

What causes mainly weight loss?

There are many people who think that extra exercise would help you lose weight. But a publication has established that only about 8% of weight loss is due to exercising. 92% of weight loss is due to dieting.

Regular exercise is important for conditioning of your lungs, heart, muscles and joints. But to keep things in balance a reasonable diet, like a Mediterranean diet, should also be part of the regimen.

Sugar overconsumption

The obesity wave in the US started to take off between 1976 and 1980. 40 years later it is still rising. It is interesting to note that both wheat flour and sugar consumption in the US were increasing parallel to the rising obesity figures. In the 70’s the old-fashioned wheat has changed into the force hybridized Clearfield wheat, which is now 100% of the commercially available wheat. Clearfield wheat contains 7-fold higher gluten amounts than the old-fashioned wheat that your grandparents consumed. Gluten stimulates your appetite, so you crave more wheat and you crave more sugar. This becomes a vicious cycle.

Excess calories are stored as fat

The liver metabolizes sugar from regular food and from processed food into triglycerides and LDL cholesterol (the bad cholesterol that plugs up arteries). As I mentioned above, the body stores any excess triglycerides as fat and deposits the excess into fatty cells. You see from this that essentially sugar and wheat end up as fat deposits. I suggest you change your food intake into eating sensible food with fewer calories. Start by eliminating most of your sugar, wheat and processed food intake. This will help you to melt fat away as I showed with an example of my 5 day FMD.

Where Does Fat Go With Weight loss?

Where Does Fat Go With Weight loss?

Conclusion

I reviewed facts about the chemistry of melting fat away. The question is where does fat go with weight loss? In the process of weight loss fat breaks down into carbon dioxide and water. I also documented how you can lose fat in just 5 days (1.1 kilogram) on a 600-calorie diet and reduce the body mass index from 22.0 to 21.5.

Most people do not recognize the importance of watching their diet to achieve weight loss. 92% of weight loss occurs as a result of dieting. Wheat and sugar consumption have a direct connection to the obesity wave that started between 1976 and 1980. I have cut out all wheat, all sugar and all processed food in 2001. This allowed me to lose 50 pounds then and my body mass index today is 21.5. It can be done, even if you are 73 years old.

Mar
24
2018

Prevent Plugged Arteries

There are several ways to prevent plugged arteries, which will translate into less heart attacks and strokes. The message is simple: if you get less heart attacks and strokes, you will live longer. Below I am examining ways to prolong life by various ways to prevent plugged arteries.

You probably heard of plaque formation in the arteries. This is the process where a combination of fat, calcium, cholesterol and cell waste forms a deposit (plaque) under the lining of the arteries.

The end result is that the blood won’t be flowing freely through the affected arteries. This can cause a heart attack or a stroke. Essentially, this is the point where a clot forms in the narrowed passage of the artery. It is also the point, when the clinicians make a diagnosis of a heart attack or a stroke.

Let’s examine what leads to plaque formation in the arteries.

Trans fats

Trans fats are contained in fried foods like French fries, in margarines and other butter substitutes. As margarine is a common ingredient of cakes, cookies, pastries and pies, these are all bad news for our heart health. I consider them off limits. If you eat those foods, you build up plaque in your arteries, which leads to premature heart attacks and strokes.

Lack of exercise

It has been common knowledge for a long time that being sessile leads to premature hardening of the arteries. In the late 1800s to the early 1900s physical exercise was promoted in various countries around the world.

The latter part of the 20th century saw a renaissance of the fitness movement. It was trendy to go running, cycling, and swimming or working out at a gym. It is not only trendy but healthy: cardiologists support all of these sports to help people stay healthy and keep the arteries free from plaque formation.

Too many refined carbs

Sugar and processed foods, especially those with added sugar to improve flavor, have a direct relationship to heart attacks and strokes. It is known that sugar causes high LDL cholesterol and high triglycerides. In addition sugar also causes inflammation of the arterial walls, which causes plugged arteries. However, sugar is only part of the problem. Starchy foods like rice, noodles, cakes, cookies and other foods made with flour get broken down into sugar. Both lead to insulin production. And both lead to changes of the lining of the arterial walls.

In the 1980s and 1990s there was a school of thought that a low fat diet would be healthy in terms of heart attack and stroke prevention (the low fat/high carb diet). This turned out to be a nutritional disaster: the high carb content of such a diet was the problem. It led to weight gain, obesity and death.

Red meat is a problem

Several studies have documented that saturated fat from red meat is only part of the problem. The other part is carnitine, which is abundantly present in beef, pork, lamb and venison. But mortality of people eating unprocessed red meat is only marginally elevated. It is when people eat processed red meat that there is a significant rise in mortality from heart attacks and strokes. This study examined this. They found that gut bacteria were stimulated by red meat to produce substances that stimulate bacteria in your gut to secrete TMA and TMAO, which makes your platelets more sticky and contributes to plugging your arteries. This research paper from the Cleveland Clinic explains it in more detail.

What must I do to prevent plugged arteries?

Eat the right food

A Mediterranean diet is anti-inflammatory. It contains lots of vegetables, but little red meat. Fish and chicken that contain much less L-carnitine are more dominant in Mediterranean food. As mentioned above, you want to avoid trans fats. And you also want to avoid sugar and too many starchy foods. This includes sugar-sweetened beverages. Making these changes will keep your insulin levels in the normal range eliminating inflammation in your arteries. Avoid eating processed foods, because they contain food preservatives and lots of sugar that we want to avoid. Eat more unsaturated fats like avocados, walnuts, olives, trout, herring, and salmon. The last three contain marine-derived omega-3 fatty acids that are particularly helpful in preventing heart attacks and strokes by being anti-inflammatory and by elevating the protective HDL cholesterol. Drink lots of green or black tea, rooibos tea, or ginger tea. They contain antioxidants and bioflavonoids that prevent plugged arteries.

Regular exercise

Many publications have shown that regular physical exercise will lower blood pressure, condition your muscles including your heart and lower mortality.

Only 10 minutes of brisk walking every day reduced the death rate by 33% compared to those who did not exercise at all.

Regular physical exercise does not only prevent heart attacks and strokes, it also reduces the risk of getting another 35 chronic diseases, as the link shows.

Here are some common exercises: jogging, cycling, running, brisk walking, swimming, playing tennis and doing aerobics. All of them will strengthen your muscles and condition your heart and lungs.

Other ways to prevent plugged arteries

Smokers must quit smoking, as smoking has been identified as a major risk factor for heart attacks and strokes.

Exposure to prolonged stress is a factor that leads to hardening of arteries. Stress management is possible by counseling, by self-hypnosis, yoga, tai chi and other relaxation methods.

Risk factors associated with plugged arteries

We already have mentioned the risk factors that are associated with clogged arteries. But for clarity I would like to repeat the major risk factors here.

  • Smoking
  • High blood pressure
  • Elevated LDL cholesterol (the bad cholesterol)
  • Reduced HDL cholesterol (HDL is increasing with exercise)
  • Obesity (often associated by ingestion of too many carbs)
  • Insulin resistance and diabetes
  • Lack of exercise (too much sitting in front of the TV or doing computer work)
  • Unhealthy diet (Standard American diet instead of Mediterranean diet)
Prevent Plugged Arteries

Prevent Plugged Arteries

Conclusion

We often think that we have no input whether or not we get a heart attack or a stroke. This is completely wrong. If you adopt the solutions I have listed here, you can change things for the better. You will reduce your risk to get a heart attack or a stroke. Treat high blood pressure. Stop smoking. Cut out sugar and starchy foods to reduce triglycerides and LDL cholesterol. Exercise regularly and your HDL will protect you from heart attacks and strokes. Shed pounds, if you are obese by starting a Mediterranean diet and cutting out sugar. This will also improve your insulin resistance or diabetes. Start daily exercise as this reduces your risk of a heart attack or a stroke. In addition exercise reduces the risk of 35 chronic diseases that have also been mentioned in one of the links.

Apr
08
2017

Breast Cancer Risks

Dr. David Zava, PhD gave a talk on breast cancer risks. His presentation took place at the 24th Annual World Congress on Anti-Aging Medicine (Dec. 9-11, 2016) in Las Vegas that I attended. The detailed title was: “The Role of Hormones, Essential Nutrients, Environmental Toxins, and Lifestyle Choices on Breast Cancer Risk”.

He pointed out that both estrogens and progesterone are safe hormones, as long as the doctor does not overdose them and keeps a hormone balance. Unfortunately many women in menopause have too much estrogen on board as the ovaries are still producing them, but there is a lack of progesterone, the moderating hormone that makes estrogen safe.

In the following I am summarizing Dr. Zava’s talk with regard to the essential messages, but leave away much of the highly technical detail of the presentation. This would dilute the message of this blog. I will include a few links for those who wish to read more details about the topic.

Balance between estrogen and progesterone

Most of her life a woman is used to cyclical hormone changes between estrogen and progesterone. When a woman no longer ovulates in premenopause and menopause there is a surplus of estrogen and a lack of progesterone. Having no ovulation means that there is no corpus luteum developing, which is where in the past progesterone production took place. This creates a disbalance where estrogen is dominating; it is called “estrogen dominance”.

This is a dangerous hormone disbalance, because the breast ducts experience a growth stimulus, but the modifying, calming effect of progesterone is missing. Mixed into this is that the stress hormone, cortisol also can make the effect of estrogen worse. On the other hand Dr. Zava showed slides from studies documenting replacement of missing progesterone with a skin progesterone cream (percutaneous bioidentical progesterone cream).

Progesterone concentration in breast lumps after progesterone cream applications

Plasma and breast tissue concentration of progesterone were measured in 40 premenstrual women. The diagnoses were breast lumps and the physicians arranged surgery for them. One group received progesterone cream treatment for 10 to 13 days; the other group was the placebo group. At the time of surgery the plasma (blood) values of progesterone were the same, but progesterone levels in breast tissue were more than 100-fold higher than the values from the placebo group who had received a neutral skin cream. The same experiment also showed that progesterone reduced the number of proliferating epithelial cells (experimental progesterone group). Estrogen on the other hand led to an increase of the number of proliferating epithelial cells (placebo group).

Progesterone cream applied to breasts of premenopausal women

Another example that Dr. Zava gave was a study where 25 mg of bioidentical progesterone cream applied directly to breasts of premenopausal women increased breast tissue progesterone 100-fold, while blood concentrations of progesterone remained the same. Again progesterone decreased the breast stimulation by estrogen of normal epithelium cells.

How to measure progesterone levels

Dr. Zava who runs the ZRT laboratory spent some time to explain how to measure progesterone in a physiological way. He said that these experiments and others that he also projected tell a clear story. Blood (serum) progesterone levels do not adequately reflect what tissue levels in a woman’s breasts are. On the other hand saliva hormone levels do give an accurate account of what breast tissue levels are like. A woman received 30 mg of topical progesterone application. She then had hourly progesterone levels in the serum and in the saliva done. The serum progesterone levels remained at around 2 ng/ml, while the saliva progesterone levels peaked 3 to 5 hours after the application. It reached 16 ng/ml in saliva, which also represents the breast tissue progesterone level.

Blood progesterone levels are unreliable

As a result, Dr. Zava said that the important lesson to learn from this is not to trust blood progesterone levels. Too many physicians fall into this trap and order too much progesterone cream, which leads to overdosing progesterone. In contrast, with salivary progesterone levels you see the physiological tissue levels, with blood tests you don’t. Dr. Zava said: avoid using venipuncture blood or urine in an attempt to interpret hormone test levels, as you will underestimate bio-potency and overdose the patient.

Historical failure of estrogen replacement therapy (ERT)

A review of breast cancer would not be complete without mentioning the Women’s Health Initiative (WHI). The U.S. National Institutes of Health (NIH) initiated this trial in 1991.

Researchers prematurely terminated Women’s Health initiative

The WHI ended suddenly in July 2002. The authors stated: “The overall health risks exceeded benefits from use of combined estrogen plus progestin for an average 5.2 year follow-up among healthy postmenopausal US women.” The study found a 41% increase in strokes, 29% increase in heart attacks, 26% increase in breast cancer, 22% increase in total cardiovascular disease, a doubling of blood clots. The recommendation made by this study was to discontinue PremPro.

Breast cancer in the Million Women Study from synthetic hormones

Another study that was mentioned was “Breast cancer and hormone-replacement therapy in the Million Women Study”.  In this study postmenopausal women received HRT with synthetic hormones, either estrogen alone or estrogen mixed with a progestin (in British English “progestagen”). After 5 years estrogen alone had a 30% increased risk of developing breast cancer. HRT with an estrogen-progestagen mix had a 100% increased risk of developing breast cancer.

Huge difference between bioidentical hormones and synthetic hormones

Unfortunately in both of these human experiments the researchers used the wrong hormone substances, namely synthetic estrogens and synthetic progestins. They are NOT identical with natural estrogens and progesterone that a woman’s body makes. As long as the hormones used for hormone replacement therapy are chemically identical to the natural hormones, the body will accept them as they fit the natural hormone receptors in the body. It is the misfit of synthetic hormones that blocks the estrogen receptors or the progesterone receptors. You can readily see from the illustrations of this link that there is a fine balance between the workings of these receptors and there is absolutely no room for patented side chains that Big Pharma introduced into synthetic HRT hormones.

Individualizing bioidentical hormone prescriptions based on blood tests

The other problem of both these studies was that every woman was getting the same dose of hormones and that nobody measured their estrogen blood or estrogen saliva hormone levels. In retrospect the regulatory agencies should never have allowed these “hormones” to hit the market.

Breast cancer develops in three stages

Dr. Zava explained that it common knowledge for some time that breast cancer develops by going through 3 stages.

  1. Initiation

First of all, damage to the DNA of one of the cells types in the breast is what starts the process in the development of breast cancer. This can be done by catechol estrogen-3,4-quinones as was shown by these researchers.

Aromatase inhibitors is useful to reduce estrogen in overweight or obese women where aromatase is present in fatty tissue. The reason obese women have more breast cancer is likely from the extra estrogen production from androgens. Aromatase converts these male hormones from the adrenal glands into estrogen.

Iodine/iodide alters gene expression, which reduces breast cancer development, but also slows down cell division in existing breast cancer. The authors suggested to use iodine/iodide supplements as adjuvant therapy in breast cancer treatment.

  1. Promotion

Furthermore, the next step is that something has to promote the DNA mutation into becoming part of a cancer cell. Estrogen quinones are dangerous estrogen metabolites. They can form from catechol estrogens (other metabolites of estrogen) by reactive oxygen species. But selenium, a trace mineral can interrupt the formation of estrogen quinones, which stops the breasts cancer promotion process. A study from the Klang Valley, Malaysia showed that selenium showed a dose-response effect with respect to prevention of breast cancer; the more selenium in the food, the less breast cancer occurred.

  1. Progression (includes invasion and metastases)

Finally, several factors can help the breast cancer cells to progress, grow bigger locally and eventually move into other areas of the body as metastases. Dr. Zava showed several slides where details of metabolic processes were shown and how changes in some of these would lead to progression of breast cancer. Estrogen excess is a common pathway to breast cancer. The key is to balance it with progesterone, supplements, remove anything that causes estrogen overproduction like obesity (via the aromatase pathway).

The fallacy of overdosing or underdosing

When estrogen is overdosed, it becomes aggressive as indicated before; it can initiate DNA mutations that can cause breast cancer. If it is under dosed, the lack of estrogen can cause heart attacks, strokes and osteoporosis. When estrogen is balanced with progesterone a postmenopausal woman feels best and she is protected from the negative effects of estrogen.

Measures that help prevent breast cancer

Supplement only with bioidentical hormones

When supplementing with bioidentical hormones, keep estrogen within physiological limits and don’t overdose. This can be measured through blood tests or saliva hormone tests. Your most important natural opponent of estrogen is progesterone, which is usually missing in menopause. Measure hormones using tests (progesterone only with saliva tests, estrogen either by blood tests or saliva tests). Don’t rely going by symptoms.

Progesterone to estrogen ratio

Keep the progesterone to estrogen ratio (Pg/E2) at an optimal range, which is in the 100- to 500-fold range. Measure the saliva hormone level of both progesterone and estrogen and calculate. Remember that progesterone serum levels are meaningless. The much higher progesterone level protects the postmenopausal woman from estrogen side effects. Here is a statement worth noting: “Until evidence is found to the contrary, bioidentical hormones remain the preferred method of HRT.” This was the conclusion of a study using bioidentical hormones, where the protection from breast cancer and heart attacks and strokes was also noted.

Eat more fiber containing foods and less beef

Increase fiber intake and reduce red meat consumption. This will eliminate conjugated steroid hormones in the stool. It also increases the sex hormone binding globulin in the blood, which limits the bioavailability of estrogens. Fiber absorbs bile toxins and removes them from the body.

Calcium supplement

Calcium-D-glucarate is a supplement that will decrease beta-glucuronidase. The estrogens were conjugated with the purpose to be eliminated, but beta-glucuronidase causes the conjugated estrogens to be reabsorbed.

Reduce breast cancer risk with probiotics

Probiotics likely stimulate the immune system and help reduce the risk of breast cancer.

No pollutants and toxic chemicals

Avoid toxins like petrochemical pollutants and toxic chemicals. Avoid trans fats. If toxic, heavy metals are present (arsenic, cadmium, lead, mercury) remove these. Some naturopaths use EDTA chelation to do this.

Other useful supplements

Supplements: sulforaphane (broccoli), EGCG (green tea), alpha-lipoic acid (antioxidant), cruciferous vegetables, resveratrol, selenium and iodide/iodine, N-acetyl cysteine-glutathione. All these supplements/nutrients will prevent estrogen to go to the “dark side”. The dark side is the formation of toxic 4-OH estrogen that could further be converted into catechol estrogen-3,4-quinones that can damage DNA and cause mutations.

Methylation of catechol estrogens

Increase methylation of catechol estrogens: vitamin B1, B6, B12 and folic acid. Methyl donors also are useful for this purpose: MSM (methylsulfonylmethane), SAMe, and Betaine.

Healthy lifestyle (diet , exercise) helps your immune system

Improve your diet (Mediterranean type), exercise moderately, reduce stress, and replace hormones in physiological doses as discussed under point 1 and 2.

Breast Cancer Risks

Breast Cancer Risks

Conclusion

Dr. David Zava, PhD gave an interesting talk at the 24th Annual World Congress on Anti-Aging Medicine (Dec. 9-11, 2016) in Las Vegas. Estrogens, when unopposed by enough progesterone, can cause mutations in breast tissue of women and cause breast cancer. He also reviewed two major clinical trials that utilized hormone replacement therapy (HRT). The problems with these were the synthetic estrogen hormones that caused breast cancer and the synthetic progestins that also behaved like estrogens (not like progesterone) and caused even more breast cancer. The lesson from this is that only bioidentical estrogens and progesterone work in hormone replacement for menopause. Also, the hormones balance each other as discussed under measures that help to prevent breast cancer. In addition there was a list of other useful supplements given that can be taken to reduce the danger of breast cancer.

Incoming search terms:

Mar
11
2017

Obesity And Diabetes Can Cause Cancer

Dr. Nalini Chilkov gave a talk about how obesity and diabetes can cause cancer. The original title was “Integrative Cancer Care, Increased Rates of Cancer and Cancer Mortality Associated with Obesity and Insulin Resistance, Nutraceutical and Botanical Interventions”. She presented her talk at the 24th Annual World Congress on Anti-Aging Medicine (Dec. 9-11, 2016) in Las Vegas that I attended.

In the following I will present a brief summary of her lecture.

Obesity is a major risk factor for cancer

Obesity causes 14% of all cancer deaths in men and 20% of cancer deaths in women.  This link explains this in more detail. The following 15 cancers related to obesity in terms of causation. They are: colon cancer, gastric cancer, gallbladder cancer, ovarian cancer, breast cancer, liver cancer, uterine cancer, endometrial cancer, rectal cancer, pancreatic cancer, cervical cancer, non-Hodgkin’s lymphoma, renal cancer, multiple myeloma and esophageal cancer.

The American Society of Clinical Oncology reported about a meta-analysis involving 82 studies. This involved more than 200,000 women with breast cancer. The researchers compared premenopausal and postmenopausal women who were obese or normal weight. Premenopausal, obese breast cancer women had a 75% increase in mortality compared to the normal weight breast cancer group. In comparison with the normal weight group the postmenopausal group of obese breast cancer women showed a 34% increase of mortality.

With obese prostate cancer patients there is a similar observation. Obese patients have a more aggressive prostate cancer on the Gleason score and the cancer is in a more advanced stage at the time of diagnosis.

Diabetes increases mortality from cancer

Obesity is a common risk factor for both cancer and diabetes. But diabetes by itself is also increasing mortality of several cancers. In a consensus report details of the relationship between cancer and diabetes have been discussed in detail. The following cancers have been identified to have an increased risk of diabetes: pancreatic, gastric, esophageal, colorectal, liver, gallbladder, breast, ovarian, endometrial, cervical, urinary bladder, renal, multiple myeloma and non-Hodgkin’s lymphoma.

A meta-analysis suggests that cancer patients who are diabetic have a 1.41-fold increased risk of dying compared to those cancer patients who have normal blood sugars. Dr. Chilkov explained in detail what the various mechanism are that account for the faster cancer growth in obese and diabetic patients. High insulin levels is one of the risk factors, so is IGF-1, an insulin-like growth factor. The aromatase enzyme in fatty tissue turns male type hormones into estrogen, which also can stimulate cancer growth.

Carbohydrate restriction diet to prevent obesity

Low carb diets like the Mediterranean diet, the ketogenic diet and the Atkins diet will drop blood insulin and lactate levels. Cancer size and cancer growth are related to insulin and lactate levels. A low carb diet can reduce insulin-mediated uptake of sugar into cancer cells.

Research has shown that cancer metabolism slows down when a 10%-20% carb/high protein diet is consumed by the patient. This reduces the amount of sugar that is taken up by cancer cells. It also reduces insulin, so there is less cancer growth. A ketogenic diet is a more strict way to restrict carbohydrates. Intermittent fasting is also a useful method to reduce carbohydrate intake.

Here is an interesting study that illustrates the power of intermittent fasting. The study involved 2413 patients with early breast cancer who were followed for 7 years. Those breast cancer patients, who consistently did not eat anything between dinner and breakfast for 13 hours or more, had a 36% lower risk of having a cancer recurrence. There was also a 21% lower risk of dying from breast cancer when fasting was done for 13 hours or more overnight.

Supplements to prevent obesity, diabetes and cancer

A low carb diet and in some cases even a ketogenic diet is beneficial as a baseline. A regular exercise program is also useful for general fitness building and cardiovascular strengthening. In addition Dr. Chilkov recommended the following supplements.

  1. To reduce inflammation in the body, Dr. Chilkov recommended taking 2000 to 6000 mg of omega-3 fatty acids per day (molecularly distilled fish oil).
  2. Berberine 500 to 1000 mg three times daily. Dr. Chilkov said that Berberine has anti-cancer properties, improves insulin sensitivity and reduces absorption of sugars in the intestinal tract.
  3. Curcumin inhibits cancer cell division, invasion and metastatic spread through interaction with multiple cell signalling proteins. Several researchers showed that curcumin could lower blood sugar levels by stimulating insulin production from beta cells in the pancreas. Triglycerides, leptins and inflammation in fat cells are also lowered by curcumin. Insulin sensitivity increases through the action of curcumin. Dr. Chilkov recommended 300 mg/day of curcumin for 3 months.
  4. Resveratrol, the bioflavonoid from red wine is a powerful anti-inflammatory. This antioxidant has several other effects, which make it challenging to measure each effect by itself. This group of investigators managed to simultaneously measure these effects. They found that resveratrol lowered the C-reactive protein by 26% and tumor necrosis factor-alpha by 19.8%. Resveratrol also decreased fasting blood sugar and insulin; in addition it reduced hemoglobin A1C and insulin resistance. The recommended daily dose of resveratrol is 1000 to 5000 mg.
  5. Green tea catechins (EGCG) help to normalize the glucose and insulin metabolism. The dosage recommended was 1-3 grams per day.
  6. Reishi mushroom (Ganoderma lucidum) contain polysaccharides with antidiabetic and antiobesity effects. They make gut bacteria produce three types of short-chain fatty acids that control body weight and insulin sensitivity.
Obesity And Diabetes Can Cause Cancer

Obesity And Diabetes Can Cause Cancer

Conclusion

Obesity is a risk factor not only for diabetes, but also for cancer. Chronically elevated blood sugars, increased fasting insulin levels and increased IGF1 levels can cause cancer. In addition they can stimulate tumor growth and increase cancer mortality. It is for this reason that the health care provider should screen all diabetics for cancer. In her talk Dr. Nalini Chilkov gave clear guidelines what supplements will be beneficial to reduce the risk of obesity and diabetes as well as cancer. Start with a healthy, balanced diet. Add an exercise program. Then consider some of the above-mentioned supplements to reduce your risk for cancer, diabetes and obesity.

Jan
28
2017

Cardiovascular Disease And Inflammation

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

New thinking about cardiovascular disease and inflammation

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

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

New approach to the old problem of plugged coronary arteries

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

Coronary artery damage from cholesterol elevation versus inflammation

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

Blood tests to screen for cardiovascular disease and inflammation

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

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

Further high risk factors for coronary artery disease

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

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

The Rasmussen score

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

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

Here is what the Rasmussen score means:

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

Non-intervention tests to measure cardiovascular health

1. The ENDOPAT test

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

2. The VC Profile

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

3.The Corus CAD score

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

4. Coronary artery calcification

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

Treatment of cardiovascular disease and inflammation

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

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

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

Case study showing the effect of metabolic cardiology program

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

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

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

Cardiovascular Disease And Inflammation

Cardiovascular Disease And Inflammation

Conclusion

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

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