Jul
09
2016

Avoid That Heart Attack

By | Cancer, fiber, Fitness, heart attack, Heart Disease, High Blood Pressure, Nutrition, Stroke

Recently Dr. Mark Hyman mentioned a 7-point program to avoid that heart attack. If you follow the recommendations below, chances are that you do not only avoid heart attacks, but also strokes, high blood pressure, diabetes and obesity.

The Potsdam (or EPIC) study has shown that adhering to 4 simple things can reduce

Diabetes by 93%

Heart attacks by 81%

Strokes by 50%

All cancers by 36%.

What were those 4 points?

  1. Not smoking
  2. Exercising 3.5 hours a week
  3. Eating a healthy diet
  4. And maintaining a healthy weight

So with a few more points added it is no wonder that the figures can be even more impressive.

The INTERHEART study

Other studies have also shown the importance of lifestyle changes to improve health outcomes; the INTERHEART study was based on 30,000 people in 52 countries that were followed along. Researchers found that 90 percent of all heart disease could be prevented by simple lifestyle changes.  I have added another point, regular exercise that has been proven to be very effective in preventing many diseases.

So, what are the 8 points that can assure that our health improves?

1.Avoid that heart attack with a colorful, plant-based diet

Your dietary intake is important, because it provides all of the building blocks for your body. You want whole foods that are rich in phytonutrients. Often rainbow colors are mentioned, because the more varied your vegetables look, the more balanced the micronutrients, vitamins and minerals in the food items. Below we will learn that we want to avoid processed foods and hydrogenated fats, but we want to increase fiber and omega-3 fatty acids.

2. Avoid that heart attack by stabilizing your blood sugar

Never eat refined carbs alone, as this goes chases up your blood sugar levels and causes unhealthy insulin reactions. Too much insulin production causes inflammation in the body, which can cause inflammatory bowel disease, arthritis, clogged arteries with heart attacks and strokes and Alzheimer’s disease. You want to balance complex carbs from vegetables with healthy fats and clean protein in every meal. Avoid sugars- no matter whether it is “natural brown” or white sugar and refined carbohydrates. Your pancreas does not differentiate between honey and other sugars, and it will react the same way!

3.Avoid that heart attack by increasing fiber intake

The more fiber you can tolerate, the better. 50 grams would be ideal, but not everybody can tolerate this due to bloating or a queasy stomach. But even if you can add 5 or 10 grams of fiber per day, this is progress. Fiber decreases LDL cholesterol by intervening with the enterohepatic pathway. Fiber is found in nuts, beans, vegetables, seeds and berries that have lower sugar in them. You can also take a fiber supplement directly like psyllium husk.

4.Avoid that heart attack by cutting out processed foods

Processed foods and junk foods are popular as they fill you up fast when you are hungry. But they need to be avoided at all costs. Sodas, juices and diet drinks affect your sugar and fat metabolism. The extra calories that come from sugary drinks are the biggest contributors to diabetes, heart disease and obesity. Even 100% fruit juice is not healthy, because all of the fiber is removed and you are drinking sugar water to which your pancreas reacts by producing extra insulin. As already discussed the extra insulin just causes inflammation.

Homemade lemon juice

May I suggest a homemade lemon juice that you make by squeezing ½ lemon into a glass; add a tiny bit of Stevia for sweetening and sparkling mineral water. This is a healthy drink without sugar. You can drink this as often as you want. Another component of processed food are omega-6 fatty acids. They are in processed foods, because they increase the shelf life in stores. But they cause inflammation in the body unless balanced by omega-3 fatty acids (see below).

5.Avoid that heart attack by increasing omega-3 fatty acids

Fish and seafood provide you with healthy omega-3 fatty acids. Unfortunately not all fish are healthy. Tuna is a predator fish that accumulates a lot of mercury from the polluted oceans. As a result of this it is not on my fish list. I prefer wild salmon. I also take molecularly distilled fish oil, which has omega-3 fatty acids in it. Many processed foods contain only omega-6 fatty acids, because this is the cheapest way to produce them (they are based on vegetable oils). Also avoid soybean oil, which is the most popular oil in the last few decades to foul up the omega-6 to omega-3 ratio.

Omega-6 to omega-3 ratio

This ratio should be 1:1 to 3:1, but many Americans’ omega-6 to omega-3 ratio is 6:1 to 18:1. Omega-6-fatty acids cause arthritis, heart disease and strokes. Instead you want to eat healthy fats like omega-3 fatty acids contained in nuts and fish. You can also add molecularly distilled, high potency omega-3 fatty acids as a supplement to help restore the balance between omega-6 and omega-3 in your food intake.

6.Avoid that heart attack by eliminating all hydrogenated fat

Hydrogenated fat like margarine has been shown to cause accelerated hardening of the arteries, which causes heart attacks and strokes. Read labels and eliminate any food that contains hydrogenated fats. If the label indicates that you are dealing with a product containing ”partially hydrogenated oil”, stay away from it as well! Butter from grass fed cows is a healthy fat. Olive oil and coconut oil are both good cooking oils. Olive oil is also good in salad dressings.

7.Avoid that heart attack by keeping alcohol to a minimum

The problem with alcohol is that it is a cell poison. On the other hand small amounts have been show to reduce heart attacks and strokes (one glass for women, two glasses for men per day). However, due to the cell poison effect even low amounts of alcohol contribute to cancer causation, and as a result of that alcohol remains a problem. If you must consume alcohol limiting the intake to minimal amounts is prudent. Alcohol can cause ovarian cancer in women and prostate cancer in men. In both sexes pancreatic cancer can be caused by alcohol. Higher amounts of alcohol raise inflammation with elevation of blood pressure, heart attacks and strokes. One recommendation: either consume no alcohol or use alcohol in moderation. One glass does not kill you, but several ones may do it over time!

8.Avoid that heart attack by exercising regularly

Regular exercise is yet another factor that can help you to reduce heart attacks, strokes and cancer even further. I added it as point 8, because it is fundamentally such an important preventative factor. Some studies have shown as much as a 50% drop in many diseases simply by introducing regular exercise.

Avoid That Heart Attack

Avoid That Heart Attack

Conclusion

It is all about lifestyle factors. Pay attention to your diet. Add fiber, subtract sugar. Avoid processed foods, omega-6 fatty acids and hydrogenated fat. Have enough omega-3 fatty acids as fish and supplements. Keep alcohol to a minimum. Your benefits from changing these lifestyle factors, result in huge benefits. You are avoiding 90% of diabetes, 80% of heart attacks, 50% of strokes and 35% of cancers.

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Mar
12
2016

Fiber, An Essential Food Ingredient

By | Cancer, Cardiovascular disease, fiber, heart attack, Heart Disease, Stroke

The Standard American Diet will not provide enough fiber, an essential food ingredient. The fiber intake in the US population is between 12.5 grams and 16.8 grams on average, which is way below the recommendations of the Institute of Medicine as listed below.

Depending on age and gender the Food and Nutrition Board, Institute of Medicine, National Academies has recommended the following guidelines for adequate daily fiber intake in grams per person.

Institute of Medicine fiber recommendations (gram per person per day)

Males: age 9-13: 21 grams; age14 to 50: 38 grams; age 51 and higher: 30 grams

Females: age 9-18: 25 grams; age 19-50: 21 grams; age 51 and higher: 21 grams

Children: age 1-3: 19 grams; age 4-8: 25 grams

Brief history regarding fiber

Sir Dr. Denis Burkitt, the famous English surgeon, examined bowel movements (stools) of African tribes in comparison to his English countrymen and came to the conclusion in the 1940’s that the Western world needed to remedy constipation problems and cancer of the colon problems by eating more fiber.

He is still right: fiber is mainly treating the constipation (not preventing the cancer), but the chemicals that are also in the vegetables contain a multitude of natural anti-carcinogenic substances, which provide the powerful preventative action against colon cancer and many other cancers. Lycopene, not known at the time of Sir Dr. Burkitt is one of these and is found in tomatoes and tomato products.

Old historic observation by Dr. Burkitt still relevant today

Sir Dr. Burkitt’s observation that high bulk foods (like vegetables and green leaves) prevent cancer is as valid today as it was in the mid 1900’s. In the meantime it has become evident that fiber also lowers cholesterol and helps prevent heart attacks and strokes as well.

What are some of the problems with fiber intake?

Here is a typical day for a Standard American diet:

1. The average breakfast with two toasts, an egg and sausage. This contains 0.7 grams of fiber. The coffee or tea or juice that is consumed contains no fiber.

2. For lunch you may eat a hamburger in a bun and a helping of French fries. There are 2 grams of fiber in the bun and 3.9 grams of fiber in the French fries, a total of 5.9 grams. Alternatively you may want to eat a pepperoni medium pizza: 0 grams of fiber!

The Standard American diet goes on

3. Dinner may consist of one baked potato (3.4 Grams of fiber), beef steak (0 grams of fiber, no matter whether it is an 8 oz. or 10 oz. steak) and mixed vegetables (1 cup, which contains 5 grams of fiber). For dessert you may have a bowl of ice cream (1 gram of fiber). If you eat in a restaurant you also get a bun with butter (0 grams of fiber) plus a small garden salad (0.9 grams of fiber).

4. Snacks during the morning: medium oat bran muffin: 5 grams of fiber

5. Afternoon snack: cinnamon roll: 1 gram of fiber.

Fiber total of the day for Standard American diet

Grand total of the day for Standard American diet: 22.9 grams of fiber. It depends whether or not you consumed the mixed vegetables and the bran muffin. If you did not eat the mixed vegetables and the bran muffin, you may only have consumed 12.9 grams of fiber. If you had pizza for lunch, you only got 7 grams of fiber that day.

Sources of fiber from foods

You can see from these few examples that processed foods tend to have a lot less fiber than vegetables and fruit. Particularly pastas and bread are devoid of fiber, but very rich in calories. So, if we were serious about wanting to increase our fiber content in the food we eat, we need to ensure enough intake of fruit and vegetables that contain fiber. There are many useful websites that list the fiber content per food item: if you look for the fiber content of a medium sized apple using this website, you find that it contains 4 grams of fiber.

This would be a much better snack than an ice cream with no or very little fiber. Here are more fiber suggestions.

How can we increase fiber intake?

We need to think about the whole nutritional equation, how many calories are in food, how much sugar, how much fat and protein. If we want to increase the amount of fiber we take in, we definitely have to watch the sugar content of the food item in question.

For instance ¼ cup of raisins has 2 grams of fiber in it, but also 29 grams of sugar, translating into 130 calories. Conversely, ½ cup of raspberries contains 4.6 grams of fiber and has only 20 calories. This choice is definitely a winner compared to raisins.

Use the Internet to learn about the fiber content of the various foods while you keep an eye on sugar content and calories as well. The idea is to maximize the fiber content in your food intake by cutting out fiber empty foods and adding fiber rich foods as much as possible.

Example of a fiber rich day

1. Breakfast: Omelet with green onions, mushrooms and spinach. Garnish this with ½ avocado and two tablespoons of salsa. The spinach/onion omelet with mushrooms has 3 grams of fiber. ½ avocado provides 5 grams of fiber; the salsa adds 0.6 grams of fiber. Breakfast total: 8.6 grams of fiber.

2. Lunch: Greek salad with turkey breast (4 grams of fiber). Add a snack of one handful (1.5 oz.) of walnuts as desert: 3 grams of fiber. Lunch total: 7 grams of fiber.

The fiber rich day goes on

3. Dinner: Small salad, salmon with broccoli and 1 grilled tomato. Fruit salad for desert. Salad: 0.9 grams of fiber; salmon: 0 grams of fiber; ¾ cup of cooked broccoli: 7 grams of fiber; grilled tomato: 0.6 grams of fiber; fruit salad: 3 grams of fiber. Dinner total: 11.5 grams of fiber.

4. Snacks throughout the day: 1 pear in the morning: 4 grams of fiber; 1 apple in the afternoon: 4 grams of fiber; 1 handful of walnuts: 3 grams of fiber. Snacks total fiber: 11 grams of fiber.

Total of fiber for the fiber rich day: 38.1 grams of fiber.

Fiber math

This is where it is getting interesting. Depending on whether you are a woman aged above or below 50 years or a man aged above or below 50 years, you have different fiber intake requirements as mentioned above. With the fiber rich diet you have exceeded your daily goal easily whether you are a man or a woman above or below 50. You won the race easily. Fiber intake does not mean that you eat fibrous food that tastes like sawdust! This diet example shows you delicious and nutritious food.

Measuring fiber content of food

But with the American Standard diet you barely reached the goal if you ate your mixed vegetables and the bran muffin and you are a woman above or below the age of 50. 22.9 grams of fiber is not enough for a child between the ages of 4 and 8 and it is definitely not enough for a man above or below the age of 50.

Watching what we are eating based on fiber content

This type of math just shows you how deficient our modern Western type food intake is. And if you look at the aspect of it being delicious or even nutritious it leaves a lot to be desired! This is what Sir Dr. Denis Burkitt found when he compared the food intake of civilized English citizens with tribes in the African jungle. He recognized last century that England’s fiber deprived diet compared to the fiber rich diet in Africa was responsible for the much higher colon cancer rates in England. It is only now that we are recognizing the enormity of his investigations.

Cardiovascular significance of high fiber

Apart from reducing colon cancer incidence fiber has also gained recognition for prevention against heart attacks and strokes. It turns out that the enterohepatic pathway is interfered with through the intake of fiber. Cholesterol from bile is bound to fiber in the gut and transported to the sewer instead of being taken up through the enterohepatic pathway, which includes the portal vein system and the liver. The end result is that triglycerides and LDL cholesterol fall, while HDL cholesterol (the good cholesterol) is raised, and hardening of the arteries slows down significantly. The patient lives longer, heart attack and stroke rates go down, and there is less disability.

Supplement fiber, if you are not getting enough in food

There is good news. Psyllium husk, Metamucil and any other fiber supplement can help you to reach and surpass your daily fiber goal. There is no danger of overdosing as any surplus simply comes out in your stool. You will notice as you increase your fiber intake that your stool volumes go up. Sir Dr. Burkitt actually weighed the stool of patients in Africa and in England: African tribes had voluminous stools, while people in English had much smaller stool volumes. This is how Sir Dr. Burkitt detected the importance of fiber intake.

Example of how to fit fiber into your dietary schedule

Let’s assume you are a male aged 45 years and your diet is a bit better than the average Standard American diet with a daily intake of 25 grams of fiber. Your daily goal is 38 grams of fiber, so you are 13 grams short. You can solve this problem. Get a fiber supplement from the health food store where 1 teaspoon contains about 5 grams of fiber. Be careful: fiber is very thirsty and uses up a lot of water. If you use psyllium husk powder, make sure to add about 1 cup of water to 1 ½ teaspoons of the psyllium husk powder or another similar product. Once you added enough water and stirred well you can drink it down.

Always drink enough fluids to get the fiber down

Between fiber gulps drink some more water to dilute any fiber stuck in your esophagus as it goes down into your stomach. Enough fluid intake is crucial, as the fiber binds fluid in your digestive tract. Repeat this procedure (1 ½ teaspoons of psyllium husk powder with lots of water) at lunchtime. You have now added 15 grams of fiber (2×7.5 grams) to your daily 25 grams of fiber. This brings you to a total of 40 grams of fiber, well above your goal of 38 grams. If you plan to use a fiber supplement it is recommendable that you start with small amounts of fiber. Start  maybe with just one teaspoon per day and increase the amount gradually.

The best is to switch your diet to the fiber rich diet

Your alternative would be to switch your diet to the fibre rich diet described above. Your basic intake was 38.1 grams, just enough to reach your goal. If you want to play it even safer, you may want to add another handful of walnuts (3 grams of fiber) or ¾ teaspoonful of psyllium husk powder with water to bring your total fiber intake to above 41 grams.

With the introduction of the various fiber products that you can buy at the health food store, it is now much easier to manage your total fiber intake.

 

Fiber, An Essential Food Ingredient

Fiber, An Essential Food Ingredient

Conclusion

In the past few years we heard from cardiologists that heart attacks, strokes and high blood pressure could all be helped by much higher fiber intakes. But the public in general has not listened very well to this message. Gastroenterologists also have been urging people to eat more fiber for colon cancer prevention, but many other cancers are also diminished by regular fiber intake. Breast cancer is one of these cancers responding to extra fiber intake. The bottom line is that we all need to pay attention to what we eat. We need to learn how little fiber there is in many foods. The tables can be found online. It may come as a surprise to you that a healthy bowl of tossed salad has only very little fiber. The total fiber content in our food may not add up to what we need (see table above). Simply supplement with psyllium husk powder or another fiber supplement. Do not forget to drink plenty of liquids. This is not only help for those who experience constipation. It is powerful prevention of heart attacks, strokes and many cancers.

Nov
30
2013

Statins Can Hurt The Consumer

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

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

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

Facts about cholesterol

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

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

Statins Can Hurt The Consumer

Statins Can Hurt The Consumer

How the traditional thinking about cholesterol has changed

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

How do statins work?

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

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

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

New information from the Framingham Heart Study

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

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

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

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

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

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

How alternative treatment can save you from heart attacks

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

Which supplements prevent heart attacks and strokes?

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

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

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

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

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

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

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

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

Conclusion

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

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

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

 

References

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

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

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

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

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

Last edited Nov. 7, 2014