Dec
23
2023

Any Form of Exercise is good

Here are a few items that can prolong life; among them any form of exercise is good. This article concentrates on the exercise part in relation to longevity. A recent publication described how regular exercise prolongs your long-term survival. According to a study released on occasion of the American Heart Association’s Scientific Session 2023 there are 8 major factors that prolong life: healthy diet, physical activity, nicotine exposure, sleep health, BMI, cholesterol, blood sugar, and blood pressure.  Among this group of factors regular physical activity plays a major role to prolong your life. Researcher who studied various people found that those who neglected their physical health had a chronological age of 53, but their average biological age was 57. On the other hand, a group of fit people who engaged in regular physical exercise had a chronological age of 41 years, but a biological age of 36.

Clinical trials showing that any form of exercise is good

JAMA Internal Medicine study by Dr. del Pozo Cruz 

This study examined what the optimal amount of physical activity per week is to reduce mortality compared to an inactive population. 500,705 eligible US adults were observed for about 10 years. The abbreviations that the authors used in the study were as follows:

MPA: moderate aerobic physical activity

VPA: vigorous aerobic physical activity

MSA: muscle-strengthening activity

Results of mortality reduction with various amounts of physical activity

  • The best group engaged in more than 0 to 75 minutes of MPA combined with more than 150 minutes of VPA and 2 or more MSA sessions per week. Their mortality rate was 50% lower than an inactive comparison group.
  • The optimal combination for reduction of cardiovascular disease (CVD) and cancer mortality risk was as follows: more than 150 to 225 minutes of MPA, more than 0 to 75 minutes of VPA, and 2 or more MSA sessions per week. This reduced combined mortality of CVD and cancer by 70%.
  • The researchers stated that the adjusted mortality rates represented 50% lower mortality rate for all-cause and cancer mortality. The mortality rate for CVD mortality was 3-fold lower than for inactive controls.

Smallest amount of exercise that reduces mortality

In a study published in the European Heart Journal the authors asked how little exercise per week was enough to reduce mortality from heart disease. They found that it takes at least 15–20 min/week of vigorous physical activity (VPA) to reduce mortality from heart attacks by 16–40%. If you increased the exercise level by 50–57 min/week the mortality rates reduced even further.

Are physically active jobs healthy?

Recent research showed that people who work in physically demanding jobs are more likely to develop early cognitive impairment. This is the pre-stage of Alzheimer’s disease. 15.5 % of people who worked in high levels of occupational physical activity developed dementia. This compared to 9% risk for people whose work involved a low level of physical activity, not too much and not too little. The finding confirms the notion that there is a need for balance of physical exercise. Several publications stressed what is optimal in terms of exercise: vigorous (75 to 300 minutes per week) and moderate physical activity (150 to 600 minutes per week). People who expose themselves to these amounts of exercise live the longest and stay healthy.

Discussion

The studies discussed here showed that the right amount of exercise can reduce mortality from heart disease and cancer. However, exercise is not the only factor that can do this. It is important to combine regular exercise with a healthy diet. Your diet should consist of fruits and vegetables, whole grains, low-fat dairy products, lean proteins and limit saturated and trans-fat, added sugars, and sodium. In addition, you need enough sleep, maintain a healthy weight, manage your stress, and don’t smoke.

Any Form of Exercise is good

Any Form of Exercise is good

Conclusion

In this review I touched on the importance of regular exercise to reduce mortality from heart disease and cancer. Vigorous (75 to 300 minutes per week) and moderate physical activity (150 to 600 minutes per week) reduce mortality from heart attacks by 16% to 40%. But physical exercise is only one factor of mortality reduction. If you want the full benefit from other factors, you must quit smoking, eat a Mediterranean type diet with fruits and vegetables, whole grains, low-fat dairy products and lean proteins. Also you should limit saturated and trans-fat, added sugars, and sodium. In addition, you need enough sleep, maintain a healthy weight and manage your stress. Once you adopted this lifestyle, you live longer and you will get less diseases.

Oct
10
2020

Medical Myths about Aging

Medical myths about aging are easy to debunk. Many people believe that it is inevitable that they become disabled as they age, their lives become unbearable, without passion, boring and full of pain. Some aspects of your health may decline with age, none of the myths discussed below is inevitably happening in everyone. Studies showed that a positive outlook on aging and life in general will help you to live longer and stay healthier.  Here I discuss 7 common myths about aging.

Myth 1: Everyone will experience physical deterioration

It is common for people to experience reduced muscle strength, increased blood pressure, excessive fat accumulation and osteoporosis. A study with 148 older patients showed that an expectation of reduced fitness in older age actually resulted in less physical activity when older age arrived.

But you can maintain good cardiovascular function and good muscle strength with a regular exercise program.  This study showed that men and women can reduce mortality by exercising regularly, even in older age.

Myth 2: Older adults cannot exercise

There are several reasons why older people stop exercising or are afraid to start exercising. People use the excuse of their arthritis getting worse from exercise. But studies showed the opposite: joint function improves and joint pains are getting better with exercise. Your muscles get stronger and you are less likely to fall. Your heart and lungs are improving their functions and your mentation improves. Exercise increases the HDL cholesterol, which reduces the risk for heart attacks and strokes.

Myth 3: As we age, we need less sleep

For many years there was the notion that older people need less sleep. What was not known then was that people above the age of 60 have no appreciable secretion of melatonin from the pineal gland. But when they replace their melatonin deficiency by taking a nighttime dose of 3 mg at bedtime, they will sleep better and longer. They may need a second dose of melatonin in the middle of the night. We need 7 to 8 hours of sleep at night for our diurnal hormone rhythm.

This will also slow down our aging clock.

Myth 4: Your brain slows as you age

Dementia is common when you get older. 13.9% have it at age 71 and older. 37.4% have dementia over the age of 90. But the majority, namely 86.1% in the 71+ age group and 62.6% above the age of 90 do not have dementia. A Mayo Clinic study showed that when the person engaged in artistic activities in midlife or later in life the risk for mild cognitive impairment (MCI) development was reduced by 73%, involvement in crafts reduced it by 45% and engagement in social activities by 55%. In a surprise finding the use of a computer late in life was associated with a 53% reduction in MCI development. These are very significant observations.

Physical activity reduces risk for dementia

Apart from stimulating your brain, physical activities also significantly reduce the risk for dementia. A synopsis of 11 such studies showed that dementia is reduced by 30% when physical activity is started in midlife and the person is aging compared to non-exercisers.

Myth 5: Osteoporosis occurs only in women

There is a serious misunderstanding about osteoporosis. Several factors work together that can cause osteoporosis. Women in menopause are more likely to develop it due to the missing ovarian hormones estrogen and progesterone. These hormones work together and stimulate vitamin D induced calcium deposition into bone as well as decreasing bone resorption.

Vitamin K2 also deposits calcium into the bone. In postmenopausal women who take bioidentical hormone replacement, vitamin D and K2 the bone density remains strong. Unfortunately, the opposite is true in postmenopausal women who take synthetic hormones. Synthetic hormones have side chains that do not fit the natural hormone receptors of a woman. This is why osteoporosis persist. And, yes, men get osteoporosis, but typically 10 years later. Typically, they get into andropause where testosterone production declines 10 years later.

Myth 6: People stop sex as they age

With age men can develop erectile dysfunction (ED) and women vaginal dryness, both of which can interfere with having sex. A large study showed that only 0.4% of men in the age group 18-29 had ED. In the age group of 60-69 there were 11.5% who suffered from ED. What this means though is that 88.5% of men age 60-69 did not suffer from ED. Fortunately for those who have ED drugs like Cialis and Viagra can correct their problem and they can have regular sex. What a change from 25 years ago when none of these drugs were available (approval of Viagra by FDA in 1998 and of Cialis in 2003).

Bioidentical hormone replacement beyond menopause and andropause preserves your normal sex drive as well. There are additional benefits of bioidentical hormones. They have positive effects on the heart, brain, bones and the muscle mass.

Myth 7: It is too late to stop smoking now

One of the myths that many older smokers like to say is that it would be too late to stop smoking. They think the damage to heart and lungs is permanent and quitting now is too late. Fact is that quitting smoking immediately improves your blood circulation and gives you more oxygen. In just 1 year the risk of getting a heart attack is cut into half. In 10 years, the risk of a heart attack or stroke is the same as that of non-smokers. There is a reduction of getting lung cancer by half.

Medical Myths About Aging

Medical Myths about Aging

Conclusion

There are all kinds of medical myths about aging. We may think that physical deterioration is inevitable. Or we believe that older people cannot exercise. And we cannot help it, but our brain slows down as we get older. And there is the question whether we need less sleep as we age. Osteoporosis is a disease of women, is it not? These older couples, they don’t have sex any more, do they? And is it too late to stop smoking now that I am 65 years old? All of these myths exist, but there is a need to debunk them.

The truth behind the medical myths about aging

I explained in detail what the medical truths are behind these questions. Many of these myths have developed in the past. But with regular exercise, balanced nutrition (Mediterranean diet) and a positive attitude much of these old myths can be overcome. Bioidentical hormone replacement when hormones are missing is another powerful tool. Yes, we all age. But we are still living and can enjoy life as long as it lasts.

Apr
06
2019

Healthier After Age 60

Unhealthy lifestyles have staying power, so what can we do be healthier after age 60? A recent CNN article describes 10 ways how to adopt a healthier lifestyle when you get close to retirement.

The thinking is that 5 years before your retirement at 65 you should perhaps adopt a healthier lifestyle.

2017 study by Dr. King regarding lifestyles before and after retirement

Dr. Dana King was the author of a 2017 study where lifestyles before and after retirement were compared.

Seven factors were examined, namely cardiovascular factors including physical activity, healthy diet, healthy weight, smoking status, total cholesterol, glucose, and blood pressure. Retirees were more likely to have poorly controlled blood pressures compared to non-retirees. 23.9% of retirees had uncontrolled blood pressure versus 15.1% of non-retirees. This difference was statistically significant. There was another significant difference with regard to physical activity. Retirees were 1.85-fold more active than non-retirees. But sadly, the other 5 of the 7 points did not significantly improve. There were no differences in healthy weight, smoking rates, healthy diet, glucose levels or cholesterol control.

Healthier after age 60: how to change your diet

Adopt a Mediterranean diet. This is an anti-inflammatory diet that prevents hardening of the arteries. It lowers the bad LDL cholesterol and also triglycerides. It is also recommended to consume at least 2 tablespoons of olive oil per day. When you cook only with olive oil and use only olive oil and Balsamic vinegar for salads, it is relatively easy to reach or surpass the recommended 2 daily tablespoons of olive oil.

Healthier after age 60: how to change your exercise status

You have more time when you retire. The easiest to get into a routine regarding regular exercise is to get a membership in a gym. In the beginning you may want to see a trainer to show you some routine exercises on weight machines. You start the program off with 30 minutes on the treadmill. Before long you get used to the exercise routine and you feel stronger. But your system also produces much more of the protective HDL cholesterol, which is sensitive to regular exercise. If you have been physically inactive, get some input from your health care provider.

Healthier after age 60: how to change your weight

It is not exercise, but a healthy diet, which controls your weight. Having adopted a Mediterranean diet is a big first step in that direction. But it is also important to cut out sugar and starchy foods (potatoes, rice, bread, muffins, pasta etc.). This will reduce your LDL cholesterol and triglycerides. On the long term you prevent heart attacks and strokes.

Healthier after age 60: how to change your smoking status

It is old knowledge that smoking cuts down on life expectancy. Better quit smoking now than later. It prevents heart attacks, strokes, lung cancer and many other cancers.

Healthier after age 60: how to lower your blood pressure

Regular exercise, weight loss and quitting to smoke will all lower your blood pressure. Some people though continue to have high blood pressure. It is important to seek medical advice regarding this. People with persistent elevated blood pressure need medication to have this controlled in order to avoid getting a hemorrhagic stroke.

Healthier after age 60: how to lower your glucose levels

The diet I described will help you to control your blood sugars. Your doctor can order a hemoglobin A1C, which summarizes your average blood sugars over the past 3 months. Controlling your blood sugar is important to prevent type 2 diabetes. Diabetes reduces your life expectancy significantly. The risks are heart attacks, strokes, blindness, leg amputations, kidney damage and cancers.

Healthier after age 60: how to lower your cholesterol

When I discussed a healthy diet, I indicted that it lowers the LDL cholesterol and triglycerides. This reduces the risk of hardening of the arteries. A regular exercise program increases the protective HDL cholesterol, which reinforces the protection from heart attacks and strokes.

Healthier After Age 60

Healthier After Age 60

Conclusion

Whether we retire or not, we should all strife to achieve these 7 changes of lifestyle that Dr. Dana King has discussed. They were cardiovascular factors including physical activity, healthy diet, healthy weight, smoking status, total cholesterol, glucose, and blood pressure. Each of these factors is important on its own. But when you tackle all of them simultaneously, there is a potentiation of these factors that allows you to get super-healthy. That’s what you want for your life after age 60. It is not too late to start! You want to be healthier after age 60!

Nov
30
2013

Statins Can Hurt The Consumer

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

Sep
01
2006

Food Choices Can Boost Good Cholesterol

Dr. Andrew Pipe, a cardiologist at the University of Ottawa Heart Institute, sees a lot of people with cardiovascular problems. He also has found that telling patients to “reduce their cholesterol and get the triglycerides down” is not very helpful. Dr. Pipe is aware that we are living in a world where people are constantly tempted by junk food, and it is not surprising that obesity is one of the consequences.
It sounds daunting to a person with a lifetime of poor food habits and poor lifestyle choices to make changes. He believes that simplifying advice for healthy living can be brought down to 5 F’s for healthy living:

-Fruit and vegetables, 3-4 each day
-Fish, 3-4 per week
-Fibre, 5 per day
-Fat, 3-6 per day. Monounsaturated fats are best
-Fast food: avoid it!

Food Choices Can Boost Good Cholesterol

Food Choices Can Boost Good Cholesterol

To this list Dr. Pipe added two more Fs:
– “Fysical” activity, 30-40 minutes per day. This may be a misspell, but it is the best way to increase your good cholesterol (HDL)
-Fun, unlimited. Your food choices and exercise need to be enjoyable and appealing or the plan does not work in the long run.

Here is a blog about slowing aging and avoiding disabilities: https://www.askdrray.com/slow-down-aging-and-prevent-disabilities/

Reference: National Review of Medicine, August 30,2006, page 10

Last edited November 1, 2014

Mar
01
2006

Dementia Prevented With Diet And Exercise

According to an Australian review a low-fat diet along with physical and mental activity is the best way to avoid dementia late in life.
The Australian team looked at numerous studies and concluded that many drugs and supplements promoted as treatments do not work. They did find that maintaining healthy blood pressure levels and an ideal body weight, staying physically and mentally active and consuming a low-fat diet reduces the risk of developing dementia. Dr. Michael Woodward, lead researcher of the report “Dementia: Can It Be Prevented?” states a very simple fact: any advice that is good for the heart is also good for the brain. A number of dietary supplements and medications have been suggested as being useful in the prevention of dementia, but none of them have been conclusive. One small study from Portugal suggested that even coffee could prevent dementia. It made headlines in the media, especially in the American press. However this was a small study involving only 54 people in Portugal. Another study a few years ago claimed that hormone replacement therapy for menopausal women reduced the risk of dementia. Again, this study got a lot of coverage. The study had a strong selection bias: these women were generally more health conscious, in better physical health and from a more socioeconomically privileged background.

The results of this review are further confirmed by Australian and American researchers led by Dr. Ralph Martins of the Center for Aging and Alzheimer’s disease in Joondalup, Australia and Dr. Samuel Gandy of the Farber Institute of Neurosciences in Philadelphia. They found that overweight and obese people are having a higher risk of developing Alzheimer’s disease than normal weight individuals. Increased body mass index and higher levels of plasma amyloid-beta, which is a key substance in the development of Alzheimer’s, go hand in hand.

Dementia Prevented With Diet And Exercise

Dementia Prevented With Diet And Exercise

Experts in the area of dementia caution that we cannot count on drugs and supplements, instead prevention is the key with dementia, which comes in the form of a healthy lifestyle.

More info about:

1. Research that has revealed a number of causes for Alzheimer’s disease: http://nethealthbook.com/neurology-neurological-disease/alzheimers-dementia-and-delirium/alzheimers-research/

2. Fitness:  http://nethealthbook.com/health-nutrition-and-fitness/fitness/

The Medical Post, January 24,2006,page 39.

3. Blog showing that exercise delays onset of Alzheimer’s: https://www.askdrray.com/regular-exercise-will-delay-onset-of-alzheimers-or-dementia/

Last edited October 30, 2014

Nov
01
2005

More Is Not Always Better In Exercise

Physical activity and good nutrition are the keys for a healthy immune system. Dr. David Nieman, PhD, from the Appalachian State University of Boone, N.C. has found that exercise and nutrition play a strong role in boosting immunity. His past research showed that women who walked briskly for 30 to 45 minutes five days for 12 to 15 weeks had colds half as often as inactive women. This is true even for the aging population, where immunity tends to decline; some research has shown that fit elderly people have better-preserved immune systems.
It is tempting to conclude, that more exercise would lead to even better benefits, but the research results are quite different. Exercising for too long (beyond 90 minutes) appears to cause a steep drop in immune function that can last up to 24 hours. In the 1987 Los Angeles Marathon, Dr. Nieman surveyed 2,311 runners and found those who raced were six times more likely to get sick afterward compared with those who dropped out of the race for non-medical reasons. Runners who trained more than 96 km per week during the two months before a race doubled their chances for sickness compared with those who trained less than 36 km per week.
In lab tests on marathon runners who ran on a treadmill for 90 minutes to 3 hours at 80% aerobic capacity, the level of immune cells had decreased (neutrophils, monocytes, natural killer cells, T cells and B cells). All these players in the immune system leave the blood and concentrate on the effort to do repairs and maintenance on the muscles. As a result the front line soldiers are unavailable for defense when viruses are present.

More Is Not Always Better In Exercise

More Is Not Always Better In Exercise

The best strategies for active as well as not-so-active individuals remain similar.
-Minimize life stresses-mental and emotional.
-Avoid over training and chronic fatigue.
-Curb exercise if you have a fever or systemic infection.
-Eat a well-balanced diet with adequate energy.

More about fitness: http://nethealthbook.com/health-nutrition-and-fitness/fitness/

Reference: The Medical Post, October 11, 2005, page 19

Last edited October 29, 2014

Mar
01
2005

Liver Cirrhosis Threatens Overweight Children

Generally the condition of liver cirrhosis has been associated with excessive alcohol intake, and the victims have been adults.
A similar condition is the fatty infiltration of the liver, where the function becomes impaired through the growth of fatty tissue, which replaces healthy tissue. In its worst form this non-alcoholic fatty liver disease can advance to cirrhosis and end-stage liver disease. So far this devastating course of illness has been seen in adults, but it is not confined to the adult population. The most important risk factor for this disease is obesity, and with one in three children in Canada now overweight, the previous adult-only disease is now affecting kids. Non-alcoholic fatty liver disease is now the most common cause of abnormal liver tests.

Dr. Ariel Feldstein, a pediatric gastroenterologist from the Mayo Clinic in Rochester reports that the average age of children with these symptoms is about 12, which is an alarmingly low age for this picture. There is also a warning, that children do not even have to sport a sky-high body-mass index (BMI). The risk is already significant with a high BMI.The most direct approach to prevent type 2 diabetes and fatty-liver disease in children has to start within the family. Instead of singling out the child it is important to work together as a family to become healthier. The terms”fat”, “chubby”, “exercise” and “diet” are less conducive to improvement than “physical activity” and “better nutrition”. Consistent minor changes are also more important than crash diets that come and go.

Liver Cirrhosis Threatens Overweight Children

Liver Cirrhosis Threatens Overweight Children

Eating more vegetables and fruit, not eating and snacking mindlessly in front of the TV, eating together as a family and preparing healthy snacks instead of tossing a cookie bar or a bag of chips into the lunch bag are all ways that benefit the entire family.
A study from Dr. Robert Berkowitz at the Children’s’ Hospital of Philadelphia affirms even more, that prevention has to start with the parents: children born to overweight mothers have a higher risk of following the pattern of having a high body mass index than those whose parents were normal weight.

More information about liver cirrhosis: http://nethealthbook.com/digestive-system-and-gastrointestinal-disorders/liver-cirrhosis/

Reference: The Medical Post, February 15, 2005, page 21

Last edited October 27, 2014