May
13
2024

Reduction of Alcohol Intake Is Associated with Less Heart Attacks and Strokes

Recently Korean researchers showed that a reduction of alcohol intake is associated with less heart attacks and strokes. This was published on March 28, 2024. The researchers followed 21,011 participants who were heavy drinkers. The baseline examination took place 2005-2008 and a follow-up exam was between 2009 and 2012. Definition of heavy drinking was as follows:

  • For men: 4 drinks (56 g) per day or more than 14 drinks (196 g) per week.
  • For females: more than 3 drinks (42 g) per day or more than 7 drinks (98 g) per week.

Reduced alcohol intake resulted in a 23% reduced risk of heart attacks or strokes, which was a significant finding. Patients benefited most from alcohol reduction regarding angina and ischemic strokes. This study was also reviewed in Medscape:

Other studies showing benefits of less alcohol intake

A 2018 study in Plos Medicine examined a US population of 99,654 adults (68.7% female).

At the time of the enrolment, they were 55–74 years old. The overall time of follow-up was 8.9 years. Scientists looked at the various risks of cancer development or deaths from cardiovascular disease as a function of the amount of average alcoholic drinks consumed. The results were as follows:

  • Never drinkers: 1.09-fold risk of cancer or death.
  • Infrequent drinkers: 1.08-fold risk of cancer or death.
  • Heavy drinkers: 1.10-fold risk of cancer or death.
  • Very heavy drinkers: 1.21-fold risk of cancer or death.

Heart attack risk and cancer risk from alcohol consumption are different

In addition, with respect to cardiovascular risk it followed a J-curve. This means that light alcohol use reduced the probability of death from a heart attack or stroke, but with moderate or heavy alcohol use the risk of death increased. In contrast, with respect to cancer there was a linear curve, which means that no dose of alcohol was safe for cancer development. The more alcohol you consumed, the higher the risk of cancer development was. Another study also showed that only moderate alcohol consumption benefited people in preventing heart attacks and strokes.

Chinese study

In 2021 a joint US/Chinese study examined the effects of alcohol consumption on cancer, deaths from cardiovascular disease and mortality in general. 83,732 adult Chinese participants were free of cardiovascular disease (CVD) and cancer in the beginning of the study. The researchers categorized participants based on self-reported alcohol consumption into 6 groups.

  1. 0 g alcohol/week (non-drinkers).
  2. 1-25 g alcohol/week.
  3. 26-150 g alcohol/week.
  4. 151-350 g alcohol/week.
  5. 351-750 g alcohol/week.
  6.  > 750 g alcohol/wk.

Results of the US/Chinese study

After 10 years of follow-up there were 6411 cases of CVD, 2947 cancers and 6646 deaths. After 10 years of observation researchers calculated the risk for cancer, CVD and mortality as follows. The risk groups are the same as mentioned above.

The lowest risk was group 2 with 1-25 g alcohol per week, which was set as 1.0. In comparison to these non-drinkers had a risk of 1.38-fold.

  1.     1.38-fold risk
  2.     1.0
  3.     1.15-fold
  4.     1.22-fold
  5.     1.33-fold
  6.     1.57-fold

The peculiar finding in this study was that non-drinkers had a risk of developing cancer, heart attacks or strokes like heavier drinkers. The risk curve has the name of a J-curve, which means the risk goes first down (like group 2, the 1-25 g alcohol/week group). Subsequently the risk curve goes up in a linear fashion. When people smoke and drink the risk is higher than the risks of people who only drink alcohol.

Reduction of Alcohol Intake Is Associated with Less Heart Attacks and Strokes

Reduction of Alcohol Intake Is Associated with Less Heart Attacks and Strokes

Conclusion

The fact that alcohol is a cell poison has been public knowledge for some time. I reviewed three studies that showed that less alcohol consumption saves lives. It does so by causing less cancer, heart attacks and strokes. The peculiar finding was that the group consuming 1-25 g alcohol/week had the best health statistic. This group had the lowest risk of causing cancers or cardiovascular disease (CVD). In comparison non-drinkers had a 1.38-fold risk to cause cancer or CVD. Those participants who were smoking as well had risks much higher than people consuming alcohol alone. If you want to live longer and stay healthy don’t smoke and drink not more than 1-25 g alcohol/week. This translates into 1.6 to 1.8 alcoholic drinks per week.

Dec
09
2023

Too much Ultraprocessed Food Makes you sick

A Lancet study published on Nov. 13, 2023 found that too much ultraprocessed food makes you sick. Researchers noted that ultraprocessed animal products and sweetened beverages were linked to an increased cancer risk as well as other diseases such as strokes or diabetes.

In Europe more than half of the food intake consists of ultraprocessed food. In the US a 2019 study found that 71% of the food supply is ultraprocessed.

Details of the study

The details of the study were summarized in a CNN report. Researchers of the study collected nutritional data from 266,666 men and women (60% were women) from 7 European countries between 1992 and 2000. The researchers followed the participants for 11 years. During that time they observed the participants for the development of chronic diseases and cancer. During the observation time 21,917 primary cancers, 10,939 cardiovascular events, and 11,322 type 2 diabetes cases developed. On entry into the study participants were questioned about their food intake in the past 12 months. This was matched with the NOVA classification system. It became clear that not all ultraprocessed foods were detrimental to the health of the participants. Animal products and sugar-sweetened drinks and foods caused chronic diseases in the participants of the study. However, ultra-processed breads, cereals or alternative plant-based products were neutral in terms of health risks.

Main findings of the study: too much ultraprocessed food makes you sick

The main findings of the study were that ingesting mostly ultraprocessed food leads to a 9% increase of heart attacks, strokes, diabetes and cancer. This is in comparison to controls who ate very little ultraprocessed food. However, when you reduce your intake of ultraprocessed food your risk of developing these diseases reduces. The key is to eat more fruit and vegetables and concentrate on eating minimally processed food.

Other studies with similar findings

In 2022 the British Medical Journal published two studies that documented a higher colorectal cancer rate and cardiovascular disease rate when subjects were eating larger amounts of ultraprocessed foods (UPF). Specifically, when men had exposure to a high percentage of UPF in their diet they developed 29% more colorectal cancer after 28 years of observation in comparison to men who ate a low percentage of UPF. A related study that went on for 14 years showed a 32% higher risk for death from cardiovascular disease for men who ate a high UPF diet in comparison to men on a low UPF diet.

French study 2019

A French study in 2019 followed 44, 551 French adults 45 years or older for 7.1 years. A 10% increase of consumption of ultraprocessed food caused a 14% higher risk of all-cause mortality. The authors stated that 80% of all premature deaths from noncommunicable disease are due to cardiovascular disease (CVD), respiratory disease, cancer, and diabetes. The authors discussed in detail the problems with overconsumption of ultraprocessed food.

Some of the contents of ultraprocessed food

Ultraprocessed food contains:

  • High salt content, and high sodium intake has been associated with cardiovascular deaths and increased stomach cancer risk.
  • Excessive amounts of added sugar. There is an association between added sugar consumption and an increased risk of mortality from cardiovascular disease.
  • Ultraprocessed foods contain very little fiber. More dietary fiber in one’s diet has an association with lower death rates.
  • Studies have estimated that reducing saturated and trans fats, salt, and added sugar in the diet prevent cardiovascular deaths.
  • High temperature food processing produces acrylamide. Acrylamide is a known carcinogen.
  • Consumption of processed meat products causes a higher risk of colorectal cancer and stomach cancer.
More ingredients of ultraprocessed food
  • Artificial sweeteners can alter microbiota and can cause the onset of type 2 diabetes and metabolic diseases.
  • With bisphenol A coating in food packaging endocrine disruptors enter the food. Bisphenol A causes endocrine cancers and metabolic diseases, such as diabetes and obesity.
  • The food industry uses additives frequently in their formulations. Some studies raised concerns about the health consequences of food additives. For instance, the food industry uses titanium dioxide widely. There is an association of titanium dioxide and increased risk of chronic intestinal inflammation and carcinogenesis.

It is easy to see that when we expose our bodies to a mix of these ingredients this can cause cardiovascular diseases, cancers and diabetes. The final outcome is that this leads to premature deaths.

Too much Ultraprocessed Food Makes you sick

Too much Ultraprocessed Food Makes you sick

Conclusion

Too much ultraprocessed food (UPF) makes you sick. This is the conclusion of a large study, which the Lancet published on Nov. 13, 2023. Researchers followed 266,666 men and women (60% women) for 11 years. The main findings of the study were that ingesting mostly ultraprocessed food leads to a 9% increase of heart attacks, strokes, diabetes and cancer. This is in comparison to controls who ate very little ultraprocessed food. Other studies going back to 2019 and 2022 showed very similar findings.

Other studies

A French study from 2019 noted that a 10% increase of consumption of ultraprocessed food caused a 14% higher risk of all-cause mortality. Several studies in 2022 showed that men who had an exposure to a high percentage of UPF in their diet developed 29% more colorectal cancer after 28 years of observation in comparison to men who ate a low percentage of UPF. A related study that went on for 14 years showed a 32% higher risk for death from cardiovascular disease for men who ate a high UPF diet in comparison to men on a low UPF diet. It follows from this data that a simple diet consisting of vegetables, fruit, nuts and lean meat (chicken turkey, fish) with minimal amounts of UPF protects you from premature death.

Apr
06
2023

Erythritol is Linked to Heart Attacks and Strokes

A recent publication found that erythritol is linked to heart attacks and strokes. The study from the Cleveland Clinic was published Jan. 19, 2023 in Nature. It showed that people with diabetes had a 2-fold risk of getting a heart attack or stroke. Researchers measured the highest concentration of erythritol in their blood versus a control group with no erythritol in it. The study further showed that erythritol causes platelets to form clots, which could break of and travel to the heart or brain vessels. This triggered a heart attack or stroke. Dr. Stanley Hazen, director of the Center for Cardiovascular Diagnostics and Prevention at the Cleveland Clinic Lerner Research Institute said: “We never expected this. We weren’t even looking for it.”

Erythritol is what causes heart attacks and strokes

What the research team was looking for was “find unknown chemicals or compounds in a person’s blood that might predict their risk for a heart attack, stroke or death in the next three years. “This is how erythritol was identified as a risk factor.

Erythritol is a sugar alcohol

Like sorbitol or xylitol, erythritol is a sugar alcohol, which occurs in many fruits and vegetables. Erythritol has less laxative effect than some of the other sugar alcohols. It tastes like sugar and adds bulk to any stevia-based sweeteners. These are the reasons why it became the preferred zero calorie sweetener of the industry. Also, in a mixture it diluted the pronounced sweet effect of stevia, but added the crystalline texture appearance like sugar to the sweetener. This is what the consumer expected of a sweetener.

The clinical trials showing there is a link between erythritol and heart attacks as well as strokes

One group of patient’s tests were 1,157 blood samples from people at risk for heart disease collected between 2004 and 2011. Another batch of blood samples came from over 2,100 people in the United States and an additional batch from 833 samples gathered by colleagues in Europe through 2018. 75% of the participants in all three populations had coronary disease or high blood pressure, and about 20% had diabetes. Over 50% were male and in their 60’s and 70’s.  All of those samples showed the following. Higher levels of erythritol showed a correlation to a greater risk of heart attack, stroke or death within three years.

Blood coagulation

Our blood has a delicate balance between coagulation from clotting factors and platelets on the one hand and fibrinolysis, which counters clotting, on the other hand. This ensures that we are not spontaneously bleeding and also not getting clots from hypercoagulation. The researchers found that it is this balance, which erythritol disturbs. Dr. Hazel said: “But what we’re seeing with erythritol is the platelets become super responsive: A mere 10% stimulant produces 90% to 100% of a clot formation”. This was the reason for the higher heart attack and stroke rates in the higher levels of erythritol in the blood.

Erythritol levels checked in healthy volunteers

The last part of the study involved tracking blood tests of erythritol in 8 healthy volunteers. They drank beverages containing 30 Grams of erythritol, which is the amount many Americans consume. According to the National Health and Nutrition Examination Survey, which examines American nutrition each year 30 Grams is the average daily consumption of Americans. The researchers took blood tests of erythritol for the next 3 days including tests of clotting risks. Dr. Hazen said: “Thirty grams was enough to make blood levels of erythritol go up a thousandfold. It remained elevated above the threshold necessary to trigger and heighten clotting risk for the following two to three days.”

Reaction of the industry

Robert Rankin, the Calorie Control Council’s executive director, an industry association, wrote in an email: “The results of this study are contrary to decades of scientific research showing reduced-calorie sweeteners like erythritol are safe, as evidenced by global regulatory permissions for their use in foods and beverages.” But this seems to be a lame excuse. The platelet clotting effect of erythritol simply was not what the FDA expected or tested for. The same was true for other regulatory bodies when they released it as safe. I have drawn my own conclusion and thrown out all sweeteners I had in my possession that contained erythritol.

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Conclusion

Sometimes studies come out of the blue, which change our everyday practice. One of these studies is Dr. Stanley Hazen, director of the Center for Cardiovascular Diagnostics and Prevention at the Cleveland Clinic Lerner Research Institute. He showed that erythritol as an artificial sweetener is not harmless as previously thought of.  This included the FDA as a regulatory agency, which labeled erythritol as GRAS (=generally recognized as safe). Now new evidence of clinical studies showed that erythritol is responsible for a twofold risk of heart attacks, strokes or death in the next three years. Dr. Hazen included all kinds of controls and also fed healthy volunteers erythritol. No matter how he looked at it, the risk remained.

Erythritol causes clots, which cause heart attacks and strokes

In animal experiments he could also show that erythritol caused platelets to stick together and cause clot formation. These clots could travel into the heart and brain vessels and cause heart attacks and strokes. For any consumer it is the most sensible approach to NOT use any sweetener that contains erythritol. This involves reading product ingredients before you buy any sweetener. Assuming that products are harmless, when the label reads “Stevia” is a fallacy! In numerous products the ingredient list will show the word “erythritol”. Buyer beware!

Jul
28
2022

What Electronic Cigarettes Do to You

A review paper of Canadian researchers showed what electronic cigarettes do to you. They can be an effective smoking cessation aid for motivated smokers who eventually want to quit. But when people continue to inhale electronic cigarettes, their use can cause heart attacks, strokes, high blood pressure and increased heart rates. With regard to the lungs electronic cigarettes can cause vaping-associated lung disease, obstructive pulmonary disease, asthma and chronic cough. A literature review showed that e-cigarettes are less harmful to the heart and the lungs than smoking combustible cigarettes.

Increased use of e-cigarettes in younger people

In Canada the 2017 Canadian Tobacco, Alcohol, and Drugs Survey, which included all ages, found that 15.4% tried e-cigarettes. But among adolescents between 15 to 19 years old 22.8% were using e-cigarettes. For young adults aged 20 to 24 the figure of e-cigarette users was 29.3%. In addition, there was a significant increase of Canadian adolescents aged 16 to 19 from 29.3% in 2017 to 37.0% in 2018. Data from the US shows similar trends. E-cigarette use among US high school students increased from 11.7% in 2017 to 27.5% in 2019.

Some facts about e-cigarettes, cigarette smoking and smoking cessation

  • First, researchers noted that the smoking of e-cigarettes has a 3.62-fold risk of leading to subsequent cigarette smoking.
  • Second, a UK study found that when people used e-cigarettes for smoking cessation, 80% of the e-cigarette group were still smoking e-cigarettes after 1 year. In contrast, only 9% of those who used traditional nicotine replacement therapy (Nicorette etc.) to quit smoking were still using nicotine replacement after 1 year.
  • One study compared heart attack rates in a group of regular cigarette smokers and compared this to e-cigarette smokers. Cigarette smokers had a 2.72-fold higher heart attack rate than non-smokers, while e-cigarette smokers had a 1.79-fold heart attack rate compared to non-smokers.

Effect of e-cigarette use on heart and lung disease

Several studies looked at the relationship between e-cigarette use, heart attacks and strokes. There was a 1.4-fold higher incidence of coronary artery disease in e-cigarette smokers in comparison to non-smokers. The e-smokers had a 1.71-fold higher stroke incidence and 1.59-fold higher heart attack rates. In a large metaanalysis done with e-cigarette smokers, researchers noted the following facts: Electronic cigarette smokers were compared to non-smokers. Researchers noted a 2.27-fold increase of the heart attack rates in e-cigarette smokers. There was a 2-fold elevation of the systolic and diastolic blood pressure in e-cigarette smokers.

Switching from cigarette smoking to e-cigarettes

Patients who switched from tobacco smoking to chronic electronic cigarette use had a 7-fold reduction of their systolic blood pressure and a 3.65-fold reduction of their diastolic blood pressure. The researchers concluded that switching from cigarette smoking to e-cigarettes had some merit in terms of risk reduction for cardiovascular disease. But the final judgment on this is still pending. Certainly, quitting entirely from cigarette smoking is the best choice. I reported previously that e-cigarette smokers find it difficult to quit completely and if they smoke conventional cigarettes to stop that.

Effect of e-cigarettes on lungs

In addition to cardiovascular effects there is a direct effect from e-cigarette smoking on the bronchial tubes and the lungs. The vaped substances from e-cigarettes contain a lot of noxious gases that irritate the lining of the respiratory tract. This syndrome is called EVALI (electronic vaping associated lung illness). In 2019 and 2020 there was a rush of EVALI cases in the US with 2807 hospitalizations and 68 deaths. In Canada there were 19 cases of EVALI, 15 hospital admissions, and no deaths. Patients with EVALI have problems breathing, they cough and they have chest pain. Researchers suspect that vitamin E acetate and tetrahydrocannabinol are the major culprits that cause EVALI. But at this time there is no definite proof for that.

Poor quality of vaping fluid from the black market

These substances are not present in commercial e-cigarettes, but when you buy vaping fluid on the black market, it is often mixed in. Prolonged use of e-cigarettes can cause changes on spirometry, such as chronic obstructive pulmonary disease (COPD). Chronic use of e-cigarettes may cause premature onset of COPD.

What Electronic Cigarettes Do to You

What Electronic Cigarettes Do to You

Conclusion

E-cigarette use is increasing at an alarming rate among youths and persons who never smoked. The emerging evidence from researchers showed that there is a risk when you expose yourself to the smoke of e-cigarettes. There is an association of both heart disease and respiratory disease to e-cigarette smoking, but the risk is less than with exposure to regular cigarette smoke. Some researchers think that a switch from cigarette smoking to e-cigarettes could provide a viable harm reduction strategy for some smokers. But unfortunately, many continue to smoke e-cigarettes instead of quitting altogether. And in this case the risks for heart disease and lung disease remain!

Feb
13
2022

How healthy are Carbohydrates?

A recent review article asked: how healthy are carbohydrates? The three food components that occur in natural food are carbohydrates, fats and protein. Among the carbohydrates it is important to distinguish between simple carbohydrates (such as sugar) and complex carbohydrates. Simple carbohydrates are readily absorbed into the blood, which causes an insulin peak. After a few hours the peak is gone, and there is a “crash”. You will know the feeling of feeling hungry just a few hours after eating doughnuts! Complex carbs like peas, beans, fruit and vegetables take longer to get digested. The final breakdown product of the digestive process is sugar as well. But this process takes longer meaning that the concentration of sugar in the blood is much lower. There is also no “crash”. The result is that complex carbs cause less insulin secretion into the blood.

Long-term effect of eating too much sugar

Integrated over several decades of life, this means that a person who constantly consumes beverages with sugar and snacks containing sugar is at a higher risk of developing type 2 diabetes. In contrast, a person who eats well balanced meals where the insulin secretion is low, will not develop diabetes and have much less hardening of the arteries. This translates into a lower risk to develop heart attacks and strokes.

The types of carbohydrates

Before I discuss the health effects of various carbohydrates, we need to look at the types of carbohydrates.

Simple carbohydrates

Table sugar is a disaccharide, which consists of one molecule of glucose and one molecule of fructose.

The enzyme amylase very quickly breaks down the chemical bond between fructose and glucose and creates these monosaccharides in the small intestine from which they are rapidly absorbed. Milk sugar is a disaccharide, which consists of a molecule of glucose bound to a molecule of galactose. Milk contains 2 to 8% of milk sugar. We have to watch these simple carbs, because they trigger insulin production and lead to accelerated hardening of the arteries, heart attacks and strokes.

Complex carbohydrates

In contrast, complex carbs are healthy, because they take some time to be digested in the digestive tract. They consist of polysaccharides, long chains of sugar molecules. Both starches and dietary fiber consist of complex carbohydrates. They often are present in vegetables and many fruit. Complex carbs slow down the absorption of their breakdown products and minimize the insulin response. Dietary fiber is the indigestible part of fruit and vegetables. It contributes to good gut health as the beneficial gut bacteria can multiply on the fibre particles.

Healthy carbs

When simple carbohydrates dominate in our food intake, we are in trouble because they are loaded with calories. Overconsumption of them leads to weight gain and obesity, to diabetes, heart attacks, strokes and even cancer. On the other hand, consumption of complex carbohydrates is healthy. We get them from eating apples, bananas, berries, vegetables like spinach, tomatoes and carrots. Other healthy complex carbs are whole grain flour, quinoa and brown rice. Black beans, lentils, peas and garbanzo beans are also healthy complex carbs. Dairy products like low fat milk, yogurt and ricotta cheese are healthy as well.

Mediterranean diet as an example of a healthy, balanced diet

In 2019 a study was published where women with polycystic ovary syndrome (PCOS) were either put on a Mediterranean diet or not. This study showed that a Mediterranean diet was anti-inflammatory, reduced insulin resistance and reduced testosterone levels in PCOS patients.  But the same is true in a general population. The Mediterranean diet is one example of a healthy, balanced diet with complex carbohydrates. It prevents insulin resistance, inflammation and hormone disbalance. Other diets have similar effects like the DASH diet, the Zone diet and the Pritikin diet.

Quantity and quality of your food intake matters

A 2018 study from India showed that it matters how many carbohydrates we consume.  On average Indians eat a diet with 65-75 percent of calories coming from carbohydrates. Many of these carbs are the unhealthy simple carbohydrates. How healthy are  carbohydrates? The authors recommended to reduce complex carbohydrates to 50-55% and to add 20-25% protein, mostly from vegetable sources and add 20-30% from fat. The fat consumption needs to include monounsaturated fats (e.g., olive oil, nuts and seeds). Among the carbs a lot of green leafy vegetables help to balance the diet. This prevents the development of type 2 diabetes, heart attacks and strokes.

The above addresses the issue of quality of food. But it is also important what quantity of food we are eating. This is where counting or estimating calories comes in. If we overeat, we will very quickly gain weight and eventually can develop obesity.

The glycemic index and glycemic load

In order to help you with the choice of right carbohydrates the glycemic index was developed.

Here is another reference about the glycemic index/glycemic load.

In table 1 towards the end of the last link you find a column designated “GI” for glycemic index. All the foods that have a value less than 55 are foods that you can eat freely.

Problematical carbohydrate foods

Baked russet potatoes and boiled potatoes are very high on the GI index list. Puffed rice cakes, doughnuts, jelly beans and corn flakes measure high on the glycemic index list. But water melons, dried dates, white bread and white rice are also items to be avoided.

You best avoid anything with a glycemic index above 55. The column to the right of GI shows you a serving size and the last column on the right the glycemic load. The lower the glycemic load per serving, the better it is for your health. The glycemic index and the glycemic load are useful concepts of helping you to sort out your diet items.

My wife and I used this in 2001 to shed weight. We both lost 50 pounds (=22.72 kilograms) each in a period of 3 months.

Fasting mimicking diet (FMD)

According to Dr. Longo intermittent fasting stimulates the stem cells of the bone marrow. This leads to new clones of lymphocytes (B cells and T cells), which are part of the immune system. Your immune system becomes stronger from this.

Dr. Longo has done detailed mouse experiments, which inspired him to develop a new diet plan. Patients would receive a fasting mimicking diet (FMD) on 5 consecutive days per month. The rest of the month consists of a normal, balanced diet. 5 days of the month the person consumes a low 600-800-calorie diet. This reduced calorie intake is enough to ensure adherence to the diet, but low enough to lead to enormous positive metabolic changes including youth-preserving stem cell stimulation.

I am following the FMD

I have followed a FMD since December 2017. It helps me to keep my weight (BMI) in the 21 to 22 range. I feel more energetic and have managed to stay in good health.

The above chapter on the FMD was previously published here.

How healthy are Carbohydrates?

How healthy are Carbohydrates?

Conclusion

Healthy eating consists of 50-55% calories from complex carbohydrates; add to this 20-25% protein, mostly from vegetable sources and add 20-30% of total calories from fat. The fat consumption needs to include monounsaturated fats (e.g., olive oil, nuts and seeds). Unfortunately, most “convenience foods” (=processed foods) are incompatible with a healthy lifestyle. They contain too much simple carbs (sugar). Many people live on 65-75 percent of calories coming from simple carbohydrates, which are too many carbs. It should be complex carbs that digest slower and that do not induce insulin resistance. The glycemic index and glycemic load are useful concepts to help you chose the right foods that keep you healthy. The fasting mimicking diet can help you to take the last few pounds off that may be difficult to shed. Weight loss and weight maintenance are possible when you choose the right foods.

Sep
04
2021

Effects of a Plant-centered Diet on Cardiovascular Disease in Midlife

A study followed younger patients for 32 years looking for the effects of a plant-centered diet on cardiovascular disease in midlife. The researchers determined the heart attack and stroke rates when the participants were in their 50’s to 60’s. When on a plant-based diet cardiovascular disease rates fell by 52% compared to a control group with a meat containing diet. One subgroup changed the diet from a regular diet to a plant-based diet over 13 years. This reduced the risk ratio by 61% for heart attacks and strokes when assessed later.

Details of this study

There were 4946 adults as participants of this 32-year study. They were recruited in 1985 and 1986, at which time none of them had cardiovascular disease. The study completed in 2018. The results were published on Aug. 4, 2021. The researchers assessed the plant-centered diet quality using a tool with the name “A Priori Diet Quality Score” (APDQS). The higher the score, the higher the quality of the food. This means the person consumed nutritionally rich plant foods, limited amounts of high-fat meat products and less healthy plant foods.

Although a plant-rich diet consisted primarily of nutritionally rich plant foods, small amounts of animal products were also allowed. This involved low-fat dairy products, non fried poultry and steamed or grilled fish. This made the diet tastier and ensured that people would stick to this diet for decades.

Improvements of heart attack rates with plant-centered diet

After 32 years 289 cases of cardiovascular disease developed. The researchers compared participants with the highest food quintile to participants with the lowest food quintile. As mentioned, the risk for participants on a plant-based diet was 52% lower to get a cardiovascular disease. Moreover, a subgroup changed from a higher risk (fatter meals, meat, less vegetables) diet to a lower risk diet (lean fat, lean poultry, vegetables). Physicians followed this subgroup for 13 years and the risk ratio for heart attacks and strokes fell by 61%.

Comparison to other diet studies

There are other studies that looked at the effect of diet changes on the risk of developing heart disease. One such study examined 86 cross-sectional studies and 10 prospective studies in a meta-analysis. Vegetarian diets reduced deaths from heart attacks by 25% and brought down the incidence of total cancer rates by 8%. A vegan diet reduced the risk of total cancer by 15%.

In a study from the United Kingdom dated March 2019 several clinical trials were analyzed regarding non-diabetic populations. The question came up, what the effect of a Mediterranean diet was on cardiovascular disease incidence and mortality. The authors reviewed 30 RCTs (49 papers) with 12,461 randomized participants and seven ongoing trials. In one study the observation time was 46 months. A Mediterranean diet reduced the cardiovascular disease mortality by 65%!

Another study from Spain

Another study from Spain published in 2019 examined 7356 older adults (average 67 years) and followed them for 6.8 years. The investigators kept track of the physical activity and put everybody except the controls on a Mediterranean diet. The group on the lightest leisure-time physical activity consuming a Mediterranean diet had the lowest mortality. The all-cause mortality of this group was 73% lower than the control group.

What is so healthy about the Mediterranean diet?

Despite a wide variation between all the 15 countries bordering the Mediterranean Sea, there are common characteristics: an abundance of vegetables and fruit, along with nuts and legumes. Cereal products are largely whole grain. Olive oil is the principal fat source, and people eat fish, seafoods and poultry in moderation. They consume red meat rarely. Cheese and yogurt can be part of the diet, depending on the region.

The first clinical evidence supporting the health benefits of the Mediterranean diet came from the Lyon Heart Study. The researchers placed patients who had a heart attack either on the diet designed by the American Heart Association or a Mediterranean style diet. After a follow-up of 27 months, the group eating the Mediterranean diet had a reduction of heart attacks by 73% and a decreased mortality by 70% compared to the other group.

More detail on the ingredients of the Mediterranean diet

An analysis of the various foods of the Mediterranean diet shows the reasons for the health benefits clearly. The fats that people on a Mediterranean diet eat are heart-healthy monounsaturated fats like olive oil or fats that contain omega-3 fatty acids. They come from fish (tuna, salmon, trout, sardines) or from plant sources (walnuts, other tree nuts and flax seed).

As there is an emphasis on natural foods, the diet is extremely low in trans fatty acids (hydrogenated fats), which otherwise increases the risk for cardiovascular disease. As people consume more than 300g of vegetables per capita daily, the contents of antioxidants and other beneficial plant chemicals is much higher in comparison to Western diets. There are many individual components of the Mediterranean diet that contribute to the reduction of disease. This is particularly true for heart disease. It also is apparent, that there is not one single food or nutrient that is responsible for the health benefits. What matters are the interactive effects of all the nutrients that lead to the health benefits.

No processed food means healthier living

The practical application does not mean deprivation and starvation, but a move away from processed fats (margarine), baked goods (donuts, muffins, pastries), and high saturated fat snacks and trans fats (chips, crackers, cookies, pies). Food choices move towards those of fresh fruit and vegetables, nuts, fish, and olive oil. Portions or servings have to be adequate to maintain a healthy weight.

Mediterranean food is not the heaping plate of pasta with an afterthought of vegetables. It also is not the super-size fast food pizza with pepperoni and cheese. Mediterranean food incorporates fresh food rather than fast food. It entails a shift from large portions of red meat to smaller portions of fish, a transition from highly processed foods to ample helpings of dark green vegetables with a dose of olive oil. Low amounts of alcohol, especially red wine can make a meal enjoyable, which means that the limit is one drink per day for women, and two drinks per day for men. After dinner go for a walk!

Olive oil is one of the reasons why the Mediterranean diet is so healthy

In the past it was thought that the monounsaturated fatty acids in olive oil would be the reason why it is protective of the heart. However, newer studies have shown that it is the polyphenols and among these in particular hydroxytyrosol that lower blood pressure and protect you from hardening of the arteries.

A 2012 study from Spain has found that mortality from heart attacks was 44% lower than that of a control group who did not incorporate olive oil in their diet.

How polyphenols in olive oil work for you

Only two tablespoons of extra virgin olive oil per day protect you from heart disease. It does so by reducing the total cholesterol level in the blood as well as the LDL cholesterol level. When there is more polyphenol in olive oil (such as in extra virgin olive oil), the body produces more HDL, which is essential to extract oxidized LDL from arterial plaque. On top of that polyphenol rich olive oil increases the size of the HDL particles (these larger particles have the name HDL2), which are more efficient in extracting oxidized LDL from arterial plaques. A Sept. 2014 study in humans showed that higher polyphenol olive oil as found in extra virgin olive oil caused an increase in the more effective HDL2 particles. This cleans out plaques from arteries more effectively than the regular, cheaper olive oil.

Effects of a Plant-centered Diet on Cardiovascular Disease in Midlife

Effects of a Plant-centered Diet on Cardiovascular Disease in Midlife

Conclusion

Several large, well-controlled studies showed that there are pronounced effects of a plant-centered diet on cardiovascular disease in midlife. Heart attack rates and mortality rates were reduced by 25% to 73% on a Vegan diet or a Mediterranean diet. When people combine a plant-centered diet with regular physical exercise they also live longer. One of the ingredients of a Mediterranean diet is extra virgin olive oil. It contains polyphenols that lower total and LDL cholesterol. It also increases the larger particles of HDL cholesterol with the name HDL2. HDL2 is more efficient in extracting oxidized LDL cholesterol from arterial plaques.

What you can eat on a plant-centered diet

A plant-centered diet incorporates fresh food rather than fast food. It entails a shift from large portions of red meat to smaller portions of fish, a transition from highly processed foods to ample helpings of dark green vegetables with a dose of olive oil. Instead of large portions of beef and sausages shift to seafood (tuna, salmon, trout, sardines), walnuts, other tree nuts and flax seed. The statistics clearly showed the effects of a plant-centered diet on cardiovascular disease in midlife with a reduction of heart attacks and mortality.

Some of the text above was published previously here.

Aug
21
2021

When Stress Becomes Abnormal

Recently CNN published an article that dealt about when stress becomes abnormal.

We all have experienced stress. It makes our heart beat faster and our breathing speeds up as well. But when the stressful situation is over, stress usually subsides also. Some people though have so much stress in their lives that they never completely recover from any stressful situation. They develop chronic stress, which can lead to physical illnesses or mental disease. I have previously written about “stress drives our lives”. In the following I am reprinting the next 5 paragraphs.

Heart attacks and strokes when stress becomes abnormal

In a 2015 Lancet study 603,838 men and women who worked long hours were followed for an average time of about 8 years with respect to heart disease or strokes. All of the subjects were free of heart attacks and strokes when they entered into the study. There was a total of 13% more heart attacks in those who worked extra hours in comparison to those who worked 40 hours per week or less. With respect to strokes there were 33% more strokes in those who worked long hours. Researchers noted a dose-response curve for strokes in groups with various workloads. Compared to standard working hours there were 10% additional strokes for 41-48 working hours, 27% for 49-54 working hours and 33% for 55 or more working hours per week.

Stress drives some of us to substance abuse

In order to cope with stress many of us “treat” daily stress with alcohol. It makes you feel good subjectively, but it can raise your blood pressure causing heart attacks and strokes down the road. A low dose of alcohol may be healthy, but medium and high doses are detrimental to your health.

Next, many people still smoke, although scientists have proven long time ago that it is bad for your health. It can cause heart attacks, various cancers and circulatory problems leading to leg amputations.

Overeating is another common problem. Comfort food relieves stress, but it causes us to put on extra pounds. As you know it is easier to put weight on than to take it off. Being overweight or being obese has its own problems: arthritis in the hips and knees makes walking more difficult. The metabolic syndrome sets in, which is a characteristic metabolic change causing diabetes, high blood pressure, heart attacks, strokes and certain cancers. The more weight you carry, the less likely you are to exercise. This can lead to further deterioration of your health.

Diabetes can occur when stress becomes abnormal

Stress causes too much cortisol secretion from the adrenal glands. This raises blood sugar, and when chronic can cause diabetes. In addition, unhealthy eating habits in an attempt to cope with stress can cause weight gain. Insulin resistance causes high blood sugars and diabetes.

Korean immigrant study

In a 2012 California study 148 adult Korean immigrants were examined. They all had elevated blood sugars confirming the diagnosis of type 2 diabetes. They had an elevated waist/hip ratio.

A high percentage of the study subjects had risk factors for type 2 diabetes. This included being overweight or obese and having high blood glucose readings. 66% of them said that they were feeling stressed, 51% reported feeling anxious, 38% said they were feeling restless, 30% felt nervous and 3% said they were feeling hopeless. It is easy to see the connection between stress and disease!

Australian study showed that anxiety can cause diabetes

An Australian long-term follow-up study computed risk factors for developing type 2 diabetes. Stress was a major contributor to diabetes.

A 30-day episode of any anxiety disorder had a 1.53-fold risk to cause diabetes. A depressive disorder had a 1.37-fold risk to cause diabetes and posttraumatic stress disorder had a risk of 1.42-fold to cause diabetes.

Infertility may develop when stress becomes abnormal

Stress changes hormones in women causing ovulation problems and infertility. 1 in 8 couples in America have problems getting pregnant. Physicians identified stress as at least one of  the contributing factors. But in men stress can also reduce sperm count and semen quality as this study describes.

Alzheimer’s disease and stress

2010 study from Gothenburg University, Sweden examined 1462 woman aged 38-60 and followed them for 35 years.

Psychologists assessed the stress score in 1968,1974 and 1980. 161 females developed dementia (105 Alzheimer’s disease, 40 vascular dementia and 16 other dementias). The risk of dementia was higher in those women who had frequent/constant stress in the past. Women who had stress on one, two or three examinations suffered from higher dementia rates later in life. Researchers compared this to a group of women who did not have any significant stress. Specifically, dementia rates were 10% higher after one stressful episode, 73% higher after two stressful episodes and 151% higher after three stressful episodes.

Hormone system affected by stress

I have written an article before about how stress affects our hormone system.

I am reprinting excerpts from this here (the next 4 paragraphs).

Dr. Andrew Heyman gave a talk about how stress affects our hormone system. He presented his talk at the 24th Annual World Congress on Anti-Aging Medicine (Dec. 9-11, 2016) in Las Vegas that I attended. It was entitled “Understanding the Stress, Thyroid, Hormone Connections & Prioritizing Systems”.

Dr. Heyman emphasized in particular that there is a triad of hormonal connections that is important to remember: the thyroid hormones, the stress hormones (adrenal glands) and the pancreas (insulin production). It seems like we need a balance of these hormones for optimal energy production and circulation. Under stress our sugar metabolism can markedly derail, we develop obesity and fatigue. But when balanced, we experience vitality and wellbeing.

Metabolic activation pathways

Dr. Heyman projected a slide that showed the metabolic activation pathways. Likewise, he stated that a number of different factors could influence the hormone system:

  • Diet: trans fats, sugar, too many carbs, food allergies.
  • Drugs: drug-induced nutrient depletion (over-the-counter drugs, prescription drugs).
  • Physical exercise: frequency and type matters.
  • Environmental exposure: chemicals, pesticides, herbicides, heavy metals, plastics, molds, and pollens.
  • Stress: physical stress, psychogenic stress.
  • Genetics: methylene-tetra-hydro-folate reductase enzyme deficiency (MTHFR mutation), APOE genes, lack of vitamin D
  • Disease: past or present conditions, active disease or syndromes.

Target areas within your system

The target areas in your system are the

  • Pancreas, where blood sugar can rise because of insulin resistance. In particular, too much insulin production causes inflammation, hormone disbalances, kidney damage, and hardening of the arteries through plaque formation.
  • Thyroid gland, which depends on TSH (thyroid stimulating hormone) for activation. Autoantibodies can also affect it negatively.
  • Brain: decrease in serotonin resulting in anxiety, depression and food cravings; decreased melatonin causing sleep disturbances; increased ghrelin and decreased leptin secretion leading to overeating and obesity.

Other target areas of stress

  • Liver/kidneys: both of these organs are important for detoxification; the liver produces thyroid binding globulin, which when increased can lower the free thyroid hormones.
  • Immune system (gut, lymph glands): the Peyer’s patches in the gut mucosa produce a large portion of the immune cells; lymph glands, the bone marrow and the spleen supply the rest. A leaky gut syndrome can affect the whole body, in addition causing inflammation and autoimmune reactions.
  • Hypothalamus/pituitary/adrenal glands: this is the main axis of the stress reaction. A brain under stress activates the hypothalamus. It sends a cascade of activating hormones via the pituitary gland and likewise activates the adrenal glands. Finally, this leads to cortisol overproduction, and release of epinephrine and norepinephrine from the center of the adrenal glands. High blood pressure, anxiety, heart palpitations, arrhythmias and more can finally develop from this.

Treatment suggestions to cope with stress

There are thyroid supplements that can support the function of the thyroid gland. Similarly, there are several supplements to support the adrenal glands.
Chromium, vitamin D, magnesium, alpha-lipoic acid, fish oil and others are useful to support the pancreas. Relaxation methods like self-hypnosis, meditation, yoga, Tai-Chi and others are very useful to counter stress. If you can change your job to evade stress, take the opportunity and find another job with less stress. See a health professional and discuss what you can do to become more stress-resistant. If you are overweight or obese, see a dietitian to help you lose weight. Aerobic exercises like running for 30 minutes on a treadmill can help reduce stress. Various relaxation methods mentioned earlier also can counter stress. They help you to block out worrying about the past and the future, but instead focus on what is positive in the present.

When Stress Becomes Abnormal

When Stress Becomes Abnormal

Conclusion

I have described what stress can do to your body. It can give you heart attacks and strokes. Stress in some people can lead to substance abuse. It can cause diabetes, infertility and even Alzheimer’s disease. I described how thyroid hormones, insulin and brain hormones are interconnected and suffer with stress. Other factors can make the effects of stress worse or better as I discussed in detail. Treatment of stress-induced conditions requires a combination of preventative steps and medical therapies. Ignoring stress is not an option as this could lead to premature death. Managing stress, as mentioned before, and keeping it to a minimum is the answer.

Oct
24
2020

Irregular Periods are Linked to Premature Deaths

A review in CNN describes that irregular periods are linked to premature deaths. This review is based on the original publication in the British Medical Journal published on September 30, 2020.

Essentially, the researchers followed 79,505 premenopausal women without a history of cardiovascular disease, cancer, or diabetes for 24 years. The researchers recorded 1975 premature deaths. The definition for a premature death was someone dying before the age of 70. There were three age groups that the researchers followed separately for 24 years.

  • ages 14-17 years
  • 18-22 years
  • 29-46 years

The most common causes of death were 894 from cancer and deaths from 172 strokes and heart attacks.

Death rates after 24 years for the three subclasses just mentioned

The researchers noted that there were differences in survival for different age groups. But there were also differences in survival for irregular periods versus prolonged intervals between periods. Crude mortality rates for 1000 person years of follow-up for women with normal versus irregular periods were as follows.

Normal periods                                  Irregular periods

14-17 age :  1.05                                            14-17 age:    1.0

18-22 age:  1.23                                            18-22 age:    1.37

29-46 age:  1.0                                              29-46 age:    1.68

Women with a cycle length of 40 days or more had a higher mortality rate. The researchers compared this to women with a normal cycle length (26-31 days). Here are the data in detail for two age groups at the outset of the study.

Women with a cycle length of 40 days or more                 

Age 18-22:    1.34

Age 29-46:    1.40

Heart attacks and strokes followed these death statistics closest.

Discussion

The researchers concluded that teenagers and women in their middle-age were at the highest risk. This risk was for premature mortality, if they had irregular periods or a cycle length of 40 days or more. There was also an association between irregular periods and a prolonged cycle length and type 2 diabetes, ovarian cancer and coronary heart disease. In addition, mental health problems were also related, the study said.

Dr. Adam Balen, a professor of reproductive Medicine at Leeds Teaching Hospitals in the UK said: “Young women with irregular periods need a thorough assessment not only of their hormones and metabolism, but also of their lifestyle so that they can be advised about steps that they can take which might enhance their overall health”.

Too much estradiol in women and men can cause cancer

In this context it is interesting that other studies have shown that unopposed estradiol may be the culprit for both irregular periods and larger intervals between periods. When estrogen is elevated in females, irregular periods can result. Unopposed estradiol can cause breast, uterine and ovarian cancer.

In males who also have a small amount of estrogen in their blood, it is important that a larger amount of testosterone balances the two hormones. Otherwise there is a risk of prostate cancer.

In addition, cardiovascular disease has been described as a side effect of standard hormone replacement therapy (HRT) in women with synthetic hormones.

The good news is that treatment with bioidentical hormones can treat these abnormal periods. This eliminates premature mortality and in many cases prolongs life.

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Conclusion

Researchers followed 79,505 premenopausal women without a history of cardiovascular disease, cancer, or diabetes for 24 years. They found that there is a linkage between irregular periods and premature deaths. There were three age groups that the researchers followed. Some of them suffered from irregular periods and others had periods that were 40 days or longer apart. The researchers recorded the premature mortalities. At an age of 29-46 there was a 68% higher mortality in women with irregular periods. The scientists compared this to women who had regular periods. In addition, women aged 29-46 with a cycle length of 40 days or more had a 40% higher mortality.

Estrogen dominance could explain premature deaths

The researchers compared this to women with a normal cycle length. It is possible that women who died prematurely were having too much estrogen in their system, which can produce cardiovascular disease and cancer of the breast, uterus and ovary. Further studies need to clarify the mechanism behind irregular periods and why a cycle length of 40 days or more causes mortality.

Aug
08
2020

Poor Diets Threaten Americans and Cause Diseases

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

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

You can improve your diet quality 

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

How does poor quality food affect your health?

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

Japanese trans-fat study (Alzheimer’s disease)

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

Diseases caused by poor lifestyle habits

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

Cardiovascular disease

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

Cancer

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

Diabetes

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

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

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

Chronic diseases

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

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

Poor Diets Threaten Americans and Cause Diseases

Poor Diets Threaten Americans and Cause Diseases

Conclusion

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

Part of this text was published before here.

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Jun
13
2020

Mediterranean Diet Reduces Heart Attacks and Strokes in Diabetes

A recent publication came to the conclusion that a Mediterranean diet reduces heart attacks and strokes in diabetes. This Canadian and Spanish study compared prospective cohort studies and randomized trials (RCT). 41 reports (3 RCTs and 38 cohorts) formed the basis for this analysis.

Details of the study

Metaanalysis showed that a Mediterranean diet reduced the cardiovascular disease incidence by 38%. It also reduced myocardial infarctions (heart attacks) by 35%. Next the authors compared the highest to the lowest adherents to the Mediterranean diet (Med diet). The highest Med diet adherents showed the following reductions:

Cardiovascular disease mortality: 21%

Coronary heart disease incidence: 27%

Coronary heart disease mortality: 17%

Stroke incidence: 20%

Stroke mortality: 13%

The conclusion was that the Mediterranean diet is beneficial to prevent heart disease and strokes in people with diabetes.

Other studies

In a study from the United Kingdom dated March 2019 several clinical trials were analyzed regarding non-diabetic populations. Again, the question came up, what the effect of a Mediterranean diet was on cardiovascular disease incidence and mortality. The authors reviewed 30 RCTs (49 papers) with12,461 randomized participants and seven ongoing trials. In one study the observation time was 46 months. A Mediterranean diet reduced the cardiovascular disease mortality by 65%!

Another study from Spain published in 2019 examined 7356 older adults (average 67 years) and followed them for 6.8 years. The investigators kept track of the physical activity and put everybody except the controls on a Mediterranean diet. The group on the lightest leisure-time physical activity consuming a Mediterranean diet had the lowest mortality. The all-cause mortality of this group was 73% lower than the control group.

What is so healthy about the Mediterranean diet?

Despite a wide variation between all the 15 countries bordering the Mediterranean Sea, there are common characteristics: an abundance of vegetables and fruit, along with nuts and legumes. Cereal products are largely whole grain. Olive oil is the principal fat source, and people eat fish, seafoods and poultry in moderation. They consume red meat rarely. Cheese and yogurt can be part of the diet, depending on the region.

The first clinical evidence supporting the health benefits of the Mediterranean diet came from the Lyon Heart Study. The researchers placed patients who had a heart attack either on the diet designed by the American Heart Association or a Mediterranean style diet. After a follow-up of 27 months, the group eating the Mediterranean diet had a reduction of heart attacks by 73% and a decreased mortality by 70% compared to the other group.

More detail on the ingredients of the Mediterranean diet

An analysis of the various foods of the Mediterranean diet shows the reasons for the health benefits clearly. The fats that people on a Mediterranean diet eat are heart-healthy monounsaturated fats like olive oil or fats that contain omega-3 fatty acids. They come from fish (tuna, salmon, trout, sardines) or from plant sources (walnuts, other tree nuts and flax seed).

As there is an emphasis on natural foods, the diet is extremely low in trans fatty acids (hydrogenated fats), which increase the risk for cardiovascular disease. As people consume more than 300g of vegetables per capita daily, the contents of antioxidants and other beneficial plant chemicals is much higher in comparison to Western diets. There are many individual components of the Mediterranean diet that contribute to the reduction of disease. This is particularly true for heart disease. It also is apparent, that it is not one single food or nutrient that is responsible for the health benefits. What matters are the interactive effects of all the nutrients that lead to the health benefits.

No processed food means healthier living

The practical application does not mean deprivation and starvation, but a move away from processed fats (margarine), baked goods (donuts, muffins, pastries), and high saturated fat snacks and trans fats (chips, crackers, cookies, pies). Food choices move towards those of fresh fruits and vegetables, nuts, fish, and olive oil. Portions or servings have to be adequate to maintain a healthy weight.

Mediterranean food is not the heaping plate of pasta with an afterthought of vegetables. It also is not the super-size fast food pizza with pepperoni and cheese. Mediterranean food incorporates fresh food rather than the fast food. It entails a shift from large portions of red meat to smaller portions of fish, a transition from highly processed foods to ample helpings of dark green vegetables with a dose of olive oil. Low amounts of alcohol, especially red wine can make a meal enjoyable, which means one drink per day for women, and two drinks per day for men. And after dinner go for a walk!

Olive oil is one of the reasons why the Mediterranean diet is so healthy

In the past it was thought that the monounsaturated fatty acids in olive oil would be the reason why it is protective of the heart. However, newer studies have shown that it is the polyphenols and among these in particular hydroxytyrosol that lower blood pressure and protect you from hardening of the arteries.

In a 2012 study from Spain it was found that mortality from heart attacks was 44% lower than that of a control group who did not incorporate olive oil in their diet.

How polyphenols in olive oil work for you

Only two tablespoons of extra virgin olive oil per day protect you from heart disease. It does so by reducing the total cholesterol level in the blood as well as the LDL cholesterol level. When there is more polyphenol in olive oil (such as in extra virgin olive oil), the body produces more HDL, which is essential to extract oxidized LDL from arterial plaque. On top of that polyphenol rich olive oil will increase the size of the HDL particles (these larger particles are called HDL2), which are more efficient in extracting oxidized LDL from arterial plaques. A Sept. 2014 study in humans showed that higher polyphenol olive oil as found in extra virgin olive oil caused an increase in the more effective HDL2 particles, which cleans out plaques from arteries more efficiently than the regular, cheaper olive oil.

Endothelial function

The endothelium is the lining of the arteries. Normal endothelial functioning involves widening of the arteries and maintaining its flexibility. The body achieves this through production of a signal molecule, called nitric oxide; the endothelial cells that line our arteries from inside produce it. Exercise increases the production of nitric oxide as well (Ref.1).

In a group of patients with poor endothelial function 2 tablespoons of olive oil (polyphenol rich) per day given over 4 months (the time of the study) showed a significant improvement of endothelial function.

The authors suggested that an enzyme in the endothelial cells, called nitric oxide synthase is being stimulated by components of polyphenol-rich olive oil. This leads to protracted release of nitric oxide, which in turn keeps blood vessels flexible and wide open. Other investigators found that olive oil can influence even a hereditary gene variant of endothelial nitric oxide synthase found in people with a history of premature heart attacks. This high-risk group of people should take extra virgin olive oil regularly to prevent premature heart attacks and strokes.

Endothelial dysfunction occurs when the arteries no longer can deliver adequate amounts of blood to vital organs like the heart or the brain. Endothelial dysfunction is also present in patients with type 2 diabetes, obesity, high blood pressure and metabolic syndrome. Introducing extra virgin olive oil in the diet of these patients will help restore their endothelial function.

Lowering blood pressure

In a study on 23 hypertensive patients it was shown as far back as in 2000 that extra virgin olive oil over 6 months allowed physicians to reduce high blood pressure medications by 48%. When the study was crossed over, the reverse was the case for the control group on sunflower oil. The polyphenols of olive oil released nitric oxide, which is known to lower blood pressure. This is an important finding. High blood pressure is a risk factor for the development of hardening of the coronary arteries. This leads to heart attacks, congestive heart failure, but also stroke. Regular intake of 2 tablespoons of extra virgin olive oil often will reverse high blood pressure and restore normal endothelial function.

Preventing heart attacks and strokes

In April of 2013 The New England Journal of Medicine published a Spanish diet study that showed that a participants on a Mediterranean diet with olive oil or nuts had 30% less heart attacks over 5 years than people on a low fat control diet. Other studies have also shown that olive oil and omega-3 fatty acids play a big role in preventing heart attacks and strokes. We also know that regular exercise reduces the risk further; so does keeping your body mass index below 25.0. Extra virgin olive oil is part of the protection from heart attacks and strokes. The study did not show any protection against cancer.

Mediterranean Diet Reduces Heart Attacks and Strokes in Diabetes

Mediterranean Diet Reduces Heart Attacks and Strokes in Diabetes

Conclusion

A Mediterranean diet reduced heart attacks and strokes in diabetic patients, but also in patients without diabetes. Here I attempted to show what the ingredients of a Mediterranean diet are that lead to such astounding positive effects. There is an emphasis on vegetables and fresh ingredients of food. In addition, olive oil and a lack of processed food are also important. With these wholesome ingredients the lining of the arteries works best. The body reduces cholesterol and lowers blood pressure. The end result is that there are less heart attacks and strokes, and people live longer.

Note: Part of this was previously published here and also here.