Tagged with 'heart-health'

An important first step in creating a heart-healthy kitchen is to read and understand food labels. Here's what to look for.

Different types of dietary fats play an important role in heart health, but it's likely not what you think.

It is so easy to go a day, a week, even a year and never think about the fact that it is a friggin’ miracle that a muscle the size of a fist is pumping gallons of blood daily.

I was taught in medical school that coronary artery disease (CAD) progresses from minor “fatty streaks” in youth, to plaques in early adulthood, to complicated plaques causing heart attacks and death later in life.

Don't miss out on resveratrol and quercetin, two antioxidants that do a lot for your health.

Turmeric, and more specifically its primary active constituent known as curcumin, has been used extensively in ancient and modern times for its medicinal qualities (1, 2). It was used as a traditional remedy in Chinese and Indian ayurvedic medicine for more than 2,000 years (3). Research on the uses of curcumin is extensive, and includes studies demonstrating a wide spectrum of biological actions. These include anti-inflammatory, antioxidant, anti-carcinogenic, anti-mutagenic, anticoagulant, anti-fertility, anti-diabetic, antibacterial, antifungal, antiprotozoal, antiviral, anti-fibrotic, anti-venom, antiulcer, hypotensive and cholesterol-lowering activities (5).

Let’s talk more specifically about curcumin’s benefit for cardiovascular health – and especially for endothelial dysfunction.

ENDOTHELIAL DYSFUNCTION

The endothelium is the tissue that lines the interior surface of the blood vessels (and lymphatic vessels). Normal functions of the endothelium include meditation of coagulation, platelet adhesion, immune function and control of the intravascular and extravascular spaces. In vascular diseases, endothelial dysfunction is a disorder broadly defined as an imbalance between vasodilating and vasoconstricting substances produced by (or acting on) the endothelium (6). Endothelial dysfunction can result from and/or contribute to several disease processes, including hypertension (high blood pressure), hypercholesterolemia, diabetes, septic shock and Behcet’s disease (a rare autoimmune disorder causing blood vessel inflammation) (7).

Maintaining healthy endothelial function is of vital importance for supporting cardiovascular health, so measuring endothelial function is a good reflection of cardiovascular health. When blood flow increases through a vessel, the vessel dilates. This phenomenon is referred to as flow-mediated dilation (FMD). FMD is a sensitive measure of endothelial function and serves as a predictive marker of cardiovascular risk. Therefore, improvements in endothelial function, as measured by FMD, are indicative of a reduced cardiovascular risk (8). Supplementation with curcumin is one way to help promote healthy endothelial function via FMD.

PRELIMINARY RESEARCH WITH CURCUMIN

Excess fructose consumption is a risk factor for metabolic syndrome, causing hyperuricemia (excess of uric acid) and endothelial dysfunction in the kidneys. In a study with fructose-fed rats, curcumin lowered uric acid levels, and appeared to improve endothelial dysfunction in the kidneys (9).

Likewise, in a randomized, controlled crossover study (10), 14 healthy male subjects were given a single serving of curry meal (a natural source of curcumin) or a spice-free control meal, to determine if it would improve endothelial function. Before and one hour after consumption, fasting and postprandial FMD responses were measured. According to the results, curry meal increased FMD from 5.2 + 2.5 percent to 6.6 + 2.0 percent (P = 0.001), whereas the control meal decreased FMD from 5.8 + 2.4 percent to 5.1 + 2.3 percent (P = 0.039).

The postprandial FMD after the curry meal was significantly higher than after the control meal (P = 0.002). The researchers concluded, “consumption of curry ameliorates postprandial endothelial function in healthy male subjects and may be beneficial for improving cardiovascular health.”

Of course, a study in rats, and a study on a single serving of curry is not enough to definitively demonstrate that curcumin is effective for improving endothelial function. However, a well-designed and executed human study on curcumin has shown just that.

CURCUMIN BIOAVAILABILITY

Before proceeding to a discussion of the human study on curcumin and endothelial function, it is important and relevant to first address the fact that curcumin has relatively poor bioavailability – with 40 to 75 percent of curcumin passing through the digestive tract unchanged in animal research (11). Also, blood concentrations of curcumin are low and tissue distribution is limited following oral dosing due to its fast metabolic turnover in the liver and intestinal wall (12-20). Even upon intake of doses as high as 10 or 12 g curcumin, maximum plasma curcumin concentrations in humans remain in the low nanomolar range (<160 nmol/L) (21).

There are, however, a few different commercial curcumin extracts supported by research showing better bioavailability vs. regular curcumin. One such extract, whose effects on endothelial dysfunction will be discussed below, is CurcuWIN, a novel curcumin formulation from OmniActive Health Technologies containing 20 percent curcuminoids. A recent human study (22) showed the absorption of total curcuminoids in the blood of this water-dispersible form of curcumin was 45.9-fold higher than normal curcumin.

CURCUMIN’S EFFECT ON ENDOTHELIAL DYSFUNCTION

A double-blind, randomized, placebo controlled parallel study (23) was conducted to examine the effect of differing doses of curcumin on FMD, and consequently on endothelial dysfunction. Researchers from Texas Christian University (USA), Massey University (New Zealand) and Increnovo, LLC (USA) recruited 59 moderately trained men and women to participate.

Subjects were assigned to placebo, 50 mg, or 200 mg curcumin (from 250 and 1,000 mg CurcuWIN, respectively), for eight weeks. The results of this study were originally presented at the Experimental Biology 2016 Meeting in San Diego, and subsequently published in the Journal of Nutrition and Metabolism.

Results showed 200 mg of curcumin produced a dose-mediated improvement in endothelial function as measured by FMD.

Consequently, the improvement in FMD with the 200 mg dose of curcumin represented a 37 percent increase over placebo.

The researchers concluded that eight weeks of 200 mg oral curcumin supplementation resulted in a clinically significant improvement in endothelial function as measured by FMD in apparently healthy adults. Not only does this suggest that oral curcumin supplementation may present a simple lifestyle strategy for decreasing the risk of cardiovascular diseases, but other research suggests for every 1 percent increase in FMD, there is a 9 to 17 percent decrease in cardiovascular disease (24). Therefore, daily supplementation with 1,000 mg CurcuWIN (providing 200 mg of curcumin) had a clinically meaningful impact on potentially reducing cardiovascular risk by 15 to 50 percent in healthy individuals.

CONCLUSION

Curcumin has been used extensively in ancient and modern times for its medicinal qualities, with research demonstrating a wide range of biological effects. A particular benefit of curcumin supplementation is protection against, and improvement of endothelial dysfunction through an increase in FMD. CurcuWIN, which has been shown to have 45.9-fold higher bioavailability vs. standard curcumin, has also demonstrated a significant increase in FMD vs. placebo in clinical study. This increase in FMD could potentially reduce cardiovascular risk by 15 to 50 percent in healthy individuals.

Article from Natural Practiioner Mag. 

References:

1. Chattopadhyay I, Biswas K, Bandyopadhyay U, Banerjee RK. Turmeric and curcumin: Biological actions and medicinal applications. Current Science. 2004;87(1):44-53.
2. Curcuma longa (turmeric). Monograph. Altern Med Rev 2001;6 Suppl:S62-6.
3. Curcuma longa (turmeric). Monograph. Altern Med Rev 2001;6 Suppl:S62-6.
4. Togni S, Appendino G. Curcumin and Joint Health: From Traditional Knowledge to clinical validation. In: Watson RR, Preedy VR (eds.) Bioactive Food as Dietary Interventions for arthritis and related inflammatory diseases. San Diego: Academic Press; 2013:67-81.
5. Chattopadhyay I, Biswas K, Bandyopadhyay U, Banerjee RK. Turmeric and curcumin: biological actions and medicinal applications. Curr Sci. 2004;28(1):44-53.
6. Deanfield J et al. Working Group on Endothelin endothelial factors of the European Society of Hypertension. J Hypertens. 2005;23(1):7-17.
7. Munzel T et al. Pathophysiology, diagnosis and prognostic implications of endothelial dysfunction. Ann Med. 2008;40:180-196.
8. Kelm M. Flow-mediated dilatation in human circulation: diagnostic and therapeutic aspects. Am J Physiol Heart Circ Physiol. 2002 Jan;282(1):H1-5.
9. Zhnag DM et al. Protection of curcumin against fructose-induced hyperuricaemia and renal endothelial dysfunction involves NO-mediated JAK-STAT signaling in rats. Food Chem. 2012 Oct. 15;134(4):2184-93.
10. Nakayama H. A single consumption of curry improved postprandial endothelial function in healthy male subjects: a randomized, controlled crossover trial. Nutr J. 2014 Jun 28;13:67.
11. Luper S. A review of plants used in the treatment of liver disease: part two. Altern Med Rev. 1999;4:178-188.
12. Shoba G et al. Influence of piperine on the pharmacokinetics of curcumin in animals and human volunteers. Planta Med. 1998;64:353-356.
13. Sharma RA. Pharmacodynamic and pharmacokinetic study of oral curcuma extract in patients with colorectal cancer. Clin. Cancer Res. 2001;7:1894-1900.
14. Vareed SK et al. Pharmokinetics of curcumin conjugate metabolites in healthy human subjects. Cancer Epidemiol. Biomarkers Prev. 208;17:1411-1417.
15. Cheng AL et al. Phase 1 clinical trial of curcumin, a chemopreventive agent, in patients with high-risk or pre-malignant lesions. Anticancer Res. 2001;21:2895-2900.
16. Lao CD et al. Dose escalation of a curcuminoid formulation. BMC Complement. Alter. Med. 2006;6:10.
17. Garcea G et al. Consumption of the putative chemopreventive agent curcumin by cancer patients: assessment of curcumin levels in the colorectum and their pharmacodynamic consequences. Cancer Epidemiol. Biomarkers Prev. 2005;14:120-125.
18. Sharma RA et al. Phase 1 clinical trial of oral curcumin: biomarkers of systemic activity and compliance. Clin Cancer Res. 2004:10:6847-6854.
19. Carroll RE et al. Phase IIa clinical trial of curcumin for the prevention of colorectal neoplasia. Cancer Prev. Res. (Phila) 2011;4:354-364.
20. Ringman JM et al. Oral curcumin for Alzheimer’s disease: tolerability and efficacy in a 24-week randomized, double blink, placebo-controlled study. Alzheimers Res. Ther. 2012;4:43.
21. Vareed SK et al. Pharmokinetics of curcumin conjugate metabolites in healthy human subjects. Cancer Epidemiol. Biomarkers Prev. 2008;17:1411-1417.
22. Jager R et al. Comparative absorption of curcumin formulations. Nutr J. 2014 Jan 24;13:11.
23. Oliver JM et al. Novel form of curcumin improves endothelial function in young, healthy individuals: a double-blind placebo controlled study. J Nutr Metab. 2016;2016:1089653.
24. Green DJ et al. Flow-mediated dilation and cardiovascular event prediction: does nitric oxide matter? Hypertension. 2011 Mar;57(3):363-9. 

According to the Center for Disease Control about 610,000 people, or one in every 4 deaths, are attributed to heart disease every year. They also note that heart disease is the leading cause of death in the United States. For many, a heart attack is the first symptom of heart disease, but one in three heart attack victims do not survive their first attack. Prevention through a healthy lifestyle and supplementation is the key in educating consumers.

Age Isn't A Factor In Heart Health

The biggest misconception is heart disease only happens to the elderly. However, according to the American Heart Association it's starting to impact people at an earlier age and is the primary cause of death among all middle-aged Americans. The association indicates heart disease causes more than 160,000 deaths in people between the ages of 35 and 64 each year. In fact, almost 150,000 Americans killed by cardiovascular disease each year are under the age of 65.

Maintaining Healthy Cholesterol Levels is a Balancing Act

It's now understood that targeted nutritional support works very well in tandem with medications to maintain healthier cholesterol levels, along with a healthy diet and exercise program.

While there has been an emphasis on cholesterol reduction in the past 15-20 years, more recent focus has been on additional factors that reduce inflammation and balance blood-sugar and hormone levels. 

Consumers are beginning to understand that cholesterol in and of itself is not a bad thing. The body naturally produces cholesterol in the liver to support brain health, as a precursor for hormone production, for Vitamin D synthesis, and as a cell membrane stabilizer. Misconceptions around cholesterol and foods like eggs have largely been discredited. For example, Harvard Medical School published findings that showed for most people only a small amount of the cholesterol in food passes into the blood. Saturated and trans fats have much bigger effects on blood cholesterol levels.

The benefits of natural fats over hydrogenated trans-fats are surfacing. Couple that with the idea that natural, unprocessed fats are a healthy choice as opposed to highly processed or synthetic trans-fats. A proactive approach now includes incorporating ingredients to promote a healthy balance of the different forms of cholesterol, rather than past emphasis on simply lowering the total and LDL cholesterol levels.

In a sea of information on heart health products, consumers are looking for ingredients and formulas that set themselves apart from the rest of the pack. Some of the long-standing and proven heart healthy ingredients are still widely advocated. Several newcomers stand out as sources for consumers seeking vitamins and supplements to help contribute to optimal heart health. 

• Omega-3 and Omega-6 Essential Fatty Acids (EFAs) are vital components of cell membranes. They are precursors to important chemical messengers that support arterial health by promoting proper blood vessel dilation, promoting flexible cell membranes and supporting vascular function. Increased consumption of Omega-3 EFAs also helps promote normal cholesterol and triglyceride levels and maintain normal blood pressure.

• Guggul has demonstrated healthy support of liver function and balanced cholesterol metabolism by supporting healthy HDL levels and blood flow.  

• Red Yeast Rice contains chemicals such as monacolin K, which promote normal blood LDL cholesterol concentrations without a substantial risk of side effects.

• Bromelain supports the metabolism of fats and proteins with natural anticoagulant properties that may help break down the blood-clotting protein fibrin. It also supports a healthy inflammatory response.

• Taurine supports the heart and blood pressure by maintaining healthy blood flow in the blood vessel walls. Taurine also promotes healthy nerve impulses in the brain to help maintain healthy blood pressure.

• Pancreatin has specific supporting roles for the digestion of proteins and fats and may play a role in the accumulation of plaque in the arteries by helping to convert homocysteine into cystathionine.

• CoQ10 supports healthy cardiovascular function by helping produce energy within the mitochondria of cells. Every cell depends on this energy, and this is especially true for the heart. While each muscle cell in the biceps contains 200 mitochondria, every heart cell has 5,000.

• Policosanol and Octacosanol are plant extracts that support healthy fat and cholesterol metabolism.

• Vitamin C has been well researched for its value in supporting a healthy cholesterol metabolism in part by protection from LDL oxidation, the most damaging form of cholesterol. Lack of dietary antioxidants may play a key role in unhealthy LDL oxidation, causing collagen used to form blood vessel walls to be weaker, less flexible and more prone to inflammation.

• Vitamin B5 supports healthy cholesterol utilization, as well as supporting the metabolism’s ability to maintain a healthy stress response.

• Antioxidants.  We now know heart disease symptoms are also tied to free radical damage, or oxidative stress. When antioxidant levels are lower than those of free radicals due to poor nutrition and other lifestyle factors, oxidation wreaks havoc in the body — damaging cells, breaking down tissue and overloading the immune system. Antioxidants like Grape Seed Extract, Vitamins A, C and E, and Phytonutrients like Turmeric, Green Tea extract and Quercitin help lower the immune system’s overactive response by fighting free radical damage. These antioxidants help dissolve free radicals that can damage cells and tissue, which means fewer triggers for inflammation.

Article written by Jack Grogan, Chief Science Officer for Uckele Health & Nutrition

Jack Grogan is Chief Science Officer for Uckele Health & Nutrition. He is a recognized expert in Hair Mineral Analysis, a valuable tool in determining the causes of nutritional imbalances or deficiencies. With considerable experience in the fields of biology, biochemistry and nutrition, he is influential in the development of hundreds of proprietary nutritional formulas and programs.

Uckele Health & Nutrition is an innovation-driven health company committed to being on the leading edge of nutritional science and technology for over 50 years; formulating and manufacturing a full spectrum of quality nutritional supplements incorporating the latest nutritional advances. www.uckele.com

We’ve all heard diabetes, smoking, and family history are among the top contributors of heart problems, but now research has uncovered some lesser known risk factors:

Your gut microbiome plays a much grander role in health than scientists ever anticipated. In fact, those microbes likely play a role in heart health.

Could it be possible cardiovascular disease has less to do with what we eat and more to do with your microbiome?

German researchers recently discovered that patients with heart failure had significantly fewer types of bacteria in their gut compared to healthy patients.

Eating a diet rich in fiber and plant-based foods like veggies, fruits, nuts, and seeds may help you maintain a healthier balance of gut bugs.

Check out our favorite gut nourishers, part 1 of 3. 

Top Probiotic Picks:

The head-heart connection should be on everyone’s radar. The biological and chemical factors that trigger mental health issues could also influence heart disease or stroke.

In one study, people with major depression or other severe mental health problems, such as bipolar disorder and schizophrenia, had a 78% higher risk of developing heart disease than healthy people.

Chronic stress exposes the heart to unhealthy levels of stress hormones, like adrenaline and cortisol, which effects heart health.

Consider reducing stress via all-natural adaptogens. In particular, reishi mushroom has many benefits and has long been used to reduce stress and support the cardiovascular system.

Top Reisi Mushroom Picks:

Besides sugar’s link to diabetes, eating sugar raises blood sugar levels, which causes inflammation. Chronic inflammation wreaks havoc on blood vessels and tissues, which increases heart disease risk.

Top Blood Sugar Control Picks:

In one recent study, people who live in more polluted areas have larger, and weaker, hearts than those who live in cleaner regions – a good reminder to limit time outdoors when air quality is bad and to plan running routes on less-trafficked streets.

Unfortunately, our air is full of contaminants. One reliable way to determine your exposure to toxins is a hair mineral analysis. It tests for aluminum, arsenic, antimony, beryllium, cadmium, lead, mercury, uranium.

Top Detoxifying Picks:

In Health and Happiness,

Kelly Harrington, MS, RDN

Registered Dietitian Nutritionist for Healthy Goods

References:

American Heart Association: Gut bacteria hold clues to heart health. 

Mental illness linked to increased risk of heart disease, stroke. 

JAMA: Internal Medicine: Added Sugar Intake and Cardiovascular Disease Mortality among US adults.

Ask 10 random people on the street what nutrients to watch for heart health, and you’ll get 10 variations on “saturated fat and cholesterol.”

In fact, there’s no real evidence saturated fat and/or cholesterol from whole foods causes heart disease. But did you know about the connection between some types of carbohydrates and heart disease? It’s not as simple as “carbs cause heart disease,” but there is a connection for certain types of carbohydrates, especially highly refined carbs. Basically, the problem is that sugar and refined carbs damage the lining of your blood vessels, technically called the vascular endothelium.

Meet Your Endothelium

The endothelium is a layer of cells on the inner surface of your blood vessels. A healthy endothelium prevents blood clotting, keeps inflammation under control, regulates the formation of new blood vessels, and controls blood pressure by constricting or dilating your blood vessels. Basically, if you want a healthy cardiovascular system, you need a healthy endothelium.

Poor endothelial function is one of the first signs of heart disease. It can cause high blood pressure (aka: hypertension) by constricting blood vessels too much. If the anti-clotting function of the endothelium fails, then you’ll be more prone to developing clots.

Blood Sugar Levels and Endothelial Function

This review goes over the relationship between carb quantity, carb quality, and endothelial function.

High blood sugar (hyperglycemia) changes the behavior of the endothelium and damages the endothelial lining of the blood vessels. This is called endothelial dysfunction. In endothelial dysfunction, the endothelium doesn’t dilate easily, even when it’s supposed to. When the endothelium stays constricted all the time, it causes high blood pressure because the same volume of blood is being forced through the constricted blood vessel.

The technical term for this is flow-mediated dilation (abbreviated FMD). If someone has normal FMD, they don’t have any endothelial dysfunction and their blood vessels can dilate as normal to prevent high blood pressure. If someone has reduced FMD, they’re in trouble – endothelial dysfunction, high blood pressure, the whole shebang.

High blood sugar also increases inflammation in the endothelium. If you really want to get technical and nerdy about it, high blood sugar increases the formation of advanced glycation end products (AGEs) in the blood vessels and impairs anti-inflammatory action in the endothelium.

But keep in mind, endothelial dysfunction is a problem caused by high blood sugar, not necessarily just eating carbs. Different amounts and types of carbs affect different people’s blood sugar in different ways. Some people can eat quite a high-carb diet and have 0 blood sugar problems. Other people start having blood sugar swings if they look sideways at a potato.

Luckily, there have been quite a few studies on what kind of carbs are linked to endothelial dysfunction.

Carb Quantity and Carb Quality and Endothelial Function

According to the review, researchers first noticed the carb-endothelium connection during oral glucose tolerance tests (OGTTs). Glucose is a type of simple sugar and the fastest type of carbohydrate to digest. In an OGTT, the doctor gives you a pure glucose drink and measures how well your body can cope with the glucose load. The whole point is to make your blood sugar spike and then see how fast your body can bring blood sugar levels back down.

Researchers started noticing that OGTTs caused relatively significant endothelial damage. That was the first sign that blood sugar spikes could cause endothelial problems. On the other hand, they could prevent problems by giving patients vitamin C (an antioxidant) or a statin (statins are anti-inflammatory). This makes sense, since endothelial damage is an inflammatory type of oxidative stress.

An OGTT is an artificial situation that doesn’t really imitate the effect of a normal meal on blood sugar. But on the other hand, an OGTT is basically a super-concentrated sugar dump, and it’s not that much different from, say, eating a huge amount of candy or drinking a big glass of Coke. And lots of people eat a lot of highly refined sugar in the form of candy and Coke. So the review went on to examine carb quantity and carb quality as they affect endothelial function.

• Carb quantity is very simple: how many grams of carbohydrate in a given meal or day of eating?

• Carb quality can be measured in all kinds of ways, but for the purposes of this study they looked at glycemic index (GI). This takes little bit of explanation. The glycemic index is basically a measure of how high a food spikes blood sugar when eaten in isolation. If you’re talking about one food at a time, it makes no sense to divide “good carbs” from “bad carbs” based only on the glycemic index. But if you’re looking at overall dietary patterns, diets with a high GI tend to be high in junk food and refined carbs, so it’s a pretty reasonable measurement of how much white bread and Coke someone is eating.

When the researchers looked at carb quantity, they actually found that low-carbohydrate diets were associated with poorer vascular health and more endothelial damage, but noted that the effects of increasing fat and protein to compensate naturally obscured any relationship between carb quantity and endothelial health. So they moved on to carb quality.

Carb quality was easier to study. In a couple different human intervention studies, low-GI (read: low-junk) diet were pretty effective for improving endothelial health. This is backed up by various different association studies, which the authors also cited. Carb quantity may or may not be important, but the ability of those carbs to cause blood sugar issues (which will obviously vary from person to person) definitely seems to be. Here's how to break your sugar habit. 

The Long Term: Insulin Resistance and Endothelial Health

Insulin resistance is a measure of long-term blood sugar problems. Looking at people with insulin resistance can give you an idea of how blood sugar problems affect endothelial health in the long term.

This study looked at subjects who started out as either insulin sensitive or insulin resistant. In people with insulin resistance, their endothelial health (measured by flow-mediated dilation) was worse all the time, when they were just walking around. Then it got even worse after a meal, especially a high-carb meal. Unfortunately, the researchers in this study didn’t test carb quality at all, only the total number of carbs in the meal.

Also, remember the OGTT results from above? People with diabetes got even worse endothelial problems from an OGTT than healthy people. That’s another sign that baseline insulin issues exacerbate the damage of blood sugar spikes.

Insulin resistance, which is a sign of long-term issues with blood sugar regulation, is pretty clearly linked to chronic endothelial damage.

Summing It Up: Carb Quality Counts for Heart Health

Even healthy people will have a transient decrease in endothelial function after a sugar overload like an oral glucose tolerance test. But the real problem here is the long term because diets full of refined carbs (high GI) tend to cause chronic endothelial dysfunction. Unsurprisingly, people with insulin resistance have higher levels of endothelial dysfunction. Blood sugar spikes and other blood sugar regulation problems damage the endothelial lining and if that keeps going on, it causes long-term problems.

Endothelial dysfunction is the very first step towards heart disease. It makes people more vulnerable to blood clots and raises blood pressure.

Carb quality and blood sugar management matters for heart health. If you want to keep your ticker going strong, maybe forget about the saturated fat and cholesterol and start focusing on sugar!

Article courtesy of Paleo Leap

Stress is often the “elephant in the room” when I discuss why my patients missed their goals for proper exercise, nutrition, abstinence from smoking, and proper sleep. Physicians aren't routinely taught how to advise others on stress-management techniques, and may do no better than the rest in terms of dealing with stress themselves. I've just completed a series of lectures to the public on stress-management tips, and list them here in the hopes they may help others.

1. Adaptogens for Adrenal Support

When I talk to patients about stress, I begin by describing adaptogens, or herbs that appear useful in stabilizing physiology and improving anxiety and stress. These are often called adrenal support herbs as the appear to be a remedy for “adrenal fatigue” or burnout. I use adaptogenic herbs to avoid needing to use Rx medications like Xanax and Ativan. 

Frankly, substituting one pill for another is something most patients accept faster than any other technique. I've had success in many patients using ashwagandha. Even elderly patients report they feel less stressed and more functional. Rhodiola is another adaptogen I like because it has been studied in heart patients and shows benefits for their symptoms. Finally, cordyceps has been shown to improve exercise performance and may provide a sense of calm as an additional benefit.

If you're new to adaptogens, incorporating them into recipes is a great way to start. Such as this Adrenal Balancing Smoothie with Adaptogens, this Raw Fudge with Ashwagandha, and this Ashwagandha-infused "Moon Milk" recipe. 

2. Breathwork

There are many styles of breathwork, but I find I can teach my patients the 4-7-8 breathing practice in the office in just a few minutes, and they use it right away. I refer them to an online video created for children, and ask them to practice this at home and use it in their daily routine.

3. Meditation

Teaching meditation is a longer process than the first two techniques, but has been shown to benefit heart patients and should be taught routinely. I ask them to study the Kirtan Kriya taught by Dr. Khalsa because it's only 12 minutes and is supported by great research results at UCLA. When I tell them they may slow aging and improve their memory while dealing with their stress, they're eager to use it in their lives.

4. Yoga

Different styles of yoga have been studied in a variety of serious stress disorders including cancer, post-trauma, and addictions. Yoga has been found beneficial even when tested using rigorous scientific study design. Yoga can be adapted for the elderly using only a chair; it provides a sense of community, and offers some cardio benefit as well.

I remind my patients of a story about a man speaking to a religious leader, repeating over and over that he was frustrated with the stresses in life. The leader suggested they take a walk, and stopped in front of a cemetery. The man asked why they stopped there and the leader replied, "There lay the only people who have no worries and stress"; for the rest of us, we need to manage and work out the issues.

I hope you share strategies you use for managing stresses in your life.

Sincerely,
Dr. Kahn

About the author
Dr. Joel Kahn is one of the world's top holistic cardiologists. He has treated thousands of acute heart attacks during his career, and would like to put a stop to ALL future heart attacks by educating and inspiring people to embrace a holistic lifestyle. America’s Healthy Heart Doctor has been featured on The Doctors and Dr. Phil television shows, and is one of the few doctors that posts consistently for Mind Body Green.  

Preventing heart disease in patients is my main goal, but early detection is the next best thing if you cannot totally block its development. Changes in lifestyle and medical therapies can delay or deny the onset of a heart attack and almost 80 percent of heart disease is preventable with lifestyle changes. My patients are surprised to learn that the following list may give clues to underlying silent heart disease years before a heart attack. 

Erectile Dysfunction (ED) Could Mean Clogged Arteries

Men have a built-in warning system for silent CHD. When achieving an erection is difficult or impossible, it can be a sign of clogged arteries in the pelvis that presents before a heart attack hits. There are, on average, three to five years between the onset of ED and the finding of CHD, which is plenty of time to detect and work on preventing heart issues. If you and your partner are worried about sexual performance, look for and treat root causes of diseased arteries before just popping a blue pill.

Baldness Could Indicate Clogged Arteries

In a comprehensive study of almost 37,000 men, severe baldness at the crown of the head strongly predicted the presence of silent CHD at any age. In a separate study of more than 7,000 people (including over 4,000 women), moderate to severe baldness doubled the risk of dying from heart disease in both sexes.

Gray Hair Is A Clue To Blocked Arteries

A new study presented in Europe at EuroPrevent 2017 found a high amount of gray hair is a risk factor for silent heart atherosclerosis. A total of 545 adult men without known heart disease had a CT angiogram of their heart arteries, a very accurate way to identify silent problems. Having equal amounts of gray and dark hair, or mainly gray and white hair, correlated with finding silent heart blockages. The researches commented that “atherosclerosis and hair graying occur through similar biological pathways”.

A Diagonal Ear Lobe Crease Might Indicate Clogged Arteries

One of the stranger markers, a crease in your earlobe (specifically, an angled crease in the ear that runs diagonally from the canal to the lower edge of the earlobe) has been mentioned in medical research reports as a sign of silent CHD for decades. The ear crease may result from poor circulation, including in arteries in the heart. Although some medical professionals have argued that a crease is just a general sign of aging, researchers last year used the most sophisticated CT scan method to measure silent CHD and found that ear crease predicted heart disease even after the authors accounted for other risk factors, such as age and smoking.

Calf Pain When You Walk Might Mean Clogged Arteries

This is known as claudication (from the Latin for “to limp”). Atherosclerosis can block leg arteries, particularly in smokers, before CHD is diagnosed. This symptom requires an evaluation without delay. Your doctor will examine the pulses in your legs and perform simple measurements of leg blood pressure and blood flow to confirm a diagnosis of poor circulation.

It is critical that heart disease be diagnosed as early as possible because there are many dietary and medical treatments that can help reverse the issue. Some of my patients took these early clues to heart. Anyone with any of the above clues to silent heart issues should know his or her numbers (blood pressure, cholesterol, fasting glucose). Asking your doctor for an EKG or a coronary calcium CT imaging is wise, whether you are a woman or man. Changing your lifestyle right away to ban smoking, walking, managing stress, and adding a plant-based diet can reverse problems before they attack your health or life. To borrow from Ben Franklin, an ounce of prevention (plus a bowl of kale) is worth a pound of cure.

Sincerely,
Dr. Kahn

About the author
Dr. Joel Kahn is one of the world's top holistic cardiologists. He has treated thousands of acute heart attacks during his career, and would like to put a stop to ALL future heart attacks by educating and inspiring people to embrace a holistic lifestyle. America’s Healthy Heart Doctor has been featured on The Doctors and Dr. Phil television shows, and is one of the few doctors that posts consistently for Mind Body Green.  

Jack and Jill, both non -smokers, walk out of their health care providers office satisfied that an annual check-up indicated a blood pressure under 140/90 and a blood sugar under 125. They were told they were low risk for heart disease and their LDL cholesterol of 150 mg/dl was therefore not of much concern. They were satisfied as they had heard somewhere in the news or maybe on a podcast that cholesterol no longer matter like in the old days. Well, those old days are back with new data from a prospective study from Spain, the PESA trial.

The PESA study is following over 4,000 bank workers in Madrid, free of known heart disease, and assessing them for silent artery damage using heart artery calcium CT scans and ultrasounds of the carotid and femoral arteries.

In a new report, researchers identified 1,779 of the study subjects that were like Jack and Jill and had total cholesterols under 240 mg/dl. A group of 740 participants had even better results with blood pressures under 120/80 and blood sugars under 100 mg/dl and were reported on too.

How frequently was silent hardening of arteries, called subclinical atherosclerosis, identified in the group of 1,779 subjects? A whopping 50% had aging arteries that raise the risk of heart attack, stroke, vascular problems of the legs, and shorten lifespan. In the 740 superstars, the rate of silent vessel disease was still 38%. These numbers are striking but match test results I see in my advanced preventive cardiology clinic where I routinely do similar vascular assessments.

Should Jack and Jill be tested for silent heart and vascular artery disease? Yes, they should and I have written repeatedly about the role of coronary artery calcium scans using CT as a cost effective way to assess individual risk. These scans are under $100 in my hospital and take under 5 minutes.

Should Jack and Jill be concerned about their LDL-cholesterol levels? They should. In the PESA study, LDL cholesterol was an independent predictor of atherosclerosis in the overall group and the picture above shows how the higher the LDL cholesterol was in the study group, the greater the chance of disease in one or more artery systems. The authors of the study indicated "LDL cholesterol, even at levels currently considered normal, is independently associated with the presence and extent of early systemic atherosclerosis in the absence of major cardiovascular risk factors. These findings support more effective LDL cholesterol lowering for primordial prevention, even in individuals conventionally considered at optimal risk".

How Low Should Jack and Jill Want Their LDL Cholesterol?

Even the nine study participants in PESA who had LDL cholesterol levels of 60-70 mg/dL range still had a 11% rate of subclinical plaques, leading the investigators to suggest that atherosclerosis develops when LDL cholesterol exceeds a threshold of approximately 50-60 mg/dL. The authors wisely recommended intensive lifestyle efforts for primordial prevention of artery damage starting as young as possible.

The Bottom Line: Do not walk out of your physical or workplace wellness exam satisfied that your LDL cholesterol is the only lab elevated beyond optimal. It might be a clue to progressive aging and damage of your heart and arteries. Ask for advanced testing and work with an experience practitioner to bring your numbers into the optimal range. As 2017 closes and 2018 approaches, LDL cholesterol is back, in fact it never went away, as an important measure of cardiovascular health to focus on. 

Sincerely,
Dr. Kahn

About the author
Dr. Joel Kahn is one of the world's top holistic cardiologists. He has treated thousands of acute heart attacks during his career, and would like to put a stop to ALL future heart attacks by educating and inspiring people to embrace a holistic lifestyle. America’s Healthy Heart Doctor has been featured on The Doctors and Dr. Phil television shows, and is one of the few doctors that posts consistently for Mind Body Green.