HEART HEALTH

Our heart and cardiovascular system is subject to the degenerative problems that beset health and longevity in the industrialised western countries and which have increased significantly throughout the 20th century. Heart failure is responsible for at least 40% of deaths. Those races renown for longevity do not suffer the same problems and retain robust cardiovascular health and energy. Pharmaceutical and medical intervention may limit health issues but they do not generally prevent degeneration nor restore full health. The heart, associated blood vessels and connective tissues require high levels of nutrients to prevent and offset challenges to their tissue’s integrity, to their immunity from disease or toxins and to premature ageing. Self-help may be appropriate but precaution is needed when under medical supervision for a identified problem or taking related medication.

Key points:

• Prevent and reduce atherosclerosis by the right diet that limits levels of triglycerides and oxidation of cholesterol. Keep sugar (and starch) intake low especially in the presence of fatty acids.

• Include in the diet and through supplementation, high levels of anti-oxidants and bioflavonoids to minimise damage to blood vessels and thereby retard ageing factors

• Add nutrients to offset key shortages in our diet and reduce damage from environmental & lifestyle factors

• If we encounter cardiovascular problems then consider nutritional programmes that can improve oxygenation, blood flow and reduce adverse metabolic effects.

• Specific supplementary nutrients can enhance physical and bio-chemical properties and improve longevity

Heart and cardiovascular system problems are intertwined. A problem with blood flow through arteries can ultimately affect heart tissues and heart operation. Atherosclerosis relates to degeneration in the condition of the major blood vessels and potentially damaging blood clots that may arise. Diets and nutrients can have major effects on the emergence and development of this condition. Some information is provided below on natural remedies and nutrition for common conditions or heart related issues. The role of natural remedies in these conditions is (a) to help prevent these conditions developing or worsening and (b) to enhance and support conventional treatment with the supervision of your medical advisors. Any disease that adversely affects the heart and disrupts circulation can lead to heart failure; the single most common cause of which is coronary artery disease which limits blood flow to the heart muscle and can lead to a heart attack.

Usually the earliest signs of cardiovascular problems are hypertension, or arrhythmias, angina or even fatigue. Cholesterol assessments are not accurate indicators of heart or stroke risks. Homocysteine or Lipoprotein(a) blood evaluations are stronger indicators. There is good evidence to show that oxidized cholesterol and high triglycerides will cause more risks of atherosclerosis. Clearly diabetics, or those with other blood quality problems, are at greater risk to ageing, injury or hardening of blood vessels. Generally, to take measures that improve blood sugar control and improve the quality of blood lipids (essential fatty acids) can improve most aspects of cardiovascular risks. High blood sugars from food intake along with poor quality fats will increase blood triglycerides and thereby lead to more oxidized cholesterol and consequently more build-up of plaques in the blood vessels. As a human race we were evolved to store more body fat (for winter month’s energy) during the seasons when high levels of both sugar(fruits) and fats were available… but not the whole year round as is the case with refined, adulterated and high starch laden modern diets.

There is good evidence to indicate that selective diets can reduce these risks. Paleo diets, low calorie/low carbohydrate(low GL) diets, 5:2 diets and balance vegetarian diets can all improve health parameters- provided that sufficient protein and sufficient essential fatty acids are included. Those with digestion issues or food intolerance problems need to address those factors as well. A good proportion of raw food (preferably organic) with its higher enzyme and antioxidant content will be important for heart health.

 Processing of food by cooking, or other treatments, can  reduce food micronutrient status and increase some toxins. Supplementation is often vital to make-up for inadequate food chain quality and to offset environmental/lifestyle factors, as well as trying to repair conditions. Historically, diets containing transfats, high sugar levels, high sodium content, and inadequate levels and balance of essential fatty acids have been responsible for poor heart health. Local or geographic factors also contribute because of low mineral and vitamin D contents.

Read more

Atherosclerosis

Atherosclerosis is a disease that involves the development of cholesterol-filled plaques, called atheromas, in the walls of the blood vessels, causing the vessels to lose their elasticity and become sclerotic, or hardened. These atheromas are especially problematic when they develop in the blood vessels of the heart, also known as the coronary arteries, where they may decrease the amount of blood that is available to feed the heart muscle, or where they may eventually lead to heart attack, also called myocardial infarction (MI), i.e. heart damage

The status of our cardiovascular health is regulated by endothelium covering the innermost lining (monolayer) of the entire vascular system. The endothelial cells control the elasticity - relaxation and tightening - of blood vessels. Atherosclerosis usually relates to an injury to the arterial endothelium. Then sticking together platelets begin to secrete a growth factor that stimulates the outgrowth of underlying endothelial cells which start to protrude into the arterial walls.

As the process continues, the atheroma, which grows larger and larger, is now comprised of enlarged macrophages and monocytes filled with oxidized cholesterol, dividing smooth muscle cells, and collagen, as well as the initial endothelial cells. Fatty plaques, called atheromas keep on enlarging and tend to cover mainly the aorta and the coronary arteries serving the heart. Far worse, plaques can become unstable or vulnerable, triggering a sudden blood clot in the artery. The plaques which in advanced situations can become calcified and, consequently making the

atheroma sclerotic or hardened, and inflexible leading to the arterial blockage.

When cholesterol becomes oxidized, either by heat or free radicals before it is absorbed in the intestines, or by free radicals found in the body, it can become dangerous. Oxidized LDL cholesterol is directly toxic to endothelial cells. It increases the adhesion of monocytes and macrophages to vascular lesions, increases the proliferation of smooth muscle cells, increases platelet clumping and thrombus formation, and inhibits the production of nitric oxide, a messenger chemical needed for vasodilation.

Progressive Homeostatic Process Atherosclerotic plaque formation then is an overly progressive homeostatic process in effort to correct and balance the condition triggered by the injury of the arterial endothelium leading to its subsequent dysfunction.

As this process occurs as long as there is a presence of platelet accumulation function, the main goal of all treatments of atherosclerosis should be to:

• protect the arterial walls against free-radical attack;

• prevent the endothelial injury leading to an abnormal blood platelet accumulation leading to formation of plaques.

And this is the total opposite to standard medical methods of treating atherosclerosis that focus:

• on reducing the effects of the plaque after it has built up --

• not on eliminating the factors which created the build-up in the first place.

Impacts of atherosclerosis

A large atheroma in the coronary vessels may start to block blood flow to the heart, leading to symptoms like shortness of breath or angina. Atheromas in the blood vessels leading to the brain may cause dizziness or lightheadedness.

Where the atheroma breaks slightly it can cause a release of blood into the surrounding tissue. In order to stop this blood loss, platelets clump together forming a blood clot, called a thrombus. A thrombus may also be caused by platelets that simply start to stick to the atheroma and then build up. Typically, the blockage of a vessel by a thrombus also involves spasm of the artery, further decreasing the blood flow. When this occurs in the blood vessels in the head, it is called a stroke

Many myocardial infarctions are mild and may even go unnoticed. In others, it can lead to ventricular fibrillation, a rapid and chaotic "fluttering" action of the heart muscle. This condition is called a cardiac arrest.

Causes of cardiovascular damage

Elevated blood levels of homocysteine and also Lipoprotein(a) are seen in patients with vascular disease and are associated with an increased risk of stroke, coronary artery disease, and peripheral vascular disease.

Our cardiovascular system is highly susceptible to damage caused by free radicals - harmful, oxidative agents that initiate the endothelial dysfunction leading to endothelial injury and, subsequently, to arterial plaque formation.

Free (unbound) radicals, also called reactive oxygen species (ROS), are highly chemically reactive towards other substances, or even towards themselves. An over-abundance of these highly unstable molecular fragments - both of internal and external origin is known to cause oxidative stress and cell damage, and

implicated in the progression of many degenerative diseases, one of them being atherosclerosis.(Free radicals, however, do play an important role in a number of biological processes and many of them are necessary for an effective immune system).

The two most important oxygen-centred free radicals are superoxide and hydroxyl radical. They derive from molecular oxygen under reducing conditions. However, because of their reactivity, these same free radicals can participate in unwanted side reactions resulting in cell damage. Excessive amounts of these free radicals can lead to cell injury and death, which may contribute to many diseases such as stroke and myocardial infarction (heart attack).

Over the years, our exposure to free radicals in the everyday life has been steadily increasing. Their production has become excessive and uncontrolled, resulting in the reduced ability of our immune system to protect us from their damage.  To prevent further damage, the body has a number of mechanisms, such as the enzymes superoxide dismutase, catalase, glutathione peroxidase and glutathione reductase used to

• minimize free-radical-induced damage and
• repair damage that occurs.

It has been documented that ambient air pollution exposure is an environmental risk factor correlating with increased incidence total mortality from cardiovascular events, such as coronary stroke and ischemic stroke. More free radicals heighten the inflammatory processes in the cells by attacking:

• cellular membranes and tissues in the body,
• our genetic material (mainly DNA),
• proteins and enzymes, and
• polyunsaturated fatty acids.

Hypertension, or high blood pressure, affects as much as 1/3 of the population of industrialized nations and has been shown to greatly contribute to the formation and progression of heart disease. Patients who are able to decrease their blood pressure to normal levels, especially without the use of medications, are at much lower risk of a fatal event.

Both elevated blood sugar and elevated insulin can be damaging to the linings of blood vessels, so people with insulin resistance are at much higher risk of developing atherosclerosis.  Diabetics are prone to damage of their blood vessels from glycation and oxidation of proteins and lipids, (the advanced glycation end products (AGEs)).The presence of higher levels of glucose in the blood stream is considered to be the cause of higher levels of AGEs. Usage of nutrients to improve insulin response can reduce this effect.

Nutritional support for heart health

According orthomolecular nutrition, if the right building blocks (nutrients) are present in the body in the right amounts and at the right time the body will:

• protect the arteries against free radical damage (antioxidant properties),
• improving endothelium recovery from injury, healing it and the underlying smooth-muscle cells,
• reduce the blood platelet aggregation & inflammation
• keep the blood slippery enough to have it flowing more freely and being less likely to form blood clots, causing a heart attack or stroke.

• improve fibrinolysis: the reduction of fibrins within a plaque

Omega-3s lower blood fats and inflammation, and omega-3s and vitamin K2 protect from heart disease. that The protective benefits of omega-3 fish oil in multiple aspects of preventive cardiology have been demonstrated.  High blood fat (triglyceride) levels have been shown to increase inflammation, raising the chances of heart disease. Signs of acute inflammation included no. of white blood cells(neutrophils), C-reactive protein and interleukin and all were decreased.  Vitamin K2 protects the heart and vascular system. Studies showed that the chances of coronary heart disease decreased 9 percent for every 10 mcg of vitamin K2 in the diet.

Elevated Homocysteine has been shown to make the endothelium more prone to the development of blood clots. Apart from genetic factors, other causes of elevated homocysteine levels include chronic kidney failure, certain medications or other medical conditions.  Homocysteine has been shown to cause damage to the endothelium, increased division and proliferation of smooth muscle cells, and increased oxidation of LDL cholesterol and other lipids. By increasing levels of free radicals, which damage endothelial cells, homocysteine can lead to reduced production by these endothelial cells of nitric oxide (NO), a chemical messenger necessary for the normal dilation of blood vessels. Certain vitamins, including vitamin B12, vitamin B6, and folic acid can lower Homocysteine.

Nutrients that decrease the formation and progression of atheromas include:

1. Nutrients that help decrease triglycerides
2. Nutrients that decrease the oxidation of existing LDL cholesterol,.
3. Nutrients that decrease the risk of damage to the blood vessel wall, both before atheromas begin and after

When present in the diet in sufficient amounts, phytosterols have been shown to lower blood levels of cholesterol, enhance the immune response and decrease risk of certain cancers.

The rich mixture of phytonutrients found in grapes—is thought to be responsible for numerous beneficial effects seen on cholesterol metabolism, oxidative stress (free radical activity) and inflammation.

Recent research has confirmed that soy protein does lower heart disease risk by increasing the size of LDL cholesterol particles. Small dense LDL is the most dangerous form of cholesterol, while large LDL, especially when accompanied by adequate supplies of HDL (a ratio of 4 LDL:1 HDL is considered ideal) is considered much less risky. High triglycerides also have the effect  of reducing LDL and HDL particle size.

Vitamin E, the primary fat-soluble antioxidant in the body, is the antioxidant found in highest quantities in LDL cholesterol particles, which it protects from oxidation. Studies have shown that people with lower vitamin E levels tend to have a higher rate of ischemic heart disease mortality and vice versa. The use of vitamin E in large amounts have been associated with a possible increase in oxidation. In order to prevent oxidation of fats, the vitamin E itself must become oxidized.  Vitamin C additions are very effective at restoring oxidized vitamin E back to its non-oxidized, antioxidant form. This process is enhanced with co-enzyme Q10.

Bioflavonoids, which are chemical substances classified as pigments, help provide fruits and vegetables has been associated with a significant decrease in risk of cardiovascular disease mortality.

Niacin (vitamin B3) helps to increase the breakdown of cholesterol to bile, decreases the proliferation of smooth muscle cells, helps to prevent LDL oxidation, reduces platelet clumping, lowers lipoprotein a levels, and can increase HDL, or good cholesterol, levels by as much as 15-40%.

Vitamin D has emerged as one of the key nutrient. vitamin D can lower inflammation by increasing levels of anti-inflammatory messengers like the cytokine named IL-10 (interleukin 10). Research has also shown that vitamin D can lower blood pressure, probably by inhibiting a regulatory system called the renin-angiotensin system (i.e. ensuring the kidney’s control over blood pressure). Low Vitamin D also impacts adversely on blood sugar control, immune response, cholesterol condition and stress factors.

Omega-3 fatty acids, a type of fat essential for normal body function, are used to make cell membranes throughout the body and immune system-related chemicals that help regulate inflammation. Omega-3 fatty acids have been shown to decrease the proliferation of smooth muscle cells, decrease the movement of macrophages into the vessel wall, increase the removal of LDL cholesterol (& triglycerides) from the bloodstream, decrease platelet aggregation and thrombus formation following endothelial injury, increase vasodilation by enhancing the effects of NO, and increase thrombus (blood clot) breakdown.

Studies have shown that LDL cholesterol particles that contain monounsaturated fats, such as from olive oil, are much more resistant to oxidation that those that contain high levels of polyunsaturated fats. The abundant polyphenols in extra virgin olive oil have anti-inflammatory, antioxidant and anticoagulant actions. Its phenolic content can also provide benefits for plasma lipid levels and oxidative damage.

When subjects in a study ate a breakfast containing virgin olive oil with its normal high phenolic content (400 ppm), their endothelial function actually improved, blood levels of nitric oxide (a blood vessel-relaxing compound produced by the endothelium) increased significantly, and far fewer free radicals were present than would normally be seen after a meal.

By decreasing the attraction of immune system cells, omega-3 fats can also prevent the high levels of free radicals. Triglycerides are important for good health because they serve as a major source of energy. High levels of triglycerides, however, are associated with an increased risk of cardiovascular disease. In addition, high triglycerides are often found along with a group of other disease risk factors that has been labeled metabolic syndrome.

Zinc is needed for the proper function of endothelial cells and helps to prevent the endothelial damage caused by oxidized LDL cholesterol and other oxidized fats Zinc has been shown to prevent some of the damage to heart muscle cells after a myocardial infarction by decreasing the free radicals

Magnesium, which is a cofactor in more than 300 enzymatic reactions in the body, is a mineral essential for normal cell metabolism and function. Low dietary levels of magnesium are associated with increased rates of hypertension, heart arrhythmias, ischemic heart disease, and sudden cardiac death. Low levels of magnesium have been found in the hearts and blood vessels of patients with angina, coronary artery disease, and also in patients who have died of ischemic heart disease related sudden death.

Low magnesium levels are related to decreased function of endothelial cells including increased susceptibility to damage and lesion formation; increased calcification of atheromas; decreased collagen breakdown, leading to increased collagen build up in atheromas; elevated lipoprotein levels; decreased normal cellular uptake and use of cholesterol; increased cholesterol build up in blood vessel walls; and increased platelet clumping and clot formation. In addition, magnesium decreases vessel spasm and increases vasodilation. Increasing dietary magnesium intake may decrease the progression of atherosclerosis.

Higher blood levels of potassium have been shown to decrease the amount of free radicals produced by damaged endothelial cells and activated monocytes and macrophages. Higher levels have also been shown to decrease the proliferation of smooth muscle cells and to decrease platelet clumping and thrombus formation.

As with potassium, magnesium levels tend to be lower when the diet is high in sodium. Red blood cell levels of magnesium are strongly related to diastolic blood pressure. Hypertension also tends to lower phosphate levels, which then can make the hypertension worse. Increasing magnesium intake has been shown to restore phosphate levels to normal.

Folate is needed for the conversion of homocysteine back into methionine. The absorption of vitamin B12 requires a certain substance called intrinsic factor that is produced by the stomach. Elderly persons and persons with stomach or digestive problems are especially prone to vitamin B12  (& folate) deficiency as they may not be producing enough intrinsic factor to absorb the vitamin B12 they take in. The effect of vitamin B12 on elevated homocysteine levels is most pronounced when the elevated levels are due in part to low vitamin B12 levels.

Co-enzyme Q10 is a vital nutrient for cellular energy and thereby muscular strength. As we age the levels of Co-enzyme Q10 naturally reduce and if these levels become too low from effects of illness, stress or medication (e.g. statins) then significant muscular weaknesses can arise. The heart functioning can be affected. Improved recovery after heart failure has been found using high levels of Co-enzyme Q10 and Selenium. The medication of statins can reduce both of these nutrients. Lower Selenium  levels will affect anti-oxidant and thereby immune condition.

Supplementation of the diet with taurine in one study showed a decrease in both systolic and diastolic pressure.

Studies have shown a correlation between higher levels of iron stores and an increased rate of cardiovascular mortality. Some studies have shown that regular blood donation may decrease the risk of myocardial infarction by as much as 86% in men. It is believed that initial injury to the endothelial wall causes iron to be released from iron stores. Once released, this iron becomes highly reactive and is able to cause the oxidation of LDL cholesterol. The relationship between dietary iron intake and cardiovascular risk does not appear to apply to non-haeme iron, which is the type found in certain vegetables. Elevated iron store levels can be decreased through blood donation as well as exercise, which can reduce iron stores through sweating, increased muscle mass, and red blood cell metabolism.

Antioxidants play a key role in the defence mechanisms against free radical damage, especially vitamin A, vitamin C, vitamin E and polyphenol antioxidants (POH) found in virtually all plants. Antioxidants are known for their ability to scavenge (deactivate) free radicals and up-regulate certain metal chelation reactions in order to maintain healthy metabolic function. There is good evidence bilirubin and uric acid can act as antioxidants to help neutralize certain free radicals. Antioxidants are essential for life as our protectors against free radical damage. Because of a close relation between free radical activity and protective function of antioxidants, it is said that atherosclerosis can be:

• caused by the absence or deficiency of antioxidants in the body,
• prevented by their regular presence in sufficient amounts, and
• reversed by their optimal or optimized supply through specific dietary supplementation.

Existing research indicates that if enough antioxidant protection is available, the oxidation of cholesterol from free radicals can be prevented  The increased risk of free radical-induced endothelial (arterial) injury can be strongly correlated with low overall nutritional status of the body.

Reducing the potential damage  to the endothelium by ‘AGEs’, as experienced by diabetics, can prevent less chance of subsequent arterial blockages. Better sugar control by adopting a low GL(Glycemic Load) diet and improving insulin response can be important. Supplements of chromium may help type 2 diabetics. Chromoprecise is recognised as a chromium supplement with  very high bioavailability and prevents insulin resistance. This supplement could reduce the risk of developing type 2 diabetes and also reducing the AGE damaging of the endothelium for non-diabetics.

There is some evidence of supplements that can improve blood flow when the vascular system has problems. PADMA is a herbal complex approved for intermittent claudication and to improve conditions like Raynaud’s syndrome.  The herb Ginkgo Biloba can improve flow through all blood vessels. Serrapeptase and Nattokinase contain enzymes that have anti-inflammatory properties for blood platelets and help maintain good circulation. The herb hawthorn has been used to improve blood flow through heart muscles and thereby improve blood pressure. The amino acid L-arginine and the supplement  Pycnogenol ( source of anthrocyanins) increase nitric oxide which assists blood pressure, and thereby circulation, from enabling the blood vessels to relax.

There is some evidence that the amino acid L-Lysine along with Vitamin C can improve fibrinolysis and reduce arterial blockage. L-Lysine is a precursor to L-carnitine and vitamin C helps this metabolic change.

Definitely, when it comes to atherosclerosis, foods have a direct impact on the quality of our blood vessels. We all know perfectly well that what we eat does affect the blood lipids. After consuming the Mediterranean-like meal rich in vegetables and olive oil, a significant increase was seen in the activity of serum paraxonase (PON 1), an enzyme transported on HDL in the blood. PON1 protects cholesterol from oxidation and inhibits macrophage foam cell formation. Even small doses of omega-3 fatty acids from fish or parental seed oils may be very protective.  The risk for ischemic stroke was dropped 31% in those eating fish just 1-3 times a month. Fruits, vegetables and fish offer significant protection against stroke. The exposure to higher temperatures of vegetable oils (i.e. above 120 ^oC) will lead to oxidation and adverse chemical changes.

Historically, saturated fats were considered adverse for heart health but large population studies have dismissed this linkage. Polyunsaturated and mono-unsaturated fats have proven health benefits and in general the combination of both saturated and polyunsaturated fatty acids should be included in our diet. There is significant concerns  for heart  and immune health with red meats that have been treated or those fried.