The Heart of the Matter
- Friday, 13 March 2009
Coronary artery disease is the number one killer in North America. Each year, approximately 1.1 million people in the United States have heart attacks. That translates to roughly 3,000 a day! Unfortunately, most are not aware that they have heart disease until a heart attack occurs.
It is believed that we can reduce our risk of heart disease by taking a preventative approach, but what does that mean? It is helpful to avoid the major risk factors for heart disease – obesity and poor diet, lack of exercise, excess stress and smoking, other established causes such as family history, elevated cholesterol, diabetes and hypertension . This list is far from comprehensive, however. In fact, half of all heart attacks occur in people with normal cholesterol levels. Your physician can test for new risk factors and bio-markers - other factors that promote atherosclerosis (the buildup of fat deposits in blood vessels).
Bio-Markers of Heart Disease
Cholesterol - HDL vs. LDL values are more critical than total cholesterol.
Triglycerides – marker of total lipoproteins in blood. Raised by diet high in saturated fats and carbohydrates.
C-Reactive Protein (CRP) - A marker of chronic inflammation.
Homocysteine - Makes platelets sticky increasing clotting and slowing blood flow. Formed when protein is metabolized as a result of deficiencies of folic acid (400 mcg/day), vitamin B6 and vitamin B12.
Fibrinogen – promotes blood clots increasing blood viscosity and impairing blood flow.
Arterial Stiffness - Leads to increased blood pressure.
Cholesterol is not necessarily the enemy we’ve been led to believe. It serves many biological functions, including the production of sex hormones and strengthening of cell membranes, among other important purposes. The cholesterol in your body comes from two sources. It is provided by eating saturated fats from animal foods (meat, poultry, fish, and animal by-products such as cheese, eggs, and milk). There is no cholesterol in plant foods like vegetable oils, nuts, seeds, or coconut. The rest is produced by your liver. While overall cholesterol values should remain on the low-side, the ratio between LDL (“bad” cholesterol) and HDL (“good” cholesterol) is of greater significance. At your next physical, ask your physician to explain the blood values.
What Your Cholesterol Numbers Should Look Like:
200–239 mg/dL = Borderline-High Risk
240 mg/dL and over = High Risk
130 to 159 mg/dL = Borderline High Risk
160 to 189 mg/dL = High Risk
<40 mg/dL for men
<50 mg/dL for women
150-199 mg/dL = Borderline High Risk
200-499 mg/dL = High Risk
LDL vs. HDL
Lipoproteins (part fat, part protein) are vehicles that transport cholesterol throughout the bloodstream. LDL stands for low density lipoprotein and is known as the “bad” cholesterol. HDL represents high density lipoprotein, the “good” cholesterol. It is not the cholesterol itself that is bad or good; it is the lipoprotein. When LDL cholesterol levels are high and HDL levels low, LDL’s tend to stick to the lining of the blood vessels, leading to the hardening of the arteries (or atherosclerosis). Atherosclerotic “plaques” cause narrowing of the arteries and lead to heart attacks and stroke.
Trans fat is one of the most dangerous ingredients in the human diet. It is bubbling hydrogen gas through vegetable oils to solidify them through a process called hydrogenation. Trans fat reduces HDL while raising LDL cholesterol and triglyceride levels. Trans fat also increases Lp(a) and promotes inflammation – other significant risk factors for heart disease. Avoid foods listing hydrogenated and/or partially hydrogenated fat on the label.
Triglycerides and cholesterol both measure the total amount of lipoproteins in the blood. A diet high in saturated fats, such as red meat, and especially a diet high (60% or more of your daily calories) in simple carbohydrates and starchy food – particularly sugar, rice, and wheat - raise serum triglyceride levels drastically. In fact, low-fat diets that substitute carbohydrates for fats may raise triglyceride levels and decrease HDL ("good") cholesterol in some people.
High triglyceride levels are a strong predictor of myocardial infarction. The American Heart Association’s guidelines for triglyceride levels are:
Normal range, low risk
Very high: high risk
To achieve safe triglyceride levels, reduce your intake of sugar and refined carbohydrates, alcohol, and avoid trans fats. Replace these foods with fruits and vegetables.
C-Reactive Protein (CRP)
A CRP reading of 3.0 mg/L or higher can triple your risk of heart disease. CRP is a protein molecule made by the liver and fat cells. It is released into the bloodstream in response to chronic inflammation anywhere in the body, such as infections, arthritis, or injury. When inflammation occurs, CRP levels dramatically rise and bind to LDL (the ‘bad’ cholesterol) in the artery wall creating an oxidized LDL considered to be the cause of inflammation. The inflammation process initiates a cascade of events that lead to the generation and rupturing of atherosclerotic plaques that cause heart attacks.
Taking nutrients with anti-inflammatory properties such as omega-3 fish oil will help, together with compounds such as bromelain, curcumin, cat’s claw, olive leaf, and fibrin dissolving nutrients such as natto can all help reduce CRP levels. Studies show that trans fats can radically raise CRP levels.
Homocysteine, an amino acid by-product of protein metabolism, contributes to atherosclerosis, reduces the flexibility of blood vessels, and increases blood clotting by making platelets stickier. Studies show a direct correlation between high blood homocysteine levels and the risk of heart attack and stroke. Elevated homocysteine is also associated with Alzheimer's disease, as well as depression, multiple sclerosis, menopausal symptoms, and rheumatoid arthritis.
Homocysteine is quickly metabolized to cysteine when the diet includes sufficient amounts of folic acid, vitamin B6 and vitamin B12 found in dark leafy green vegetables, whole grains and animal foods, as well as multivitamins.
The risk for heart disease triples when the homocysteine blood level exceeds 15.8 umol/L. The optimum target should be under 8 umol/L.
Fibrinogen is a protein essential for the formation of blood clots. High levels of fibrinogen increase blood clotting, thereby increasing one’s risk of heart attack and stroke. If a clot forms inside an artery, it can increase blood viscosity, blood pressure, and impair blood flow.
Nattokinase, made from fermented soy beans, prevents the coagulation of blood and dissolves existing thrombus (clots). Use under the supervision of a physician.
Skin is held together by collagen. As we age, collagen breaks down causing the signs of aging. As the collagen in skin deteriorates, so does the collagen in blood vessels. A poor diet (low in antioxidants, fresh vegetables and fruit), lack of exercise, and smoking promote the loss of elasticity. As collagen is lost and elasticity reduced, stiffening of the arterial wall leads to an increase in systolic and diastolic pressure (or high blood pressure).