ATHEROSCLEROSIS
The following Supplements and information can be helpful in preventing and managing atherosclerosis. Please inform your healthcare provider about any supplements and medications which you are taking in order to optimize your care and to help prevent any adverse interactions. This information is only intended for an educational purpose.
I believe that atherosclerosis is a preventable and potentially reversible nutritional disease which is highly associated with chronic inflammation. But, what causes the inflammation?
Inflammation is the body’s attempt to heal itself, defend against foreign invaders, and repair tissue damage. Inflammation is part of our innate immunity. It is a protective response involving molecular mediators, immune cells and responsive blood vessels: an immuno-vascular response to eliminate the cause of cell injury, clear out necrotic cells and tissues, and initiate tissue repair. CHRONIC INFLAMMATION lasts for long periods of time; is mediated by monocytes and lymphocytes; continues because of protected viruses and non-degradable pathogens, persistent foreign bodies, and auto-immune responses; and, results in tissue damage, scarring and debilitation. It is now known that chronic inflammation is the fundamental origin for many chronic and degenerative diseases such as cardiovascular diseases, asthma and COPD, Alzheimer’s dementia, cancers, chronic allergic conditions, and arthritis. If chronic inflammation can be successfully managed, then these plagues of our modern life styles can be alleviated. {***If you are interested is specific suggestions, please see my detailed handout on Suggestions to Manage Chronic Inflammation.***}
***ATHEROSCLEROSIS PREVENTION***
{per the Linus Pauling and Matthias Rath: “Unified Theory of Human Cardiovascular Disease” (1989).}
Dr. Pauling proposes that a long term deficiency of vitamin C and a relative lack of L-lysine causes the enzyme lysine hydroxylase to be less activated which results in a deficiency of collagen fibril cross-linking strands which weakens the endothelium and surrounding connective tissue. Lipoprotein-a {Lp(a)} sticks to the damaged ends of lysine residues in the areas of the damaged artery, repairing the leakage with a fatty patch. Eventually, these fatty patches accumulate platelets and fibrous tissue, and, calcium deposits which forms an atherosclerotic plaque that is the hallmark of cardiovascular disease.
***The Pauling-Rath protocol can help to prevent and repair this damage. For treatment: consider having a compounding Pharmacist mix the following ingredients together– (in order to deal with only one bottle of supplements, rather than several bottles): Vitamin C 3,000 mg, L-lysine 2,800 mg, L-proline 500 mg; and, take this twice daily. In order to enhance the antioxidant effect of the formula, also include: CoQ10: 200 mg, N-Acetylcysteine (NAC): 300 gm, and, Tocotrienols: 200 mg. {Per Glenn S. Rothfeld, MD; “Nutrition & Healing”, 2017 Feb;23:10.}
HOWEVER, especially consider using ***“Lypo-Spheric Vitamin C”*** from LivOnLabs.com (1-866-790-2107). It comes as a box of 30, 1,000 mg individually wrapped packages of a lipid gel which is squeezed into a “shot” of orange juice or other juice and knocked-back in one swallow. It is pleasant. The lipo-encapsulated vitamin C has >7 times the bioavailable dose of other products, without GI side-effects.
***I highly recommend reading the 2013 book by Thomas E. Levy called “Death by Calcium”.*** The calcification of arteries is intrinsically related to CAD. Early stages of atherosclerotic plaques are cholesterol-laden, while advanced plaques are very calcium-rich. 1/3 of Americans >45 years old have arterial calcifications {15337212}. An important screening tool is a Coronary Artery Calcium Score (CAC). It is sensitive, specific and reliable, inexpensive and relatively safe as an indicator of atherosclerosis {26965738, 16365194, 22357989, 11451257}. The radiation dose is only a small fraction of the natural background radiation in the U.S. CAC is a computerized low-dose X-ray test, which takes less than 10 minutes and costs about $100. It can be obtained once or twice per year to diagnose atherosclerosis and to monitor the effectiveness of treatments.
Detectable coronary calcifications in young, asymptomatic men have a 12-fold increased risk of CAD {20730016}. CAC reliably predicts CAD and all-cause mortality {22357989, 23206619}. It is a significant indicator of extracellular calcium deposition which can reliably help to predict death from chronic degenerative diseases. The higher the CAC, the greater the mortality hazard: eg. a CAC 1-100 points has a 3-fold risk; a CAC 101-1000 points has a 6.13-fold risk; and, a CAC >1000 has a 10.93-fold risk {22357989}. Males with the highest Vitamin C levels have the lowest CAC scores {15003962}. Increased markers of inflammation are associated with increased progression of CAC {23340891}, and also associated with low levels of Vitamin C. People with the highest Vitamin C levels have the longest life expectancy, with a reduced rate of all-cause mortality {11247548, 17442130}.
Calcium Channel Blockers (CCB) exert an anti-atherosclerosis effect. The long-term use of these drugs in older individuals without hypertension almost never results in unwanted hypotension. The logical answer is that virtually all individuals using these drugs also have chronic states of excess intracellular calcium, which increases oxidative stress. Calcium channel blockers lower all-cause mortality {10323641, 10923432, 15716708, 19451836}. CCBs reduce intracellular calcium levels, thus, reducing oxidative stress. CCBs reduce methylmercury, associated with damage to the nervous system, and reduce cytoplasmic iron accumulation, associated with malignant transformation {8882354, 21860702}. CCB use is negatively correlated with the incidence of prostate cancer {19451836, 23308170}.
There is a significant association between atherosclerosis and osteoporosis. In addition to a decrease in the sex hormones associated with aging, another major cause of osteoporosis is “focal scurvy” (severe vitamin C deficiency) of the bones. Vitamin C is essential for the synthesis of collagen and for creating the fibrous interconnecting collagen cross-linking strands required to optimize the physical strength and resilience of the bones. A vitamin C deficiency results in weaker bones and a fragile endothelium. This can be easily prevented, cured and reversed with appropriate dosing of vitamin C and other important nutrients. Vitamin C maintains a healthy osteoblast (bone depositing)—osteoclast (bone dissolving) balance. In the absence of vitamin C, bone-making osteoblasts fail to form. At the same time, there is an unchecked increase in bone-dissolving osteoclasts, resulting in weakened bone integrity along with calcium loss, which is then abnormally deposited within the arterial system. Also, a deficiency of vitamin C directly increases oxidative stress within all cells causing damage and even death of the cells.
Toxins increase intracellular calcium {23160928, 22927718, 23049237}. Degenerative neurological conditions such as ALS, Parkinson’s disease, and Alzheimer’s dementia have elevated intracellular calcium {20493207, 21884755, 21697951}. The ultimate mechanism of cell death is a high level of intracellular calcium {23250754, 2220009}. Ectopic calcifications (calcium deposited in soft tissues other than bone), including atherosclerosis, are often found in patients with chronic diseases and cancer {23308170}. Mammograms, used for breast cancer screening, often demonstrate microscopic and macroscopic calcifications which may indicate a need for a biopsy {23370209}. Thus, managing excessive calcium is critical for preventing and reversing chronic diseases associated with aging. ***Treatment with Vitamin C is fundamental for managing excessive calcifications***.
Another highly significant risk factor for developing atherosclerosis is ***GLUCOSE INTOLERANCE*** (otherwise known as: insulin resistance, pre-diabetes, a part of the metabolic syndrome, and “diabesity”), much more than an elevated serum cholesterol level. Heart disease is more closely associated with inflammation (which is HIGHLY associated with an increased simple sugar load). Saturated fats and cholesterol in the diet do no lead to heart disease. Over the age of 60, the higher your total cholesterol, the longer you are likely to live. Thus, it is very important to manage glucose intolerance with the goal to reduce the marker hemoglobin A1C below 5.
***AMPK (adenosine monophosphate-activated protein kinase) activation is very important for both the prevention and treatment of atherosclerosis. AMPK is the metabolic master switch: a) it mitigates LDL oxidation and the resulting endothelial damage, which slows the development of atherosclerosis; b) it reduces the conversion of monocytes into fat laden macrophages (“foam cells”), which reduces their accumulation in vessel walls; c) it increases cholesterol export out of endothelial cells and suppresses the inflammatory stimulus normally produced; d) it offers critical protection of coronary artery endothelial cells against “fat poisoning”—the death of endothelial cells in the presence of high fat concentrations; and, e) it prevents fragmentation of mitochondria (the energy producing organelles) in endothelial cells which is known to be a precursor of atherosclerosis. The prescription medication Metformin activates the metabolic regulator AMPK AND helps to reduce glucose intolerance. In one study, patients who had a heart attack who were taking Metformin had a 75% reduction in the risk of dying after 30 days, and a 68% reduction in their risk of dying 12 months after the attack. {Cardiovasc Drugs Tger, 2015;29(3):265-275.} Metformin reduced the risk of heart attack, stroke, atrial fibrillation and death from all-causes. {Endocr Pract. 2016;22(8):999-1007.} Alternatively, a proprietary product called “AMPK Activator” is available from www.LifeExtension.com. It contains 2 nutrients shown to boost AMPK activity: 1) Gynostemma pentaphyllum: otherwise known as Southern Ginseng or Jiaogulan, is an adaptogen with powerful anti-oxidant properties, and 2) Trans-Tiliroside: a rosehip extract with anti-obesity and anti-diabetes activity.
Consuming an over-abundance of calories for a long time will suppress the AMPK system. AMPK reduces insulin resistance and supports glucose transport, inhibits the metabolic syndrome associated inflammation, increases utilization of stored fat for energy, improves mitochondrial fat burning, reduces weight gain by enhancing the effect of the anti-obesity hormone– adiponectin, and improves immune functions and other functions that support longevity. Increased AMPK activity normalizes hyper-activated mTOR activity. {Excessive mTOR accelerates cell aging and malignant transformation, and depletes stem cells.} A suppressed AMPK system leaves the body in a state of continued energy storage and reduced energy utilization. Cutting calories forces the body to activate AMPK. Also, AEROBIC EXERCISE is a powerful AMPK activating strategy. Only when adding exercise will reducing calories be truly effective for weight loss. Hesperidin, found in citrus peel extracts and in orange juice, also activates AMPK.
***NITRIC OXIDE (NO) plays a key role in the healthy functioning of the endothelium. The AMA has published studies showing that adults over age 40 don’t produce enough NO. In fact, they produce only half of what they did when they were 20 years old. NO is an important signaling molecule in the cardiovascular system that promotes arterial dilation by relaxing smooth muscles which helps the body support healthy blood pressure levels, heart health, and increased circulation throughout the body. Nitrates found in beets and green leafy vegetables begin the conversion to nitrites by bacteria in the saliva. Gastric acid then converts nitrites to NO. Exercise also increases NO levels. A healthy oral microbiome is critical for converting nitrates to nitrites. For example, Chlorhexadine (used in mouth wash) kills these important bacteria which results in decrease NO levels, and, consequently, increased blood pressure. Thus, hypertension may be a symptom of oral dysbiosis.
Decreased NO levels result in endothelial inflammation and oxidative stress. NO helps to inhibit platelet stickiness, increases mitochondrial function and improves longevity, and promote angiogenesis in situations with low blood flow. Also, the PDE5 inhibitor medications (such as Viagra and Cialis) used to treat erectile dysfunction require NO in order to work by causing vaso-relaxation. The enzyme endothelial nitric oxide synthetase (eNOS) is needed to produce NO. The following conditions impair eNOS activity: dyslipidemia, hypertension, diabetes, obesity and aging.
A proprietary extract from the rind of sweet oranges called “Cordiart” contains highly bioavailable hesperidin which reduces the destruction of the enzyme eNOS that is needed to produce nitric oxide which subsequently increases nitric oxide availability. Hesperidin reduces the inflammation marker CRP, and lowers serum amyloid A which promotes impairment of eNOS. It also lowers levels of E-selectin, an adhesion molecule that can initiate inflammatory infiltration of endothelial tissue. A proprietary product called “Endothelial Defense with Full-Spectrum Pomegranate and Cordiart” is available from www.LifeExtension.com.
Pomegranate enhances nitric oxide synthesis and supports reverse cholesterol transport by HDL which can result in shrinking of atherosclerotic plaques (see above). Superoxide dismutase (SOD) protects against damage to eNOS from oxidative destruction resulting in decreased production of nitric oxide. This product also contains an orally active form of SOD called “GliSODin” that supports arterial function and structure. Nitrate rich foods include spinach, beets, carrots, arugula, pomegranate, garlic, cocoa and citrus fruits.
Beets (Beta vulgaris) are probably the richest dietary source of nitrate. The nitrate in beets (best taken as the raw juice or baked) acts as a reservoir by forming nitrite for the production of the local microvascular vasodilator nitric oxide, which helps with managing angina and with erectile dysfunction. In 2012, a randomized, controlled, single blind crossover trial investigating the effect of eating beets on blood pressure demonstrated that eating beets substantially lowered both systolic and diastolic blood pressure. Also, beets make 2 key detoxifying enzymes: glutathione peroxidase and glutathione-S-transferase. The first protects against free-radical damage and the second is crucial for detoxifying chemicals. Inducing activity with beets may protect against cancer. Additionally, beet fiber increases colon immune CD8 cells which detect and eliminate abnormal cells. This is particularly helpful to protect against colon cancer. Consider drinking 10 oz of beet juice daily.
A patented formula which is available exclusively through physicians may help the body increase Nitric Oxide levels. It is called “Neo40 Pro”. Nitric Oxide indicator strips can measure NO present in saliva which helps to appropriately dose Neo40 Pro and achieve an optimal range. One oral dissolving lozenge use twice daily can help to decrease blood pressure. Also, in a comparison study with aggressive statin use for 3 years where plaque regression was 2.7%, use of Neo40 Pro demonstrated plaque regression by 11% in only 6 months of use.
***Periodontal disease is a significant cause of atherosclerosis! DENTAL PLAQUE causes gum irritation and activation of immune cells which attack the endothelial lining. Treating periodontal disease reduces endothelial inflammation and damage. See a dental hygienist and have your teeth cleaned every 6 months. Floss or use a water pick after every meal. Consider brushing your teeth with an electric toothbrush. Dunk the brush into 3% hydrogen peroxide then tap it into some baking soda and brush with that mixture: it doesn’t taste very good, but the anti-infectious effects are dramatic. Use CoQ10 (or Ubiquinol) 300 mg daily. And, consider applying ozonated olive oil to your gums before bed and upon awakening. Ozonated olive oil can be obtained from Longevity Resources by calling 877-543-3398. A more palatable form called Olive Gold O3 can be obtained by calling 561-882-4153.
{***Also, I highly recommend reading the book “Hidden Epidemic” by Thomas E. Levy, MD, JD.} “Oral infections are responsible for most heart attacks and breast cancers, as well as a majority of other chronic diseases. What is alarming is the fact that most of these oral infections are painless and asymptomatic. Frequently, they are even more deadly than when they hurt! The majority of these infections can now be identified using 3D Cone Beam imaging. A general treatment protocol includes: 1) Prevent or minimize daily toxin exposure. 2) Neutralize existing toxins already in the body. 3) Excrete and eliminate toxins in as non-toxic a manner as possible. 4) Resolve existing infections, and eliminate the reasons for contracting new infections. 5) Supplement optimally to maximize the antioxidant and nutrient status in the body. 6) Eat and digest optimally to maximize the antioxidant and nutrient status in the body. Consider regularly using a complete food pulverizer device such as a “NutriBullet”. 7) Correct hormone imbalances, typically deficiencies of testosterone, estrogen, and thyroid hormone. 8) Use prescription medications sparingly and appropriately, when the listed measures don’t resolve or control a significant condition adequately (eg. control of hypertension, angina, significant pain); long-acting calcium channel blockers are of particularly great benefit. 9) ALWAYS include 3D cone beam imaging of the teeth as part of the baseline workup for any chronic degenerative disease, especially heart disease and breast cancer, and repeat this examination periodically for the optimal long-term management of any medical condition. 10) Have the oral surgeon, endodontist, or dentist follow an infected tooth extraction protocol that completely removes the periodontal ligament ad all infected bone, and that incorporates established measures to optimize good healing, including ozone applications and platelet-rich plasma. 11) Always attempt to have your physician communicate with your dentist in constructing your long-term healthcare management, and vice-versa. ***12) Various SUPPLEMENTS can be beneficial:
Vitamin A 25,000/day as beta carotene
Vitamin B complex without iron, copper and calcium daily
***Vitamin C (liposomal encapsulated) 1,000 once or twice-per-day (x7 bioavailability—no digestive upset nor diarrhea; best intracellular delivery; slower excretion rate): the DOSE is the most critical factor for health and healing: no absolute maximum range.
Vitamin D3 5,000 IU/d–(monitor for optimal range of 50-80 ng/ml)
Vitamin E (mixed tocopherols) 800 IU/d
Vitamin K (family: especially K2 as Menaquinone-4) 3-6 mg/d
Lysine 2,500 mg in a 5:1 ratio with Proline 500 mg/d
Magnesium (as a chelated form, eg. Glycinate: 400-1,000 mg/d)
Multimineral complex without iron, copper and calcium
Omega-3 Fish Oil and Krill Oil 3-9 gm/d
Iodine (potassium iodine) 12.5-25 mg/d {pp. 308-312}
***THE ENDOTHELIAL GLYCOCALYX LAYER***
Cardiovascular disease begins with endothelial dysfunction. Blood vessel bifurcations create flow turbulence which increases the risk of vascular damage which increases the inflammatory response to injury. A thin glycocalyx (GC) gel layer coats the single cell width luminal side of the vascular endothelium. It is a mesh of complex sugars which makes the vessel wall slippery. It provides a barrier function, maintains platelet inhibition, assists with shear induced NO function, harbors readily available enzymes, and provides many other benefits. Like armor, it protects the endothelium from oxidative stress and inflammation. Damage to the GC layer (by elevated blood glucose, hypervolemia, tobacco smoke, turbulence, inflammation, etc.) causes leakage of substances into the subendothelial layers, which triggers plaque development. Current strategies to improve the GC layer include: 1) Glycemic control eg. Metformin; 2) Decreasing inflammatory mediators; and, 3) Increasing GC regenerating compounds eg. using a specialized sulfated polysaccharide product (SSP).
The Abstract in PLoS One. 2017; 12(10): e0186116, “Regeneration of glycocalyx by heparan sulfate and sphingosine 1-phosphate restores inter-endothelial communication,” by Mensah SA, et. al. states:
“Vasculoprotective endothelium glycocalyx (GCX) shedding plays a critical role in vascular disease. Previous work demonstrated that GCX degradation disrupts endothelial cell (EC) gap junction connexin (Cx) proteins, likely blocking interendothelial molecular transport that maintains EC and vascular tissue homeostasis to resist disease. Here, we focused on GCX regeneration and tested the hypothesis that vasculoprotective EC function can be stimulated via replacement of GCX when it is shed. We used EC with [i] intact heparan sulfate (HS), the most abundant GCX component; [ii] degraded HS; or [iii] HS that was restored after enzyme degradation, by cellular self-recovery or artificially. Artificial HS restoration was achieved via treatment with exogenous HS, with or without the GCX regenerator and protector sphingosine 1- phosphate (S1P). In these cells we immunocytochemically examined expression of Cx isotype 43 (Cx43) at EC borders and characterized Cx-containing gap junction activity by measuring interendothelial spread of gap junction permeable Lucifer Yellow dye. With intact HS, 60% of EC borders expressed Cx43 and dye spread to 2.88 ± 0.09 neighboring cells. HS degradation decreased Cx43 expression to 30% and reduced dye spread to 1.87± 0.06 cells. Cellular self-recovery of HS restored baseline levels of Cx43 and dye transfer. Artificial HS recovery with exogenous HS partially restored Cx43 expression to 46% and yielded dye spread to only 1.03 ± 0.07 cells. Treatment with both HS and S1P, recovered HS and restored Cx43 to 56% with significant dye transfer to 3.96 ± 0.23 cells. This is the first evidence of GCX regeneration in a manner that effectively restores vasculoprotective EC communication.”
Dilated capillaries in your cheeks and nose can be a sign of HYPOCHLORHYDRIA or low stomach hydrochloric acid and low pepsin production. With hypochlorhydria, you may not be properly digesting and absorbing important nutrients, supplements or medications. There is an association with atherosclerosis, elevated lipids, and hypertension as well as a long list of other diseases. If diagnosed, then treatment with glutamic acid-hydrochloride-pepsin capsules before meals may be very beneficial for your digestion. Using lemon juice or vinegar may have a similar benefit. NOTE: Hypochlorhydria is induced by proton-pump-inhibitor (PPI) medications, histamine 2 blockers, and antacid use.
SUPPLEMENTS
1) ***VITAMIN K2: Matrix Gla-protein is a vitamin K2-dependent protein, and it must be carboxylated (“turned on”) to function properly in order to bind calcium. Poor vitamin K status leads to inactive un-carboxylated (“turned off”) matrix Gla, which enables calcium to accumulate in soft tissues. When vitamin K levels are less than optimal, matrix Gla-protein allows calcium to infiltrate into arterial walls, literally hardening the arteries. Thus, vitamin K functions as a control switch which blocks calcium from entering soft tissues {22416724}. Also, Vitamin K2 helps to dissolve existing calcium deposits {17138823}. Vitamin K2 levels are negatively associated with all-cause mortality and with aortic calcifications {15514282}. Vitamin K2 also helps to improve bone mass and to reduce fractures {19949271}. It helps to take calcium out of tissues and put it back into bone where it belongs.
It is optimal to supplement with the vitamin K family: I recommend taking 1mg vitamin K1, 1 mg (MK-4) vitamin K2 and 200 mcg (MK-7) vitamin K2. Studies are pending to determine if extended supplementation with high dose vitamin K might induce a regression of arterial calcification. A proprietary product containing the recommended doses for the vitamin K family is called “Super K with advanced K2 complex” from www.LifeExtension.com. One might think that taking higher amounts of vitamin K “the coagulation vitamin” would increase thrombotic risk. This concern has no basis in reality. Only small amounts of vitamin K are required to fully saturate coagulation proteins. Once fully saturated, there is no increased thrombotic risk in response to additional vitamin K intake. Vitamin K is critical for blocking calcification of heart valves, arterial linings, and other soft tissues, while helping to keep calcium in bone where it is needed.
2) ***VITAMIN C: at least 6 gm/day.*** Endothelial collagen binding requires Vitamin C. A Vitamin C deficiency causes less collagen binding which sets up a cascade of reactions damaging to the endothelium ending in the deposition of calcium within the endothelium, and the plaques (scars) which form. Vitamin C can help to prevent and to reverse this calcification process. It can also help to relax angio-spasms. Vitamin C competes with glucose for intracellular transport. {Note: it can disturb accurate lab glucose measurements. It may also be how Vitamin C helps to manage cancers.} Also, Vitamin C helps to reduce inflammation. {A person weighing 160 pounds needs 13 to 15 gm of Vitamin C daily. Goat physiology is similar to human physiology in its requirements for Vitamin C, however, unlike humans, goats can manufacture Vitamin C. When a goat is stressed, it will increase its production of Vitamin C by ten-fold. Thus, it is not a problem for humans to take large doses of vitamin C. Oral dosing is limited by the osmotic effects it can have resulting in loose stools. Thus, for de-toxification and for the treatment of cancers, vitamin C is typically used by the intravenous route or by using liposomal vitamin C for doses greater than about 10 gm daily.
3) ***MAGNESIUM: is nature’s calcium channel blocker {10618948}. Magnesium counter-balances calcium deposition in the cardiovascular system. Magnesium can dissolve calcium deposits {2133625}. Additionally, magnesium supports muscle and nerve function. It is a very useful supplement for essential tremors, restless leg syndrome, inducing and maintaining sleep, migraine headaches, palpitations and cardiac dysrhythmias, and muscle pains and cramps. Magnesium helps to increase bone density and to decrease fracture rates {16274367}. There is an inverse relationship between magnesium levels and all-cause mortality {7908076, 12845247}. A magnesium deficiency is associated with increased intracellular calcium, which is the final mechanism for cell death. Magnesium levels are strongly associated with the anabolic hormones testosterone and human growth hormone. Magnesium is at the center of every chlorophyll molecule, thus, eating green leafy vegetables is a good dietary source for magnesium. Magnesium is also found in nuts, legumes, whole grains, fruits and fish. However, you cannot reliably expect to obtain consistent and sufficient amounts of magnesium by ingesting these foods. Magnesium content is vegetables has seen a huge decline since pre-1950 levels because of soil depletion. Additionally, many soils have too much potassium which competes for absorption of magnesium into the plant. Also, typical grain refining processes for bread and pasta removes 80%-95% of total magnesium.
Only about 1% of your body’s magnesium is in your blood, the rest is in the cells of your muscles, bones, nerves and organs. If you have a low blood level then you have a very low intracellular level. If you have a normal level, you may still have a low intracellular level. The WHO found that 75% of Americans take in less magnesium than they need. By age 50 most of us have significant deficiencies. When blood sugars rise, magnesium is excreted in the urine. Thus, people with diabetes frequently are deficient in magnesium. And, supplementing with magnesium can lower the risk of type 2 diabetes. A relatively modest increase in magnesium supplementation/ingestion can also lower the risk of developing pancreatic cancer and colorectal cancer. The symptoms of mitral valve prolapse syndrome are identical to magnesium deficiency, and, if treated with magnesium often resolve. Note: Hypomagnesemia is commonly associated with hypokalemia.
Start supplementing slowly and back off if diarrhea ensues. The mineral form, Magnesium Oxide 400 mg to 800 mg daily, is the least expensive and works just fine if it is absorbed and if it doesn’t cause you diarrhea. However, some people don’t absorb the mineral form of magnesium well. A chelated form of magnesium is usually much better absorbed. The best gut tolerated form is magnesium glycinate 400 mg-500 mg or magnesium asporatate 400 mg to 500 mg daily. Magnesium L-Threonate 1,000 to 2,000 mg taken at bedtime can be very helpful with sleep management and for neurological conditions. This form of magnesium most easily crosses the blood-brain barrier with comprehensive benefits for sleep, anxiety, cognitive function, and migraines. {It can be obtained from www.LifeExtension.com.} Try to AVOID magnesium stearate which can impede absorption in the gut and reduce bioavailability of other nutrients. As a guideline, a maintenance dosage is 3 mg per pound of body weight. However, if there is inflammation in your system or if you are stressed, I recommend 5 mg per pound of body weight. Another good proprietary blend of highly absorbable magnesium can be obtained from www.unikeyhealth.com.
4) ***The sex hormones Estrogen and Testosterone: There is an inverse relationship with coronary artery calcification and with all-cause mortality {23460719, 22747181}. Estrogen decreases inflammatory cytokines and inhibits a protein that promotes calcification {20595654}. The higher the estrogen level, the lower the CAC score {20512078}. Testosterone has a calcium channel blocking effect {21439799}. The higher the testosterone level, the lower the CAC score {22522505}. Bio-identical Hormone Replacement therapy (BHRT) is helpful for both the prevention and treatment of atherosclerosis. It needs to be monitored closely by your physician.
5) ***L-Lysine and Proline amino acids in a 5:1 ratio (approx. 2,800 mg lysine and 500 mg proline) helps to prevent and reduce plaque. Lysine binds to lipoprotein a {Lp(a)} and dislodges it from being bound to atherosclerotic plaques. Dr. Pauling observed that the combination of Vitamin C and lysine could significantly reduce angina pectoris.
6) ***Gotu kola (Centella asiatica) is a facilitator of tissue healing. It can stabilize soft plaques which are prone to ulceration by improving the synthesis of collagen. Collagen is a component of the thick caps that hold soft plaque in place. Additionally, it helps inhibit the progression of plaque by reducing the adhesion of monocytes that promote atherosclerosis. The dose is: 4 ml (approximately 1 tsp) of a strong 1:1 liquid extract twice per day mixed in water, or a 100 mg extract.
7) ***Pycnogenol (French Maritime pine bark extract) is a patented mixture of plant flavonoids with abundant beneficial effects. Pycnogenol can prevent and reverse the oxidative damage that produces blood vessel disease, metabolic syndrome, diabetes, and neurodegenerative disorders. Endothelial function improved by 32% compared to a placebo after 8 weeks of supplementation with 100 mg/d in a cross-over study. {Eur Heart J. 2012 Jul;33(13):1589-97.} Pycnogenol relaxes arterial tension in part by stimulating the eNOS enzyme system that produces nitric oxide. Nitric oxide produces a wider artery and increased blood flow. It also reduces the arterial wall content of calcified-collagen (which contributes to hypertension and endothelial damage). Pycnogenol reduces activation of NF-kappaB, a master inflammatory regulator, responsible for release of inflammatory cytokines. It also inhibits the expression of adhesion molecules that make arterial walls sticky for platelet aggregation, and white blood cell clumping in early stages of plaque formation. It reduces levels of isoprostanes, which are an index of how much oxidized fat is present, and a measure of overall oxidative stress. It helps improve the ejection fraction and heart failure class, improves treadmill walking distance and reduces blood pressure. The typical dose is 100 mg daily. {Luo H, et. al., 2015 Oct 23, Exp Mol Med; 47:e191; Enseleit F, et. al., 2012 Jul, Eur Heart J; 33(13):1589-97; Fitzpatrick DF, et. al., 1998 Oct, J Cardiovasc Pharmacol; 32(4):509-15.}
Both Pycogenol and gotu kola individually help to reduce atherosclerotic plaque progression and promotes plaque stability. They have an enhanced effect when they are used together. {Belcaro G, et. al.: 2014 Feb, Int Angiol; 33(1):20-6; and, 2015 Apr, Int Angiol; 34(2):150-7; and, 2017 June, 26, Int Angiol; (2):95-101.} There is a proprietary dual-compound product from www.LifeExtension.com called “Arterial Protect”.
8) CARNITINE helps mitochondrial function and energy production by facilitating the transport of fatty acids into mitochondria. In a double-blind trial, 160 patients with acute MI received 4 gm/d of L-carnitine or no L-carnitine after hospital discharge for 1 year. After 1 year, the mortality rate was 90% lower in the L-carnitine group than in the control group: 1.2% vs 12.5%; p<0.005. {Drugs Exp Clin RES. 1992;8:355-365.}
9) QUERCETIN is found in onions, buckwheat and apples. It has been shown to preserve mitochondrial function in the heart, brain, liver and skeletal muscles. It triggers reverse cholesterol transport, which results in the removal of cholesterol from the arterial wall by HDL for transport to the liver for safe disposal. It activates the Nrf2/ARE defense system. It boosts cardiovascular function, muscular endurance and performance, protects against loss of brain cells, corrects blood glucose and lipid abnormalities in the metabolic syndrome, and shows evidence of anti-cancer and bone health-promoting properties. A typical dose is 250 mg per day.
10) LUTEIN is a carotenoid that is known to protect vision by reducing the risk of age-related macular degeneration and cataracts. An article {in Am. J Clin Nutr. 2016;103(2):481-94} doing a meta-analysis of 71 published papers representing more than 387,000 individuals showed that people with a higher intake of lutein had a reduced risk of coronary heart disease, stroke and the metabolic syndrome. Lutein protects tissues from oxidative stress and inflammation.
HELPFUL FOODS
1) ORANGES and CV support: patients with an increased risk for CVD ingesting 2 cups of OJ daily for 1 week had a significant decrease in inflammatory markers that accompanied a 38.5% improvement in endothelial function. {Am J Clin Nutr. 2012 Apr;95(5):1089-1095.} Oranges contain a lot of folate which enhances homocysteine metabolism. {J Inherit Metab. 2011 Feb;34(1):75-81.} Oranges favorably alter lipid metabolism. For patients with high cholesterol, 3 cups of OJ daily for 2 months had their LDL-cholesterol decrease by 19 mg/dL without affecting HDL and triglycerides. {Nutr RES. 2010 Oct;30(10):689-694.} In addition to vitamin C, oranges contain pectin fiber which decreases inflammation and enhances immunity by stimulating production of the anti-inflammatory molecule interleukin-4. {Brain Behav Immun. 2010 May;24(4):631-640.} And, remember, oranges are also high in hesperidin which reduces the destruction of the enzyme eNOS that is needed to produce nitric oxide which subsequently increases nitric oxide availability for vasodilation.
2) Essential Fatty Acids have some calcium channel blocking effects, and blood levels are inversely related to all-cause mortality.
3) Watermelon is the richest edible natural source of L-citrulline, a close relative to L-arginine, the amino acid required for the formation of nitric oxide, essential to the regulation of vascular tone and healthy blood pressure. Since consuming L-arginine isn’t a good option for many people with hypertension because of nausea and GI tract discomfort, watermelon is a generally well tolerated alternative. 6 grams of L-citrulline daily for 6 weeks in one study improved arterial function and consequently lowered aortic blood pressure.
4) Grape Seed Extract 150 mg-200 mg per day has been found to improve the capillary microcirculation, especially in the eye, kidney and supplying the long nerves of the body, such as to the legs. Pine bark extract (Pycogenol) has similar properties.
5) The following HERBS can boost microcirculatory health: a) Bilberry Extract: 160 mg twice per day can improve diabetic retinopathy, changes induced by cortisone therapy, and reduce post-op complications. b) Cocoa added raw in a smoothy, or eating 20 grams (about 2/3 oz) per day of 85-90% cocoa dark chocolate can reduce impairment of endothelial function, improve microcirculation and act as an effective anti-oxidant. c) Garlic as a fresh-crushed raw clove or 600-900 mg/day allicin-releasing powder increases capillary blood flow. d) Ginko Biloba 240 mg/day has a positive effect on retinal microcirculation and improves vision in patients with glaucoma.
6) Multiple culprits initiate and promote atherosclerosis by damaging the delicate endothelium such as elevated: glucose, insulin, triglycerides, LDL, homocysteine, C-reactive protein, oxidative stressors, low HDL, and low testosterone. Also, reduced nitric oxide bioavailability initiates endothelial dysfunction which accelerates atherosclerosis. Endothelial function can be restored by consumption of plant polyphenols such as those found in pomegranate, green tea, brassica vegetables and red grapes which also helps to protect nitric oxide production. KALE is an outstanding cruciferous vegetable for reducing the risk of cardiovascular disease. Kale is abundant in sulforaphane, and the carotenoids lutein and zeaxanthin which helps to prevent atherosclerosis. Its high fiber content has protective effects against high levels of CRP, and helps to lower cholesterol. It also has a high content of vitamins K, A and C, and the minerals calcium, manganese, copper and potassium.
7) OLIVE OIL promotes cardiovascular health. Although olive oil’s health benefits have historically been attributed to its high monounsaturated fatty acid content, new evidence suggests it’s the polyphenols in olive oil, which have anti-inflammatory properties, that may contribute most to the oil’s cardiovascular benefits {J Transl Med. 2014 Aug 3;12:219.} Benefits are greatest when consuming 2 tablespoons of virgin or extra virgin olive oil (rather than a refined one) per day. It decreases total cholesterol and low-density lipoprotein levels. Consuming 50 ml of virgin olive oil daily for 3 weeks produced significant reductions in the inflammatory markers associated with increased heart disease risk, interleukin-6 and C-reactive protein. {Eur J Clin Nutr. 2008 Apr;62(4):570-4.} Compared to those who never use olive oil, those with the highest olive oil consumption have a 41% reduced risk of stroke {Neurology. 2011 Aug 2;77(5):418-25,} AND, a 44% lower risk of dying from heart disease. {Am J Clin Nutr. 2012 July;96(1):142-9.} The following olive compounds are some of the most important for your heart: oleuropein (helps lower blood pressure, fight free radicals and has anti-inflammatory effects); phytosterols (decrease LDL cholesterol levels in the blood by interfering with cholesterol absorption in the small intestine); and, polyphenols, especially hydroxytyrosol, tyrosol and verbascoside (helps fight free radicals, lower blood pressure, and slow atherosclerosis.)
8) ***FIBER: If you are an omnivore, you can lower your risk for cardiovascular disease when eating meat, eggs and dairy by increasing the fiber in your diet with supplementation. Trimethylamines are high in animal products and found in lower amounts in peas, beans, peanuts, soy, and cruciferous vegetables. It is also found in popular supplements such as carnitine, choline, phosphatidylcholine and lecithin. Trimethylamines are converted to trimethylamine N-oxide (TMAO) by intestinal bacteria. However, too much TMAO is problematic. In a study of over 4000 people, the subgroup with the highest levels of TMAO had 2.54 times the chance of a major cardiovascular problem compared with those in the lowest subgroup. Vegetarians and Vegans have significantly lower levels of TMAO than omnivores because they eat more fiber. The amount of fiber in a diet is what determines the overall balance of the bacteria in the colon. If you are an omnivore and eat plenty of vegetables, you will get about 16 gm of fiber from your diet. Vegetarians typically get around 30 grams. By supplementing with fiber, you can lower your risk of CVD. Consider eating a quarter cup of steel cut oatmeal for breakfast which will provide 4 grams of fiber. A good fiber called “Super Immune QuickStart powder” can be obtained by calling 800-791-3395. It will take your intestines a little time to get used to the increased fiber. So, go slowly. Start by adding a quarter-scoop of QuickStart powder each morning for 2 weeks and gradually increase to a heaping scoop. Then, use a teaspoon of fructooligosaccharides for another 4 grams of fiber. Fructooligosaccharides are special fibers found in vegetables and fruits which balance the different intestinal bacteria. It can be obtained from www.Nutricology.com. Start off by adding a quarter-teaspoon to the QuickStart fiber daily and each week add another quarter teaspoon until you reach a teaspoon daily. You don’t have to give up your meat, you just have to increase your fiber.
9) POMEGRANATE protects the endothelium against atherosclerosis. Pomegranate extracts contain polyphenols, tannins and anthocyanins which: 1) enhance cholesterol outflow from inflammatory white blood cells, helping to reduce the risk of plaque formation. 2) Protect vulnerable LDL molecules from the oxidation that leads to arterial wall inflammation that promotes plaque generation. And, 3) Boost natural antioxidant systems, particularly superoxide dismutase (SOD), protecting vital nitric oxide and allowing the endothelium to recover from the effects of chronic oxidative and inflammatory stressors. Pomegranate also elevates the enzyme paraoxonase-1 (PON-1) activity. PON-1 blocks destructive lipid peroxidation reactions. It is anchored to the surface of HDL which helps to cleanse arterial walls of plaque, protects LDL against oxidation and inhibits chronic inflammation, vascular adhesion molecules and platelet activation all of which leads to atherosclerosis. A proprietary product from www.LifeExtension.com called “Endothelial Defense” provides pomegranate extracts.
10) BUCKWHEAT contains a number of nutrients that deliver cardiovascular benefits, including protection against blood clots, reducing blood pressure, lowering cholesterol and managing diabetes. It contains the richest food source for the flavonoid rutin. Rutin blocks the enzyme protein disulfide isomerase that is excreted by endothelial cells and platelets when a clot forms in an artery or vein. It also helps reduce blood pressure. Buckwheat is a good source of magnesium and has a rich fiber content which helps to reduce inflammation, and lower total and LDL cholesterol. Buckwheat contains a high concentration of D-chiro-inositol which increases insulin sensitivity. It also contains quercetin which is known to reduce free radicals and inflammation.
ADDITIONAL INFORMATION
1) Sexual Intercourse is good for your heart. It has been reported that having sexual intercourse with your partner twice per week can reduce the incidence of myocardial infarctions by 50%.
2) According to “The Book of JOY”, a conversation between the Dalai Lama, Archbishop Tutu and Douglas Abrams: “When we help others, we often experience what has been called the “helper’s high,” as endorphins are released in our brain, leading to a euphoric state. The same reward centers of the brain seem to light up when we are doing something compassionate as when we think of chocolate. The warm feeling we get from helping others comes from the release of oxytocin, the same hormone that is released by lactating mothers. This hormone seems to have health benefits, including the reduction of inflammation in the cardiovascular system. Compassion literally makes our heart healthy and happy.” (p. 258)
3) EPIGENETICS: We are not prisoners of our genes. In the article in Nature 2011 Feb 10; 47:264-268 “9p21 DNA variants associated with Coronary Artery Disease Impair Interferon-gamma signaling response” the authors demonstrate the 9p21 chromosome as the most robust gene ever associated with heart disease. It is an inflammation driver in the endothelial cells of blood vessels. If one carries this gene they are at a higher risk of coronary and generalized arterial disease. The high risk genotype can be mitigated by consuming a diet high in fruits and vegetables! Both raw and cooked, fresh and frozen fruits and vegetables in 5 to 6 servings per day were protective. As we begin to understand the crucial importance of epigenetic factors, we will continue to better understand the significance of our lifestyle choices, thoughts and beliefs, and the impact of environmental toxicity upon our genome expression.
4) Adiponectin is a protein hormone secreted by adipocytes. Adiponectin improves insulin sensitivity and blood lipid levels, and lowers cardiovascular risk factors. High plasma adiponectin levels are associated with a lower risk of myocardial infarctions in men. {Pischon, et. al., JAMA, 2004;291(14):1730-1737.} Increasing AMPK activation will increase adiponectin.
5) Homocysteine is a byproduct of methionine metabolism, and it is a risk factor for atherosclerosis. OBSERVATIONS: 1) oral or parenteral administration of homocysteine thiolactone (a precursor to homocysteine) caused atherosclerosis in rabbits. {Atherosclerosis 1975;22:215-227.} 2) Individuals with homocysteinuria (a rare inborn error of metabolism) develop early-onset osteoporosis, premature atherosclerosis, and thromboembolism, and usually die by age 13. 3) Hyperhomocysteinemia has been associated with an increased incidence of atherosclerosis, thromboembolism, stroke, osteoporosis, recurrent miscarriage, and age-related cognitive decline. 4) The 677C to T variant of methylenetetrahydrofolate reductase (which is associated with hyper-homocysteinemia) is associated with increased risk of heart disease, stroke, dementia, miscarriage, and osteoporosis. This suggests that the association with hyperhomocysteinemia with these diseases is causal. A) POSITIVE CLINICAL RESULTS: 1) In an uncontrolled trial, supplementation with folic acid, vitamin B6, and vitamin B12 appeared to reverse carotid atherosclerosis in hyperhomocysteinemic patients. {Lancet 1998;351:263.} 2) Meta-analysis of 8 randomized controlled trials found that folic acid supplementation significantly reduced the risk of stroke by 18%. {Lancet 2007;369:1876-1882.} B) NEGATIVE CLINICAL RESULTS: Numerous randomized controlled trials have found that homocysteine-lowering regimens failed to reduce various endpoints including all-cause mortality, myocardial infarction, heart disease-related deaths, and venous thrombosis, and failed to slow the progression of Alzheimer’s disease. POSSIBLE EXPLAINATIONS FOR NEGATIVE RESULTS: 1) Nutrient imbalances from supplementing with just a few nutrients, thus causing, for example, an exacerbation of magnesium deficiency. {J Am Coll Cardiol 1985;6:725-730.} 2) Betaine (and presumably choline, which were not investigated in clinical trials) appear to be more effective than folic acid, vitamin B12, and vitamin B6 for lowering postprandial (i.e. post methionine load) homocysteine levels. {Atheroscler Thromb Vasc Biol 2005;25:379-385.}
THUS, the RECOMMENDED DOSES for BETAINE and CHOLINE are: Betaine: 500 mg/d up to 2,000 mg tid; and, Choline: 500-1,000 mg/d. Note: supplementing with Folic Acid sometimes fails because it has to be converted to 5-methyltetrahydrofolate (5-MTHF). As people age, many people lack the enzymes for this conversion. By adding 5-MTHF as a supplement, 5 mg to 10 mg daily, higher than normal homocysteine levels can be reduced. Adequate amounts of the other B-vitamins are also required, especially vitamin B2 (50 mg), B6 (75 mg) and B12 (300 mcg).
Additionally, homocysteine levels can be effectively lowered by taking “NT factor” which supplies phospholipids to damaged mitochondrial membranes. In addition to helping with energy and stamina, NT factor can help to clear mental fogginess quickly. Studies show that supplementation can help to improve memory and avoid the “Winter blues” and help to stabilize patients with Alzheimer’s Dementia. Additionally, it can be very helpful for lowering fasting insulin levels. High levels are associated with diabetes, hypertension, atherosclerosis, BPH, kidney and liver disease and cancers. It contains 10 crucial phospholipids including: 1) Phosphatidylethanolamine, the main lipid found in cell membranes, as much as 45% in the brain; 2) Phosphatidylcholine which helps grow new brain cells and connections; and, 3) Phosphatidylserine, which influences cognitive performance, neurotransmitters and memory. A proprietary product containing NT factor called “Vibrant & Clear Energy Wafers” can be obtained from www.WaferEnergy.com for about $50 for a 60 count bottle. The recommendation is to use 6 wafers in 2 or 3 divided doses, and then 1 wafer daily for maintenance.
6) Use of a far infrared sauna for 10 minutes per day for at least 2 weeks can increase the amount of nitric oxide synthase in the arteries which then produces more nitric oxide which then dilates the arteries and improves heart function and lowers blood pressure. Combining a 20 minute daily sauna with 97% oxygen and 3% ozone in a sauna steam cabinet can increase blood peroxide levels which can reduce cardiovascular disease and other systemic illnesses. The skin penetration of OZONE is equivalent to intravenous administration or to rectal insufflation. A good home unit (which is expensive) can be obtained from Longevity Resources (1-877-543-3398) called the “Cyclone Ozone Sauna System” costing about $6500 with shipping. Home ozone generators can be problematic. Since ozone is a highly reactive gas, it can react with metals, plastics, ceramics, glues, etc. creating toxic substances. For medical application, only pure oxygen should be used, not room air, as the input gas. And, only quartz glass, silicone and kynar (polyvinylidene fluoride) should come in contact with the ozone. Check the website, www.aaot.us to be informed about safety standards. Using an ozone sauna 1 to 3x/week for 20 to 30 minutes can “pre-condition” your body and improve your resiliency.
7) C-reactive protein (CRP) is an important marker of inflammation. High levels of CRP are associated with cardiovascular disease and with cancers. Abdominal fat can over-produce pro-inflammatory cytokines that cause CRP to increase. People with obesity and with the metabolic syndrome increase their risk of all inflammatory and degenerative diseases. Optimal CRP levels for men are under 0.55 mg/L for men and under 1.0 mg/L for women. Various nutrients favorably influence CRP levels: for example, Creatine prevents exercise-induced rises in athletes; Curcumin; Fenugreek; Ginger in diabetic adults; Green Tea polyphenols; Isoflavones in post-menopausal women combined with exercise; L-carnitine in end-stage renal disease patients on dialysis; probiotics in diabetic patients; magnesium in overweight middle-aged women; Omega-3 fatty acids; Quercetin when given with vitamin C; Red yeast rice; Vitamin C in smokers; Vitamin D; mixed tocopherol Vitamin E; Zinc in diabetics with kidney disease and in young obese women. Also, statin medications such as Crestor lower CRP levels in patients with elevated blood lipids.
8) Another marker of inflammation is myeloperoxidase (MPO). MPO diminishes the effect of nitric oxide production which causes endothelial breakdownand it also oxidizes LDL-cholesterol. Thus, it is a good predictor for CVD. Elevated MPO levels indicate serious endothelial inflammation. Note: more than half the time it is associated with periodontal disease.
9) TOXICITY: f you have limited success in lowering your cholesterol by modifying your diet, consider that lead and/or other heavy metals may be contributing to the problem. ZEOLITE is a volcanic mineral with a honeycomb crystalline structure which can detoxify and strengthen the immune system. The chambers within the honeycomb structure are negatively charged which attracts positively charged toxins like lead, mercury and nitrosamines. Once bound, the body can then excrete the heavy metals and toxins. Zeolite also helps to alkalinize the body. Alkalinizing minerals like calcium, potassium and magnesium are within the zeolite crystal structure. Heavy metals impair kidney function. Thus, zeolite helps to bind and rid the body of toxins and consequently helps to improve kidney function and balance the body’s acid/base pH. Zeolite also helps to increase T-cell activity and to increase the number of macrophages. Zeolite can support intestinal wall integrity and decrease excessive “leaky gut” permeability. Because heavy metals like mercury can result in depression, excessive anger, and problems with anxiety, zeolite detoxification can support positive moods. And, zeolites have a powerful antimicrobial activity. It has been used to treat urinary tract infections and dental plaques. It can also adsorb viral particles within its crystalline cages. Treating patients with cancer daily for one month with zeolite can help to restore their immune systems. You need to supplement with a high quality source product that has been properly cleansed and sized for optimal adsorption. A good product is available from Touchstone Essentials and also from MDPrescriptives.
If there is poor improvement, consider heavy metal toxicity, and measure serum levels. Consider ORAL CHELATION for heavy metals, including mercury, using a humic and fulvic acid complex, for example: 1 capsule twice daily for 5 days per week– (“Metal Magnet” www.enzy.com). If acutely toxic, then intravenous chelation therapy is indicated. ALSO, Consider removing any mercury amalgam fillings and replacing them with non-toxic substitutes. (An intravenous infusion of EDTA for chelation followed by an 8 hour urine collection for testing for heavy metals may diagnose the problem.)
10) Chlorine found in our drinking water is a powerful oxidizing agent which can damage blood vessels. While initially necessary for water decontamination, you should remove it before drinking by boiling the water for 5-10 minutes, or adding a pinch of vitamin C powder crystals to the water, or using charcoal filtration, or using reverse osmosis.
LIVE LONGER BY CHANGING HOW YOU COOK
Foods cooked at high temperatures create a) mutagens, which damage DNA and increase cancer risk, and b) advanced glycation end products (AGEs), which increase inflammation and oxidative stress by cross-linking with body proteins, which alters the protein structure and function causing them to lose their functionality and prematurely age. For example, breast and prostate cancers are sharply increased in people who eat heavily cooked meat such as hamburgers. Heat destroys crucial vitamins such as C, B6 and E, destroys fatty acids, denatures proteins, and limits mineral availability. Heat also creates toxic oxidized lipids, which aggravate vascular disease, and dangerous, gene-mutating heterocyclic amines, which can be carcinogenic, inflammatory, and which can adversely activate the immune system.
The higher the number of kilounits (kU) of AGEs the greater the risk for cancer. For example, deep fried breaded chicken breast for 20 minutes has 8,965 kU/serving, vs. roasted chicken has 5,418 kU/serving, vs. stir fried with canola oil for 7 minutes has 3,726 kU/serving, vs. boiled chicken breast in water has 1,089 kU/serving. Grilling, broiling, roasting, searing and frying propagate and accelerate AGE formation in food. Cooking methods that produce relatively low AGE levels include poaching, steaming, stewing and boiling. The use of acidic marinades, such as lemon juice and vinegar before cooking also limits AGE formation. Most “junk foods” are cooked at extremely high temperatures, so it makes sense to avoid them.
High blood glucose levels are another cause of protein glycation. Thus, people with diabetes suffer a disproportionately higher number of diseases. Health conscious people can exert a significant amount of control over how quickly their body proteins are destroyed by toxic glycation reactions by reducing the amount of simple sugars and starches they ingest, AND by minimizing their exposure to foods cooked at high temperatures.
Consider eating 70-80% of your food as raw fruits and vegetables (whole or blenderized rather than juiced) or steamed. Steaming, boiling or cooking with water (or broth) limits the heat to 212 degrees fahrenheit which is below the threshold of most toxic chemical reactions. A randomized cross-over study evaluated the difference between one group steaming their food and the other group cooking with higher temperatures. After 1 month, the group cooking with higher temperatures had adverse changes including lower insulin sensitivity, lower plasma concentrations of long-chain omega-3 fatty acids, and lower vitamin C and vitamin E levels. Also, plasma triglycerides and cholesterol increased. {Am J Clin Nutr. 2010 May;91(5):1220.} Another 6-week study showed that people with diabetes eating food cooked at lower temperatures reduced glycated LDL by 33%, whereas consuming the same food at higher temperatures increased glycated LDL by 32%. {Proc Natl Acad Sci USA 2002 Nov 26;99(24):15596-601.}
Consider supplementing with products that will lower your glycation risk when eating foods prepared at high temperatures. Anti-mutagenic agents have been identified in fruits and vegetables. The most potent are indole-3-carbinol (I3C) and chlorophyllin. I3C is found in cruciferous vegetables such as broccoli, cauliflower and cabbage. It helps to prevent DNA damage. Chlorophyllin inhibits deadly mutagens by trapping heterocyclic hydrocarbon carcinogens (by reacting with their structure making it impossible for them to form adducts with DNA) which are the precursors to malignant transformation in cells. Additionally, Carnosine, Benfotamine and Pyradoxal-5-phosphate (P5P) are helpful for reducing AGEs and mutagens. Carnosine has been shown particularly in people with diabetes to reduce levels of atherosclerosis. Benfotamine is vitamin B1 in a highly absorbable, fat-soluble form that easily penetrates cell membranes. Pyridoxal-5-phosphate (P5P) is activated vitamin B6. A proprietary product called “Glycation Protection Formula” containing Carnosine 1,000 mg, Benfotamine 200 mg and Pyridoxal-5-phosphate 100 mg is available from www.LifeExtension.com.
***CONSIDER A MEDITERRANEAN DIET***
If you have a problem with atherosclerosis, epidemiological studies have suggested a Mediterranean diet can lower your risks for cardiovascular disease and death. A Mediterranean diet is predominantly plant based. Meat and fish, eggs, dairy products are added as a condiment. Olive oil is the dominant oil, and red wine is acceptable, in moderation. The European PREDIMED study published in the New England Journal of Medicine {2013;368(14):1279-90}, examined 7,447 women (aged 60 to 80) and men (aged 55 to 80) who were at high cardiovascular risk. A Mediterranean diet reduced cardiovascular disease and death by 30% compared with a standard low-fat diet. Related studies have demonstrated that polyphenol consumption is the major factor in reducing the risks. Hydroxytyrosol makes up about 50% of extra-virgin olive oil’s polyphenol content and should be given the most credit. Additionally, oleuropein and tyrosol are beneficial, along with the monosaturated fat: oleic acid. Both systolic and diastolic blood pressures were reduced. Nitric oxide (a vasodilator) was increased. 5 important markers of inflammation were reduced: vascular cell adhesion molecule-1; intercellular adhesion molecule-1; interleukin-6; tumor necrosis factor alpha, and monocyte chemotactic protein-1. Beneficial HDL-cholesterol was increased. Additionally, in a 3-year study at the University of Edinburgh, patients age 73 to 76 eating a Mediterranean diet reduced their brain shrinkage by 50% with resultant improved cognitive benefits compared to their less diet-faithful counterparts {Neurology. 2017}. For people who wish to increase their concentration of polyphenols, www.LifeExtension.com has a proprietary blend called “Mediterranean Whole Food Blend” which combines grape seed extract, olive leaf extract, pomegranate fruit extract, black walnut extract, pecan extract, artichoke fruit extract, and lentil bran extract.
In addition to benefitting cardiovascular disease, extra-virgin olive oil reduces the risk of Alzheimer’s dementia. It also reduces the risk of osteoporosis caused hip fractures. {Bone mineral density markedly increased with the addition of CoQ10 supplementation.} If extra-virgin olive oil is added to a high-fat breakfast, weight loss improved by 80% compared to controls. People who ate the highest amount of the polyphenol hydroxytyrosol lived an average of 9.5 years longer (after age 65). {Am J Clin Nutrition. 2017;105(6):1297-304.} Also, both systolic and diastolic blood pressures were reduced using extra-virgin olive oil.
THE GUT-HEART CONNECTION
Probiotics can reduce both systolic and diastolic blood pressures. The greatest effect is found when the baseline BP is elevated and when the daily consumption is >100 billion colony forming units for over 8 weeks duration. Lactobacilli help to reduce blood cholesterol levels. Some bacteria express the enzyme bile salt hydrolase which affects intestinal cholesterol reabsorption. Yogurts help to decrease total cholesterol and LDL-cholesterol and improve the LDL/HDL ratio. There is an inverse relationship between fiber consumption and CVD: the more fiber ingested, the less the risk for CVD. Prebiotics stimulate bacteria to produce butyrate which helps to lower cholesterol, triglycerides and atheroma plaques.
Modifiable risk factors include: 1) Obesity: Germ-Free mice (GF-mice) are a useful model. They are leaner than wild mice. When there is a fecal transplant from obese mice to GF-mice, they become fatter than from lean mice donors. 2) Cholesterol levels: certain gut microbes, such as Eggerthella, Pasteurellaceae and Butyricimonas alter the bile acid pool which modulates hepatic and systemic lipid and glucose metabolism. 3) Toxic burden: microbes can directly alter chemical activity and structure; produce metabolites that compete for detoxification pathways; and, affect expression of detoxification enzymes. 4) Leptin and Insulin resistance: microbial fermentation of dietary fiber produces a short-chain fatty acid called butyrate which increases leptin expression in adipocytes and improves insulin sensitivity. 5) Inflammation: gut microbes mediate inflammatory signals. Age-associated dysbiosis causes increased inflammation and increased CVD. 6) Nutrient deficiency: gut microbes synthesize B-vitamins, vitamin K and vitamin C and some are absorbed by the host. However, “greedy microbes” may preclude absorption. 7) TMAO and Heart disease: Trimethylamine-N-Oxide (TMAO) is produced via microbial metabolism of choline to trimethylamine (TMA) with subsequent oxidation in the liver. An increased amount of TMAO is an independent risk factor of increased CVD. It is microbial dysbiosis, and not dietary choline, which is the problem.
The liver is a key player between the gut and the heart during nutrient deprivation (that is, fasting). In fasted GF-mice, the heart relies upon glucose metabolism for energy. Evolutionarily, because the heart needs a constant supply of energy to function, it has the capacity to use different substrates, depending upon availability. In mammals, fasting conditions cause an increased production of ketone bodies in the liver which results in increased ketone utilization by the heart, brain and other tissues. Gut microbes can cause increased acetate production which increases the pool of hepatic Acetyl CoA which is the starting molecule for ketone production.
Gut pathologies and CVD: 1) Dysbiosis: animals with hypertension have an increased Firmicutes to Bacteroides ratio, and they have decreased bacterial diversity and richness. Also, they have decreased butyrate and acetate microbial metabolites with resultant increased inflammation. People with chronic CHF also have decreased microbial diversity and diminished important bacterial genra. 2) Small Intestinal Bacterial Overgrowth (SIBO): is associated with increased arterial stiffness and decreased Matrix Gla Protein (MGP), which when activated prevents the calcification of blood vessels. Decreased MGP is related to decreased vitamin K absorption by the small intestines and/or to decreased vitamin K production by colonic bacteria. Also, SIBO causes systemic inflammation which is associated with increased CVD. 3) Infections: Chlamydia pneumoniae and Helicobacter pylori infections are associated with increased CVD. Patients with chronic CHF had increased quantities of pathogenic bacteria, including Campylobacter spp, Shigella spp, Salmonella spp, Yersinia enterocolitica, and Candida spp in their colons. Bacterial DNA can be identified in >50% of coronary plaques. 4) Intestinal Permeability: A “leaky gut” allows bacteria and their metabolites to enter the blood stream, triggering an immune response, and allowing them to become associated with the heart. TLR4, a receptor of the adaptive immune system, binds to lipopolysaccharides which are a component of gram-negative bacterial cell walls. This binding initiates inflammatory signaling. In mice, if the TLR4 receptor is ablated, there is decreased atherosclerotic plaque formation. Increased intestinal permeability both induces inflammation and weakens coronary plaque stability. {Plaque rupture is the trigger for an acute MI.} Patients with chronic CHF have increased intestinal permeability compared with healthy controls.
EXERCISE AND CARDIOVASCULAR DISEASE
The best exercise for CVD is aerobic exercise. The WHO and US CDC recommend making your exercising goal be 150 minutes per week (divided however you choose) in order to effectively lose weight, achieve cardiovascular fitness, and enhance your overall health and sense of well-being. {This includes time for twice weekly muscle strengthening.} {NOTE: For time-conscious people: ***High Intensity Interval Training can produce the same results in half the time.***} Think of your exercise as THE BEST MEDICINE you can give yourself. REMEMBER: in order to prevent injuring yourself by over-doing it initially, because of your enthusiasm to see results quickly, when starting out: GO SLOWLY, and then steadily build up to your desired goal. And, more is NOT necessarily better. There is a “sweet zone”. Too much exercising can stress your joints and your heart-lung capacity.
An observational study published in Circulation, 5/15/2018, of 11,000 adults in the Atherosclerosis Risk in Communities (ARIC) study, demonstrated people doing 150 minutes of vigorous exercise weekly were 31% less likely to develop congestive heart failure (CHF). Couch potatoes who started exercising decreased their risk of CHF by 23%. This study supports the JAMA July 22/29, 2009 study of 20,000 male physicians who had a healthy lifestyle for more than 20 years who developed significantly less CHF. A similar study of 36,000 Swedish women published in the Archives of Internal Medicine, 5/11/2009 who were eating a DASH diet (to manage hypertension) along with doing regular exercise for 7 years had a 37% decrease in CHF.
Particularly for those of us who are older, WALKING lowers your risks for diseases and probably will extend your life. Walking helps to keep you limber longer and helps to make you feel happier. In a study of 80,000 women, their risk of breast cancer was decreased by 42% by walking for a few hours per week. Other studies similarly demonstrate a decreased risk of kidney and prostate cancer mortality by walking. Walking has the lowest “quit rate” of any exercise. In a study of 400,000 Taiwanese who walked for 15 minutes daily, they lived 3 years longer than their sedentary peers. A 5-minute walk outdoors can elevate your mood and enhance your creativity, decrease your anxiety and depression, and increase your sense of well-being. SUGGESTIONS for success: pick-up your pace so that it becomes a power-walk rather than a stroll. {Maintain a pace that makes you a little breathless when walking and talking.} Count your steps: your goal is 7,000 to 10,000 steps/day, with 3,000 purposeful steps. Break-up your day into 50-step mini-walks every 45 minutes. Walk with a group for mutual support.
THE PERILS OF GLOOMY WEATHER
According to an article in The WEEK, 16 November 2018, “Cold, cloudy, and gray weather doesn’t just make people miserable—it can also increase their risk of suffering a heart attack. Researchers looked at weather records and the medical data of 274,000 patients in Sweden between 1998 and 2013, reports The Guardian (U.K.), and found an increased incidence of heart attacks during periods with lower air temperature and air pressure, higher wind velocity, and fewer sunshine hours. The most pronounced link was with temperature; heart attack rates increased noticeably when the mercury dropped below 37 to 39 degrees Fahrenheit. The scientists suggested several possible factors: arteries narrowing because of the cold, people exercising less and eating more unhealthy foods on gloomy days, and the seasonal spread of infections. ‘We are very interested in the triggers of heart attacks,’ says study leader David Erlinge, from Lund University. ‘If you know those triggers, you may be able to protect yourself.’”
IMPORTANT REFERENCES
- “Prevent and Reverse Heart Disease,” by Caldwell B. Esselstyn, Jr., MD.
- “The Simple Mediterranean Diet,” by Ariel Soffer, MD.
- “Death By Calcium,” and “Hidden Epidemic: silent oral infections cause most heart attacks and breast cancers” by Thomas E. Levy, MD.
NOTE: Literature sited as numbers refers to articles that can be fond in the PMID Index in PubMed.com.