Keeping Your Heart Healthy – Cholesterol Friend or Foe?
In the past three decades we have been bombarded with nutritional information and dietary mandates that should have American hearts beating to a healthy rhythm As a nation, we are eating less meat and dietary cholesterol, smoking less cigarettes, and exercising more. So it’s surprising that the incidence of heart disease has actually increased over the last fifteen years. And while the overall death rate from heart disease actually declined by 40 percent during that time, it still remains the leading cause of death in the United States, and the leading cause of early death in men Statistics now tell us that, by age sixty, one in every five men will have suffered a heart attack.
More than 350,000 men will die of heart attacks this year.
All of the research and studies done on cardiovascular disease seems to have resulted in more confusion than anything else. Sorting through the daily barrage of “heart smart” information from newspapers, magazines, radio, and television can be overwhelming. By now, we all know that smoking, excess weight, lack of exercise, and poor eating habits are risk factors for heart disease. And many of us still believe that consumption of dietary cholesterol and saturated fats are the leading cause of clogged arteries. We have been told that switching from butter to margarine, from real eggs to substitutes, is the wise thing to do.
Now, suddenly, we are being told that we were misinformed. Margarine is bad for the cardiovascular system, and real eggs don’t raise our cholesterol levels. And cholesterol may not be the villain, as it has been portrayed. All of this contradictory advice reminds me of a poem by James Kavanaugh in which he says that after listening to all the conflicting advice from numerous nutritionists and doctors, he decided it was just easier to live on Fritos and Jack Daniels.
But don’t give up hope! This post will assist you in sorting through the most up-to-date information on risk factors for heart disease. You will learn, once and for all, why not all cholesterol is bad. The information presented here will also help you understand the roles of cholesterol, sugar, insulin, drugs, environmental toxins, homocysteine, and iron overload in the development and progression of heart disease.
CHOLESTEROL: FRIEND OR FOE?
Heart disease results when blood flow through coronary arteries, which supply the heart with oxygen and nutrients, becomes restricted or blocked. This causes damage to the heart muscle, resulting in a heart attack. Often—but not always—heart attacks result from hardening of the arteries, known as atherosclerosis, a condition in which plaque, containing cholesterol and other materials, builds up in the arteries. Atherosclerosis is a degenerative condition affecting many people in our country, including young people. A 1993 study based on autopsies of 1,532 teenagers and young adults found that all of them had fatty patches in their aortas and 59 percent had heart disease.
It has become popular for us to blame cholesterol for all heart problems and to avoid cholesterol- containing foods in an effort to prevent or treat the problem. There are, in fact, many holes in this theory. Cholesterol has been associated with heart disease without question. Mosquitoes have been associated with stagnant water. But mosquitoes do not cause water to be stagnant any more than cholesterol causes plaque to build up in the arteries. Many feel that cholesterol deposits actually result from the body’s efforts to repair already existing arterial damage.
Cholesterol enters our body through dietary sources, from animal products such as meat and eggs. However, the body also produces its own cholesterol. In fact, 80 percent of this substance is manufactured in the liver and brain. And it’s contained in nearly every cell. Our bodies produce cholesterol because it is essential to maintain our health. The major functions of cholesterol include:
- Construction and repair of cell walls.
- Insulation of nerve fibers.
- Production of adrenal hormones such as cortisone, which is released in response to stress.
- Production of bile acids, which break up fats for absorption.
- Synthesis of male and female hormones.
- Vitamin D synthesis (sunlight turns cholesterol into vitamin D).
Cholesterol also has antioxidant properties and, as such, it helps to fight disease-causing free radicals.
Deficiency of cholesterol has been associated with a number of conditions, including anemia, acute infection, excess thyroid function, autoimmune disorders, and cancer. The fact is, drugs that artificially lower cholesterol can cause a number of cancers. So when it comes to cholesterol, too little can be just as harmful as too much. Again, balance is the key.
Dr. Cass Ingram (PPNF Nutritional Journal, bl 15, #1-2, 1991) compiled a list of the causes of high and low cholesterol. They are as follows:
Causes of High Cholesterol
Alcoholism Amino-acid deficiency Antioxidant deficiency EFA deficiency
Excess sugar, starch, or hydrogenated / processed fats in the diet Food allergies Liver dysfunction
Tissue damage (due to infection, radiation, free radicals)
Causes of Low Cholesterol
Adrenal stress Cholesterol-lowering drugs Chronic hepatitis
Immune-system decline Liver infection / disease Manganese deficiency Street drugs
Cholesterol is actually a lubricant that is meant to keep the blood “oily” so it can flow freely through the blood vessels. However, when inorganic mineral deposits collect on artery walls, cholesterol may adhere to them, gradually building up into layers of artery-clogging plaques. Minerals tend to go out of solution and form deposits (in arteries and elsewhere) when the body’s pH is out of balance. As you recall, pH is regulated by electrolytes. Certain trace minerals, because of their electrolyte activity, not only assure that minerals are kept in solution, but also improve digestion and metabolism of fats and encourage proper liver function.
The Role of the Liver
Liver function is critically important in cholesterol metabolism The liver not only produces cholesterol, but also converts it into bile, and regulates its level in the blood. A healthy liver will adjust cholesterol production according to dietary intake, decreasing or increasing it as needed.
Eighty percent of the body’s cholesterol is used in bile production. That bile, along with excess cholesterol, is stored in the gall bladder. When fat is present in the intestines, the gall bladder contracts, sending bile to the intestines to break down the fat. The bile is absorbed by the body in direct proportion to the amount of time it takes to pass out of the digestive tract.
Slow transit times, resulting from constipation, cause an excessive amount of bile to be reabsorbed. When bile is reabsorbed and recycled, less new bile is formed in the liver and cholesterol cannot be turned into bile at the same rate. Therefore, excessive cholesterol builds up. This theory was put forth by Dr. William Welles in his book The Shocking Truth About Cholesterol (1990). He states: “The real issue is bile flow, not diet.”- One of the reasons that high-fiber foods, like oat bran, are effective in lowering cholesterol is that they decrease the reabsorption of bile salts and relieve constipation. From this perspective, factors like liver congestion and constipation and may cause cholesterol to build up.
I have found—almost without fail that men with good elimination and healthy liver function can properly handle dietary cholesterol, as long as they are getting the nutrients necessary to metabolize it. I recommend a basic foundation for every heart-smart nutrition plan that includes the essential fatty acids, the minerals chromium and magnesium, and the B vitamins niacin and choline. These elements are largely lacking in the Standard American Diet, and the incidence of liver dysfunction and constipation is also high in our culture.
Many people are not well able to handle the cholesterol in animal foods. This does not mean, however, that they should avoid cholesterol-containing foods. What it does mean is that they should perhaps limit their intake of these foods until balance is restored in the body. In an imbalanced state, protein and fat from animal products is properly metabolized. The thing to eliminate is not the fat, nor the protein, but rather the conditions of imbalance. This calls for elimination of processed, fragmented foods and restoration of essential nutrients, especially electrolytes.
The Framingham study, in progress for more than thirty years, was designed to investigate the risk factors in heart disease. The researchers have found that the level of cholesterol in the blood does correlate with heart disease. But there is no correlation found between cholesterol in the diet and heart disease. No significant differences were found in the blood cholesterol of people who ate several eggs per week (up to twenty-four) and those who ate only a few (up to two and a half.)
UNDERSTANDING CHOLESTEROL LEVELS
Blood cholesterol does not travel through the body on its own, but must attach itself to a solid substance. In order to get cholesterol where it is needed, the liver has developed a complex system that bundles cholesterol and triglycerides—the major class of lipids in the diet and body—together into lipoproteins.
High-density lipoprotein (HDL) cholesterol is composed principally of lecithin, a type of phospholipid that supplies the body with choline, which is essential for liver and brain functioning. HDL carries very little fat and has more protein Its job is to pull cholesterol back from body tissues to the liver where it’s converted to bile and excreted. Low-density lipoprotein (LDL) cholesterol, on the other hand, is made up of about 50-percent cholesterol. It carries cholesterol from the liver to the parts of the body where it is needed. LDL cholesterol tends to deposit fats in the body and, if it is not controlled, these deposits can result in the development of atherosclerosis.
The latest guidelines that we’ve been given about cholesterol levels is that total cholesterol should be less than 200 and “good” HDL cholesterol should be greater than 35. The higher the HDL in relationship to total cholesterol, the lower the risk of heart disease. The ratio between total cholesterol and HDL cholesterol is now considered more important than just the total cholesterol alone. Optimally, the ratio of total cholesterol to HDL cholesterol should be three to one.
I remember how anxious one of my clients was when he got his most recent blood test results. Peter was a forty-five-year-old mechanic with a history of heart disease in his family. His total cholesterol was a little over 200. When I asked him what the HDL was, he said 60.1 quickly put his mind at ease and congratulated him on his heart-healthy ratio.
FACTORS AFFECTING CHOLESTEROL LEVELS
Blood cholesterol levels increase or decrease according to a range of variables. Certain “bad” fats such as trans fatty acids, for instance, may raise LDL cholesterol, and at the same time lower HDL cholesterol. Insulin, too, has an impact on cholesterol levels, because the insulin response may give rise to the production of the harmful eicosanoids that we first discussed earlier. Likewise, chromium deficiency, which can cause elevated blood-sugar levels, can also cause cholesterol levels to rise.
Good Fats Versus Bad Fats
A lack of the nutrients needed for cholesterol metabolism, paired with a deficiency of antioxidant nutrients, are primary factors in the development of heart disease. The antioxidant nutrients—vita— mins A, C, and E, selenium, and zinc—prevent oxidation of cholesterol. Foods left out at room temperature, or those that are fried, smoked, cured, or aged become oxidized. Oxidation gives rise to free radicals, those renegade molecules that damage blood vessel walls. The body then tries to repair the damage with cholesterol.
All processed foods—powdered milk, powdered eggs, dried custard mixes, cake mixes, aged cheeses, and smoked, dried, and aged meats, including bacon, ham, sausage, and packaged sandwich meats—give rise to free radicals. These foods can contribute significantly to the clogging of arteries.- It is important to understand that, while powdered eggs are to be avoided, fresh ones can be included in the diet as long as you don’t fry them. Soft- or hard-boiling and poaching are the best methods for preparing eggs.
As you learned in this post, one of the most critical problems with the typical American diet is the lack of sufficient essential fatty acids. Both the omega-3 and omega-6 EFAs are involved in the regulation of cholesterol and triglycerides in the body and in the formation of many hormones. You’ll recall that the higher the ratio of omega-3s to omega-6s, the less likely that a clot will obstruct an artery. Because of food processing and food choices, omega-3s are in short supply in our diet. More are needed—especially the EPA form Increasing your intake of cold-water fish, fish oils, and flaxseed and canola oils can help you boost your omega- 3 fatty-acid levels to regulate cholesterol.
Refined and man-made hydrogenated oils need to be totally eliminated from the diet, for the trans fats they form interfere with the functioning of EFAs and increase serum cholesterol. TFAs actually raise “bad” LDL cholesterol, and lower “good” HDL cholesterol. When Northern Europe’s supply of hydrogenated foods was cut off during the last world war, the result was the most dramatic decline in heart disease of the century!
Insulin Strikes Again
Remember our discussion from this post about the hormonal effects of food? The insulin response from a diet too high in carbohydrates produces harmful eicosanoids that can lead to high blood pressure, heart attack, atherosclerosis, increased fat storage, and unstable sugar levels. You learned how balancing macronutrients with the 40/30/30 plan creates a favorable hormonal response, as a result of the glucagon release triggered by the protein. Not only will this mobilize stored body fat, but the “good” eicosanoids produced will regulate the cardiovascular system
The Balance Bar Company, makers of the Balance nutrition bar, sponsored two independent clinical studies, one at Pepperdine University and the other at Sansum Medical Research Foundation in Santa Barbara. These studies demonstrated that the 40/30/30 formula not only improves athletic performance, aids in weight loss, and is safe for people with diabetes, but also raises the levels of good HDL cholesterol. The Pepperdine University double-blind crossover study showed an increase in HDL of 13.5 points in just four weeks.-
This issue has also been recognized by some progressive members of the medical profession. As quoted in The Santa Barbara News in December 1994, Diana L. Schwarzbein, a Santa Barbara endocrinologist, believes that:
Eating foods high in cholesterol does not increase blood cholesterol…. Overeating carbohydrates can lead to abnormal cholesterol levels. And foods that raise insulin levels are the ones that cause obesity, high blood pressure, high cholesterol and heart disease.
A diet high in carbohydrates is one that will put a man at risk for developing cardiovascular disease. This is especially true if that diet is made up of refined carbohydrates.
In the refining process, white sugar loses 93 percent of its chromium White flour has only 23 micrograms per 100 grams of this important trace mineral, compared with the 175 micrograms per 100 grams found in whole wheat flour (if the wheat was grown in mineral-rich soil). It is well known that chromium plays an important role in sugar metabolism What is not so well known is that it also plays a crucial part in fat metabolism
It appears that there is a link between disorders of fat metabolism and those of sugar metabolism: practically everybody with clinical atherosclerosis of moderate severity has a mild form of diabetes. People with moderate to severe diabetes have especially severe atherosclerosis, from which most die. This association was established a number of years ago. In 1959, researchers discovered that rats with reduced glucose tolerance, or diabetes, were chromium deficient. This disorder can be prevented or cured by adding chromium to the diet. It was later established conclusively that chromium is necessary for the utilization of insulin in glucose metabolism Subsequent animal studies indicated not only elevated blood sugar levels when chromium was deficient, but also elevated blood cholesterol levels. Both can be lowered by the addition of chromium to the diet.
When it comes to humans, chromium tends to be present in the bodies of all young people. However, according to Dr. Schroeder, author of The Trace ElementsandMan (The Devin-udair Company, 1973), it is not detected at all in the tissues of 15 to 23 percent of Americans over fifty. Chromium is present, however, in 98.5 percent of foreigners over fifty. Furthermore, no chromium was found in the aortas of people who died from coronary artery disease, while it was present in those who died of other causes. These findings highlight the importance of including chromium in the diet for the prevention of heart disease. Good sources of chromium include brewer’s yeast, brown rice, cheese, clams, corn oil, grapes, honey, meat, raisins, and whole-grain cereals. (Refer to this post for a more detailed discussion of chromium)
In view of these findings, we would be wise to limit our intake of refined foods, or better yet, to eliminate them entirely—espe daily white sugar and white flour. Many individuals following the gospel of the low-fat, high-carbohydrate diet over the last decade have overdosed on sugar.
What the Evidence Shows
People around the world enjoy good health, free of heart disease, until they either migrate to Westernized cities or adopt a Western diet, heavy in sugar-laden, processed foods. Several Mediterranean societies have also been free of cardiovascular disease, despite a diet that is up to 70-percent fat. Among people whose natine diet consists of a high percentage of animal fat are the Yemini Jews, the Eskimos, and the Masai tribesmen of Africa.
Over thirty years ago, Ancel Keys, Ph.D., discovered that people living in the southern European countries had a very low rate of heart disease. It was especially low among the people of the Greek island, Crete-90 percent lower than the United States—despite the fact that 40 percent of their diet was composed of fat. Olive oil, a monounsaturated fat, was their primary source of fat, with only 8 percent of the calories coming from saturated fats.
Another group of people with a very low incidence of heart disease are the Japanese from Kohama Island. These people have something in common with the people of Crete- they both have a high dietary intake of linolenic acid, an omega-3 EFA. The Cretans get their linolenic acid from walnuts and purslane, a thick-leaved “weedy ” plant used in salads, while the Japanese get theirsfrom soybean products and rapeseed (canola) oil.
French researchers took a group of605 patients who had one heart attack, and placed half of them on a typical Cretan diet. They ate bread, grains, vegetables, fruit, poultry, fish, and some cheese, and used only olive and canola oil for cooking. No butter or margarine was used, but rather a spread rich in omega-3 essential fatty acids. The other half of the patients were placed on the American Heart Association diet, high in polyunsaturated fats and low in cholesterol and saturated fats. Total fat was restricted to 30 percent, with saturated fat limited to 10 percent. Their progress was charted over a twenty-seven-month period, during which time the cholesterol levels, blood pressures, and weight of people in bothgroups remained about the same.
Interestingly, there was a marked difference in the number of patients having a second heart attack and surviving it. Of the individuals on the American Heart Association diet, thirty-three had heart attacks, and sixteen people died as a result of heart attacks. On the other hand, of the people following the Mediterranean diet, only eight suffered heart attacks, and three individuals died from heart attacks.-
The advantages of the Mediterranean diet were so obvious that the study was prematurely ended. The patients on the AHA diet were put on the Cretan diet. By the completion of the study, those on the Cretan diet showed concentrations of linolenic acid in the blood that were near to that of the natives of Crete and Kohma. This study is significant in that it demonstrates that establishing omega-3 EFA sufficiency is more important than lowering cholesterol. It is not necessary that we adopt a Mediterranean diet, though it may be most beneficial to those of Southern European ancestry, but we do want to get plenty of omega-3 fatty acids in our diet.
TAME YOUR SWEET TOOTH
Sugar is eight times as concentrated as flour and much more harmful. The refining process has robbed it of trace minerals and many other nutrients, including the family of B vitamins. In the absence of B vitamins, carbohydrate metabolism can’t take place. When carbohydrates aren’t properly broken down, they ferment in the system, adding a toxic burden to the body. Sugar is, of course, a carbohydrate. When we consume sugar in its refined form, in which none of the nutrients needed to metabolize it are present, the body must rob its storehouses to obtain these nutrients. As the storehouses become depleted, degenerative diseases develop.
The average American consumes over 138 pounds of sugar and high fructose com syrup per year. That breaks down to over four dozen teaspoons daily per person! Only one-fourth of that amount is consumed at the table and for cooking. The rest is found in our foods. And it’s not just in the obvious foods like cookies, cake, candy, and ice cream. Sugar is also hidden in ketchup, salad dressings, canned soups, peanut butter, luncheon meats, and canned and frozen vegetables. Even cigarettes, cigars, and pipe tobacco contain sugar! Used in curing tobacco, sugar contributes to the addictive qualities of tobacco products. Read labels. There are many forms of sugar and many names for it. Avoid foods containing com syrup and any containing ingredients that end in “ose.”
As sugar consumption increases, so does the incidence of heart disease. A professor of nutrition and dietetics at Queen Elizabeth College of London University found the following associations between deaths from heart disease or heart attack (per 10,000 people) and the amount of sugar they consumed per year: 20 pounds per person resulted in 60 deaths; 120 pounds per person resulted in 300 deaths; and 150 pounds per person resulted in 750 deaths.-
Sugar raises triglyceride, cholesterol, and insulin levels, and raises blood pressure as well. Tests at Brookhaven National Laboratory found that patients on a high-sugar, low-fat diet had triglyceride levels two to five times greater than those on a low-sugar, high-fat diet. High sugar intake also contributes to obesity. These are all risk factors for the development of heart disease. But that’s not all. Sugar has also been linked with birth defects, cancer, diabetes, gallstones, hypoglycemia, kidney damage, learning disabilities, migraine headaches, premature aging, reduced immunity, and tooth decay.
Our liking for that sweet taste may have been nature’s way of prompting us to include fruits and vegetables in our diet. Back when they were rich in minerals, these foods had a sweet taste. Because of their fiber content, naturally sweet foods delay the release of sugar into the bloodstream and their minerals assist in its utilization. On the other hand, consuming sugar by itself, or any of the concentrated sugars—such as honey, barley malt, rice syrup, maple syrup, and molasses—triggers an immediate insulin response and all of the attendant negative consequences.
All of these sweeteners are refined products. Even “raw” sugar is only white sugar to which molasses has been added. While these foods are somewhat more nutritious than white sugar, they all raise cholesterol and triglycerides, depress immune activity, and contribute to yeast overgrowth, which can cause fatigue and a variety of mental symptoms. Excess sugar can also block the manufacture of good prostaglandins from essential fatty acids.
Fructose: The Natural Alternative?
Many people consider fructose to be a healthy alternative to refined sugar because it’s a “natural” sweetener found in fruit. Over the past fifteen years, consumption of high fructose corn syrup has tripled, going from 19 pounds per person in 1980 to 56 pounds in 1994. During that same period, sugar consumption actually decreased. High fructose com syrup is widely used by food manufacturers in soft drinks, baked goods, jellies, jams, syrups, and ketchup. Even health food stores deal in fructose, sold in its crystalline form and as an ingredient in concentrated fruit juices.
Since fructose has a low glycemic index rating—meaning that it does not convert quickly to blood sugar, or raise insulin levels rapidly—it has been recommended by some for people with diabetes. However, this recommendation is invalid. The liver is the only organ that can metabolize fructose. A
high-fructose diet puts a strain on the liver similar to that of alcohol consumption. While every cell in the body can metabolize glucose, the liver must convert fructose into glucose before it enters insulin pathways. For these reasons, fructose should be avoided by diabetics.
Another strike against fructose is that it elevates “bad” LDL cholesterol, thereby increasing the risk of heart disease. The U.S. Department of Agriculture study found in 1993 that consuming as little as two to three soft drinks with high fructose com syrup daily can elevate LDL levels.
A warning about switching to diet sodas: Diet sodas contain aspartame,sold under the trade names of NutraSweet or Equal. Although there is no evidence linking it to cholesterol levels, aspartame has its own set of health problems. Severe anxiety attacks, confusion, convulsions, decreased vision, depression, dizziness, extreme irritability, headaches, nausea, numbing of hand and feet, palpitations, marked personality changes, and ringing in the ears have all been associated with ingestion of aspartame. Eighty to eighty-five percent of consumer complaints to the FDA have involved aspartame. And aspartame is not only found in diet soda. Over 1,200 products, including children’s vitamins, drugs, baked goods, laxatives, and chewing gum now contain aspartame.
THE HOMOCYSTEINE FACTOR
In a revolutionary new book entitled The Homocysteine Revolution (Keats, 1997), Harvard-trained physician and researcher Kilmer S. McCully suggests that elevated levels of a potentially toxic amino acid called homocysteine is a more potent risk factor than cholesterol in predicting heart disease. His theory points to our vitamin-B depleted food supply as the underlying cause behind the heart disease epidemic. Three vitally important B vitamins—B6, B12, and folic acid—are lost from our food supply due to processing and packaging. Consequently, a deficiency of these vitamins and the amino acid methionine elevates levels of homocysteine resulting from the normal metabolic breakdown of proteins in the system In combination with the “bad” LDL cholesterol, homocysteine damages the arterial walls and plaque can build up in the heart. Stroke and blood clots in the legs or lungs have also been tied to elevated homocysteine levels.
The good news is that vitamin B12 and folic acid can convert homocysteine to the harmless essential amino acid methionine. In addition, vitamin B6 helps to decrease homocysteine levels by converting homocysteine into cysteine for excretion from the body.
I suggest that all of my clients have their homocysteine levels tested on a yearly basis. There are now homocysteine formulas on the market that contain higher amounts of vitamins B6, B12, and folic acid. According to Dr. Ronald L. Hoffman, in his book Intelligent Medicine (Fireside, 1997), the following daily supplements are recommended for people with elevated homocysteine levels:
Folic acid: 5 milligrams daily
Vitamin B6: 100 milligrams daily
Vitamin B12: 1,000 micrograms (1 milligram) daily
With proper vitamin supplementation, many people find it easy to reduce their elevated homocysteine levels.
Plain and simple, iron can be a hidden killer that adversely affects the heart under certain circumstances. High levels of iron in the body have been linked with heart disease and hypertension, as well as with headaches, liver disorders, arthritis, diabetes, and cancer. A five-year study conducted in Finland followed 1,900 men who had no clinical evidence of heart disease when the study began in 1984.- The researchers measured the amount of ferritin, a protein that binds iron in the blood. They found that for each 1-percent increase in the amount of ferritin in the blood, there was a more than 4-percent increase in heart attack risk. A ferritin level of 200 micrograms or greater more than doubled the relative risk of heart attack. Typical ferritin levels for adult males are from 100 to 150 micrograms. Next to smoking, the study found ferritin levels to be the strongest risk factor for heart attack. LDL levels alone were not found to be a significant risk factor, but they were significant when paired with elevated iron Another study found iron in atherosclerotic plaques in humans. And iron promotes oxidation of LDL cholesterol.
These findings underscore the importance for men of excluding iron supplements from their diet unless a need for the mineral is demonstrated through laboratory analysis. And men must also make sure that the iron they put into their bodies is from organic sources, or bioavailable, so that it stays in solution and does not contribute to plaque formation. To assure this, body pH must be normalized through electrolyte balance and a balanced diet. Since meat is high in bioavailable iron, excessive consumption of it can cause a build-up of the mineral in the body, especially if pH is off balance.
Surprisingly, new research indicates that many people suffer from iron overload caused by a genetic condition known as hereditary hemochromatosis (HH). People with normal iron metabolism absorb no more than the amount of iron needed daily, while those with HH absorb it excessively, to toxic levels. Once absorbed, iron is not excreted. The only way iron levels can be lowered is through blood loss. Once thought to be extremely rare, HH is proving to be quite prevalent, especially among Caucasians, affecting 2 of every 400 people.
Over a million Americans carry the gene for hemochromatosis. Roberta Crawford was one of them It took her twenty-six years and four doctors to get a correct diagnosis. During this period of time, she was misdiagnosed, as many are, with anemia and given more iron Her symptoms included headaches, joint pain, diarrhea, heart irregularities, and heavy menstrual bleeding. After her ordeal, Crawford formed the Iron Overload Diseases Association and wrote The Iron Elephant to help educate the public about the problems associated with iron overload.-
Symptoms of excess iron can also include abdominal pain, anemia, fatigue, lack of mental clarity, low immunity, and a gray or bronze tint to the skin Over time, the accumulation of iron in the system can cause organ damage, resulting in such conditions as arthritis, cancer, cirrhosis, diabetes, heart disease, impotence, premature menopause, and sterility.
Many people, like Crawford, are misdiagnosed, as doctors commonly make the faulty assumption
that anemia is caused only by low iron levels—without doing the proper testing. Anemia can be diagnosed with a fingerprick test and hemoglobin count, but without further laboratory analysis, the cause of the anemia cannot be ascertained with certainty. While low iron levels can cause anemia, iron overload can cause it too. The most effective tests to screen for HH are those that measure serum iron (SI) concentration, the total iron-binding capacity (TIBC), and the stored iron or ferritin.
Once HH is diagnosed, it is important that family members be tested, since it can be passed on genetically. Prognosis for HH is good, especially if it’s detected early before organ damage results. For this reason, blood profiles are recommended for those men showing symptoms that may indicate HH.
Iron overload should be considered a major risk factor in heart disease, second only to cigarette smoking. Excess iron causes the oxidation of LDL, promoting the formation of plaque in the arteries. Becoming a frequent blood donor is the main therapy for iron overload.
ENVIRONMENTAL TOXINS AND THE HEART
Our environment—the air we breathe, the food we eat, the water we drink—is becoming increasingly contaminated. Among the pollutants are a class of toxic minerals known as heavy metals, including lead, cadmium, aluminum, and mercury. None of these metals belong in our bodies (except for a minute amount of aluminum), but have found their way there through our polluted food, air, and water supplies.
Heavy metals have been linked with heart disease, among other disorders. Lead toxicity is associated with cardiovascular dysfunction, arteriosclerosis, and atherosclerosis; aluminum toxicity can paralyze the heart; mercury—even in small amounts—can damage the heart, as well as other organs; and cadmium toxicity gives rise to hypertension. This happens because cadmium replaces zinc in the arterial walls, leading to reduced flexibility and strength in the arteries. A buildup in arterial plaque results, as the body coats the arteries in an effort to prevent formation of aneurysms.
Cardiomyopathy’ll a generalized term, pertaining to myocardia, or heart muscle, disease. The term encompasses congestive heart failure (CHF), atherosclerosis, and high blood pressure, also known as hypertension. There’s evidence that cardiomyopathy results from selenium deficiency. This was demonstrated in 1972, when Keshan disease, which has plagued the Keshan Province of the People’s Republic of China since 1930, was found to be identical to mulberry heart disease in pigs, known to be caused by a selenium deficiency. As it turns out, the soil in Keshan Province is almost totally lacking in selenium
One of the many functions of selenium in the human body is the protection of the cellular membranes of both skeletal and cardiac muscle fibers from free-radical damage. A selenium deficiency is intensified by exercise and by a high intake of polyunsaturated fats. This important trace mineral is added to commercial food for pets, and laboratory and farm animals, but not to food meant for human consumption. So the pigs may not be getting mulberry heart disease anymore, but we are!
The next few pages will explore two distinct problems—congestive heart failure and hypertension —in more detail.
Congestive Heart Failure
While the death rate for heart disease has been decreasing, the number of cases of congestive heart failure (CHF) have increased. According to American Heart Association statistics, the number of people hospitalized for the disease more than doubled between 1979 and 1992, jumping from 377.0 to 822,000. It is the most common cause of hospitalization for people over sixty-five, with 50.0 people dying from it each year, and cost of care exceeding $50 billion annually.
The American Heart Association describes CHF as a condition in which the heart becomes weakened, unable to pump out all the blood that flows through it. According to Dr. Bruce West, CHF would more appropriately be called “beriberi of the heart.”- Beriberi is a disease caused by deficiency of B vitamins, especially B12 or thiamine. Symptoms of this deficiency disease include nerve conductivity problems, weakness, and muscle paralysis. Dr. West draws the parallel to CHF, describing it as a “problem of poor nerve conductivity to the heart, an almost paralyzing weakness of the heart muscle and the resultant failure of the heart muscle to be able to pump out blood.”-
According to Dr. West, vitamin B 4, which has not been synthesized, nor recognized by the FDA,
together with B1? are vitally important for proper heart muscle function He emphasizes the fact that all of the B vitamins are linked together by thousands of plant chemicals known as phytochemicals, most of which have not been synthesized or even identified. Phytochemicals are needed to activate vitamins and minerals, and they are absent in isolated vitamins produced in the laboratory. We must look to whole foods as a source of supply. The alternative is to use a B-complex supplement made from food and plant sources, one that is processed in such a way as to maintain the phytochemicals. The B vitamins are found in brewer’s yeast, liver, and whole-grain cereals. Vitamin B j is also found in egg yolks, fish, fowl, legumes, meat, and nuts.
Julian Whitaker, M.D., has observed that thirty years ago patients with CHF invariably had a history of heart attack that had inflicted damage upon the heart muscle. Today, some CHF patients have no history of heart attack. Dr. Whitaker believes that the factor responsible for this and for the escalation of CHF over the last few decades is the “overuse of medications called beta blockers.”- Beta blockers are used to lower blood pressure. They do so by blocking the heart’s ability to respond to epinephrine and adrenaline, two hormones that stimulate and elevate both blood pressure and pulse rate. Basically, these drugs lower blood pressure by weakening the heart.
Dr. Whitaker believes that, while beta blockers are useful for temporary relief of symptoms, longterm use can lead to congestive heart failure. His belief is supported by multiple references in the Physicians Desk Reference, which doctors use to prescribe drugs. The PDR points to possible cardiac side effects including heart failure from long-term use of beta-blockers such as Lopressor.
Calcium channel blockers, another class of drugs commonly prescribed for high blood pressure, are also associated with an increase in death from heart disease—a 60-percent increase. The mineral magnesium works better than these drugs as a calcium-blocking agent to prevent spasm of the coronary arteries—and it has no side effects.
Separate studies have found that supplementation with taurine, a nonessential amino acid,— and the mineral potassium11 can be useful in the treatment of CHF. A deficiency of muscle potassium could not, however, be corrected if magnesium deficiency was also present.
Hypertension is an abnormal elevation of blood pressure that can lead to heart and kidney diseases or stroke. It affects one out of four men. Actual physical ailments such as kidney infection, obstruction of a kidney artery, adrenal disorder, or constriction of the aorta account for about 10 percent of the cases. These conditions can usually be corrected. For the majority of people, however, the exact cause of hypertension is not known. The condition is then referred to as essential hypertension. A major factor associated with hypertension is atherosclerosis, which obstructs the flow of blood through arteries. Stress is also an important factor, for it causes contraction of arterial walls.
When blood pressure is high, the body is out of balance. Drugs used to lower pressure won’t correct the basic imbalance, which is an electrolyte imbalance, and indeed can further disturb it. A possible side effect of hypertension drugs is cardiac problems. Diuretics are the most commonly prescribed medication for hypertension, and they are the safest. But you should be aware that diuretics can rob the body of minerals essential to heart function. As Dr. Earl Mindell explains in his Joyof Health newsletter (April 1995, page 3):
Most diuretics lower blood pressure by preventing the kidneys from returning sodium to the blood, which increases the volume of urine. The result is to reduce the volumeof fluid in the blood and in other cells of the body. Unfortunately, as the urine carries sodium out of the body, it takes other minerals salts with it, most importantly potassium and magnesium—two minerals that are essential to your heart health.
Since one of the purposes of taking diuretics is to reduce sodium levels, a sodium-restricted diet is recommended for people with hypertension. Sodium intake can be reduced just by avoiding packaged and processed foods. There’s no need to avoid foods that are naturally high in sodium, such as celery —in fact, it has been found that there’s a substance in celery that can relax the walls of blood vessels. Regular table salt, which is highly processed and devoid of trace minerals, should be eliminated entirely. It can be replaced with a totally unrefined, mineral-rich salt such as Celtic Sea saltg used in moderation. This type of salt will not cause fluid retention. Most sea salts found in health food stores are processed to some degree and should be avoided.
Salt restriction will not lower blood pressure if potassium levels are low, which is most often the case with people who take diuretics. Symptoms of potassium deficiency include constipation, insomnia, irregular heartbeat, muscle cramps, nervous disorders, and weakness. The level of this important mineral can be increased by eating potassium-rich foods such as fruits, vegetables, lean meats, legumes, sunflower seeds, and whole grains. Drinking fresh fruit and vegetable juices is an excellent way to get plenty of potassium. If you take diuretics to control hypertension, you should take in around 2,000 milligrams of potassium daily from food sources.
Diuretics not only cause potassium loss but also the excretion of other minerals such as calcium and magnesium Inadequate levels of calcium, magnesium, and potassium can cause contraction of blood vessels, resulting in elevated blood pressure—which puts us right back where we started! To
replace these minerals, I recom mend regular use of a good multimineral formula in conjunction with the Trace-Lyte electrolyte formula. Long-term use of diuretics can result in inpaired glucose tolerance if potassium and chromium aren’t replaced.
Spending more time outside in the sun can help to increase vitamin D levels. This, together with increased intake of potassium and calcium, will cause the body to excrete more sodium Vitamin C and bioflavonoids can help maintain or restore the health of blood vessels strained by the increased pressure they’re under.
Weight loss can favorably influence blood pressure. In fact, for every 2 pounds of weight lost, blood pressure should drop 1 point in both systolic (top number) and diastolic (bottom number) readings. Most people with hypertension are overweight, weighing an average of 29 pounds more than people with normal blood pressure. Even 5 pounds of excess body weight can contribute to high blood pressure. Weight loss can be achieved without dieting, simply by following the 40/30/30 eating
Regular exercise is also helpful in reducing blood pressure. Individuals who exercise are 34 percent less likely to develop hypertension than those who don’t. Strenuous exercise is not necessary. Dr. Mindell tells us that “just a brisk half-hour walk three to four times a week can lower blood pressure by 3 to 15 points in just three months.”—
Hypertension, like diabetes, is associated with insulin. Both conditions can be caused by insulin resistance. In insulin resistance, the pancreas (even in the person with diabetes) produces plenty of insulin—sometimes too much. The problem is that the insulin just isn’t getting to the cells because its entry is blocked by fat. In addition to avoiding the “bad” fats—such as trans fats, refined oils, or too much unsaturated fat—and replacing them with EFAs, insulin resistance can be prevented or corrected by reducing carbohydrates, which trigger the insulin response.
The trace element vanadium inhibits the synthesis of cholesterol and, given in large doses in the form of vanadyl sulfate, can eliminate diabetes and certain forms of high blood pressure. It appears to do this by making cells more responsive to insulin. The intriguing thing is that improvement is sustained even after supplementation is discontinued, according to research studies.
Apart from the traditional risk factors associated with hypertension—excess weight, stress, lack of exercise, smoking, and poor diet—we can add “exposure to environmental toxins,” such as cadmium, to our list.
SUPPLEMENTS FOR A HEALTHY HEART
Heart problems are not inevitable. By making changes to your diet and implementing a program of regular exercise, you can keep your heart strong and healthy and greatly reduce your chances of developing heart disease. For example, nutritional supplements such as carnitine and coenzyme Q10 can help regulate triglyceride and cholesterol levels. Magnesium is well known as a “heart-smart” mineral, but one that the majority of men are deficient in. Likewise, all men need to make sure they take in sufficient amounts of powerful antioxidants such as vitamin E, superoxide dismutase, and glutathione peroxidase.
Carnitine is a vitamin-like substance once considered to be a nonessential amino acid. The body can synthesize carnitine from the essential amino acids lysine and methionine. The conversion cannot take place, however, without adequate iron and vitamin C. Higher levels of carnitine are found in men’s blood than in women’s, suggesting that men have a greater need for it.
Carnitine stimulates fat metabolism, regulates triglyceride levels, increases HDL cholesterol, and decreases LDL cholesterol. It can be of potential value for a number of heart disorders. When carnitine levels are normalized through supplementation, the heart can better use its limited oxygen supply. In addition, it has recently been demonstrated that carnitine can help protect cells from damage wrought by free radicals, though it is not actually an antioxidant. Rather than neutralizing free radicals, carnitine helps cells recover from free-radical damage.
Dietary sources of carnitine include muscle and organ meats, dairy products, and legumes. It is not present in vegetable protein, however, and vegetarians may be deficient due to low levels of the precursor, lysine, in the diet.
Like carnitine, coenzyme Q10, or CoQ10, is another vitamin-like compound that can be synthesized by the body. It’s a substance found in all body cells, with the greatest concentration in the liver and the heart, but tissue levels decrease with age. CoQ10 plays a major role in energy production in the body and a deficiency of it can cause or aggravate many conditions, including heart disease, diabetes, and periodontal disease. CoQ10 can lower triglycerides and total cholesterol, while raising “good” HDL cholesterol. It appears to be useful as a weight-loss aid due to its ability to stimulate the mitochondria and increase the fat-burning process.
The heart may be particularly vulnerable to CoQ10 deficiency because it contains the most metabolically active tissues in the body. A CoQ 10 deficiency has been demonstrated in up to 75 percent of myocardial biopsies in patients with various heart diseases. Conditions such as angina (heart pain), mitral valve prolapse, high blood pressure, and congestive heart failure can benefit from CoQ10 supplementation. A University of Texas study using coenzyme Q10 with CHF patients found that 78 percent improved and their survival rate was higher than those receiving standard treatment.
Good food sources of CoQ10 are meat, some types of fish, and certain vegetable oils. Other good sources include rice bran, wheat germ, soy and other beans.
Every man that I work with is directed to take extra magnesium I firmly believe that magnesium deficiency is the cause of many of our current maladies, including heart disease.
Magnesium is the second most common mineral in our cells. It plays a major role in protecting the heart. Deficiency of this important mineral has been linked to hypertension, arrhythmias, and CHF. Insufficient magnesium can cause coronary artery spasms that reduce blood and oxygen flow to the heart, resulting in a heart attack. It has been found that individuals who died suddenly from heart attacks had very low levels of magnesium in their hearts. Death from ischemic heart disease, caused by obstruction of arteries, is more common in areas where soil and water have low levels of magnesium. It has also been shown that magnesium is needed for the body to use insulin properly.
A recent Gallup survey found that 72 percent of adult male Americans fail to meet the 350- milligram Recommended Daily Allowance for magnesium The survey also showed that magnesium consumption decreases with age. Low levels of magnesium not only increase the risk of developing high blood pressure and heart disease, but also increase susceptibility to insomnia, muscle cramps, diabetes, kidney stones, and cancer.
Compounding the problem of low magnesium intake is the high calcium intake of Americans. Magnesium should optimally be taken in equal proportion to calcium Americans have been urged to eat more dairy products as a source of calcium, and we’re doing so, much to our detriment. Dairy products contain nine times as much calcium as magnesium
Early man adapted to an environment rich in magnesium but lacking in calcium by developing mechanisms for storing calcium Our bodies still store calcium more efficiently than magnesium, so we don’t need as much of it in our diet as we’ve been led to believe. What little magnesium we do consume in the Standard American Diet is depleted by a diet high in sugar and alcohol, which increases magnesium excretion through the urine.
Magnesium is abundant in whole foods—leafy greens, legumes, nuts, seeds, tofu, whole grains, and sea vegetables. However, refined foods, which are so abundant in the typical American’s diet, lack adequate levels of this valuable mineral. We can get ample calcium in our diets without including dairy products that are not well absorbed due to their low magnesium content and their high phosphorus content.
Other Heart-Smart Nutrients
Since the oxidation of harmful LDL cholesterol is proving to be an important contributing factor in heart disease, antioxidant nutrients become important weapons in the fight against the disease. Flavonoids are powerful antioxidants found in fruits and vegetables. A five-year study involving 500 men in the Netherlands found that those who consumed the most flavonoid-rich foods were half as likely to have a heart attack or die from coronary disease as those eating the least amount of flavonoids.
One study on vitamin E involved 39,910 healthy men. It began in 1986 and lasted for four years. During that period of time, 667 of the men developed coronary artery disease. The study found that those men with the highest vitamin E intake had 40-percent less risk of coronary disease compared with those men with the lowest intakes. Risk reduction was seen only for men taking in at least 100 international units (IU) per day, and the use of supplements for at least two years seemed to be necessary to achieve this protection.
Another study interviewed patients following angioplasty—a procedure in which blocked coronary arteries are dilated—and found that those who regularly took vitamin E experienced restenosis, the
reoccurrence of blood vessel narrowing, at a rate of only 15.8 percent compared with a rate of 30.7 percent in those not taking the vitamin.
B Complex Vitamins
I’ve already mentioned some of the B vitamin family members that play an important role in protecting the heart—Bb B4, and choline, which is necessary for fat metabolism The body’s fat metabolism can be inpaired by a severe deficiency of biotin, a B vitamin needed for the metabolism of carbohydrates, fats, and protein. Vitamins B6 and B12 and folic acid are also helpful for keeping homocysteine levels down.
Niacin (vitamin B3) has been used for many years to treat high cholesterol and elevated
triglyceride levels. High doses of niacin can cause flushing of the skin, itching, upset stomach, and increased levels of blood glucose, uric acid, and liver enzymes. For this reason, you should take large doses of this vitamin under the supervision of a health-care professional. Do not use niacin if you have a history of gout, liver dysfunction, or diabetes.
Important antioxidant enzymes, such as superoxide dismutase (SOD) and glutathione peroxidase, scavenge free radicals seven to ten times faster than antioxidant vitamins and minerals. Supplemental antioxidant enzymes, however, have low bioavailability and can be quite costly. Good food sources of the antioxidant enzymes are alfalfa, barley, bee pollen, wheat grass juice, and wheat sprouts.
A true electrolyte formula, which includes trace minerals in a crystalloid form, will also enhance this ability. Trace minerals, including manganese and zinc, are needed for the production of SOD factors. Glutathione peroxidase is also mineral-dependent—it requires selenium Both glutathione peroxidase and SOD are normally present in large amounts in heart tissue to protect it from oxidative damage.
In humans, a link has been found between selenium and heart disease. People found to have overt selenium deficiencies have also been found to suffer from heart problems that respond to selenium supplementation. Selenium is the mineral activator of the vitamin E complex. The mineral works together with vitamin E to protect the heart. A deficiency of either nutrient can be damaging, but a deficiency of both is observed to produce more severe oxidative damage.
We’ve heard from the aspirin people that an aspirin a day will keep clotting away. And while there have been studies showing that aspirin can be helpful in preventing clotting that can lead to heart attacks, aspirin can have serious side effects, such as bleeding of the stomach lining, when taken regularly. Recent studies link aspirin to macular degeneration, the number-one cause of blindness in people over fifty-five.
Fortunately, there’s a safe, natural alternative to aspirin for achieving antiblood-clotting results. It is an extract from pineapple called bromelain. Research shows that bromelain breaks down arteriosclerotic plaques and relieves angina pectoris through enzymatic action. In one study, fourteen patients with angina were given 400 to 1,000 milligrams daily of bromelain and all were asymptomatic within ninety days—some in as few as four days, depending on severity. Systemic enzyme therapy can also be used to improve blood fluidity and circulation.
Another extremely potent anti oxidant is Pycnogenol, which comes from pine tree bark. Studies show that it is completely nontoxic and highly bioavailable. Rather than being a specific nutrient, Pycnogenol is actually a group of substances called proanthocyanidins found in a particular type of flavonoid or bioflavonoid. This antioxidant has been found to scavenge free radicals 50 percent more effectively than vitamin E and 20 percent more effectively than vitamin C. Proanthocyanidins greatly increase vitamin C activity, strengthening collagen in the blood vessels and increasing capillary resiliency. This, in turn, improves circulation.
Dr. David White at the University of Nottingham in England found that proanthocyanidins prevent the oxidation of LDL cholesterol. While vitamin E scavenges free radicals only in fatty areas of the body, and vitamin C scavenges them only in watery areas, Pycnogenol scavenges them in both locations. It also has anti-inflammatory activity.
Antioxidants and flavonoids help to improve circulation, strengthen blood vessels, and decrease clotting, thereby lowering the risk of atherosclerosis, heart disease, and stroke. Certain herbs contain these compounds. Most notable of them is hawthorn, a member of the rose family that contains anthocyanidins and proanthocyanidins, which give the plant its antioxidant properties. Hawthorn decreases cholesterol, inhibits atherosclerotic plaque buildup, lowers blood pressure, and dilates coronary vessels, which improves blood flow and increases blood supply to the heart muscle. This herb has also been shown to increase the force of the heart’s contraction and prevent arrythmias. Although it works well with many heart medications, you should not use hawthorn if you take beta blockers.
Another herb that has been demonstrated to decrease cholesterol and triglyceride levels is garlic. These findings have been the result of studies on animals and humans conducted for over thirty years. Consuming 600 milligrams per day (half of a clove) of garlic powder for two weeks reduced significantly the susceptibility of fats in the blood to oxidation. Garlic has powerful antioxidant
properties and can lower cholesterol by at least 10 percent in less than one month. It also has the ability to prevent blood from clotting. Be aware, however, that raw garlic can lower blood sugar.
Cayenne can play an important role in supporting heart function. It has been used traditionally by herbalists as a crisis herb in coronary and other emergencies. Cayenne is also useful when taken on a regular basis (a quarter teaspoon taken three times daily) to stimulate circulation and prevent heart attacks and stroke. It also helps prevent arthritis, colds, flu, headaches, and indigestion. Both cayenne and garlic have been used successfully to lower blood pressure in hypertension.
START TAKING CHARGE
Heart disease is a product of modern “civilized” society—stressful lifestyles and diets consisting heavily of devitalized foods create the conditions for its development. As with all of the illnesses discussed so far, changes in your dietary habits are essential for improving your heart’s health.
As you’ve read, high dietary cholesterol does not necessarily correlate with an increase in heart disease. Increased sugar consumption does. What you need to do now is switch your focus. Don’t concentrate on selecting foods with those “no cholesterol” labels, but instead start keeping an eye out for hidden sugars in prepackaged foods and condiments.
The saying that “the way to a man’s heart is through his stomach” certainly holds true in more the its original intention. There are a lot of ways to protect your heart, starting with diet. By adopting a balanced eating plan, you can control your weight, raise your levels of “good” cholesterol, and lower your levels of “bad” cholesterol. Supplement with nutrients such as magnesium, chromium, vitamin E, carnitine, coenzyme Q10, and a variety of herbs to strengthen your heart muscle and protect against
harmful free radicals. Avoid taking in too much iron to prevent iron overload. And don’t forget about those important EFAs. There’s a lot that you can control here. Your health is in your hands.