A multi-billion-dollar industry has been built around the concept that large, cholesterol-filled blockages in the arteries cause heart attacks. That concept is just plain wrong. The reality is that as many as 80 percent of all heart attacks occur when smaller plaques, destabilized by inflammation, rupture and attract a blood clot that blocks blood flow to the heart.
So while cardiologists are placing stents to prop open large blockages or bypassing them altogether with surgery, inflammationthe real culprit in heart diseasecontinues unimpeded.
The Ins and Outs of Inflammation
Inflammation is the bodys frontline immunological response. Without it, youd fall prey to each and every infection that came along. But sometimes inflammation turns from friend to foe, and that is precisely whats going on in coronary artery disease.
Although there are many markers for inflammation, the best studied for relevance to cardiovascular disease is C-reactive protein (CRP). Studies have shown that men with the highest CRP levels have three times the risk of heart attack and twice the risk of stroke as men with the lowest levels. In women, a high CRP level is the single most important predictor of heart attack riskmore so than elevated cholesterol.
This may explain why half of heart attacks occur in individuals with normal cholesterol levels and a quarter occur in people with no risk factors at all. For these clean-living folkswho dont smoke, and dont have high blood pressure, high cholesterol, or diabeteschronic low-grade inflammation and the resulting damage to arteries may be the culprit.
A high level of inflammation isnt just a harbinger of heart attack and stroke. Research reveals that individuals who have elevated CRP levels are at greater risk of macular degeneration, hypertension, type 2 diabetes, peripheral artery disease, colon cancer, osteoporosis, and Alzheimers disease. In fact, an elevated CRP level is a marker for increased risk of premature death.
Get the Red Out
How do you reduce inflammation and, by extension, lower your risk of disease? For starters, reduce your weight to a healthy level. Fat cells are not just a parking lot for excess calories but are metabolically active, churning out hormones and inflammatory chemicals. Excess body fat, especially in the abdomen, closely correlates with chronic inflammation.
Second, eat a low-fat, high-fiber diet with plenty of antioxidant-rich fruits and vegetables and healthy fats from olive oil and cold water fish. At the same time, reduce your intake of saturated and trans fats and refined carbohydrates. In a 2004 study by UCLA researchers, postmenopausal women who followed this type of diet reduced their CRP levels by 45 percent in just two weeks.
Third, exercise. People who exercise regularly have lower CRP levels than sedentary folks. In a JAMA study, middle-aged couch potatoes who took up a walking program (just 30 minutes five times a week) reduced their CRP levels by 35 percent in only six months.
Fourth, take a high-potency multivitamin and mineral supplement. A 2003 survey of more than 14,000 Americans revealed that those with the highest blood levels of vitamins A, C, and E, selenium, beta-carotene and other carotenoids had significantly lower levels of CRP than those with the lowest levels. And in a six-month study at the Cooper Clinic, taking a high-dose multivitamin and mineral supplement lowered CRP levels 14 to 30 percent, with those with the highest levels experiencing the greatest reductions.
My Plaque-Busting Regimen
Next, get serious about oral health. Plaque that builds up in your gum line and plaque in your arteries are connected. Dental plaque causes gingivitis (inflammation of the gums), and as it progresses, your mouth becomes a breeding ground for bacteria that pass into the blood and cause inflammation elsewhere. People with gum disease invariably have higher CRP levels than those with healthy gums. They also have greater risk of heart attack and stroke.
Start by investing in a Sonicare toothbrush. Studies show that this toothbrush, which uses high-frequency vibration, outperforms its competitors in reducing the bacterial biofilms that take hold between the teeth and below the gum line. I also recommend that you use an antibacterial mouth rinse that contains chlorhexidine gluconate. (Get a prescription for Peridex or make your own rinse by combining a half ounce of Hibiclens, an over-the-counter antibacterial scrub, with 16 ounces of mouthwash.)
Another suggestion is to chew xylitol gum throughout the day, especially after meals when you cant brush. Unlike table sugar, this natural sweetener creates an unfavorable environment for bacterial growth and has been shown to reverse the progression of early tooth decay.
More Ways to Deflate Inflammation
Youve probably heard that statin drugs not only lower cholesterol but also lower CRP. However, these drugs have myriad side effects, including muscle pain and weakness, blurred vision, gastrointestinal problems, and liver damage. In fact, in a recent clinical trial, more than one in five participants dropped out during the first year and one in three disappeared by year two due to intolerable side effects of these drugs.
The real wonder drug when it comes to reducing inflammation and protecting against heart disease risk is aspirin. This little white pill relaxes the arteries, enhances blood flow, and discourages the formation of blood clots, but its anti-inflammatory effect may be its most important feature. In one study, small doses of aspirin cut the risk of heart attack in half in men with the highest levels of CRP.
Unfortunately, aspirin isnt for everyone, but there are several safe, natural anti-inflammatories. Kaprex, an herbal product that contains extracts from hops, rosemary, and olive leaf, was recently shown to significantly lower CRP levels. Fish oil (2,000 mg per day), curcumin (1,4001,800 mg), and guggulipid (2,000 mg three times a day) also curb inflammation.
Because chronic inflammation adversely affects virtually every organ system in the body, by following this program you will reduce your risk of cardiovascular disease as well as Alzheimers, cancer, macular degeneration, and other aging-related diseases.
Recommendations
If your CRP level is above 1.0 mg/L, get serious about implementing the therapies discussed here.
Look for Sonicare toothbrushes in your local drugstore or department store.
The suggested dose of aspirin is one baby aspirin (81 mg) every day, with food. Consult your doctor first if you are on Coumadin or have a stomach ulcer, an aspirin allergy, or a history of gastrointestinal bleeding.
The suggested dose of Metagenics Kaprex is one tablet three times a day.
Look for fish oil, curcumin, and guggulipid in your health food store.
References:
Church, TS et al. Am J Med. 2003 Dec 15;115:702-7.
Ford, ES et al. Eur J Clin Nutr. 2003 Sep;57(9):1157-63.
Harris TB et al. Am J Med 1999;106:506-12.
Ridker PM et al. N Engl J Med 1997;336:973-9; 2002;347:1557-65.
Smith JK et al. JAMA 1999;281:1722-7.
Wegge JK et al. Metabolism 2004;53:377-81.
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Not All High Cholesterol Foods Are Created Equal
Do you shudder at the thought of eating high cholesterol foods?
The idea of those thick greasy fried foods running through your bloodstream thickening your arteries can be anything short of repulsive. The media and advertisers are all on the same bandwagon to sell the consumer foods that are low in cholesterol and low in fat.
Even though its true that some high cholesterol foods may not be so good for you, please note that not all high cholesterol foods are created equal.
That means that there are some high cholesterol foods that may actually be good for your health and your heart as well.
I remember seeing many patients in my 28 years of practice who were trying to lose weight and went on a strictly low or no fat diet.
Sure they lost weight, but were they healthy?
Some showed signs of dry and scaly skin, some even had eczema, others complained of cycle irregularity (in women) and almost all had signs of fatigue.
When the cholesterol goes too low, the hormones become affected. The body needs healthy fats to maintain proper hormone levels, the nerves need fats for the myelin sheath (which covers the brain and spinal cord), and the body uses fat to metabolize the fat soluble vitamins A,D,E,and K.
Keeping this in mind, I still recommend staying away from the bad high cholesterol fats. For example, frying foods at 300 degrees Fahrenheit creates oxidation, damages the oils and depletes the vitamin content.
It is best to avoid fried foods altogether, but if you must eat fried, please follow these helpful tips:
1.Fry on a lower flame. It will take longer, but you will be doing less damage to the food.
2.Use oils such as olive oil and coconut oil. They tend to be more stable under high heat then corn oil or canola oil.
3.Sautee your foods. The added water helps prevent overheating of the oils.
On the other hand, foods that you always thought are bad for you may even be good. For example, eggs may not be so bad after all, including the yolks. Eggs are a complete food. In fact the whites are high in choline and lecithin which helps reduce homocysteine and break down cholesterol.
In 1999, JAMA reported a study done at Harvard University which concluded that eating 2 eggs a day does not cause a health concern. This is the conclusion of many other studies as well.
We tend to let ourselves get swept away with strong media advertising, and even health professionals tend to recommend low cholesterol diets. Heart Disease is the number one killer in the US today.
Anyone who wants to cure himself of heart disease goes on a low cholesterol diet, and yet the statistics have not changed in years. Look at the studies and you will see that heart disease is not caused by high cholesterol foods, but foods that cause inflammation in the blood vessels. Such foods are trans fats, such as margarine and hydrogenated oils. These are typically found in many cakes and crackers (even many whole wheat crackers), and cream cakes. Read the labels.
Low glycemic index foods such as sugar, and simple carbs and of course your junk foods such as donuts, muffins, fast foods, candy, and the list goes on.
Do your own research, but get many differing opinions. That way you can come up with your own conclusions and develop a diet that can lead you on the path to a healthy heart.