Archive for heart disease
Tea and Heart Disease
This is an editorial that covers some of the metabolism that is involved with quercetin; don’t chew gum while trying to comprehend it. What this article does point out is that there are several factors that effect the bioavailability of the bioflavonoid quercetin. GI flora is important in activating the compound. And sex of the study participants also plays a major role, with women being able to produce a much higher bioavailabilty of the compound than men. Remember this the next time you see an article titled “natural substance X protects/doesn’t protect against disease Y.” Nature is not so simple. Tea and Coronary Heart Disease: the Flavonoid Quercetin Is More Bioavailable From Rutin in Women Than in Men
Dietary Patterns and the Risk of Coronary Heart Disease in Women
I just thought I’d put this one up. This does fall into the “how much did we pay for this?” category, but the number of the women in the study (69,017) is huge, and the larger a study, the better the results can extrapolate to the general population.
3 Months of Antimicrobials in Acute Non–Q-Wave Coronary Syndrome
This article throws more weight in the ineffective etiology of cardiovascular disease. However, before you run to your cardiologist and ask for antibiotics (which will disturb normal flora in the GI tract and create other imbalances worse than your risk for CVD), remember that a natural approach to CVD is multifactorial. All the recommendations I give to lower risk of heart disease will also stimulate the immune response and address infectious agents from the inside.
Circulation — Abstracts: Sinisalo et al. 105 (13): 1555
FFA-Induced Endothelial Dysfunction Can Be Corrected by Vitamin C
Kind of makes you wonder how we can see headlines that vitamin C does not protect against heart disease, huh? This study finds that antioxidant therapy may help to protect the lining of the blood vessels against oxidative damage from increased free fatty acids in the bloodstream. The FFA can be increased when insulin resistance lowers the ability of cells to take up the FFA from the bloodstream, so lifestyle changes to increase insulin sensitivity would go nicely with the antioxidant therapy.
JCEM — Abstracts: Pleiner et al. 87 (6): 2913
By now, you’ve probably heard the news about two recent research studies strongly linking a compound called TMAO to heart disease and stroke. After all, Dr. Oz covered it, so it’s got to be big news.
Here’s the basics:
- Two dietary compounds L-carnitine and phosphatidylcholine (we’ll cover diet sources later) get converted by bacteria in the gut to TMA.
- TMA heads to the liver where it is further converted by an enzyme called FMO3 to TMAO.
- TMAO has been strongly linked to heart disease and stroke irrespective of other, more widely known, risk factors.
L-carnitine comes from a few notorious sources. Red meat. Energy drinks boasting high levels of L-carnitine. Bodybuilding supplements.
Phoshotidylcholine is founds in eggs and beef liver (just in case you eat this on a regular basis…).
While some articles are blowing off the results of this study, I think that we need to look at this data as real, and try to figure out why and how it may occur. Overall, the results in these two particular studies (New England Journal of Medicine, Nature Medicine) should raise some eyebrows. Here’s what they found:
- Those with the highest levels of TMAO had a 254% overall increased risk of having a heart attack, stroke or dying.
- The risk of dying in the highest TMAO group was an impressive 337% higher.
- This risk was present even after accounting for traditional risk factors as well as in those patients who were considered low-risk.
Now here’s where the story gets a little more interesting…
- In one of the studies, participants were given antibiotics. The antibiotics almost completely shut down the production of TMAO.
- Once the antibiotics were stopped, the TMAO levels increased again.
- In vegetarians and vegans, the levels of TMAO remained low despite increased intake of phosphatidylcholine or L-carnitine.
Clearly, the bacterial flora in the gut had an incredibly strong role in whether or not these dietary components caused problems or not.
Gee…have we heard this somewhere before?
Have you maybe heard someone say that destruction of the normal flora in the human body is a potentially devastating event, especially in a child? Like…maybe me??
There is a well accepted concept that the bacterial flora in the gut adapts to a particular lifestyle. Women in Asian countries with higher intakes of soy have higher equol-producing bacteria in their gut and thus, derive greater benefits from eating soy than do their American-born, non-soy-eating counterparts. Could this be yet another example of how the bacterial flora in vegetarians adapt to that lifestyle, lowering the risk of disease?
Further, could our country’s love of antibiotics for minor sniffles be destroying the delicate balance of the bacteria in our gut, leading to chronic disease? Multiple lines of research suggest this is a solid answer.
So what is the bottom line? Of course, avoiding energy drinks and limiting red meat intake was already on your list. While these studies did not identify specific bacteria that were responsible for the conversion, they generally fall under the category of methylotrophic bacteria. These are NOT generally the types of bacteria found in probiotic supplements. It would seem likely that the use of probiotics would lead to less of the bacteria that leads to the conversion of these dietary compounds to TMA.
Vitamins Use in a Male Physicians and Subsequent CVD
This article found no protective effect for multivitamins or vitamins C or E on cardiovascular disease. Before you run to the cabinet and throw away your Centrum multis (on second thought…if you are taking Centrum….) consider a few things. These articles rarely look into the type of multivitamin that the participant is taking. Multi quality varies incredibly, and my biased opinion would be that the researchers would have a hard time identifying characteristics of a high quality multivitamin. Just because a multi has 100% of the RDA does not mean it will be absorbed. Many nurses in the past have referred to Centrums as “bedpan bullets.” And ask any radiologist if they have identified intact vitamins on Xray. My guess would be that a good, high quality multivitamin WILL lower risk of many diseases, CVD included.
Vitamin Supplement Use in a Low-Risk Population of US Male Physicians and Subsequent Cardiovascular Mortality
Cardiovascular Disease Outcomes During 6.8 Years of Hormone Therapy
I hate to beat a dead, crumbling dog, but I’m still confused as to why Premarin is one of the top few prescription drugs. No benefit and possible increased risk for heart disease. Increased risk for breast and endometrial cancer. Little, if any benefit on bone health. No benefit for Alzheimer’s disease. What the hell is left?? Hot flashes? Those respond very readily to phytoestrogens and progesterone cream. I’m scratching my head on this one….
Impaired Carotid Viscoelastic Properties with Polycystic Ovaries
The picture of insulin resistance, polycystic ovaries, and cardiovascular disease gets clearer with each research paper. Insulin affects conversion of testesterone to estrogen via 15,20 lyase and aromatase enzymes, leading to increased levels of testesterone. The increased testosterone strongly predisposes to PCOS. On the vascular side of the picture, insulin has been shown to reduce to “stretchiness” of arteries. Here we see A=B, B=C, with research to support A=C.
Circulation — Abstracts: Lakhani et al. 106 (1): 81
Role of endogenous oestrogen in aetiology of coronary heart disease
I just hate it when research finds that estrogen, the wonder-substance of perimenopausal and postmenopausal women designed to eliminate all age related diseases and bring a woman back to her twenty-something health, really has little impact on heart disease and environmental risk factors are the major role. What a novel concept!! Imaging lifestyle changes such as exercise, healthy plant-based diets having more power to prevent disease that a prescription drug!!
bmj.com Lawlor et al. 325 (735 =9): 311