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Nutritional Support For Heart & Cardiovascular Health

Natural and alternative therapies offer safe approaches to improved cardiovascular health.

There’s little about Americans’ lifestyles that don’t lend themselves to creating cardiovascular issues: insufficient exercise; diets dependent on heavily processed foods leading to an obesity epidemic and skyrocketing cholesterol levels; financial issues causing stress levels to go through the roof. Then, there’s the genetic aspect of heart health—that no matter how healthily one lives, there’s no escaping your genetic makeup and family history.

According to the recently published “Heart Disease and Stroke Statistics— 2012 Update; A Report From the American Heart Association,” about one-third of American adults (about 76 million) have hypertension, with only 80 percent of those people aware of their condition. In addition, more than 18 million people (eight percent) have diagnosed diabetes, over seven million have undiagnosed diabetes, and over 37 percent have prediabetes. Furthermore, about two-thirds of American adults are overweight or obese (149 million people), and about one-third have metabolic syndrome or, as the AMA describes it, “a cluster of major cardiovascular risk factors related to overweight/obesity and insulin resistance.” 

Another startling American Heart Association statistic offered by Alyssa DiRienzo, ND, a practitioner affiliated with Washington-based BioGenesis, a practitioner-specific supplements provider, is that while one in six women die of breast cancer, cardiovascular disease (heart disease, hypertension and stroke) claimed one in two. “Approximately half a million women die of heart-related causes each year,” she said. “Because women have increased risk of cardiovascular disease after menopause, the Baby Boom generation has created a greater amount of people at risk for heart disease.”

Traditional Treatments, Natural Alternatives 

Exercise and eating healthy have always been traditional approaches prescribed for those seeking to preserve or improve their heart health, as noted by Dr. Eric Ding, nutritionist and epidemiologist, faculty at Harvard Medical School Department of Medicine. “However, adherence and compliance is always the biggest problem with exercise,” he pointed out. “Additionally, obesity risks are not completely offset until BMI (body mass index) drops to between 18. 5 and 22, and only if the lower BMI is maintained.

“Moreover bariatric surgery, which is becoming more popular, should never be considered unless used as a last effort for those morbidly obese and resistant to all other efforts,” Dr. Ding said.

Neither surgery nor pharmaceutical drugs, such as statins, guarantee a return to health absent lifestyle changes, including improved diet, stress reduction and exercise, offered Neil Levin, CCN, DANLA, nutrition education manager for Protocol For Life Balance, an Illinois-based provider of dietary supplements for the professional health care market since 2007. “Dr. Dean Ornish demonstrated that these lifestyle changes were as powerful as conventional medical approaches and, in some cases, were more important measures of health,” he said.

While it has been 10 years since statins were first recommended as mainstream required medication for those with documented cardiovascular diseases or equivalents such as diabetes, Dr. Scott Eisenberg, a cardiologist at Change of Heart Cardiology in New Jersey, noted that “after all the studies, the overall risk reduction these controversial medications provide is about 30 percent. This means there is an excess of 70 percent cardiovascular risk still not covered by these potent drugs,” he said. “In our practice, we begin with a more natural approach, along with aggressive lifestyle modifications. A 10-pound weight loss can reduce up to 10 points on blood pressure, which can be the difference between a heart attack or stroke. Sixty minutes of aerobic exercise five days a week can significantly lower blood sugar, cholesterol, blood pressure and inches from the waistline. The difference between aggressive lifestyle practice and reducing multiple medications cannot be overly emphasized.”

Key concerns with statin medications are that they can lead to suffering liver and mental function, as well as cardiac muscle and skeletal muscle health due to a depletion of coenzyme Q10 (CoQ10), said Dr. DiRenzio. CoQ10 is present in almost all cells, where it is necessary for mitochondrial energy production, she continued. The body’s highest concentrations are in the heart, where constant chemical energy availability is imperative. In addition to its benefits for cardiac function through energy production, CoQ10 also functions as a powerful fat-soluble antioxidant, providing protection against free radical attack for vascular structures, as well as for other tissues, said Dr. DiRenzio.

Protocol for Life Balance suggests that CoQ10 be used to support cardiovascular health, either as high strength ubiquinone (up to 600 mg per capsule) or as ubiquinol CoQH (up to 100 mg per capsule). “Ubiquinol is more absorbable than most ubiquinone formulas because it is typically processed by dissolving it in a fat-soluble carrier to aid its bioavailability, besides being the reduced (unoxidized) form of the nutrient,” explained Levin.

BioGenesis’s Ultra CoQ10, which provides 100 mg coenzyme Q10 stabilized in lecithin, nutritionally supports normal cardiovascular and neurological health, the company states.
“Ultra CoQ10 supports cellular energy production and respiration, enhances mitochondrial electron transport, and is important for overall cardiovascular and neurological health,” said Dr. DiRenzio. “Ultra CoQ10 is helpful in correcting CoQ deficiencies resulting from HMGCoA- reductase inhibiting medications.” 

Other Heart Healthy Nutrients 

Omega-3s 

Omega-3 fatty acids, especially fish oils, have been cited as an important research-backed supplement for cardiovascular disease. So much so that the American Heart Association has suggested the use of fish oil for those with heart disease, those trying to prevent heart disease and for people with elevated triglycerides. In addition, the U.S. Food and Drug Administration issued a qualified health claim for omega-3 fatty acids in 2004: “Supportive but not conclusive research shows that consumption of EPA and DHA omega-3 fatty acids may reduce the risk of coronary heart disease.” 

“As beneficial as fish oil is, the real issue for a practitioner is how to get their patients to take fish oil daily and at the correct dosage in order to receive the therapeutic benefits. At the same time, people don’t like taking a handful of pills, so concentrated products are the best way to deliver that amount,” said Keri Marshall, MD, ND, chief medical officer with Nordic Naturals, the California-based fish oil supplement manufacturer, who noted that the American Heart Association recommends 2 to 4 g of EPA and DHA daily for individuals with elevated triglycerides and 1 g of EPA and DHA daily for individuals with risk factors for heart disease. The company’s professional division offers more than 35 products in its line that contain fish oils rich in the omega-3 fatty acids EPA and DHA to improve lipid profiles, reduce inflammation, normalize cardiovascular biomarkers, improve arterial elasticity and improve blood pressure and blood flow.

Among its products, Nordic Natural’s ProEPA is a concentrated fish oil formula in soft gel form that delivers 850 mg EPA per serving for highintensity omega-3 support. A randomized, placebo-controlled study published last year in Clinical Lipidology showed that an eight-week treatment with omega-3 fatty acids as ProEPA resulted in a significant percentage reduction of C-reactive protein levels, a marker of inflammation and a strong predictor of future cardiovascular events, as compared with baseline, a finding not seen with the placebo, Dr. Marshall said.

One of the company’s newest introductions is Arctic Omega Fortify, a food- and water-soluble omega powder said to have zero hint of fish and that offers a convenient alternative to soft gels and liquids. Each single-serving stick pack contains 500 mg of EPA+DHA and can be added to meals, snacks and drinks.

Antioxidants 

Levin from Protocol for Life Balance noted that some scientists believe a lack of dietary antioxidants plays a key role in cardiovascular health. “This lack of antioxidants causes collagen used to form blood vessels to be weaker, less flexible and more prone to inflammation when damaged,” he said, “in the process encouraging formation of sticky foam cells that intrude into the blood flow and promote dangerous clotting that can partially obstruct circulation.” 

To that end, Protocol’s E-400 MT + Selenium is recommended because, as Levin noted, vitamin E, an important fat-soluble antioxidant, is essential for maintaining the integrity, function and flexibility of cell membranes. He said this formula supplies all four major dietary tocopherols, alpha, beta, gamma and delta; with 400 IU of alpha-tocopherol, 80 mg of mixed tocopherols and 100 mg of selenium supplied in each soft gel capsule. “Recent research indicates this family of compounds works best as a team to quench the lipid and nitrogen free radicals known to cause injury to cells and tissues,” said Levin. “Vitamin E may support normal cell division and immune health, influence blood coagulation speed and provide protection to neural tissues.” 

According to Judy K. Gray, MS, a master nutritionist and president of Illinois-based Physician’s Strength, a source for health practitioners who use alternative medicines within their practices, one antioxidant trend garnering strong attention is resveratrol and, in a particular, muscadine as a source of natural resveratrol. In response to interest and strong clinical evidence, she said the company introduced Cholest-X, which is said to naturally support healthy cholesterol. “Its active ingredients—crude red grape flavonoids, northern Pacific kelp, garlic and wild cumin—are ideal for healthy cholesterol support,” said Gray. “Cholest-X is high in natural resveratrol, vitamin C, chromium and potassium. These nutrients support arterial and heart health. This is nature’s answer for healthy cholesterol support, without side effects.” 

Tocotrienols 

The benefits of palm tocotrienol complex toward cardiovascular health were evident through several animal and human studies dating back to the ‘80s and ‘90s, according to W.H. Leong, vice president of New Jersey-based Carotech, whose Tocomin palm tocotrienol complex has been marketed on this basis. Carotech, an ingredient supplier to branded supplement lines, began supplying to the natural practitioners’ market in 2006 via Metagenics, and can also be found in Life Extension’s Super- Absorbable Tocotrienols product.

When Carotech’s Tocomin SupraBio was developed and obtained a U.S. patent in 2003 for its clinically proven bioenhanced absorption and delivery system, the potential in cardiovascular health for tocotrienols grew, Leong noted. He said human trials show that high levels of tocotrienol in the blood help in lowering total and LDL-cholesterol levels significantly in hypercholesterolemic subjects, as well as reversing arterial blockage in carotid stenosis patients.

“What is most important is to ensure the optimum and maximum absorption of tocotrienols into the body. As such, bioavailability is of utmost importance to ensure the organs and cells can accumulate tocotrienols,” said Leong. “Due to its increased absorption, Tocomin SupraBio allows companies to formulate at a lower dosage, yet reach a therapeutic blood level. This also means that consumers do not need to take too many capsules to attain the benefits of palm tocotrienol complex as shown by research—lowering the cost for supplementation.” 

Phytosterols 

The ability of phytosterols to reduce cholesterol levels was first demonstrated in humans in a study, “Reduction in blood cholesterol in man” by O.J. Pollak, published in the May 1953 issue of Circulation, and has since accumulated an impressive body of research, according to Rick Janke, co-founder and principal of New York-based dietary supplement manufacturer American BioSciences. “One of the best known natural therapies for lowering cholesterol and hopefully lowering the chances of developing heart disease is phytosterols. There is an amazing amount of research on phytosterols and lowering cholesterols levels, without any known side-effects,” he said.

This was the foundation for the company to create its CHOLESTSolve 24/7 Phytosterol Healthy Heart Support, a phytosterol-based tablet, which also includes resveratrol, CoQ10, green tea leaf extract, red grape skin extract and quercetin.

Fermented Wheat Germ 

Janke referenced a study, “Fermented Wheat Germ Extract (Avemar) in the Treatment of Cardiac Remodeling and Metabolic Symptoms in Rats,” conducted at the University of Queensland, Brisbane, Australia and published in 2011 in Evidence-Based Complementary and Alternative Medicine. “It is one of the most impressive research experiments conducted on fermented wheat germ extract in the past few years [that] showed the beneficial effects this ingredient has on heart disease, specifically cardiac remodeling,” he said. “In this particular study, fermented wheat germ extract improved cardiac function and reduced many dangerous aspects of heart disease including hypertension and metabolic disease.” 

American BioScience’s AvéULTRA Fermented Wheat Germ Extract is a wheat germ fermented by baker’s yeast to produce a standardized methoxy-substituted benzoquinone that is available both as a powder to be mixed with liquid and as a capsule. “With more than 30 published scientific studies showing its efficacy in a number of health conditions, including human clinical studies and cardiac-specific research, AvéULTRA Fermented Wheat Germ Extract is the only fermented wheat germ extract produced under the license and supervision of the patent holder and inventor, Dr. Mate Hidvegi,” said Janke.

Niacin 

Niacin is known to be critical for DNA replication and repair, and therefore plays a critical role in genetic stability. In addition, it has been shown to have a number of beneficial effects on lipid and cholesterol transport, and thus is important for the maintenance of healthy serum lipid levels that are already within the healthy range.

Regular niacin has a long track record of positively affecting serum lipid levels, but has the negative drawback of causing dermal flushing in persons taking it. Due to this flush and some itching that may accompany it, regular niacin has had a poor longterm patient compliance record.With that in mind, Protocol for Life Balance’s Flush Free Niacin 500 mg and BioGenesis’s BioLipotrol both utilize inositol hexanicotinate, described as a stable, non-flushing source of niacin.

Hawthorn 

Hawthorn (Crataegus oxyacantha) leaf and flower extract is naturally rich in procyanidins, flavonoids and flavonols, according to Levin. “People with congestive heart failure taking 160-900 mg of hawthorn extract daily for eight weeks have showed improved quality of life, including greater ability to exercise without shortness of breath and exhaustion, in clinical trials,” he said.

Levin said Protocol For Life Balance’s Hawthorn Extract provides powerful flavonoids including standardized vitexin that, along with other components in hawthorn, have been found to support healthy blood flow and blood pressure already within the healthy range. “These active compounds in hawthorn encourage normal blood flow throughout the cardiovascular system by lowering the resistance to blood flow in peripheral blood vessels, supporting coronary artery blood flow and strengthening of the contractions of the heart muscle,” said Levin.

Practitioner Cues 

Dr. DiRienzo said that her patients who pursue heart health fall generally in the 40 years and over age group. “While younger consumers are becoming aware of this, they often do not pursue it. I feel as a physician, however, that it is my responsibility to screen for, teach and treat my younger patients as well. A good family history, exam and laboratory studies help to screen for and identify those younger patients who need to start in on the education and lifestyle changes now rather than wait until it becomes a necessity.”

Approximately half a million women die of heart-related causes each year.

Neither surgery nor pharmaceutical drugs guarantee a return to health absent lifestyle changes, including diet, stress reduction and exercise.

The American Heart Association has suggested the use of fish oil for those with heart disease, those trying to prevent heart disease and for people with elevated triglycerides.

A lack of dietary antioxidants causes collagen used to form blood vessels to be weaker, less flexible and more prone to inflammation when damaged.

A good family history, exam and laboratory studies help to screen for and identify those younger patients who need to start education and lifestyle changes.

FOR MORE INFORMATION:

American BioSciences, (845) 727-0800, www.americanbiosciences.com

BioGenesis, (866) 272-0500, www.bio-genesis.com

Carotech, (732) 906-1901, www.carotech.net

Change of Heart Cardiology, www.changeofheartcardiology.com

Maharishi Ayurveda Products International, (641) 469-6940, www.mapi.com

Nordic Naturals, (800) 662-2544 ext.1, www.nordicnaturals.com

Physician’s Strength, (800) 243-5242, www.physicians-strength.com

Protocol for Life Balance, (877) 776-8610, www.protocolforlife.com

The Raj Ayurvedic Spa, www.theraj.com

Mending Broken Hearts Through Ayurveda

From the ayurveda perspective, the heart is the seat of prana, or life energy, which is maintained by a delicate balance of agni (the solar energy element) and soma (the lunar energy element). Mark Toomey, PhD, director of ayurvedic programs at The Raj Ayurvedic Spa, explained that “excess mental and emotional stress wastes away soma in the heart. The heart is also the seat of ojas, the substance within us that maintains life and promotes bliss and longevity. To protect and nourish the physical and the emotional heart, it is essential to promote both soma and ojas. The function of the heart is governed also by three sub-doshas: Sadhaka Pitta (emotional balance), Avalambaka Kapha (stability, strength and sense of security) and Vyana Vata (blood flow and beat).” 

Toomey mentioned the nutritional supplement Cardio Support from Iowa-based Maharishi Ayurveda Products International, which contains three herbs that are renowned for their ability to support the heart: arjuna, which balances Sadhaka Pitta and nourishes both the physical and the emotional heart; rose petals, which are cooling and nourish soma; and guggul, which Toomey said has been shown in research studies to help balance cholesterol.

“The herbs in Cardio Support are combined in precise proportions and prepared in the traditional ayurvedic way. This improves the bioavailability of vital nutrients,” said Toomey. “It also creates synergy, which is the collective benefit much greater than that of isolated individual herbs.

“In ayurvedic medicine, arjuna is the foremost rejuvenative for the heart,” Toomey continued. “It strengthens and tones the circulatory system and promotes proper function of the heart muscles. Arjuna’s strengthening and toning actions help maintain healthy blood pressure already within the normal range. It is also used to help maintain healthy cholesterol levels and to support healthy coagulation. Arjuna is traditionally used to promote emotional balance for those experiencing grief and sadness. It is said to mend a ‘broken heart’ and to impart courage and strengthen the will.” 

For natural practitioners seeking to utilize ayurvedic practices and products, Paul Schaefer, public relations and marketing with Maharishi, noted “very experienced practitioners utilize traditional ayurvedic pulse assessment and assorted other client inputs to determine the best approach to recommending a variety of ayurvedic treatments. Others might simply recommend herbal products. Practitioners can incorporate at varying levels depending on their skill levels and client demand.”