Preserving Heart Health
Fear of heart issues remains prominent among adults, many of whom don’t know how to caretake their cardio system.
Although most people think of the romantic heart during February, ruminating about one’s physical heart also tends to be common this month. Unfortunately, during the snowy month of February, fatal heart attacks rise in the brittle cold weather while exerting one’s self in activities such as shoveling snow.
Heart disease and fatal heart attacks have been in the spotlight recently during the holiday season when the entertainment industry lost icons such as television actor Alan Thicke, pop musician George Michael and film actress and author Carrie Fisher.
In this modern age, all three individuals are considered too young to die—and many middle-aged Americans who held the trio in high esteem have been shocked, and wondering just where they stand, cardiovascular wise.
And many may be turning to natural practitioners to help discover where they stand and how they can improve cardiovascular status. A number of clients/patients may also be holding onto older notions of what affects and influences the health of their hearts and cardiovascular systems.
For example, according to Jonny Bowden, PhD, CNS, “The Nutrition Myth Buster,” the biggest shift in the nutrition arena is a growing realization about the roles of fats and sugar in heart disease. “I’ve been arguing for a decade that fat has been wrongly demonized,” he asserted. Dr. Bowden pointed to several significant meta-analyses that have “absolved saturated fat of a causative role in heart disease—e.g. American Journal of Clinical Nutrition (Siri-Tarino, 2010) and the Annals of Internal Medicine (Chodhury, 2014). Sugar is being shown via research to be a major dietary instigator in the development and progression of heart disease. “This is a pretty seismic shift in our understanding of the real demons in the diet,” he commented.
Further, a December 12, 2016 scientific press release from the Houston Methodist DeBakey Heart and Vascular Center via the American Heart Association, described how many women may miss signs of heart trouble, thinking that some symptoms are simply anxiety or indigestion. According to Karla Kurrelmeyer, MD, a cardiologist at the center, stress can cause symptoms of a heart attack in women that aren’t as obvious as heart attack symptoms in men. These include: sweating, nausea, vomiting and dizziness (flu-like symptoms), indigestion, fullness and tightness in throat area, tachycardia, extreme weakness, anxiety and shortness of breath, and pressure, heaviness or pain in the arm, chest and below the breastbone in the middle of the back.
And there are other studies and recent theories that your peers find worthwhile to discuss with their clients/patients who are concerned about their cardiovascular status. A majority of clients/patients will immediately want to discuss cholesterol levels as most people believe that unfavorable levels of cholesterol is the main (and sometimes only) culprit of heart disease. However, said Raphael Kellman, MD, founder of the Kellman Center for Functional and Integrative Medicine, “Cardiovascular health is not just about lowering cholesterol or raising ‘good’ cholesterol; that’s old medicine. There are several other important factors that need to be considered,” he stated. Endothelial function—and dysfunction—is key here, as the most important functional characteristic of arteries is elasticity. Inflammation affects nitric oxide, which keeps endothelial tissue pliable, and therefore, controlling or lessening the inflammatory response is important for overall cardiovascular health.
“In the body, the ability to accommodate changes allows for adaptability that maintains health,” Dr. Kellman elucidated. “Once rigidity sets in, disease takes hold. Likewise, the way vessels heal when damaged is also critical. There are different pathways in the cardiovascular toolkit to correct the nicks and damage to vessels. In inflammatory states, genes turn on and off leading to the repair vessels in ways more likely to cause atherosclerosis and dyslipidemia. Now we know Apo A and B and particle sizes are critical. If there is inflammation then there will be more atherosclerosis.”
Additionally, said Dr. Kellman, heart disease also is affected by bacteria. There are approximately 10 times more bacteria in the human body than cells, and 150 times more DNA. “This genetic component is truly what determines health and impacts cardiovascular disease,” he said. The body uses bacteria to coordinate genes to turn the inflammatory process on or off; and while genes are fixed, so to speak, “the great genetic diversity of the microbiome is where freedom lies to heal cardiovascular disease,” he added.
Microbiome medicine, Dr. Kellman described, works on healing the gut and bacteria, which in turn helps strengthen the body to realign to achieve homeostasis and resilience, helping to repair insulin resistance, and lower inflammation, among other benefits. These bacteria produce butyrate, a biochemical that also helps lessen inflammation and insulin resistance. “The microbiome is our greatest ally,” he attested.
Finally, he added, the thyroid is often the most overlooked factor that impacts cardiovascular status. In the medical field, “routine testing is abysmal,” he declared. Low thyroid increases homocysteine, slows the methylation pathway, raises cholesterol and contributes to insulin resistance. “It makes sense that low functioning thyroid plays a role in CVD (cardiovascular disease)—if the vessels can’t function and the patient’s body can’t produce antioxidants, increased inflammation will result. If we overlook the hidden world of the microbiome and proper thyroid function, we put the patient at risk.”
Dr. Bowden believes that the American medical community has wasted not only millions of dollars but has placed millions of lives in cardiovascular jeopardy by collectively focusing on cholesterol and saturated fat as the causes of heart disease. “They are not and they never were,” he declared. “And our single-minded myopic concentration on lowering cholesterol has caused us to take our eye off the ball when it comes to identifying and fixing the real culprits in heart disease: dietary sugar, inflammation, oxidative damage and stress. The focus on lowering cholesterol in the blood and fat in the diet led to the craziest nutritional experiment in history—the low-fat, high processed carbohydrate diet—which, in my opinion, is largely responsible for epidemic explosions in diabetes, heart disease, obesity and Alzheimer’s.”
As these myths are busted and new causes or contributors to poor cardiovascular status are found, your peers are relying on specific tests to reveal status or presence of causative factors of potentially devastating cardiovascular conditions, and creating sound protocols to preserve or improve cardiovascular functioning.
Testing
The cardiovascular care program at Kellman Center for Functional and Integrative Medicine, noted Dr. Kellman, always begins with improving overall function of the entire body and includes deep testing to find areas that may be weak and contributing to the underlying issues. Testing, he reminded, should be well rounded to check inflammation biomarkers such as CRP (c-reactive protein), TNF-a (tumor necrosis factor-alpha), interleukins IL1, IL6, IL8, IL10 and homocysteine, as well as glucose and insulin dysregulation. Lipid panels should also include a check for particle size.
“The routine thyroid test simply is not enough to catch many cases of low thyroid, so we include a full panel to check TSH, free and total T3, free and total T4, RT3, thyroid antibodies, plus a TRH stimulation test and secondary markers including cholesterol and alpha/beta carotene.”
A third area of testing for cardiovascular status that Dr. Kellman feels is necessary includes a full exploration into bacterial health; this may include breath testing for overgrowth, blood testing for LPS, urinalysis to check bacterial metabolite markers and a stool assay to show the balance of bacteria, look for parasites and yeasts, plus check functional markers including SIgA and butyrate.
As a nutritionist, Dr. Bowden said he recommends a cholesterol particle test, which functional medical physicians tend to perform. He agrees with Dr. Kellman, noting that thyroid (not just the TSH test, also free T4 and T3) is very important to test as well. Further, he recommends testing for the following: “all hormones including testosterone (for both sexes), estradiol, DHEA; triglycerides, which are underappreciated as a risk factor; fasting glucose and also fasting insulin; and homocysteine, the hs-CRP test. Lp(a). And maybe even a CIMT test (carotid inter-medial thickness), which is a pretty direct measurement of what’s going on in the arteries. And of course blood pressure. Many of my colleagues also like to do an adrenal panel of some kind.”
Natural practitioners can easily recommend a free “test”—the triglyceride: HDL ratio—that clients/patients can do at home, said Dr. Bowden. Look at their recent blood test, and divide triglycerides by HDL. If that number is 2 or less, he or she is in good shape risk wise, as that number is a surrogate for many things including insulin resistance. Also, weight measurement is indicative of status. “There are fewer health risks for women with a waist of 35 inches or under and for men with a waist size of 40 inches or under,” he said.
Be a Quitter
The recent new year has brought with it a refrain of every new year for decades—folks dedicated to smoking cessation to prevent heart disease. Unfortunately, many people who quit, start again. But there are quite a few who remain successful former smokers. Your clients/patients who smoke may need some more enlightenment as to why abandoning so-called “cancer sticks” (or in this case, “heart attack sticks”) is a very wise idea.
According to Dr. Kellman smoking greatly increases the amount of free radical exposure to the body and cells as well as increases inflammation. As a practitioner, he emphasized, “It is never too late to quit smoking!”
Cigarette smoking, added Dr. Bowden, causes about one in five deaths. Beyond significantly increasing risk for lung cancer and emphysema (and COPD), it also happens to exponentially increase the risk for heart disease. “Toxins and chemicals in the smoke interfere with cellular health and metabolism, constrict the vascular system and increase blood pressure,” he explained. “And when one stops smoking, those things begin to reverse. The cells can start to ‘breathe’ again and carry on basic metabolic processes without interference. The mitochondria are no longer overwhelmed and rendered dysfunctional by the toxins in cigarette smoke.”
Aparna Kalidindi, PharmD, BCPS, technical sales and marketing manager for New Jersey-based Natreon, Inc. agreed, stating that cigarette smoking is not only a major cardio-pulmonary disease risk factor—it is also known to adversely affect other organs in the body. “It is one of the major sources of free radical production, and these free radicals contribute to many complications, including cardiovascular disease,” she said. The company’s key cardiovascular product, Capros, may help protect the heart in smokers by decreasing the production of free radicals and improving antioxidant status. Capros has an ORACFN value of 47,110 µmoles TE/g, “which is significantly higher than most other superfruits,” she said. “In addition, Capros significantly improves endothelial function, improves the lipid profile (significantly increases HDL, lowers LDL, lowers total cholesterol, and lowers triglycerides), and lowers hsCRP levels by greater than 50 percent.”
FDA (U.S. Food and Drug Association) GRAS (generally recognized as safe)-affirmed Capros, which can be formulated in dietary supplements and functional foods/beverages, is a pro-oxidation free cascading antioxidant. “Under oxidative stress, most antioxidants become inactive, whereas Capros utilizes a multilevel cascade of antioxidant compounds resulting in a prolongation of its antioxidant capabilities,” Kalidindi explained.
Natreon’s Crominex3+, described Kalidindi, is a trivalent chromium supplement, prepared by complexing chromium chloride with two natural products, Phyllanthus emblica (Capros) and Shilajit (PrimaVie), which minimizes the conversion of trivalent chromium to toxic hexavalent chromium. Crominex3+ has shown significant anti-hyperlipidemic and anti-inflammatory activities in type 2 diabetic patients as well as pre-diabetics. Also, she noted, Crominex3+ has been clinically shown to be efficacious for those who are type 2 diabetic and pre-diabetic (metabolic syndrome) notably in the support of healthy endothelial function, HDL, nitric oxide and glutathione levels and reduction of total cholesterol, LDL, VLDL, HbA1C and triglycerides.
Arjuna Heart is a cardio-specific supplement from Washington-based Ayush Herbs. Arjuna Heart, said Jared Paulson, MTCM, sales and education manager, is “a simple combination of the herbs arjuna and inula with CoQ10, vitamins and minerals. Arjuna Heart benefits cardiovascular health by strengthening the heart as a cardiotonic, promoting oxygenation and calming the sympathetic nervous system. In addition, it improves the elasticity of blood vessels and increases the sensitivity of baroreceptors allowing the blood vessels to maintain heathy blood pressure levels within a normal range. These herbs have long been used in both ayurvedic (Indian) and Chinese medicine to support health and longevity.”
Of course, there are omega-3 EFAs, vitamin K2, bergamot, oligomeric proanthoycanidins, vitamin E (tocopherols and tocotrienols), phytosterols and more—all natural substances that have attractive human clinicals showing cardiovascular benefit. After thorough testing and consultation with your client/patient, you can recommend the most suitable supplement and lifestyle program to ensure his or her (heart)beat goes on.
For More Information:
Ayush Herbs, www.ayush.com
Natreon, www.natreoninc.com