Improving cardiovascular health often requires major lifestyle and dietary changes—ones that practitioners must simplify for their patients.
Eric Ding, PhD, a nutritionist and epidemiologist at the Harvard School of Public Health, believes the reason why cardiovascular health continues to erode in the United States is that its obstacles and ill effects span a lifetime.
Maybe the person who dropped dead of a stroke lived in a food desert.Maybe he couldn’t afford supplements. Perhaps he was injured and couldn’t exercise regularly.“Everything along the way caused it, and everything increases the risk X, Y, Z percentage,” said Dr. Ding, whose 2011 meta-analysis on the heart-healthy effects of cocoa flavonoids made headlines. “But there is no single thing.”
Or is there?
Isaac Eliaz, MD, Lac, MS, an integrative medical doctor and founder of Amitabha Medical Clinic & Healing Center in Sebastopol, CA, said that stress “above and beyond anything else” is the biggest contributor to poor cardiovascular health. “Physical, mental and emotional stress increase chronic inflammation and trigger a cascade of harmful biochemical reactions that damage the cardiovascular system,” he noted.
“The second cause is lack of exercise, lack of movement,” Dr. Eliaz continued. “And the third, of course, is diet: too many high glycemic (high sugar) foods, too much fat, too many calories. Also related to diet is dehydration, which negatively affects the cardiovascular system and, specifically, heart conductivity.”
Despite the logic ceaselessly espoused by Big Pharma—described by Michael Smith, MD, as “one cause, one drug, one result”— cardiovascular disease is multi-factorial, said the senior health science specialist for Florida-based Life Extension, the maker of Olive Leaf Vascular Support. “If you don’t modify other risk factors,” Dr. Smith added, “you don’t gain anything statistically for that person.”
“In general,” Dr. Eliaz said, “cardiovascular health is related to lifestyle.” And in a country where people eat out an average of five times a week, where the Centers for Disease Control and Prevention (CDC) reports that fewer than two in 10 Americans get the recommended amount of exercise, it should come as no surprise that the statistics for cardiovascular health are pretty grim.
According to the American Heart Association’s “Heart Disease and Stroke Statistics—2013 Update,” based on the 2009 death rate data, 2,150 Americans die of cardiovascular disease (CVD) each day. That’s an average of one death every 40 seconds.About 153,000 Americans who died of CVD in 2009 were under 65 years of age. (Keep in mind the average life expectancy is 78.5 years.) Coronary heart disease caused one of every six U.S. deaths in 2009. The estimated cost of CVD and stroke four years ago: $312.6 billion.
“The market potential [for cardiovascular supplements] is as big as the general popula-Tion and everyone is a potential consumer since heart disease still remains the leading cause of death among our population,” said Nutritionist Jolie Root of Carlson Laboratories, a dietary supplement manufacturer based in Illinois.
Reducing those frightening numbers is an arduous task. “It takes a societal movement,” said Dr. Ding. “It takes a village to move everything. Society has to be designed from the ground up.”
Fortunately, knowledgeable, communicative and patient natural practitioners can serve as architects.
A Simple Start
The blueprint for that healthy lifestyle is a massive, sprawling metropolis, one that can overwhelm patients used to bad habits.“What’s worse than drug compliance,” Dr. Smith half-joked, “is diet and exercise compliance.”
Dr. Smith’s solution is to keep it simple.“Make deals with your patients,” he said.“Don’t worry about all the sugar at first. How about eating half?” It could be something as simple as buying smaller plates or saving half of Monday’s dinner for Tuesday night.
A strategy Dr. Smith employs for his patients is the “250/250 rule,” which involves eating 250 fewer calories a day—half your bread serving—and burning 250 calories a day—the equivalent of a brisk hour-long walk. Follow this for a week, and that’s a pound of weight loss. Plus, Dr. Smith explained, two of the factors behind poor cardiovascular health get eliminated: inactivity and sugars.
Dr. Ding said patients need to view their eating options in terms of substitutions that will allow them to move up a spectrum of better choices. For example, a whole-wheat bun is better than white bread; saturated fats are better than “metabolically poisonous” trans fats. “I feel that’s more digestible to people in terms of health advice,” said Dr. Ding.
Motivation can crumble under stress, said Dr. Eliaz. Address that and “people are happier and have a better outlook about life, they are naturally more inclined to take better care of themselves,” he said. “Daily meditation practice, even for just 10 minutes, can really help in this area.”
Leo Galland, MD, director of the Foundation for Integrated Medicine, also recommended “daily periods of meditative activity.” Thirty minutes of walking a day works, but these are not hard and fast rules.“Make the patient a partner in designing a therapeutic program,” he said.“Identify those factors that prevent the person from following a program and have him or her decide how to deal with them. Forms of exercise should be those a person will enjoy. For diet, start by identifying taste and flavor preferences, and help design a diet that meets those for the individual.”
Practitioners may want to look at group treatment. Dr. Ding is the director of epidemiology at Microclinic International, a non-profit development organization whose name is its mission, takes a social- and community-oriented approach to managing deadly diseases.In a microclinic, groups of two to six people share access to education, technology and social support as they work together to achieve lifestyle behavior changes that prevent and manage chronic conditions.
In Team Up 4 Health, a two-year pilot program co-sponsored by Microclinic, the residents of Bell County, KY put the principles of the microclinic to the test. According to Microclinic, by the end of the program’s first year, 97 percent of county residents who completed Team Up 4 Health saw improvement in one of the following areas: reduced body mass index, sustained weight loss, decreased symptoms of diabetes and reduced blood pressure.
Whatever the course of action, said Hubert Wewer, general manger of Pritikin Longevity Center & Spa in Florida, it needs to be achievable. “Nobody does it 100 percent, he said.” (Please see related sidebar on page 35.)
The path to cardiovascular health isn’t all jaunty walks and eating double cheeseburgers on multi-grain buns. Dr. Eliaz favors “a low glycemic diet with the right profile of fatty acids, meaning balanced omega-3 and omega-6 fats. Also, emphasize plenty of antioxidant-rich vegetables and fruits to combat inflammation and keep arteries clear. Caloric restrictions are important, regardless of how healthy your diet is.We tend to think that if we eat a low glycemic diet, we can eat as much as we want, but it’s not true—we’re still going to gain weight.”
Supplementation plays a big part in an improved cardiovascular profile. Dr. Galland recommends omega-3 and niacin.
“These seem to exert their greatest effect in people who are not taking conventional medications,” he said. “Beyond these, I find it important to do a nutritional evaluation and correct deficits.Magnesium deficiency should be corrected with supplements. For patients taking statin drugs, I recommended coenzyme Q10 (CoQ10) 100-300 mg/day.Vitamin D to produce a blood level of 25- hydroxy vitamin D in the mid-40s may be helpful; cardiovascular benefits are achieved with vitamin D and seem to plateau at about 43 ng/ml.”
Many supplements could be beneficial,but lack sufficient evidence, Dr. Galland Said. These include curcumin, lipoic acid and selenium. “The use of B vitamins to reduce homocysteine may be helpful for primary prevention,” he added, “but has not been shown to help for secondary prevention, although all clinical trials used folic acid rather than s-methyltetrahydrofolate, which is the preferred form.”
Because minerals, especially electrolytes, support “numerous aspects of cardiovascular/ heart health,” Dr. Eliaz recommends magnesium and calcium at a 1:1 ratio in addition to potassium, zinc and selenium.There is the “classical category”: vitamins C, D-3, A and K2; tocopherols; and the B vitamins.As for enzymes, “nattokinase and lumbrokinase also help with hyperviscosity and can reduce arterial plaque formation and increase circulation,” Dr. Eliaz added.
“Nattokinase has been the subject of 17 studies, including two small human trials,” said Dave Barton, director of education at Enzymedica, Inc., the Florida-based manufacturer of the Enzyme Science line of supplements.
“Researchers from JCR Pharmaceuticals (Japan), Oklahoma State University and Miyazaki Medical College tested nattokinase on 12 healthy Japanese volunteers (six men and six women between the ages of 21 and 55) ,” Barton continued. “The tests indicated that the natto generated a heightened ability to support circulation. On average, the volunteers’ ELT (a measure of how long it takes to dissolve a blood clot) dropped by 48 percent within two hours of treatment. An additional study showed an 11 percent decrease in blood pressure after just two weeks.”
Supplement manufacturers have developed products starring these research-backed ingredients.
Carlson Laboratories’ cardiovascular multivitamin formula, HeartBeat Elite, features “a balanced combination of cardiac supporting B vitamins; vitamin C for blood vessel health; magnesium, carnitine and CoQ10 for cardiac tone and energy; and vitamins D and E for blood vessel, lipid balance and inflammation balance,” said Root. HeartBeat Elite, she advised, should be taken daily with any of Carlson’s omega-3 products.
Enzymedica’s Barton said that Enzyme Science Nattokinase Plus “contains a blend of nattokinase, lipase and CoQ10 to provide a synergistic formula for heart health. In general, proteolytic enzymes can be a big support to circulation by hydrolyzing specific protein molecules, like fibrin, that restrict/reduce blood flow.”
Dr. Eliaz described modified citrus pectin (MCP), available through a number of companies, as a special, enzymatically modified form of citrus pectin that is easily absorbed into the bloodstream. Of interest is MCP’s role as an inhibitor of galectin-3, a biological protein “directly involved in chronic inflammation and the remodeling of blood vessels and heart tissue. The American Heart Association just published a study showing that elevated galectin-3 in the body contributes to hardening of the arteries and atherosclerosis,” he explained, “and that MCP reversed these effects through its ability to bind and block galectin-3.”
Ayurveda is represented with the dairyand grain-free Renewal Greens from New Hampshire-based Innate Response. The product features the branded ingredient Capros, which James Doherty, brand manager at Innate Response, explained is derived from Phyllanthus emblica, a “superfood that has been scientifically proven to promote cardiovascular health, act as an effective detoxifier and rejuvenator, promote healthy skin and reduce free radical activity.”
Among its body of research—available on www.capros.net—Phyllanthus emblica was found in 2005 to relieve oxidative stress and improve glucose metabolism in diabetic rats.
Olives are renowned for their health benefits, but what about the leaves? According to Life Extension’s Dr. Smith, they contain more oleuropein, the key compound that provides vascular support, than the fruit.That’s the logic behind Life Extension’s Olive Leaf Vascular Support. A 2011 Indonesian study1 found that subjects who took 500 mg of olive leaf extract twice a day over eight weeks saw their systolic and diastolic blood pressures drop by an average of 12 points and five points, respectively.
Natura Guard BP from Ajinomoto USA, available exclusively through health care Providers, has also shown promise with blood pressure.
“Twelve trials of Natura Guard BP, published between 1996 and 2005 and including 623 participants, have demonstrated significant changes in both systolic and diastolic blood pressure,” said Jeremy A. Holt, the New Jersey company’s manager of health services.“This evidence demonstrates the positive effect of the dietary ingredient lactotripeptide (LTP) on blood pressure. This is important since it is well-established that a decrease in systolic blood pressure (SBP) and diastolic blood pressure (DBP) of 5 mmHg can lead to a seven percent and 16 percent decrease in CVD incidence, respectively.”
Of course, impressive statistics and fancy research mean nothing if patients aren’t committed to making a change. “Living a healthy lifestyle is the most important element of heart health,” Holt said.
“[Practitioners] need to keep encouraging their patients to eat a low-fat diet, refrain from excessive use of alcohol and exercise regularly.”
In other words: time to get back to work on those blueprints.
1 Susalit E, Agus N, Effendi I, Tjandrawinata RR, Nofiarny D, Perrinjaquet-Moccetti T, Verbruggen M. Olive (Olea europaea) leaf extract effective in patients with stage-1 hyptertension: comparison with Captopril.Phytomedicine. 2011 Feb 15;18(4):251-8. Doi:10. 1016/j.phymed.2010.08.016. Epub 2010 Oct 30.
Healthy Take Aways
According to the American Heart Association, every 40 seconds someone dies from cardiovascular disease.
Practitioners need to treat patients’ cardiovascular issues by addressing their lifestyle—diet, exercise and stress levels.
Compliance is a major issue with lifestyle changes. Don’t overwhelm patients with a drastic overhaul. Work with them on a game plan, starting with simple suggestions: a daily 30-minute walk, eating smaller portions, switching from white to wheat bread.
Well-researched supplements geared toward cardiovascular health abound, featuring ingredients from EPA and DHA to vitamins (K2, C, B, etc.) to enzymes.
FOR MORE INFORMATION:
Ajinomoto USA, (201) 292-3200, www.ajinomoto-usa.com
Carlson Laboratories, (800) 323-4141, www.carlsonlabs.com
Centers for Disease Control and Prevention, http://circ.ahajournals.org/content/early/2012/12/12/CIR.0b013e31828124ad
Enzymedica, (888) 918-1118, www.enzymedica.com
Innate Response, (800) 634-6342, www.innateresponse.com
Life Extension, (800) 544-4440, www.lef.org
Team Up 4 Health, http://microclinics.org/team-up-4-health
The Magic of Discipline
The research from Pritikin Longevity Center & Spa isn’t just impressive; it’s almost incomprehensible.
A five-year follow-up of 64 men who came to the Pritikin Longevity Center instead of undergoing bypass surgery (the suggestion of their doctors) found that 80 percent never needed the surgery. The Archives of Internal Medicine evaluated the LDL cholesterol reductions of more than 4,500 men and women who attended the center. The average was 23 percent in three weeks.
That’s just the tip of the research; more can be found at www.pritikin.com. So, what’s the secret?
“A lot of this is common sense,” explained General Manager Hubert Wewer. “What we teach is discipline.”
That’s about the only thing you can’t get on the website, an information-packed resource on healthy living. “We believe in educating,”Wewer said. “We want visitors to our site to see that this is readily available.You can live the Pritikin lifestyle without stepping foot in class.”
Going to Pritikin is expensive. Through March 29, a one-week stay at the center costs $5,900 (though one can save $1,000 by sharing a room). But for that price, according to Wewer, “you immerse yourself in a cocoon of health.”
That means a lengthy one-on-one consultation with a physician; access to a variety of classes and fitness programs (including golf, but only if you walk the course); and learning the nutritional ins and outs of grocery stores and restaurants.
It’s all about eating, exercise and making the right choices. “The key here is the lifestyle,”Wewer said. “You come here and it’s 100 percent Pritikin. Afterward, you might live 80 percent of the ultimate lifestyle that we have here, so you will find that level where you’re comfortable.”
Those who look at Pritikin as a foolproof diet plan will be sorely disappointed in multiple ways. “A diet will inherently fail because it has a start date, so it has an end date,”Wewer observed.
“We consider Pritikin a lifestyle change program,”Wewer said.
Note:Wewer is offering a free online membership to Natural Practitioner readers.
Send an e-mail to mypritikin@pritikin.Com with “Natural Pratitioner” in the subject line, and include the following information:
• First and last name
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Improving cardiovascular health often requires major lifestyle and dietary changes—ones that practitioners must simplify for their patients.