It may surprise you to learn that many risk factors traditionally thought to be predictive of heart disease are not holding up with current research. A report from the American Journal of Critical Care found that 50% of the patients with coronary artery disease do not have any of the traditional risk factors.1 For example, it is now understood that C-reactive protein, a measure of overall body inflammation, is more indicative of someone’s risk of heart disease than cholesterol. In fact, most people (over 80%) who experience a heart attack do not have elevated cholesterol levels.2 Focusing on what we now know to be the underlying causes of heart dysfunction has opened the doors to understanding what nutrients allow the heart and circulatory system to work at their best – attack free!
Research is finding that the real underlying culprits of heart disease are free radical damage, excess inflammation, elevated homocysteine, and insulin imbalance. It is thought that atherosclerosis (thickening of the arterial walls) is the most common cause of heart disease.3 Substances, such as collagen, triglycerides, and cholesterol adhere to arterial lining only after it has been damaged by some prior causative factor.4,5 Damage can result from nutrient deficiencies (e.g. vitamins C, E, and magnesium), sudden high blood pressure episodes brought on by stress, and free radicals. These highly-reactive free radical molecules are generated in the body from compounds like drugs, preservatives, exhaust fumes, cleaning fluids, rancid fats, alcohol, emotional and physical stress, chlorinated drinking water, heavy metals, and radiation (X-rays or excess sun exposure).3 Thankfully we have nutrients called antioxidants to help combat their effects.
Research is rapidly redefining coronary artery disease as an inflammatory disease of the blood vessels.6 A clear demonstration of this relationship is the fact that the use of anti-inflammatory drugs (namely aspirin) help lower the risk of a heart attack. Due to the serious and sometimes life-threatening side effects associated with the use of these drugs long-term, they are not the best option for prevention. The New England Journal of Medicine recently published three articles showing that the presence of blood markers of inflammation are strong predictive factors for determining coronary artery disease risk.7,8,9 Those with high levels of the protein fibrinogen, one of the inflammatory markers, are more than twice as likely to die of a heart attack. Another inflammatory marker, C-reactive protein, indicates an increased risk for destabilized atherosclerotic plaque and abnormal arterial clotting. One study has shown that people with high levels of C-reactive protein are almost three times as likely to die from a heart attack.10
Research suggests homocysteine plays a significant role in damaging artery walls. Homocysteine is naturally produced in the body as a normal by-product of the conversion of the amino acid methionine to the amino acid cysteine. Problems arise when homocysteine accumulates due to a deficiency of the nutrients necessary for it to fully metabolize, namely folic acid, B6, and B12. High homocysteine levels prevent the normal repair process of the artery wall, and actually irritate the muscles of the arteries and encourage plaque formation. One study involving almost 15,000 doctors found that men who had homocysteine levels 12% above average had three and a half times the risk of suffering a heart attack than men with lower levels, regardless of other risk factors for cardiovascular disease.11,12
Finally, excess insulin is intimately linked with the processes leading to the build-up of plaque in the arteries. When carbohydrates (found abundantly in sugars, flours and starchy foods like potatoes) are consumed, they are broken down into glucose (a sugar), which triggers the release of insulin. Insulin is the hormone responsible for moving glucose out of the blood stream and into the cells of the body so it can be burned for energy. It is also responsible for converting any glucose that is leftover into triglycerides (fats) and cholesterol. It is normal for this conversion to occur to some extent; however, when the diet supplies excess carbohydrates, insulin levels are elevated and so is the production of triglycerides, which is a major risk factor for plaque formation. Other factors that raise insulin levels are stress, dieting, caffeine, alcohol, aspartame, tobacco, steroids, stimulant and other recreational drugs, lack of exercise, excessive and/or unnecessary thyroid replacement therapy and some over-the-counter prescription drugs.
Perhaps some of the most controversial topics surrounding heart health have stemmed from different foods. Are eggs good or bad? Should one eat fat-free or high-protein? There are doctors in the media touting all different types of diets, so how do you know what is right for you? It boils down to two main concepts, individuality and consuming whole, traditional foods. The latest research is firmly establishing that the best diet for overall health is based on traditional foods. Our bodies were not designed to handle processed flours and sugars, hydrogenated oils, and soda all day long. Beyond eating whole foods, you have to decide what diet plan works best for your individual genetic makeup thru experimentation.
It is often thought that, in general, fats are bad and grains are good for the heart. However, studies have found that total fat intake, independent of type, is not strongly associated with coronary heart disease. However, trans-fatty acids (those found in margarine and most processed/packaged foods) raise LDL cholesterol and result in a reduction of HDL. In other words, the type of fat, not the total fat, is the significant factor.14 In regards to grains, it has also been determined that diets high in refined carbohydrates, such as sugars and flours, increase inflammation. In one study, women eating large amounts of potatoes, breakfast cereals, white bread, muffins, and white rice had elevated C-reactive protein levels, indicating high levels of inflammation and an increased risk of heart disease. Overweight women who ate a lot of these foods had the highest and most dangerous C-reactive protein levels. Not only do these carbohydrate-rich foods increase inflammation and cause blood sugar imbalances, they also displace far healthier foods, such as anti-inflammatory vegetables, fruits, grass-fed meats, and fish.15
When supporting the heart, it is important to focus on reducing free radical damage, quenching inflammation, reducing homocysteine, and stabilizing insulin. Bringing these body functions into balance will optimize heart function and improve circulation. Vitamin C works as an antioxidant and helps reduce inflammation. In a study of more than 11,000 Americans who were tracked for an average of 10 years, those supplementing with an average of 300 mg vitamin C daily reduced their risk of heart disease by one-third.16 In another study, heart disease patients given 2000 mg a day of vitamin C had a 27% decrease in the platelet aggregation, a 12% reduction in total cholesterol, and a 45% increase in fibrinogen breakdown activity.17
Alpha Lipoic Acid improves blood sugar metabolism, insulin sensitivity,18,19,20,21 and functions as a powerful antioxidant.22 Lipoic acid also acts as a heavy metal chelating agent, which has the ability to grab and bind metallic substances, neutralize them, and carry them to a place where they can be excreted from the body. Excess heavy metals contribute to our oxidative stress load, which play into cellular damage and disease.
Vitamin E reduces blood clotting23 and is an antioxidant that protects cell membranes and other fat-soluble parts of the body, particularly LDL cholesterol.24 Only when LDL is damaged (oxidized) does cholesterol appear to contribute to heart disease. The most commonly recommended dose of vitamin E for adults is 400 to 800 IU per day.27
Homocysteine-Reducers. Foods rich in B complex vitamins include brewer’s yeast, eggs, meats, fish, nuts and seeds, and dark leafy greens. Overall, supplementing with a full spectrum B complex vitamin is a good idea to ensure adequate intake of these vital nutrients for maintaining healthy homocysteine levels.25 More specifically, research supports the daily use of 1 mg of folic acid, 10 mg of vitamin B6, and at least 400 mcg of B12 to modulate homocyseine levels. ii
Fish Oil contains EPA and DHA, powerful fatty acids that reduce blood clotting and have inflammation modulating activity.27 For most individuals, one to two tablespoons of cod-liver oil is optimal, or try another fish oil product and follow the directions on the bottle. In addition, people who supplement with fish oil should take additional vitamin E supplements to protect EPA and DHA within the body from oxidative damage.29
Carnitine helps the heart work more effectively. The heart is highly dependent on the energy produced from fatty acids for normal functioning. Carnitine is the “key-master” for fatty acids to enter the cell. This nutrient also lowers triglycerides and raises HDL cholesterol.30 31 The daily dosage of carnitine (a.k.a. L-carnitine) is typically between 1,500 and 4,000 mg in divided doses.32
Coenzyme Q10 (CoQ10) protects the body from free radicals33 and helps preserve vitamin E.34 It is found in the greatest concentrations in the heart and liver, and is used by the body to transform food into energy. It can increase the heart’s tolerance to a lack of oxygen36 and appears to modulate blood pressure by reducing resistance to blood flow.35 CoQ10 is found primarily in fish and meat, but the amounts in food are far less than what can be obtained from supplements. Cardiologist Stephen Sinatra recommends 90-150 mg daily for basic adult supplementation and for people with specific health conditions up to 600 mg a day (with the involvement of a physician).
Other nutrients that may need to be considered in addition to a multiple vitamin and mineral include magnesium, niacin, calcium, potassium, selenium, thiamine, vitamin A, beta-carotene, and zinc.
Hawthorn is thought to exert many beneficial effects on the heart and blood vessels. These include improved blood flow and strengthening of the contractions of the heart muscle.37 Hawthorn may also improve circulation to the extremities by lowering the resistance to blood flow in peripheral blood vessels.38 The bioflavonoids in hawthorn are potent antioxidants.39 Many doctors recommend 80 to 300 mg of the herbal extract in capsules or tablets two to three times per day.40
Turmeric has been shown to modulate platelet aggregation41 as well as inflammation.42 A standardized extract of turmeric supplying 400 to 600 mg of curcumin, the active constituent, can be taken three times per day in capsules or tablets.43 Turmeric as a spice can also be incorporated into the diet.
Garlic helps inhibit inappropriate blood clotting as well as reduce blood pressure, triglycerides, and LDL cholesterol levels while increasing HDL cholesterol.44,45 This pungent herb also has antioxidant properties and protects the heart from insufficient blood flow.46
Don’t forget to exercise! A study published in the journal Circulation in 1999 is a terrific example of the power of physical movement. The study, involving 2,600 men, found a 15% decrease in heart disease risk for every half mile walked per day. The men who walked one and a half miles or more per day had less than half the rate of heart disease compared to those who walked less than a quarter mile per day.47 The body was meant to move!
There are many nutrients involved in keeping one’s ticker running smoothly and efficiently. The first place to start is with diet and then it may be appropriate to include certain nutrient supplements into your heart support program for long-term health and disease prevention.
Note: This information is not to be taken as medical advice. If you are taking any prescription medications, consult a holistic doctor before incorporating supplements.