Heart Health: Are You at Risk?
The World Health Organization has recognized coronary heart disease (CHD) as the number one worldwide preventable killer. Every day approximately 120 Canadians and 1,500 Americans die of heart attacks. Millions more suffer non-fatal heart attacks.
Why is Prevention Key? Atherosclerosis (or hardening of the arteries) can start at a very young age and often we experience no obvious symptoms until they are more than 60% blocked, if at all.
Classical Risk Factors? The most well known risk factors are entirely preventable by lifestyle: smoking, hypertension, obesity, diabetes and elevated cholesterol. Smoking increases the risk of sudden cardiac death by tenfold in men and fivefold in women. Those with high blood pressure are two to three times more likely to sustain a heart attack. Excess weight in the truncal area makes us prone to heart disease. Having adult onset diabetes increases the risk twofold in men and four-to-six-fold in women.
Emerging Risk Factors? But we all know even thin people with normal cholesterol get heart attacks. If you have a strong family history or just want to be proactive there are some important new markers of risk that you can be screened for: fibrinogen, LP (a), homocysteine, fasting insulin and CRP. High fibrinogen levels indicate your blood is more likely to clot. High homocysteine levels are associated with a widespread aggressive form of arteriosclerosis. Elevated Insulin is much more common than we know since it is usually only tested for if someone is diabetic, and yet it can be elevated years before the onset of diabetes. C – reactive protein, a marker for inflammation, is a strong predictor of cardiovascular events in some studies. CRP is especially interesting as inflammation is emerging as trend underlying all chronic disease. Inflammation can be cause by fat tissue, by chronic low grade infections (such as non-symptomatic old root canals and/or H-Pylori bacteria, autoimmune conditions and more.
Under Emphasized Risk Factors? Growing evidence points to other diseases that are associated with an increased risk for heart disease: gout, polycystic ovarian syndrome, sleep apnea, autoimmune diseases and vitamin D deficiency. In my clinical experience vitamin D deficiency is epidemic and everyone should be tested.
Just emerging is evidence that testosterone may have anti-inflammatory effects which may point to a link between aging, reduced testosterone levels (especially in men) and inflammation which is underlying all disease including atherosclerosis. As we explore we may find heavy metal toxins such as lead, mercury, arsenic and cadmium have a significant role to play. A fascinating recent study points to lead as the leading cause of high blood pressure in menopausal women (see ‘Sizzling Studies’).
DIETARY MUST FOR HEART HEALTH
Much evidence points to three primary keys to diet and heart health:
- antioxidant
- fiber
- healthy oils
ANTIOXIDANTS
Without enough antioxidants our cells (including arterial walls) become damaged by oxidants (free radicals) contributing to CAD, aging, cancer and chronic disease in general. Some major contributors to this process are smoking, chronic infections, alcohol, environmental pollution and excessive UV light. A diet high in fresh fruits, vegetables, nuts, seeds and whole grains is key.
FIBER
A high fiber diet can lower cholesterol levels by as much as 10%, a major risk factor for CHD. Eating whole fruits instead of juices, and whole grains instead of refined grains, and more vegetable proteins (nuts, seeds, beans, lentils and tofu) instead of animal proteins (dairy, poultry and meat) can significantly raise our fiber intakes. Your diet should provide 20-30 grams daily.
OILS
Both fish oils and olive oil are important for our hearts and arteries. According to an epidemiological study done by the Danish, the Greenland Inuit have only 1/10th the incidence of heart attacks that their Danish counterparts had. The Inuit diet is largely composed of cold-water ocean fish, which provide an essential ingredient called omega-3 fatty acids. They are found in anchovies, herring, mackerel, salmon, sardines, tuna and white fish. VIRGIN olive oil down-regulates genes associated with atherosclerosis. Two tablespoons of unheated olive oil a day is a good amount.
