Submitted by: R. McElroy

Q: My Father passed away from a heart attack. I'm worried I might be going down the same road. Can you give me some suggestions on ways of preventing heart disease?

A: As a nation, we are doing a very poor job of keeping our hearts healthy. Heart disease and stroke together are responsible for at least 45% of all deaths in the United States. Cardiovascular disease (CVD) claims over 950,000 lives a year in the U.S., or an average of about 2,600 each day.¹ Both CVD and strokes are referred to as "silent killers" because the first symptom in many cases is death. Atherosclerosis (hardening of the arteries) is thought to be the cause. But what causes atherosclerosis? There is no doubt that in most cases atherosclerosis is a disease directly related to diet and lifestyle.

Total Cholesterol ­ Serves as a marker for both cardiovascular disease and oxidative stress. The incidence of heart disease increases as serum cholesterol levels increase.

Low Density Lipoproteins (LDL) ­ Major cause of coronary artery disease by promoting atherosclerotic plaque formation.

Homocysteine ­ A molecular abrasive to endothelial cells, causing atherosclerotic lesions and plaque formations.

Triglycerides ­ Powerful predictor of myocardial infarction (heart attack).

Lipoprotein (a) ­ Lp(a) has been cited as a better predictor of coronary disease severity than most other lipid parameters.

Apolipoprotein B ­ Indicator of premature coronary atherosclerosis. Ratio of Apo B/Apo A-1 ­ A higher ratio was found in sons of fathers with severe coronary atherosclerosis, and researchers suggest that the ratio be used to detect children who have an increased probability of developing severe atherosclerosis later in life.

Fibrinogen ­ Plays a key role in arterial occlusion (narrowing of the artery).

C-Reactive Protein ­ CRP is a marker for systemic inflammation, and is a strong predictor of myocardial infarction and stroke.

High Density Lipoproteins (HDL) ­ Commonly called the "good cholesterol," HDL promotes removal of cholesterol from peripheral tissues such as arterial walls.
Apolipoprotein A-1 ­ Higher levels of this protein are predictive of a decreased incidence of cardiovascular disease.

What You Can Do
Some general recommendations follow, but since so many factors are known to be involved in cardiovascular disease, any treatment plan must be individualized to assure optimal results.

Exercise. The better physical shape you are in, the greater your odds of enjoying a healthier and longer life. Most studies have shown that an unfit individual has an eight times greater risk of having a heart attack or stroke than a physically fit individual. Do something to increase your heart rate at least 3 to 4 times a week (racquet sports, swimming, cycling, hiking, dancing, or simplest of all brisk walking).

Limit your intake of refined carbohydrates (sugar). Read food labels for hidden added sugar content, such as sucrose, glucose, maltose, lactose, fructose, corn syrup, white grape juice concentrate, evaporated cane juice, etc. Refined carbohydrates also include bagels, pasta, crackers, chips, cookies, pastries, and other refined flour products. These types of "foods" elevate insulin levels and are associated with increased cholesterol, increased triglycerides, and increased blood pressure. To optimize insulin sensitivity exercise, lose weight, and consider supplementing with chromium and vanadium.

Eliminate your intake of margarine and partially hydrogenated oils. Read food labels and throw away foods that contain these ingredients, which are some of the worst products of human food manufacturing. Hydrogenated vegetable oils raise LDL cholesterol, lower HDL cholesterol and interfere with essential fatty acid metabolism. Use organic olive oil for sautéing and salad dressings.

Reduce the amount of saturated fat and salt in your diet. We pay a significant price for our consumption of burgers, fries, and high fat snacks (ice cream, pastries, etc.)

Eat five or more servings of fruits and vegetables a day. This is one of the easiest and most well known ways to avoid cardiovascular disease, but less than 10% of the population does it.

Increase your intake of soluble fiber, from a variety of fruits and vegetables, beans and grains (especially oat bran). Soluble fibers have been shown to both lower plasma cholesterol and modulate the rate of glucose absorption.

Increase intake of cold water fish (salmon, mackerel, herring, halibut), and take essential fatty acid supplements containing EPA and DHA. Among the many other health benefits, they lower cholesterol and triglycerides. Eat breakfast. Serum cholesterol is highest among those who skip breakfast.

Stop smoking. Need I say more? Okay, I will: People who smoke are three to five times more likely to develop heart disease and they will die seven to eight years sooner than a non-smoker will.

Cholesterol is a precursor to the major steroid hormones in the body: cortisol, DHEA, testosterone and estrogen. During times of stress there is a greater demand on the body to produce these steroid hormones. Both the release of cholesterol from tissue stores and increased cholesterol synthesis may occur as a response to chronic stress.⁴ If the stress does not subside, and an individual is eating the Standard American Diet (S.A.D. -consisting of high amounts of saturated fat, high amounts of refined, processed carbohydrates, and low levels of fiber) cholesterol can reach very unhealthy levels. In this situation cholesterol lowering drugs are not getting to the underlying cause of the problem. They are merely managing or suppressing the symptoms.

If diet, exercise and lifestyle modifications are not adequate for controlling cholesterol levels, there are natural products that can help keep the numbers in check. Perhaps the most natural and least invasive way to impact cholesterol levels is by adding fiber to the diet through food choices and supplements. A review article in the Journal of the American Dietetic Association concluded that soluble fiber supplementation was very effective in lowering cholesterol levels. If you currently have a low fiber diet, start out slowly with a dosage of between 1 to 2 grams before meals and at bedtime and gradually increase to 5 grams.

In preliminary clinical research, a patented nutritional supplement called Sytrinol balanced the production of cholesterol by the liver. It is theorized that the citrus polymethoxylated flavones block the HMG-coA reductase enzyme and the tocotrienols from Sytrinol inhibit production of a cholesterol precursor.

Policosanol is a natural substance extracted from sugar cane and bees wax. Studies have evaluated the effect of policosanol supplementation versus traditional cholesterol-lowering drugs in patients with elevated cholesterol and have found the results comparable to, or more significant than those of the traditional statin drugs in lowering cholesterol.^5-7 While the statin drugs cause adverse effects, such as myopathy, liver dysfunction, and suppression of coenzyme Q10 synthesis, policosanol produced no observable side effects.

Along with Sytrinol or policosanol, I usually recommend a non-flushing form of niacin (vitamin B3) called inositol hexaniacinate. Niacin is recommended by the National Cholesterol Education Program as the first "drug" of choice to lower blood cholesterol levels. One may ask what should be "alternative," a natural substance that strengthens and heals tissue (in addition to being effective), or a harmful synthetic drug with a long list of adverse side effects?

Some other substances which have shown to be positive for lipid balance and the heart are Garlic and garlic capsules.⁸

If you have been under chronic stress for an extended period of time and you have elevated cholesterol or a developing heart condition, do not just suppress the symptoms, work on the root cause. When the body is under oxidative stress, vitamin B-complex nutrients will help your body respond more appropriately to the stressors. An herb called rhodiola rosea has shown a lot of promise recently and may be considered for decreasing the signs and symptoms associated with stress.

Do your best to not become one of the statistics. Empower yourself to start implementing as many of the above recommendations as you can.

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13. Chang CT, et al. Potent fibrinolytic enzyme from a mutant of Bacillus subtilis IMR-NK1. J Agric Food Chem 2000 Aug;48(8):3210-6.