The Power of the Heart

The heart is a powerful & amazing organ. This fist sized, upside-down pear shaped organ is located under your rib cage & between your lungs. 

According to the Cleveland Clinic,

• The heart pumps about 5 quarts of blood each minute throughout the body. That’s approximately 2,000 gallons of blood each day.
• The heart beats about 100,000 times each day.
• Blood is about 78% water.
• It takes our blood about 20 seconds to circulate throughout the entire vascular system.

A healthy heart is vital for a happy & functional life. Unfortunately, today we’re experiencing growing rates of heart disease around the world. According to the Center for Disease Control & Prevention (CDC),

• Heart disease is the leading cause of death in the U.S. for men and women.
• About 600,000 Americans die from heart disease each year—that’s 1 in every 4 deaths (Kochanek, 2011).
• Coronary heart disease is the most common type of heart disease, killing more than 385,000 people annually (Kochanek, 2011).
• In the U.S., someone has a heart attack every 34 seconds. Each minute, someone in the U.S. dies from a heart disease-related event (Roger, 2012).
• Coronary heart disease alone costs the U.S. $109 billion each year (Heidenriech, 2011). This total includes the cost of health care services, medications, and lost productivity.

Heart Disease 101

Heart disease is a broad term, not a single disease, that is used to describe many possible conditions that affect your heart. These conditions/diseases include:

1. Arteriosclerosis: A hardening of the arteries
2. Atherosclerosis: Type of arteriosclerosis that includes buildup of plague (fats, cholesterol that deposit inside the artery walls that narrow them & restrict blood flow). This condition can lead to:
   • Coronary Artery Disease (CAD) or Coronary Heart Disease (CHD): Any disease affecting the arteries of the heart. Common symptoms include chest pain & heart attack.
   • Hypertension: High blood pressure. Pre-hypertension is defined as a systolic BP between 120-139mmHg or a diastolic ranging from 80-89mmHg.
     • Stage 1 hypertension: systolic of 140-159mmHg or diastolic of 90-99mmHg
     • Stage 2 hypertension: systolic >160mmHg or diastolic >100mmHg
   • Stroke: Blood clot or bleeding in the brain that cuts of oxygen supply
   • Transient Ischemic Attack: Milder, shorter form of a stroke
   • Heart Failure: Inability of the heart to pump sufficient blood to the body
   • Arrhythmias: Premature atrial contractions & ventricular contractions

Causes of Heart Disease

According to the CDC, high blood pressure, high LDL cholesterol, and smoking are key risk factors for heart disease & about half of Americans (49%) have at least one of these three risk factors. Several other medical conditions and lifestyle choices can also put people at a higher risk for heart disease, including:

• Diabetes
• Overweight and obesity
• Poor diet
• Physical inactivity
• Excessive alcohol use

However, there is a growing number of researchers including Jonny Bowden, PHD, CNS & Stephen Sinatra, MD, FACC who have called for a discontinuation of what they call "the perpetuated myth that cholesterol causes heart disease." Bowden & Sinatra claim this is a false believe & have begun dissecting the very studies from which this 'myth' originally stems (the Framingham Heart Study & Seven Countries Study, among others). They believe that at the very most, cholesterol is only a minor player in heart disease & it is a poor predictor of heart attacks. Cholesterol is only a problem & factor in heart disease risk when it is oxidized (Bowden & Sinatra, 2012).

From their research, we are learning that half of all people with heart disease have normal cholesterol levels, half of all people with elevated cholesterol have healthy hearts & lowering cholesterol (a vital & basic raw material made by the liver, brain, & almost every cell in our bodies) has extremely limited benefits (Bowden & Sinatra, 2012).

What is Cholesterol?

1. Cholesterol is a waxy substance (known as a sterol) that is an important constituent of cell membranes & is mostly made in the liver, if enough is not included in the diet.

2. Cholesterol helps digest fats & fat-soluble vitamins (A, D, E, K), strengthens cell membranes, & insulates nerves.

3. Cholesterol is used by the body to make vitamin D, sex hormones like estrogen, progesterone, & testosterone (so it’s important for fertility), & the bile acids needed for digestion.

According to Uffe Ravnskov, a leading researcher on cholesterol, the effect of lowering dietary cholesterol intake on blood cholesterol is only about 0.5%.  So why are we often advised to lower our levels of dietary cholesterol & limit nutrient-dense, health-promoting foods like farm fresh eggs & grass-fed meat?

The Real Culprits of Heart Disease

Research is now showing that fat, especially saturated fat, & cholesterol have been incorrectly vilified in the fight against heart disease. Instead the real culprits are oxidation, inflammation, sugar, & stress (Bowden & Sinatra, 2012).

1. Oxidation
   • Oxidation is one of the prime initiators of inflammation through the creation of free radicals that can cause damage to your cells & DNA
2. Inflammation

   • Inflammation is initiated by damage from free radicals (oxidative stress)

   • Antioxidants like vitamins A, C, E & the minerals selenium & zinc help neutralize free radicals

3. Sugar

   • The number one dietary contributor to heart disease 

   • Creates inflammation in artery walls

   • High intake of sugar drives up the hormone insulin, which raises blood pressure & increases cholesterol

   • Sugar raises triglycerides

   • When sugar in the bloodstream sticks to proteins, it creates damaging and toxic molecules called advanced glycation end products (AGEs)

4. Stress

   • Contributes to every known disease

   • When under stressful conditions, your body releases stress hormones (mainly cortisol & adrenaline)

   • Excess stress hormones can create inflammation & contribute to heart disease

   • When stress is chronic, too much cortisol in the blood begins to promote hardening of the arteries

A Better Predictor of Heart Disease Risk

According to Bowden & Sinatra, instead of looking at cholesterol levels to determine your risk for heart disease or in order to determine whether or not prescription medication is needed (ie: statins), a better predictor of heart disease is to look at your level of triglycerides & HDL on your blood test.

A study from Harvard University published in Circulation, a journal published by the American Heart Association, showed that those with the highest triglyceride to HDL ratio had a 16 times greater risk of developing heart disease as those with the lowest ratios (Gaziano, 1997).

Therefore, taking those two numbers & calculating the ratio of triglycerides to HDL will give you a good sense for your risk. A ratio of approximately 2 is good, regardless of cholesterol levels. A ratio higher than that is cause for potential concern.

Example: triglycerides of 200 mg/dL & HDL of 50 mg/dL equals a ratio of 4

Game Plan for Detecting Your Risk & Promoting Heart Health

Many forms of heart disease can be prevented or treated with healthy diet & lifestyle choices to address oxidation, inflammation, sugar & stress.

1. The standard total cholesterol reading may not be a good indicator of heart disease risk. Below are several tests you should ask from your medical practitioner in order to properly access your risk:
   • Particle Size Test
   • C-Reactive Protein (CRP)
   • Blood Pressure
   • Fibrinogen
   • Serum Ferritin
   • Lp(a)
   • Homocysteine
   • Interleukin-6
   • Coronary Calcium Scan
2. Eliminate health bandits from your diet & pro-inflammatory foods like:
   • Food sensitivities (gluten, peanuts, soy)
   • Sugar
   • Pop
   • Processed foods
   • Highly refined carbohydrates
   • Trans fats
   • Highly processed, conventionally raised meats
   • Refined vegetable oils that may be oxidized or rancid
3. Include health heroes in your diet & anti-inflammatory foods like:
   • Omega-3 rich foods like wild salmon
   • Low glycemic, antioxidant rich berries
   • Grass-fed meat
   • Organic vegetables
   • Nuts
   • Garlic
   • Turmeric
   • Green tea
   • Resveratrol rich red wine
4. Make lifestyle changes to lower stress:
   • Meditate
   • Deep breathing exercises
   • Yoga
   • Time with family & friends

References:

Bowden, J & Sinatra, S. (2012). The Great Cholesterol Myth: Why Lowering Your Cholesterol Won’t Prevent Heart Disease – And the Statin-Free Plan That Will. Beverly, MA: Fair Winds Press.
Gaziano, J.M. et al. (1997). Fasting Triglycerides, High-Density Lipoprotein, & Risk of Myocardial Infarction. Circulation 96, no. 8: 2,520-25.
Heidenriech PA, Trogdon JG, Khavjou OA, Butler J, Dracup K, Ezekowitz MD, et al. Forecasting the future of cardiovascular disease in the United States: a policy statement from the American Heart Association. Circulation. 2011;123(8):933–44.
Kochanek KD, Xu JQ, Murphy SL, Miniño AM, Kung HC. Deaths: final data for 2009 . National vital statistics reports. 2011;60(3).
Murray, M. (2012). The Encyclopedia of Natural Medicine. New York: Atria Books.
Ravnskov, Uffe. High Cholesterol May Protect Against Infections & Atherosclerosis. QJM: An International Journal of Medicin. Volume 96, Issue 12, Pgs 927-934
Roger VL, Go AS, Lloyd-Jones DM, Benjamin EJ, Berry JD, Borden WB, et al. Heart disease and stroke statistics—2012 update: a report from the American Heart Association.Circulation. 2012;125(1):e2–220.
Topol EJ (ed). Cleveland Clinic Heart Book (2000) New York: Hyperion.
Wang, C. (2013). Role of vitamin D in cardiometabolic diseases [Abstract]. J Diabetes Res, 2013: 243934. doi:10.1155/2013/243934