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June 9, 2009 -- Genetic testing confirms that high levels of a type of cholesterol known as lipoprotein(a) are associated with an increased risk for heart attacks, but the clinical implications of the finding are unclear. Lipoprotein(a) has long been suspected of contributing to cardiovascular risk. But this new research offers the strongest evidence yet identifying it as an independent risk factor for heart attack. The study appears in the June 10 issue of the Journal of the American Medical Association.

ScienceDaily (June 9, 2009) - Overweight individuals who ate a low-calorie, low-carbohydrate diet high in plant-based proteins for four weeks lost weight and experienced improvements in blood cholesterol levels and other heart disease risk factors, according to a report in the June 8 issue of Archives of Internal Medicine, one of the JAMA/Archives journals. A high-carbohydrate, low-fat vegetarian diet also resulted in weight loss but without the additional cardiovascular benefits.

Derived from the bulb or clove of the plant. Garlic is used as a spice and to treat hyperlipidemia, hypertension, atherosclerosis, cancer, and infections. Processing can have a substantial effect on the chemical content in garlic; the volatile oil components are sensitive to heat and certain enzymes are acid-labile. Several oral garlic formulations are available, and clinical studies have addressed a variety of the proposed claims. Placebo-controlled trials on the cholesterol lowering effect of garlic yielded mixed results (16) (17) (18) (21) (22) (26). Studies evaluating the antithrombotic effects repeatedly have shown modest reduction in platelet aggregation, but varying levels of fibrinolytic activity. Research shows mixed effects with regard to reductions in blood glucose, blood pressure, or risk of cardiovascular disease (23). Frequently reported adverse events include bad breath, headache, fatigue, GI upset, diarrhea, sweating, and possible hypoglycemia (9). Because garlic is known to decrease platelet aggregation and potentially elevate the INR, it should not be used with anticoagulants or in patients with platelet dysfunction (15). Garlic appears to induce cytochrome p450 3A4 and may enhance metabolism of many medications (e.g. cyclosporin and saquinavir) (12). An analysis of several case-control studies in Europe suggests an inverse association between garlic consumption and risk of common cancers (25).

Biochemical effects of consumption of eggs containing omega-3 polyunsaturated fatty acids. Ohman M, Akerfeldt T, Nilsson I, Rosen C, Hansson LO, Carlsson M, Larsson A. Ups J Med Sci. 2008;113(3):315-23. PMID: 18991244 Addition of one regular egg per day to the normal diet had no negative impact on blood lipids or inflammation markers. Consumption of omega-3 enriched eggs resulted in higher levels of ApoA1, lower ApoB/ApoA1 ratio and lower plasma glucose. These effects have been associated in previous studies with a reduced risk for cardiovascular mortality and diabetes.

Fish consumption and risk of major chronic disease in men. Virtanen JK, Mozaffarian D, Chiuve SE, Rimm EB. Am J Clin Nutr. 2008 Dec;88(6):1618-25. PMID: 19064523 doi:10.3945/ajcn.2007.25816 Conclusions: Modest fish consumption was associated with a lower risk of total cardiovascular disease, consistent with cardiac mortality benefits but not with total cancer or overall major chronic disease; n-6 fatty acid consumption did not influence these relations.

March 27, 2009 - A significant decrease in serum 25-hydroxyvitamin D (25[OH]D) levels has led to an increase in vitamin D insufficiency in the US population, especially in racial and ethnic groups, according to results of a population-based study reported in the March 23 issue of the Archives of Internal Medicine. "Vitamin D insufficiency has been associated with increases in cardiovascular disease, cancer, and infection," write Adit A. Ginde, MD, from the Department of Emergency Medicine at the University of Colorado Denver School of Medicine, Aurora, Colorado, and colleagues. "Vitamin D supplementation appears to mitigate the incidence and adverse outcomes of these diseases and may reduce all-cause mortality." [...] "These findings have important implications for health disparities and public health," the study authors conclude. "Our data provide additional evidence that current recommendations for vitamin D supplementation (200-600 IU/d) are inadequate to achieve optimal serum 25(OH)D levels in most of the US population." They add that large, randomized controlled trials of higher doses of vitamin D supplementation are needed to evaluate their effect on general health and mortality.

ScienceDaily (Apr. 8, 2009) - According to a recent study in the Archives of Internal Medicine, 75 percent of Americans do not get enough Vitamin D. Researchers have found that the deficiency may negatively impact immune function and cardiovascular health and increase cancer risk. Now, a University of Missouri nutritional sciences researcher has found that vitamin D deficiency is associated with inflammation, a negative response of the immune system, in healthy women.

de Lorgeril M, Salen P, Martin J-L, Monjaud I, Delaye J, Mamelle N:\nMediterranean diet, traditional risk factors and the rate of\ncardiovascular complications after myocardial infarction. Final report of the Lyon Diet Heart Study.\nCirculation 1999, Febr

© 2005 Elsevier (Am J Cardiol 2005;96:810-814). After 3 months, the extent of stress-induced ischemia decreased in the pomegranate group but increased in the control group. This benefit was observed without changes in cardiac medications, blood sugar, hemoglobin A1c, weight, or blood pressure in either group. In conclusion, daily consumption of pomegranate juice may improve stress-induced myocardial ischemia in patients who have CHD. (Small sample; further study warranted with quantitative coronary arteriography + intravascular ultrasound.)

A Systemic Review of the Roles of n-3 Fatty Acids in Health and Disease. Riediger ND, Othman RA, Suh M, Moghadasian MH. J Am Diet Assoc. 2009 Apr;109(4):668-79. PMID: 19328262 doi:10.1016/j.jada.2008.12.022

Omega-3 fatty acids: a comprehensive review of their role in health and disease. Yashodhara BM, Umakanth S, Pappachan JM, Bhat SK, Kamath R, Choo BH. Postgrad Med J. 2009 Feb;85(1000):84-90. PMID: 19329703 doi:10.1136/pgmj.2008.073338