Hu FB, Willett WC.
Optimal diets for prevention of coronary heart disease.
JAMA. 2002 Nov 27;288(20):2569-78. Review.
PMID: 12444864 [PubMed - indexed for MEDLINE]
Zittermann A, Schleithoff SS, Tenderich G, Berthold HK, Korfer R, Stehle P.
Low vitamin D status: a contributing factor in the pathogenesis of congestive heart failure?
J Am Coll Cardiol. 2003 Jan 1;41(1):105-12.
PMID: 12570952 [PubMed - indexed for M
Scientists say a natural supplement made from tomatoes, taken daily, can stave off heart disease and strokes.
The tomato pill contains an active ingredient from the Mediterranean diet - lycopene - that blocks "bad" LDL cholesterol that can clog the arteries.
This week sees the publication of yet another study showing the superiority of the low-carbohydrate diet as compared to the low-fat diet. This study, published in the prestigious American Journal of Clinical Nutrition, demonstrates that subjects following the low-carb diet experience a decrease in triglyceride levels and an increase in HDL-cholesterol (HDL) levels; and that these changes are accompanied by a minor increase in LDL-cholesterol (LDL), which prompts the authors to issue a caveat.
Yes, although just about all the parameters that lipophobes worry about improved with the low-carb diet, the small increase in LDL has caused great concern and has prompted the authors to gravely announce that this small increase is troublesome and should be monitored closely in anyone who may be at risk for heart disease. Since most people who go on low-carb diets do so to deal with obesity issues, and since obesity is a risk factor for heart disease, it would appear that this small increase in LDL often seen in those following a low-carb diet could put these dieters at risk. Does it? We'll see.
A new study by researchers at the University of Colorado Denver and Massachusetts General Hospital (MGH) shows vitamin D plays a vital role in reducing the risk of death associated with older age. The research, just published in the Journal of the American Geriatrics Society, evaluated the association between vitamin D levels in the blood and the death rates of those 65 and older. The study found that older adults with insufficient levels of vitamin D die from heart disease at greater rates that those with adequate levels of the vitamin.
Paradigms and Paradoxes
Last month Dr. Armin Zittermann of Ruhr University, Germany, published the best vitamin D paper of the month. He reviewed the mounting evidence that vitamin D deficiency is a major cause of heart disease. Zittermann A, Schleithoff SS, Koerfer R. Putting cardiovascular disease and vitamin D insufficiency into perspective. Br J Nutr. 2005 Oct;94(4):483-92.
Before we start, let's talk about paradigms and paradoxes. A paradigm is a set of assumptions, concepts, and practices that constitutes a way of viewing reality. The current paradigm is that heart disease is caused by a combination of genetics, hypertension, diabetes, cholesterol, smoking, obesity, inactivity, and diet. A paradox is a fact that contradicts the paradigm.
NEW ORLEANS, Nov. 10 -- Gram for gram, trans fatty acid from milk and meat may be as bad for the heart as it is from processed foods, Dutch researchers found.
In a randomized trial, a diet containing a high quantity of trans fats significantly increased cholesterol levels across the board whether from natural or "industrial" sources (P=0.014 to P<0.001), Ingeborg A. Brouwer, Ph.D., of VU University Amsterdam, and colleagues reported here at the American Heart Association meeting.
"Possible effects of berberine, a chemical found in small amounts in goldenseal, include headache, slow heart rate, nausea, vomiting, abdominal bloating, and low white blood cell count. It is not clear if the amount of berberine in goldenseal products is enough to cause these reactions. Toxic doses of berberine may cause seizures or irritation of the esophagus and stomach when taken by mouth. Berberine used intravenously (through the veins) may cause abnormal heart rhythms. Based on laboratory and animal studies, berberine may increase blood concentrations of bilirubin. Berberine theoretically may cause low blood pressure, although a different chemical in goldenseal, hydrastine, may actually cause increased blood pressure. There is limited study of the blood pressure effects of these agents in humans.
Based on laboratory and animal studies, the use of goldenseal or berberine could increase the risk of bleeding. However, there are no reliable published reports of bleeding in humans. Caution is advised in patients with bleeding disorders or taking drugs that may increase the risk of bleeding. Dosing adjustments may be necessary.
Based on an initial report, goldenseal or berberine may cause increased sun sensitivity, although this is not a commonly reported symptom.
Based on laboratory studies, berberine may lower blood sugar. Caution is advised in patients with diabetes or hypoglycemia, and in those taking drugs, herbs, or supplements that affect blood sugar. Serum glucose levels may need to be monitored by a healthcare provider, and medication adjustments may be necessary. "
Are statins analogues of vitamin D?
Grimes DS.
Lancet. 2006 Jul 1;368(9529):83-6. Review.
PMID: 16815382
doi:10.1016/S0140-6736(06)68971-X
There are many reasons why the dietary-heart-cholesterol hypothesis should be questioned, and why statins might be acting in some other way to reduce the risk of coronary heart disease. Here, I propose that rather than being cholesterol-lowering drugs per se, statins act as vitamin D analogues, and explain why. This proposition is based on published observations that the unexpected and unexplained clinical benefits produced by statins have also been shown to be properties of vitamin D. It seems likely that statins activate vitamin D receptors.
Research has uncovered the fact that vitamin K also plays a crucial role in maintaining bone health. It was found that the amount of vitamin K required to halt bone absorption leading to osteoporosis requires much greater intakes than that required for blood clot regulation. Further, it appears that bone and vascular tissue (like coronary arteries) maintain a preference for a different form of vitamin K than that required for blood clotting regulation. Rather than vitamin K1 needed for clotting, vitamin K2 is the form preferred by bones and arteries (Schurgers LJ et al 2001). It appears that much of the information generated over the years for vitamin K focused on the K1 form, ignoring the K2 form necessary for bone and vascular health.
Normal deposition of calcium occurs only in bone and in teeth. Abnormal deposition of calcium in the body occurs in three places: the inner lining of the arteries of the body (the intima) that causes atherosclerotic plaque; the muscle layer of arteries ("medial calcification"); and heart valves. K2 appears to be the form of vitamin K responsible for controlling these phenomena.
A diet rich in coconut oil reduces diurnal postprandial variations in circulating tissue plasminogen activator antigen and fasting lipoprotein (a) compared with a diet rich in unsaturated fat in women.
Müller H, Lindman AS, Blomfeldt A, Seljeflot I, Pedersen JI.
J Nutr. 2003 Nov;133(11):3422-7.
PMID: 14608053
In conclusion, our results indicate that a coconut oil-based diet (HSAFA-diet) lowers postprandial t-PA antigen concentration, and this may favorably affect the fibrinolytic system and the Lp(a) concentration compared with the HUFA-diet. The proportions of dietary saturated fatty acids more than the percentage of saturated fat energy seem to have a beneficial influence on Lp(a) levels.
The connection between Lp(a) and atherosclerosis is not entirely understood. Different studies have provided strong evidence that Lp(a) level is an independent risk factor for developing coronary artery disease in men (47,48), but the question of causality continues to be debated. Recent data suggest that Lp(a) might be atherogenic (49), in particular when combined with other risk factors. High levels of Lp(a) combined with other risk factors such as the ratio of plasma total/HDL cholesterol have been shown to increase the risk for coronary heart diseases (50). It has also been reported that when substantial LDL cholesterol reductions were obtained in men with coronary heart disease, persistent elevations of Lp(a) were no longer atherogenic or clinically threatening (51).
In conclusion, the present results show that the HSAFA-diet lowered postprandial t-PA antigen and thus potentially improved fibrinolysis compared with the HUFA-diet. Diets with either high or low levels of saturated fatty acids from coconut oil beneficially decrease Lp(a) compared with a HUFA-diet. The proportions of dietary saturated fatty acids more than the percentage of saturated fat energy may be of importance if the goal is to decrease Lp(a).
A 1999 meta-study of five studies comparing vegetarian and non-vegetarian mortality rates in western countries found the mortality rate due to ischemic heart disease 26% lower among vegans compared to regular meat eaters, but 34% lower among ovolactovegetarians and those who ate fish but no other meat. No significant difference in mortality was found from other causes.[84] A 2003 review of three studies comparing mortality rates among British vegetarians and non-vegetarians found only a nonsignificant reduction in mortality from ischemic heart disease, but noted that the findings were compatible with the significant reduction found in the 1999 review
The American Dietetic Association considers "appropriately planned" vegan diets "nutritionally adequate",[6] but poorly planned vegan diets can be deficient in nutrients such as vitamin B12,[87] vitamin D,[88] calcium,[88][89] iodine[90] and omega-3 fatty acids.[91] These deficiencies have potentially serious consequences, including anemia,[92] rickets[93] and cretinism[94] in children, and osteomalacia[93] and hypothyroidism[94] in adults.
"Coconut oil is extracted from the kernel or meat of matured coconut harvested from the coconut palm (Cocos nucifera). Throughout the tropical world it has provided the primary source of fat in the diets of millions of people for generations. It has various applications in food, medicine, and industry. What makes coconut oil different from most other dietary oils is the basic building blocks or fatty acids making up the oil. Coconut oil is composed predominately of a special group of fat molecules known as medium chain fatty acids (MCFA). The majority of fats in the human diet are composed almost entirely of long chain fatty acids (LCFA).
The primary difference between MCFA and LCFA is the size of the molecule, or more precisely, the length of the carbon chain that makes up the backbone of the fatty acid. MCFA have a chain length of 6 to 12 carbons. LCFA contain 14 or more carbon
Historically, many populations within the tropics have used coconut medicinally as a treatment for a wide variety of ailments.[8]
A study into the effects of a "diet rich in.." medium-chain fatty acids (such as in coconut oil and butter) concluded that "MCFAs in the form of MCTs significantly increased plasma triacylglycerol and LDL-cholesterol concentrations and the ratio of LDL to HDL cholesterol and thereby resulted in a less beneficial lipid profile overall."[9]
Further, research done by nutritionist Mary Enig has found that non-hydrogenated coconut oil (i.e. extra-virgin) consumed in moderate amounts "is at worst neutral with respect to atherogenicity of fats and oils and, in fact, is likely to be a beneficial oil for prevention and treatment of some heart disease."[10] The lack of negative effects of a diet rich in coconut oil on cardiovascular health is born out in studies of Polynesian populations who consume as much as 65% of their calories in the form of coconut oil and yet, have almost no incidence of heart disease and normal blood lipid profiles.[11]
"The Ornish diet was developed by Dean Ornish, M.D. Ornish was the first physician to demonstrate that heart disease can be reversed by natural methods, including specific dietary and lifestyle changes. Before Ornish published his clinical studies of patients whose cardiovascular problems were improved by diet and other means, doctors believed that heart disease was irreversible."
"Largest-ever meta-analysis finds CRP is unlikely to be causal for CVD
December 21, 2009 | Lisa Nainggolan
Cambridge, UK - In the largest and most comprehensive meta-analysis to date looking at C-reactive-protein (CRP) levels and risk of coronary heart disease (CHD) and stroke, British researchers conclude that CRP is unlikely to be a causal factor for cardiovascular disease [1].
Although CRP concentration was linearly associated with CHD, stroke, and vascular mortality, as well as nonvascular mortality, statistical adjustment for conventional cardiovascular risk factors "resulted in considerable weakening of associations," note the scientists of the Cambridge-based Emerging Risk Factors Collaboration (ERFC), who report their findings online December 21, 2009 in the Lancet.
In an editorial accompanying the paper [2], Drs S Matthijs Boekholdt and John JP Kastelein (Academic Medical Center, Amsterdam, the Netherlands) say the UK authors "are to be commended for this impressive data set." Although the findings "add weight to the evidence of noncausality" for a role of CRP in the development of cardiovascular disease, "the debate can be resolved only by randomized trials with agents that specifically target CRP, and such compounds are currently under development," say the Dutch doctors.
Commenting on the new meta-analysis for heartwire, Dr Paul Ridker (Brigham and Women's Hospital, Boston, MA), a long-time advocate of CRP and the lead investigator of the JUPITER trial, said: "Whether or not CRP is 'causal' for heart disease is neither the crucial issue at hand nor relevant for public health. What is crucial is getting international agreement that CRP identifies higher-risk individuals who would not otherwise qualify for a life-saving therapy, and then showing that such individuals clearly benefit from treatment. The new meta-analysis demonstrates the former, and JUPITER demonstrates the latter." "
Last week, Harvard researchers reported how healthy 50-year-old men and 60-year-old women could benefit from taking a statin even if they didn't have high cholesterol. The people they studied had high levels of C-reactive protein, or CRP, which is a marker for inflammation. The study showed that risk for major heart problems was cut by about 50 percent among the statin users.\n\nBut like many industry-sponsored drug studies, the results focused on something called "relative risk," which compares differences between study groups. Relative risk has the effect of exaggerating a drug's benefits. What does a 50 percent reduction in heart risk mean? It means that just one out of 120 statin users was helped by the drug.