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Natural Heart Attack Protection

November 11, 2009 Written by JP       [Font too small?]

Perhaps you’ve seen the series of commercials promoting Lipitor (atorvastatin) while watching your favorite TV shows. Lipitor is a cholesterol lowering medication that, according to the October 2009 edition of the AARP Bulletin, had sales of over $5.88 billion in 2008 alone. Needless to say, that buys a lot of advertising time. One of the major points made in these “heart to heart” adverts is that this prescription drug can lower “bad” (LDL) cholesterol levels by 39%-60%. The implication is that lowering LDL cholesterol can help reduce the risk of heart attacks and strokes. But there’s an emerging body of evidence that suggests that another measure of cardiovascular health should come to the forefront when assessing heart attack risk.

All the way back in 1992, scientists at a “health consensus conference” set up by the National Institutes of Health were discussing the possibility that high triglycerides and low HDL cholesterol may be a key factor in promoting heart disease. At that point, there was only suggestive data to support this theory. The conclusion of that meeting was that patients should be urged to use diet, exercise, smoking cessation and weight loss “to lower TG (triglycerides) and/or raise HDL”. Since then, several major studies in both men and women have strengthened the connection between the “triglycerides-to-high-density lipoprotein cholesterol ratio” (TG/HDL). (1)

  • A study in the November 2009 issue of the American Journal of Cardiology examined the link between high triglycerides/low HDL cholesterol and first time heart attacks in a group of 2,288 middle-aged men. The authors concluded that, “the TG/HDL ratio has a high predictive value of a first coronary even regardless of BMI (body mass index)”. Another study conducted on 1,824 younger men determined that those with the least desirable TG/HDL ratios were 75% more likely to suffer from coronary heart disease. This particular trial followed the participants for an average of 6.5 years. (2,3)
  • The TG/HDL ratio also appears to be a reliable marker for cardiovascular health in women. Recent research from the University of Alabama at Birmingham examined 544 middle-aged women who had never had a heart attack or heart related surgery. Over the course of approximately 6 years, the female participants were monitored via blood tests, coronary angiography and standard physical exams. There were a total of 33 deaths and 83 “cardiovascular events” during the test period. The strongest association found between health markers and heart risk was the triglyceride/HDL ratio. The researchers determined that a high TG/HDL ratio was responsible for a 95% increased risk of mortality and a 54% elevation in cardiovascular events. An Italian trial from 2005 found a “quadrupled risk of mortality” in elderly women with that same combination of high triglycerides and low HDL cholesterol. (4,5)

The American Heart Association defines low HDL cholesterol as under 40 mg/dL for men and 50 mg/dL in women. An HDL level of 60 mg/dL or higher is mentioned as possible protection against heart disease. The AHA suggests keeping triglycerides below the 150 mg/dL mark. (6)

Based on this information, I’ve searched through the scientific literature to find some natural options that might improve the aforementioned TG/HDL ratio. While doing so, I came across some research about a relatively obscure supplement that seems to benefit the heart in multiple ways.

Astaxanthin is a reddish pigment (carotenoid) that possesses potent antioxidant properties. If you’ve eaten wild salmon, then you’ve consumed astaxanthin. It is this carotenoid that provides salmon with its distinctive color. From a supplement standpoint, astaxanthin is generally derived from an algae known as Haematococcus pluvialis (pictured above) or krill oil.

A study that appears in the October 14th issue of the journal Atherosclerosis examined the effects of various dosages of astaxanthin on HDL cholesterol levels. 61 “non-obese subjects” with normal triglycerides and varying ages (25-60 years old) participated in this 12 week experiment. The test subjects were split up and given 0 mg, 6 mg, 12 mg or 18 mg of astaxanthin daily. The 12 mg dosage was found to be the most effective means of both lowering triglycerides and elevating HDL levels. The researchers also discovered an increase in serum adiponectin, a hormone that assists the body in maintaining healthy blood sugar and lipid levels. Previous trials in animals and humans substantiate this lipid modifying effect. (7,8,9)

But there’s significantly more to the astaxanthin story than just HDL cholesterol. Other research shows that this valuable pigment can prevent lipid peroxidation in humans, which may lower the risk of arterial plaque accumulation. A study currently underway is investigating its effect on arterial stiffness in high-risk patients. In addition, astaxanthin reduces systemic inflammation that may promote the progression of cardiovascular disease. Lastly, it appears to be free of serious adverse effects, with several human studies to support its positive safety profile. (10,11,12,13,14,15)

Effects of 4 mg of Astaxanthin on Cardiovascular Risk Markers

(A) Systolic Blood Pressure (B) Diastolic Pressure (C) Triglycerides (D) Blood Glucose

Source: J Clin Biochem Nutr. 2009 May; 44(3): 280–284. (link)

When it comes to high triglycerides, lifestyle changes are probably the best way to address the issue. Recent studies indicate that cutting back on most sweeteners is a good start. The December 2009 issue of the journal Physiology and Behavior determined that feeding rats agave syrup, fructose and high fructose corn syrup significantly increased their triglyceride levels. This effect was not apparent when the same rats were given the natural, non-caloric sweetener stevia. Similar findings are evidenced in humans who are fed experimental diets rich in crystalline fructose. The take home message is clear: reduce your intake of caloric sweeteners and processed foods that contain them and your cardiovascular system will thank you for it. (16,17)

Some people have significantly elevated triglycerides. If you’re one of them, there are two additional techniques that may drastically improve your situation. A recent study conducted at the University of Connecticut, Storrs discovered that a low carbohydrate diet (20-25% carbohydrates, 50-55% fat and 25-30% protein) lowered triglyceride levels by 39% in a group of 39 men and women over the course of 12 weeks. A separate trial published in August 2009 found that short term (10 day) exposure to a “paleolithic, hunter-gather type diet” (containing fruits, nuts, meat and vegetables only) brought about “large significant reductions in total cholesterol, low-density lipoproteins (LDL) and triglycerides”. (18,19)

Another powerful tool that can decrease triglyceride concentrations can be found at your local health food store or almost any pharmacy. High potency fish oil concentrates are available over-the-counter and via your doctor’s prescription pad. A recent medical review points out that 4 grams of fish-based omega-3 fatty acids (totaling 1,395 mg of EPA and 1,125 DHA) “can effectively decrease TG (triglyceride) levels by up to 45%, and is generally well tolerated”. The prescription variety fish oil is typically much more expensive, unless your insurance covers part of the cost. (20,21)

If a third-line approach is needed, you might try emphasizing dietary fiber in your menu plan or including it as a supplement. Some preliminary evidence suggests that adding fiber to a healthy diet may lower TGs. The upside of this strategy is that, generally, fiber is also thought to lower LDL cholesterol and can possibly reduce inflammatory substances such as C-reactive protein which may also contribute to poor cardiovascular health. (22,23)

In closing, I want to add that staying physically active is almost always a good idea if you’re concerned about your heart or any aspect of your health. There’s a lot of evidence that supports this link. For instance, 30 minutes of brisk walking can offset some of the ill effects of occasionally eating too much sugar. 6 months worth of Kung Fu training can lower long term blood sugar levels (HbA1c), total cholesterol and triglycerides. As little as 8 weeks of high-intensity interval training is effective in improving the TG/HDL ratio. There really are many natural and safe options for improving heart health. I’m not saying that prescription medications such as Lipitor don’t have a place in medicine. There may be instances where a cardiologist truly believes that they’re the best option. However, today’s column presents an alternative to what you’re likely to be prescribed. If you mention to your doctor that you’d like to try out something different first, he just might be willing to support your decision. At the very least, that option should exist. It is, after all, your body. (24,25,26)

Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!

Be well!

JP

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25 Comments & Updates to “Natural Heart Attack Protection”

  1. liverock Says:

    Dr William Davis, a cardiologist, thinks that wheat is the main problem with low HDL and high trigs.

    “Too many wheat products, including breakfast cereals, sandwiches,crackers,cookies,waffles and cakes can lower HDL and raise trigs as well as blood sugar levels. Wheat is also responsible for the high amount of “small LDL” which is the artery clogging part of LDL.
    It also raises CRP(inflammation)levels and is also responsible for the increase in abdominal fat which should really be called wheat belly.”

  2. Nina K. Says:

    cool “wheat belly” :-) lol

  3. JP Says:

    Good day, Liverock.

    I really like Dr. Davis. I think his approach to managing cardiovascular disease (and health) is about as solid a strategy as I’ve ever seen.

    I personally avoid wheat but I suspect that there’s more to the picture than just that one grain. I know too many low carbers who regularly include foods that contain (wheat) gluten such as low carb tortillas, bread and other baked goods who have excellent TG/HDL ratios.

    There may be a “tipping point” involved here. Some people eat a lot of wheat-based foods. Perhaps it’s a matter of quantity and the overall composition of the rest of their diet that makes a difference as well. Just my hunch! :)

    Be well!

    JP

  4. JP Says:

    Nina,

    I wonder how many “beer bellies” are actually “wheat bellies”? :)

    Be well!

    JP

  5. liverock Says:

    When you think about it beer is really wheat and sugar fermented so wheat belly may be more accurate.

  6. liverock Says:

    Another interesting point made by Dr Davis. According to his own testing with patients, high HDL on its own does not lower the smaller LDL particles which cause artery plaque build up, only lowering wheat intake as well seems to do that.

  7. Dr. Bill Rawls Says:

    Thanks for the great information, JP. Your article is of great interest to me, as I have been researching alternative cholesterol testing to offer my patients. Abnormal cholesterol levels present a real quandary for wellness-based physicians like myself. Representing only one indicator of risk, cholesterol levels do not define the degree of arterial stiffness, which (in my opinion) is the problem at the root of many heart attacks and strokes.

    My preliminary research suggests that omega-3 testing shows great promise. As a big believer in the benefits of fish oil, this measurement of the ratio of omega-3 fatty acids to omega-6 fatty acids is one test that I would like to see go mainstream. However, while valuable, this test still doesn’t answer the million-dollar question: “What is the patient’s cardiovascular risk from the actual degree of arterial stiffness already present?”

    Performed with the SphygmoCor system, a measurement called pulse wave analysis shows the physician and patient the effect of arterial stiffness on central blood pressure. The analysis is performed by pressing a sensor against the strongest pulse point on the patient’s wrist. The SphygmoCor system displays the pressure wave form as it exists in the ascending aorta and also produces a wealth of data, including central blood pressure and numerous measurements of arterial stiffness.

    I have just brought this SphygmoCor equipment to my practice on a trial basis during Nov/Dec. Will keep you posted on my findings! More info on SphygmoCor– http://www.atcormedical.com. Thanks JP!

  8. JP Says:

    Good points, Liverock. Thanks for pointing them out! :)

    Be well!

    JP

  9. JP Says:

    Fascinating information, Bill! Thanks for sharing it! I’d really love to read about your personal experiences with the SphygmoCor system. Please report back! :)

    Be well!

    JP

  10. Julia Says:

    I think that wheat is making our body stronger.But we have to eat not so much it.

  11. JP Says:

    Julia,

    I personally find that I do better without any wheat.

    I certainly agree that your second statement.

    Be well!

    JP

  12. Edwin Says:

    Thanks for sharing. I absolutely agree that one way of reducing triglycerides levels is by taking fish oil regularly.

  13. JP Says:

    Thanks, Edwin. We agree. :)

    Be well!

    JP

  14. Tommy Says:

    Well JP, I have read through most of your articles in the past few hours and I must say you really have me thinking! At the age of 29 now I have some major changes that must happen. I became divorced at the age of 25 and went through a tough cycle in life. Between weight gain, restarting smoking, terrible diet, little exercise, minimal sleep, etc my doctor told me on my most recent physical things needed to change.

    I was put on an ADD, Anxiety, Depression medication and was told my cholesteral is through the roof, my BP is high and my lifestyle is out of whack! Now I am trying to focus on getting healthy finally. What I have gotten out of all these articles is obviously I need weight loss but for cholesteral I should be taking fish oil pills, EVOO pills daily, long release garlic pills, and eat kiwi daily. Does that sound extreme or would you agree that should be apart of my new lifestyle? I’m just looking for some general thoughts and advice to get me pointed in the right direction.

    Thanks for all your knowledge in this website!

    Tommy

  15. JP Says:

    Tommy,

    Good on you for making so many positive changes in your life.

    Your program doesn’t seem extreme to me. Here are a few options that I would consider if I were in a similar circumstance:

    For high blood pressure, cholesterol and general wellness: a) a low carbohydrate, whole food diet that’s naturally rich in fiber, low glycemic fruits and vegetables and omega-3 fatty acids; b) daily or almost daily exercise and stress management techniques such as meditation and walking; c) select supplements including fish oil or krill oil and a multivitamin for starters.

    I opt to get my garlic and extra virgin olive oil via my diet instead of supplementation. Also, a few foods that merit special mention under the given circumstances: avocados and tree nuts (almonds, pecans, walnuts, etc.). Excellent for the cardiovascular system. To drink? An occasional glass of organic red wine and tea (green or white tea, ginger, hibiscus, rooibos, etc.).

    Be well!

    JP

  16. JP Says:

    Update: Low carb diets are an effective way to lower triglycerides and raise HDL cholesterol …

    http://annals.org/article.aspx?articleid=1900694

    Ann Intern Med. 2014 Sep 2;161(5):309-18. doi: 10.7326/M14-0180.

    Effects of low-carbohydrate and low-fat diets: a randomized trial.

    BACKGROUND: Low-carbohydrate diets are popular for weight loss, but their cardiovascular effects have not been well-studied, particularly in diverse populations.

    OBJECTIVE: To examine the effects of a low-carbohydrate diet compared with a low-fat diet on body weight and cardiovascular risk factors.

    DESIGN: A randomized, parallel-group trial. (ClinicalTrials.gov: NCT00609271).

    SETTING: A large academic medical center.

    PARTICIPANTS: 148 men and women without clinical cardiovascular disease and diabetes.

    INTERVENTION: A low-carbohydrate (<40 g/d) or low-fat (<30% of daily energy intake from total fat [<7% saturated fat]) diet. Both groups received dietary counseling at regular intervals throughout the trial.

    MEASUREMENTS: Data on weight, cardiovascular risk factors, and dietary composition were collected at 0, 3, 6, and 12 months.

    RESULTS: Sixty participants (82%) in the low-fat group and 59 (79%) in the low-carbohydrate group completed the intervention. At 12 months, participants on the low-carbohydrate diet had greater decreases in weight (mean difference in change, -3.5 kg [95% CI, -5.6 to -1.4 kg]; P = 0.002), fat mass (mean difference in change, -1.5% [CI, -2.6% to -0.4%]; P = 0.011), ratio of total-high-density lipoprotein (HDL) cholesterol (mean difference in change, -0.44 [CI, -0.71 to -0.16]; P = 0.002), and triglyceride level (mean difference in change, -0.16 mmol/L [-14.1 mg/dL] [CI, -0.31 to -0.01 mmol/L {-27.4 to -0.8 mg/dL}]; P = 0.038) and greater increases in HDL cholesterol level (mean difference in change, 0.18 mmol/L [7.0 mg/dL] [CI, 0.08 to 0.28 mmol/L {3.0 to 11.0 mg/dL}]; P < 0.001) than those on the low-fat diet.

    LIMITATION: Lack of clinical cardiovascular disease end points.

    CONCLUSION: The low-carbohydrate diet was more effective for weight loss and cardiovascular risk factor reduction than the low-fat diet. Restricting carbohydrate may be an option for persons seeking to lose weight and reduce cardiovascular risk factors.

    Be well!

    JP

  17. JP Says:

    Update: Higher protein diets may lower risk of cardiometabolic disease …

    http://jn.nutrition.org/content/145/3/605.abstract

    J Nutr. 2015 Mar;145(3):605-14.

    Higher-Protein Diets Are Associated with Higher HDL Cholesterol and Lower BMI and Waist Circumference in US Adults.

    BACKGROUND: Protein intake above the RDA attenuates cardiometabolic risk in overweight and obese adults during weight loss. However, the cardiometabolic consequences of consuming higher-protein diets in free-living adults have not been determined.

    OBJECTIVE: This study examined usual protein intake [g/kg body weight (BW)] patterns stratified by weight status and their associations with cardiometabolic risk using data from the NHANES, 2001-2010 (n = 23,876 adults ≥19 y of age).

    METHODS: Linear and decile trends for association of usual protein intake with cardiometabolic risk factors including blood pressure, glucose, insulin, cholesterol, and triglycerides were determined with use of models that controlled for age, sex, ethnicity, physical activity, poverty-income ratio, energy intake (kcal/d), carbohydrate (g/kg BW) and total fat (g/kg BW) intake, body mass index (BMI), and waist circumference.

    RESULTS: Usual protein intake varied across deciles from 0.69 ± 0.004 to 1.51 ± 0.009 g/kg BW (means ± SEs). Usual protein intake was inversely associated with BMI (-0.47 kg/m(2) per decile and -4.54 kg/m(2) per g/kg BW) and waist circumference (-0.53 cm per decile and -2.45 cm per g/kg BW), whereas a positive association was observed between protein intake and HDL cholesterol (0.01 mmol/L per decile and 0.14 mmol/L per g/kg BW, P < 0.00125).

    CONCLUSIONS: Americans of all body weights typically consume protein in excess of the RDA. Higher-protein diets are associated with lower BMI and waist circumference and higher HDL cholesterol compared to protein intakes at RDA levels. Our data suggest that Americans who consume dietary protein between 1.0 and 1.5 g/kg BW potentially have a lower risk of developing cardiometabolic disease.

    Be well!

    JP

  18. JP Says:

    Update: Higher intake of dietary calcium may lower cardiovascular and all-cause mortality risk in older adults …

    http://onlinelibrary.wiley.com/doi/10.1002/jbmr.2515/abstract

    J Bone Miner Res. 2015 Mar 31.

    Higher Dietary Calcium Intakes are Associated With Reduced Risks of Fractures, Cardiovascular Events and Mortality: A Prospective Cohort Study of Older Men and Women.

    The aim of this population-based, prospective cohort study was to investigate long-term associations between dietary calcium intake and fractures, non-fatal cardiovascular disease (CVD), and death from all causes. Participants were from the Melbourne Collaborative Cohort Study which was established in 1990-1994. A total of 41,514 men and women (∼99% aged 40-69 years at baseline) were followed-up for a mean (SD) of 12 (1.5) years. Primary outcome measures were time to death from all causes (n = 2,855), CVD-related deaths (n = 557), cerebrovascular disease-related deaths (n = 139), incident non-fatal CVD (n = 1,827), incident stroke events (n = 537) and incident fractures (n = 788). 12,097 participants (aged ≥50 years) were eligible for fracture analysis and 34,468 for non-fatal CVD and mortality analyses. Mortality was ascertained by record linkage to registries. Fractures and CVD were ascertained from interview ∼13 years after baseline. Quartiles of baseline energy-adjusted calcium intake from food were estimated using a food frequency questionnaire. Hazard ratios (HR) and odds ratios (OR) were calculated for quartiles of dietary calcium intake. Highest and lowest quartiles of energy-adjusted dietary calcium intakes represented unadjusted means (SD) of 1,348 (316) mg/d and 473 (91) mg/d, respectively. Overall there were 788 (10.3%) incident fractures, 1,827 (9.0%) incident CVD; and 2,855 people (8.6%) died. Comparing the highest with the lowest quartile of calcium intake, for all-cause mortality, the HR was 0.86 (95%CI; 0.76 to 0.98, Ptrend  = 0.01);for non-fatal CVD and stroke, the OR was 0.84 (95%CI; 0.70 to 0.99, Ptrend  = 0.04) and 0.69 (95%CI; 0.51 to 0.93, Ptrend  = 0.02), respectively, and the OR for fracture was 0.70 (95%CI; 0.54 to 0.92, Ptrend  = 0.004). In summary, for older men and women, calcium intakes of up to 1,348 (316) mg/d from food were associated with decreased risks for fracture, non-fatal CVD, stroke and all-cause mortality.

    Be well!

    JP

  19. JP Says:

    Update 05/28/15:

    http://www.nmcd-journal.com/article/S0939-4753%2815%2900119-2/abstract

    Nutrition, Metabolism and Cardiovascular Diseases – May 13, 2015

    The triglyceride-lowering effect of supplementation with dual probiotic strains, Lactobacillus curvatus HY7601 and Lactobacillus plantarum KY1032: reduction of fasting plasma lysophosphatidylcholines in nondiabetic and hypertriglyceridemic subjects

    Background and Aims: This study evaluated the triglyceride (TG)-lowering effects of consuming dual probiotic strains of Lactobacillus curvatus (L. curvatus) HY7601 and Lactobacillus plantarum (L. plantarum) KY1032 on the fasting plasma metabolome.

    Methods and Results: A randomized, double-blind, placebo-controlled study was conducted on 92 participants with hypertriglyceridemia but without diabetes. Over a 12-week testing period, the probiotic group consumed 2 g of powder containing 5 x 109 colony-forming units (cfu) of L. curvatus HY7601 and 5 x 109 cfu of L. plantarum KY1032 each day, whereas the placebo group consumed the same product without probiotics. Fasting plasma metabolomes were profiled using UPLC-LTQ-Orbitrap MS. After 12 weeks of treatment, the probiotic group displayed a 20% reduction (p = 0.001) in serum TGs and 25% increases (p = 0.001) in apolipoprotein A-V (apoA-V). At the 12-week follow-up assessment, the following 11 plasma metabolites were significantly reduced in the probiotic group than the placebo group: palmitoleamide, palmitic amide, oleamide, and lysophosphatidyl choline (lysoPC) containing C14:0, C16:1, C16:0, C17:0, C18:3, C18:2, C18:1, and C20:3. In the probiotic group, changes (△) in TG were negatively correlated with △ apoA-V, which were positively correlated with △ FFA. In addition, △ FFA was strongly and positively correlated with △ lysoPCs in the probiotic group but not the placebo group.

    Conclusions: The triglyceride-lowering effects of probiotic supplementation, partly through elevated apoA-V, in borderline to moderate hypertriglyceridemic subjects showed reductions in plasma metabolites; fatty acid primary amides and lysoPCs (NCT02215694; http://www.clinicaltrials.gov).

    Be well!

    JP

  20. JP Says:

    Updated 09/07/15:

    http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0135221

    PLoS One. 2015 Sep 4;10(9):e0135221.

    Dietary Inflammatory Index and Incidence of Cardiovascular Disease in the SUN Cohort.

    BACKGROUND: Diet is known to play a key role in atherogenesis and in the development of cardiovascular events. Dietary factors may mediate these processes acting as potential modulators of inflammation. Potential Links between inflammatory properties of diet and the occurrence of cardiovascular events have not been tested previously.

    OBJECTIVE: We aimed to assess the association between the dietary inflammatory index (DII), a method to assess the inflammatory potential of the diet, and incident cardiovascular disease.

    METHODS: In the prospective, dynamic SUN cohort, 18,794 middle-aged, Spanish university graduates were followed up for 8.9 years (median). A validated 136-item food-frequency questionnaire was used to calculate the DII. The DII is based on scientific evidence about the relationship between diet and inflammatory biomarkers (C-reactive protein, IL-1β, IL-4, IL-6, IL-10 and TNF-α). Cox proportional hazard models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the association between the DII and incident cardiovascular disease (myocardial infarction, stroke or cardiovascular death).

    RESULTS: The risk for cardiovascular events progressively increased with each increasing quartile of DII (ptrend = 0.017). The multivariable-adjusted HR for participants in the highest (most pro-inflammatory) vs. the lowest quartile of the DII was 2.03 (95% CI 1.06-3.88).

    CONCLUSIONS: A pro-inflammatory diet was associated with a significantly higher risk for developing cardiovascular events.

    Be well!

    JP

  21. JP Says:

    Updated 09/07/15:

    http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0136560

    PLoS One. 2015 Aug 31;10(8):e0136560.

    Relationship between Urinary Level of Phytate and Valvular Calcification in an Elderly Population: A Cross-Sectional Study.

    Pathological calcification generally consists of the formation of solid deposits of hydroxyapatite (calcium phosphate) in soft tissues. Supersaturation is the thermodynamic driving force for crystallization, so it is believed that higher blood levels of calcium and phosphate increase the risk of cardiovascular calcification. However several factors can promote or inhibit the natural process of pathological calcification. This cross-sectional study evaluated the relationship between physiological levels of urinary phytate and heart valve calcification in a population of elderly out subjects. A population of 188 elderly subjects (mean age: 68 years) was studied. Valve calcification was measured by echocardiography. Phytate determination was performed from a urine sample and data on blood chemistry, end-systolic volume, concomitant diseases, cardiovascular risk factors, medication usage and food were obtained. The study population was classified in three tertiles according to level of urinary phytate: low (<0.610 μM), intermediate (0.61-1.21 μM), and high (>1.21 μM). Subjects with higher levels of urinary phytate had less mitral annulus calcification and were less likely to have diabetes and hypercholesterolemia. In the multivariate analysis, age, serum phosphorous, leukocytes total count and urinary phytate excretion appeared as independent factors predictive of presence of mitral annulus calcification. There was an inverse correlation between urinary phytate content and mitral annulus calcification in our population of elderly out subjects. These results suggest that consumption of phytate-rich foods may help to prevent cardiovascular calcification evolution.

    Be well!

    JP

  22. JP Says:

    Updated 05/02/17:

    http://www.tandfonline.com/doi/abs/10.1080/19390211.2017.1310784?journalCode=ijds20

    J Diet Suppl. 2017 Apr 28:1-8.

    A Polyphenol-Based Multicomponent Nutraceutical in Dysmetabolism and Oxidative Stress: Results from a Pilot Study.

    To assess short-term efficacy and safety of a multicomponent nutraceutical (MCN) on dysmetabolism and oxidative stress, a pilot prospective observational study was performed on 21 individuals (12 men and 9 women) who took, for 60 days, 2 tablets per day of an MCN based on antioxidants and metabolism regulators: hydroxytyrosol (15 mg), maqui (300 mg), amla (200 mg), monacolin K (10 mg), berberine (245 mg), astaxanthin (0.5 mg), coenzyme Q10 (100 mg), and folic acid (200 mcg). On day 0 (T0) and day 60 (T60), all participants underwent laboratory tests related to lipid profile, carbohydrate metabolism, oxidative stress, and cellular inflammation. Statistical analysis was applied to the resulting data. A significant improvement of most atherogenesis and oxidative stress biomarkers was recorded (mean figure at T0 and T60, p value): total cholesterol 243.50/194.83 mg/dl, p =.0002; low-density lipoproteins 174.50/124.58 mg/dl, p =.0001; glycemia 96.25/88.50 mg/dl, p =.035; total free radicals 306.44/280.93 U.Carr., p =.036; serum antioxidant capacity 2103.00/2246.06 umol/l, p =.0042; oxidized cholesterol 680.33/597.25 uEq/l, p =.0511. Insulinemia, microalbuminuria, high-density lipoproteins, C-reactive protein, and triglycerides had no statistically significant variation. Body weight and systo-diastolic pressure showed no significant change from T0 to T60. No relevant side effects were reported. The investigated MCN (Eonlipid), based on polyphenols, significantly improved the oxidative stress parameters and decreased the majority of atherogenesis parameters at short term. No significant side effects were reported. Further placebo-controlled studies should possibly corroborate the promising results of this pilot study.

    Be well!

    JP

  23. JP Says:

    Updated 06/17/19:

    http://jn.nutrition.org/content/early/2017/06/13/jn.116.245126.long

    J Nutr. 2017 Jun 14.

    Inclusion of Almonds in a Cholesterol-Lowering Diet Improves Plasma HDL Subspecies and Cholesterol Efflux to Serum in Normal-Weight Individuals with Elevated LDL Cholesterol.

    Background: Almonds may increase circulating HDL cholesterol when substituted for a high-carbohydrate snack in an isocaloric diet, yet little is known about the effects on HDL biology and function.

    Objective: The objective was to determine whether incorporating 43 g almonds/d in a cholesterol-lowering diet would improve HDL subspecies and function, which were secondary study outcomes.

    Methods: In a randomized, 2-period, crossover, controlled-feeding study, a diet with 43 g almonds/d (percentage of total energy: 51% carbohydrate, 16% protein, and 32% total and 8% saturated fat) was compared with a similar diet with an isocaloric muffin substitution (58% carbohydrate, 15% protein, and 26% total and 8% saturated fat) in men and women with elevated LDL cholesterol. Plasma HDL subspecies and cholesterol efflux from J774 macrophages to human serum were measured at baseline and after each diet period. Diet effects were examined in all participants (n = 48) and in normal-weight (body mass index: <25; n = 14) and overweight or obese (≥25; n = 34) participants by using linear mixed models.

    Results: The almond diet, compared with the control diet, increased α-1 HDL [mean ± SEM: 26.7 ± 1.5 compared with 24.3 ± 1.3 mg apolipoprotein A-I (apoA-I)/dL; P = 0.001]. In normal-weight participants, the almond diet, relative to the control diet, increased α-1 HDL (33.7 ± 3.2 compared with 28.4 ± 2.6 mg apoA-I/dL), the α-1 to pre-β-1 ratio [geometric mean (95% CI): 4.3 (3.3, 5.7) compared with 3.1 (2.4, 4.0)], and non-ATP-binding cassette transporter A1 cholesterol efflux (8.3% ± 0.4% compared with 7.8% ± 0.3%) and decreased pre-β-2 (3.8 ± 0.4 compared with 4.6 ± 0.4 mg apoA-I/dL) and α-3 (23.5 ± 0.9 compared with 26.9 ± 1.1 mg apoA-I/dL) HDL (P < 0.05). No diet effects were observed in the overweight or obese group.

    Conclusions: Substituting almonds for a carbohydrate-rich snack within a lower-saturated-fat diet may be a simple strategy to maintain a favorable circulating HDL subpopulation distribution and improve cholesterol efflux in normal-weight individuals with elevated LDL cholesterol.

    Be well!

    JP

  24. JP Says:

    Updated 1/17/18:

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5755999/

    J Tradit Complement Med. 2017 May 29;8(1):150-163.

    Thoughts modulate the expression of inflammatory genes and may improve the coronary blood flow in patients after a myocardial infarction.

    Background: Mental stress is one of the main risk factors for cardiovascular disease. Meditation and music listening are two techniques that are able to counteract it through the activation of specific brain areas, eliciting the so-called Relaxing Response (RR). Epidemiological evidence reveals that the RR practice has a beneficial prognostic impact on patients after myocardial infarction. We aimed to study the possible molecular mechanisms of RR underlying these findings.

    Methods: We enrolled 30 consecutive patients after myocardial infarction and 10 healthy controls. 10 patients were taught to meditate, 10 to appreciate music and 10 did not carry out any intervention and served as controls. After training, and after 60 days of RR practice, we studied the individual variations, before and after the relaxation sessions, of the vital signs, the electrocardiographic and echocardiographic parameters along with coronary flow reserve (CFR) and the carotid’s intima media thickness (IMT). Neuro-endocrine-immune (NEI) messengers and the expression of inflammatory genes (p53, Nuclear factor Kappa B (NfKB), and toll like receptor 4 (TLR4)) in circulating peripheral blood mononuclear cells were also all observed.

    Results: The RR results in a reduction of NEI molecules (p < 0.05) and oxidative stress (p < 0.001). The expression of the genes p53, NFkB and TLR4 is reduced after the RR and also at 60 days (p < 0.001). The CFR increases with the relaxation (p < 0.001) and the IMT regressed significantly (p < 0.001) after 6 months of RR practice.

    Conclusions: The RR helps to advantageously modulate the expression of inflammatory genes through a cascade of NEI messengers improving, over time, microvascular function and the arteriosclerotic process.

    Be well!

    JP

  25. JP Says:

    Updated 2/1/18:

    http://apjcn.nhri.org.tw/server/APJCN/27/2/341.pdf

    Asia Pac J Clin Nutr. 2018;27(2):341-346.

    Astaxanthin improves glucose metabolism and reduces blood pressure in patients with type 2 diabetes mellitus.

    BACKGROUND AND OBJECTIVES: This randomized, placebo-controlled trial was performed for 8 weeks to investigate the potential effects of astaxanthin (AST) supplementation on the adiponectin concentration, lipid peroxidation, glycemic control, insulin sensitivity, and anthropometric indices in participants with type 2 diabetes mellitus.

    METHODS AND STUDY DESIGN: We enrolled 44 participants with type 2 diabetes who met our inclusion criteria. Eight milligrams of AST supplementation or a placebo were randomly administered once daily for 8 weeks to these participants.

    RESULTS: The 8-week administration of AST supplementation increased the serum adiponectin concentration and reduced visceral body fat mass (p<0.01), serum triglyceride and very-low-density lipoprotein cholesterol concentrations, and systolic blood pressure (p<0.05). Furthermore, AST significantly reduced the fructosamine concentration (p<0.05) and marginally reduced the plasma glucose concentration (p=0.057).

    CONCLUSIONS: We demonstrated that because participants with type 2 diabetes often have hypertriglycemia and uncontrolled glucose metabolism; our findings of dual beneficial effects are clinically valuable. Our results may provide a novel complementary treatment with potential impacts on diabetic complications without adverse effects.

    Be well!

    JP

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