Home > Heart Health, Interviews, Nutritional Supplements > Dr. Stephen Sinatra Interview – Part One

Dr. Stephen Sinatra Interview – Part One

June 27, 2012 Written by JP    [Font too small?]

Coronary heart disease (CHD) is by far the leading health risk in the United States and beyond. It affects men and women in almost equal proportions and pays little attention to ethnicity. In fact, African Americans, Asian or Pacific Islanders and Caucasians register very similar vascular mortality rates. What’s more, the most recent estimates from the Centers for Disease Control and Prevention place a hefty price tag of over $100 billion/year for health care services, lost productivity and medications relating to CHD. While these figures are undoubtedly grim, it’s helpful to have frequent reminders that heart disease is largely preventable. For over forty years, Dr. Stephen Sinatra, has been investigating and reporting on this very topic.

A healthy, whole food diet is the cornerstone of any wellness program. In the first part of my interview with “America’s #1 Integrative Cardiologist”, we’ll focus on the role of food preparation and selection in relation to cardiovascular function and health.

JP – In November 2012, The Great Cholesterol Myth: Why Lowering Your Cholesterol Won’t Prevent Heart Disease, will be released. As a cardiologist and researcher, what do you think are genuine risk factors for heart disease?

Dr. Sinatra – Nutrient depletion, sugar, inflammation and environmental toxins (mercury, insecticides, pesticides, etc.).

JP – There are many statin alternatives currently available in health food stores and online. Given your position about cholesterol in general, is there any reason to consider nutraceuticals that are mainly intended to lower LDL cholesterol?

Dr. Sinatra – Lowering non-oxidized LDL cholesterol is not the problem. What you really want to do is prevent the oxidation of LDL cholesterol or try to change a small particle LDL to a less inflammatory fluffy particle. Nutraceuticals like coenzyme Q10, low-dose mixed tocopherols, vitamin C, niacin and omega 3’s are good ways to impact blood lipids.

JP – A recent study in The Lancet questions whether HDL cholesterol is cardioprotective based on genetic tests of patients with and without heart disease. What are your thoughts about this research and the role of HDL cholesterol as a marker of cardiovascular health?

Dr. Sinatra – HDL can be dysfunctional and if it is, it could be a marker of cardiac vulnerability. HDL does many more things than just transport cholesterol in the blood. It is vital for the immune system and it is generally cardioprotective, but if it becomes oxidized or inflammatory it can certainly have a downside.

Note – More information about HDL cholesterol: Why “Good Cholesterol” Isn’t Always Good

JP – Another major headline of late linked the use of calcium supplements to more incidents of heart attacks. Please offer your insights about the relative benefits and proposed risk associated with calcium supplementation.

Dr. Sinatra – The newest research on calcium supplementation is extremely provocative. In the last few years, it was generally thought that 1500 mg of calcium to postmenopausal women and 1000 mg to premenopausal women was the way to go. This is obsolete and not smart medicine, as the newest research has suggested that higher serum calcium with or without vitamin D supplementation may be a risk factor in cardiovascular disease.

JP – In years past, researchers, such as Dr. Dean Ornish, have established that very low fat diets and lifestyle interventions can reverse heart disease. In your years as a clinician, have you found similar observations using a different dietary approach?

Dr. Sinatra – Dr. Ornish’s original data about very low fat diets reversing heart disease, in my opinion, was not relevant. Although his research was novel and exciting, he had many factors such as stress reduction, lifestyle modifications, yoga, exercise, etc. which have all been shown to have a positive impact on reversing heart disease. Low fat diets can throw the baby out with the bath water, which could have a serious impact on limiting omega 3’s. The best diet is one that is low in sugar and processed carbohydrates. The good aspect of the Ornish diet, if chosen with diligence, would be high fiber vegetables, beans and legumes which any cardiologist would endorse.

Environmental Toxins Such as Ozone Increase Cardiovascular Risk

Source: Cardiovasc Ultrasound. 2009 Jun 24;7:30. (link)

JP – Cooking and food selection play a major role in many of the books and newsletters you’ve written. Can you please share some cooking tips and recommendations about the most health promoting foods that you personally include in your diet.

Dr. Sinatra – If you go to my website, heartmdinstitute.com, you will see some very recent videos – the most striking for cardiovascular health is my fruit and veggie antioxidant smoothie. This high-fiber, nutrient rich liquid, in my opinion, is one of the best ways of supporting cardiovascular health. I also like steamed vegetables, lots of fiber, and certainly natural omega 3’s found in nuts, seeds, wild Alaskan salmon, etc.

JP – With the current emphasis on lowering sugar intake, sweeteners such as agave, coconut sugar and stevia have gained much popularity. In your opinion, are these better options than artificial sweeteners and conventional sources of sugar?

Dr. Sinatra – Yes and no. Stevia is a great option, but the problem is if you cook with it you get taste issues. Agave is very sweet and will elicit an insulin response. Stevia is the best choice by far, but any of the above is certainly better than artificial sweeteners, pure fructose or white table sugar.

In part two of my Q&A with Dr. Sinatra, he’ll offer guidance about exercise, mind-body practices and nutritional supplements. There’s also a wealth of information about a holistic approach to various chronic conditions, including heart disease, on Dr. Sinatra’s homepage and weekly blog. It’s one of my prime destinations when I want to catch up on the latest news about integrative cardiology and natural advice about how to avoid dis-ease.

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!

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Posted in Heart Health, Interviews, Nutritional Supplements

7 Comments & Updates to “Dr. Stephen Sinatra Interview – Part One”

  1. Paul F. Says:

    Hi JP,

    Adding Dr Sinatra’s interview to the resources of your already on-line updated virtual natural health encyclopedia makes it my preferred source of guidance for staying healthy and vibrant at 78+ years old.

    Thank you!


  2. JP Says:

    Thank you, Paul! It makes me very happy to know it. I wish you continued health and vitality! 🙂

    Be well!


  3. rob Says:

    So far so good

  4. JP Says:

    Thanks, Rob. More to come tomorrow!

    Be well!


  5. JP Says:

    Update: Dietary calcium may lower cardiovascular and all-cause mortality risk in older adults …


    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!


  6. JP Says:

    Updated 1/17/16:


    Nutr Res. 2016 Jan;36(1):16-23.

    Green tea catechins prevent low-density lipoprotein oxidation via their accumulation in low-density lipoprotein particles in humans.

    Green tea is rich in polyphenols, including catechins which have antioxidant activities and are considered to have beneficial effects on cardiovascular health. In the present study, we investigated the effects of green tea catechins on low-density lipoprotein (LDL) oxidation in vitro and in human studies to test the hypothesis that catechins are incorporated into LDL particles and exert antioxidant properties. In a randomized, placebo-controlled, double-blind, crossover trial, 19 healthy men ingested green tea extract (GTE) in the form of capsules at a dose of 1 g total catechin, of which most (>99%) was the gallated type. At 1 hour after ingestion, marked increases of the plasma concentrations of (-)-epigallocatechin gallate and (-)-epicatechin gallate were observed. Accordingly, the plasma total antioxidant capacity was increased, and the LDL oxidizability was significantly reduced by the ingestion of GTE. We found that gallated catechins were incorporated into LDL particles in nonconjugated forms after the incubation of GTE with plasma in vitro. Moreover, the catechin-incorporated LDL was highly resistant to radical-induced oxidation in vitro. An additional human study with 5 healthy women confirmed that GTE intake sufficiently increased the concentration of gallated catechins, mainly in nonconjugated forms in LDL particles, and reduced the oxidizability of LDL. In conclusion, green tea catechins are rapidly incorporated into LDL particles and play a role in reducing LDL oxidation in humans, which suggests that taking green tea catechins is effective in reducing atherosclerosis risk associated with oxidative stress.

    Be well!


  7. JP Says:

    Updated 08/27/16:


    Int J Prev Med. 2016 Jul 29;7:95.

    Effect of Garlic and Lemon Juice Mixture on Lipid Profile and Some Cardiovascular Risk Factors in People 30-60 Years Old with Moderate Hyperlipidaemia: A Randomized Clinical Trial.

    BACKGROUND: This study was performed to effects of garlic and lemon juice mixture on lipid profile and some cardiovascular risk factors in people 30-60 years old with moderate hyperlipidemia.

    METHODS: In a parallel-designed randomized controlled clinical trial, a total of 112 hyperlipidemic patients 30-60 years, were recruited from Isfahan Cardiovascular Research Center. People were selected and randomly divided into four groups. Control blood samples were taken and height, weight, and blood pressure were recorded. (1) Received 20 g of garlic daily, plus 1 tablespoon lemon juice, (2) received 20 g garlic daily, (3) received 1 tablespoon of lemon juice daily, and (4) did not receive garlic or lemon juice. A study technician was done the random allocations using a random numbers table. All participants presented 3 days of dietary records and 3 days of physical activity records during 8 weeks. Blood samples were obtained at study baseline and after 8 weeks of intervention.

    RESULTS: Results showed a significant decrease in total cholesterol (changes from baseline: 40.8 ± 6.1, P < 0.001), low-density lipoprotein-cholesterol (29.8 ± 2.6, P < 0.001), and fibrinogen (111.4 ± 16.1, P < 0.001) in the Group 1, in comparison with other groups. A greater reduction in systolic and diastolic blood pressure was observed in Group 1 compared with the Groups 3 and 4 (37 ± 10, P = 0.01) (24 ± 1, P = 0.02); respectively. Furthermore, a great reduction in body mass index was observed in the mixed group compared with the lemon juice and control groups (1.6 ± 0.1, P = 0.04). CONCLUSIONS: Administration of garlic plus lemon juice resulted in an improvement in lipid levels, fibrinogen and blood pressure of patients with hyperlipidemia. Be well! JP

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