Heart health

The cardiovascular system (CVS) includes our blood, the network of vessels that carries it around the body and the heart, which is a large muscle that pumps the blood though the vessels. The CVS interacts with almost every other part of the body through over 160,000 kilometres of blood vessels.

There are many things that can go wrong within the system. But beyond being born with CVS defects or trauma (such as causing massive blood loss) the most common problems that arise in the CVS are from the vessels (a bit like pipes) blocking up, becoming too rigid or generally shutting down, blood clots causing major obstructions in the blood vessels, or the heart itself failing (problems with the valves, electrical impulses, outer layer of the heart, the actual muscle itself etc). Because of the close interaction of the CVS with other body systems, a problem elsewhere can have a secondary effect on the CVS for example lung or kidney disease or even an infection.

The aim of good CVS care is to prevent the pipes clogging up (a common source of high blood pressure) or hardening, keeping the weight within normal range so the heart doesn’t have to work harder to pump blood around the body and exercising that big muscle – the heart, appropriately. But as almost every aspect of our health can impact on our CVS – general wellbeing including balance in our body, mind and spirit is essential.

Key nutrients for the CVS

Ultimately being deficient in any essential nutrient can impact on our heart health, however the following have the most direct effect to prevent or moderate common CVS problems.

Vitamin E: Considered the king of antioxidants, it assists the CVS in many ways. One key action is by reducing or preventing oxidation of cholesterol, which can otherwise form a fatty plaque on vessel walls (causing constriction and blockages). To have the most impact on preventing oxidation, Vitamin E works better in a combination with all the other antioxidants.

Currently there is controversy regarding the effectiveness of Vitamin E in heart health. This article by Jeffrey Blumberg helps explain some of the anomalies in current research on the subject.

Coenzyme Q10 (CoQ10): a naturally occurring coenzyme essential to the production of cellular energy, this new kid on the block (in regards to the history of modern nutrition) is especially important in heart muscle function and as in stopping oxidation of “bad” cholesterol. Conversely the group of drugs known as statins, to lower cholesterol, reduced CoQ10 levels leading to a nutritionally counterproductive side effect).

A recent meta-analysis of 12 studies involving CoQ10, showed it’s potential to significantly lower high blood pressure.

Fish oil: Omega 3 Fatty acids had a recent show of their own. Apart from overall health support, there is increasing evidence for fish oils and heart health. One of the most recent is in the revision of guidelines handed down in the UK for patients who have suffered a heart attack. These include – a Mediterranean diet, regular exercise of 30 minutes a day and at least 7 g of Omega 3 FA/week.
(Listen to my podcast on omega 3 fats)

Garlic: bad news for those who don’t like garlic breath as it’s the smelly sulphur compounds in it that benefit the heart! One key new finding is that it significantly reduces the tension in vessel walls (remember that narrow vessels increase blood pressure as the heart has to work harder to force the blood through smaller ‘pipes’).

Diet

The Mediterranean diet: rich in fish and natural plant oils, fruits, vegetables, nuts, beans and grains (also low in red meat, processed and fried foods) can form the basis of a healthy CVS eating plan. Eat food that looks like it does when it comes from the fields and the sea, use good quality cold pressed vegetable oils as dressings (cooking with any oil caused oxidation) and have masses of fruit and vegetables. Keep in mind that what you eat at an Italian or Greek restaurant is not usually what a family would have at home – a Mediterranean meal has lots of salad and vegetable dishes. In a restaurant we tend to choose the festive foods and eat them at the expense at all the other components that would balance the richness.

Salt: the cook’s best friend, is nature’s own flavour enhancer. Though a little can help balance our electrolytes, too much can harden our arteries and raise our blood pressure. The more salt we eat, the higher the flavour threshold is so that we want to have more to make the food taste good. Having a rest from salt (which includes all processed foods or restaurant meals, rather than just the table salt we might add) for a week can help reset your tastebuds.

However, though salt is an easy culprit it is really about mineral balance. While excess sodium (the key ingredient in salt is sodium chloride) can raise blood pressure and cause CVS havoc it is actually about sodium levels relevant to potassium. We need at least as much potassium as sodium to keep blood pressure normalised. Potassium is high in vegetable foods eg: fruit, vegetables and legumes. Sodium is high in processed food eg: ham and cheese. Diuretics cause potassium loss. Magnesium (also rich in plant foods) is the other key mineral to sodium balance.

The cholesterol controversy: while a good balance between high density (“good”) and low density (“bad”) cholesterol is a key to keeping good heart health, to have very low overall cholesterol is not necessarily the answer for a long and healthy life. For notes from a previous show on cholesterol, with references to the whole conundrum click here. Note – independent medical advice now suggests that cholesterol-lowering drugs have the most benefit for middle-aged men with a history of cardiovascular disease. For people outside that age group, women or men who have no signs of cardiovascular disease – always get a second opinion before commencing this type of medication.
(Listen to my podcast on cholesterol

Lifestyle

Appropriate exercise: doesn’t have to be doing a triathlon (unless that is what you love) – think about strength, flexibility and endurance – not just getting aerobic, heart rate increasing exercise. Walking is one of the safest, convenient and most stuck-at forms of exercise. Aim for at least half an hour a day of dedicated exercise is the place to start.

Smoking : do we even need to go there? There is overwhelming evidence linking smoking (any type of vegetation) and CVS disease! If you would like to give up smoking consider hypnotherapy, which has a high success rate in people who genuinely want to quit by reducing cravings and increasing will power.

Stress: As part of our survival mechanism our primitive nervous system (ANS) triggers an increase in blood flow and heart activity. While in a healthy person an episode of acute stress should not lead to a heart attack – it is not unusual for even a young person to experience chest pain and an elevated or erratic heart beat. Prolonged stress does many things, including long term increased heart activity, reducing levels of cardio-protective nutrients and increasing inflammatory hormones in the body. On top of that at such times of stress other protective lifestyle measures may drop off, such as healthy sleeping patterns, diet and exercise. People may also drink more alcohol and caffeine, increase cigarette intake or use other drugs, which may ultimately damage the CVS.

Happiness: Will being happy keep your CVS healthy? Other than happiness being an antidote to stress, studies are emerging that when happy people do become stressed the negative CVS effects of it are less. One study showed that happy people had significantly lower levels of cortisol (associated with stress, type 2 diabetes, hypertension and autoimmune diseases) and less plasma fibrinogen (to do with inflammation and blood clots – a cause of heart attacks and strokes).

Join the Happiness Thread.

An anecdotal experience of hypertension

A non-smoking, 46 yo male with moderate to high essential hypertension and family history of myocardial infarction at a similar age monitored his blood pressure twice a day for 2 weeks, with the support of his GP and naturopath. He drank no caffeine and his diet was basically Mediterranean at home. Stress levels were variable (though not excessive) through the trial and exercise was moderate.

In reviewing his data the 3 most significant factors in raising his blood pressure were:

Salt – immediate worsening of hypertension. Despite having a higher than average intake of plant foods, the peak in sodium levels had a definite negative impact on blood pressure.

Alcohol – intake over recommended units of alcohol caused a delayed worsening of hypertension causing a peak around 24 hours later.

Feeling cold – feeling physically cold caused immediate worsening of hypertension, relieved by having a warm shower. (Peripheral circulation narrows down in a response to cold causing an increase in central pressure).

Managing these factors has allowed him to avoid medication, usually multiple drugs for the rest of his life. But he needs to remain vigilant and have regular check ups.

Make up your own mind

This morning I was writing a piece about how the 'official' messages we get about food inform our choices even when they fly in the face of common sense. One aspect of this being the impact of corporate sponsorship on some of our professional associations and other authorities we look to for unbiased, nutritional advice. While taking a break I picked up yesterdays “Age” and came across one of those vox pop style bites, this time asking leaders in appropriate professions whether “We should ban junk food such as McDonalds?” There smiling at me was the pretty face of Alison Graham, spokeswoman for the Dieticians Association of Australia. If you represented the peak orthodox organization for nutrition what message would you give about not just junk food, but McDonalds in particular? Her response did not surprise me. In a piece of perfect spin she was quoted as saying, “It’s wonderful that we have such a diverse food supply in Australia, so we can’t take choice away from people. Fast food is more than deep fried fatty foods: it can be quick and convenient and it’s here to stay, but they’re not all bad choices – salads, sushi and wraps can all be healthy”.

Once more, the take home message is that fast, or junk, food can actually be healthy. Let’s ignore the direct issue of the deep fried, empty caloried most popular choices and shift the focus to something innocuous like sushi, which I could be wrong, but don’t believe is actually on the multinational in question’s menu. What is more it is one step away from saying it is UnAustralian if we banned fast food. Choice is important! The positive spin on the fast food industry would seem curious from a member of the Dieticians Association if you didn’t realise that although McDonalds are not direct sponsors of the Association, unlike the industries providing the meat and cheese for their burgers, but have donated generously by way of things like purchasing a stall at their annual conference. The quote obtained from the Association could not have been better written if a lobbyist for McDonalds had dictated it.

While many of us do not directly consult a member of the DAA to teach us about food choices, other than by well-placed media quotes their influence is reaches wider than we would imagine. Recently I spoke to a final year Medical Student at the country’s leading medical. We chatted about the course and how they were assessed. I asked directly about nutritional training and she happily informed me they had a whole semester on it now. “Fantastic a whole semester on how to eat!” No, I was informed, it was actually about digestion and a little nutrition got tagged on the end. “How then do you teach your patients about healthy food choices?” I enquired. To which she responded about the handing over of pamphlets from the Heart Foundation (the organization that McDonalds has now paid at least $330,000 a year for the privilege of a few of their well placed ‘ticks’) and the DAA. “Or”, she added “I’d send them to a dietician or nutritionist”. “I’m curious”, I asked, “what is the difference between the two?” She admitted to not know, but would refer them anyway.

This did not engender me with hope as to the future of orthodox nutritional advice. Does the sponsorship of the DAA, by Nestle (a leading manufacturer of infant formula and controversial for it’s work in the developing world) indirectly influence advice given to a breastfeeding mother? Would a registered dietician ever cite the many studies that repeatedly prove that milk or even high calcium intake does not reduces the risk of fractures nor prevent osteoporosis, when Dairy Australia is a generous sponsor of the Association? Would they point out the biggest study to date, observing 120,000 woman for more than 10 years, not only disproved the dairy-healthy bones link but went further to show the more milk you drank the higher your chances of developing ovarian cancer? Not mentioning a study in one thing, but actively promoting contradictory advice is another.

While individuals of a profession may not speak for every member, using high profile doctors to advertise a product sends a much more universal message. Although that toothpaste ad doesn’t show us the face of the dentist, the milk commercial with high profile GP, Cindy Pan more than trades on her reputation, using her as the face of all doctors. In a nifty and possibly subliminal twist it goes even further by using a Chinese woman it neatly subverts the contradictory message that the majority of Asians are lactose intolerant. We should all drink milk, Cindy the doctor, media personality and Asian tells us it will give us strong bones, so it must be true!

Recently I went shopping with my 80 year old father. He has only had to acquaint himself with the supermarket in recent years and is a good consumer, taking time to read labels and pour over information about food ingredients. Diligently he grabbed the low fat, high calcium milk, the “lite” potato chips and chose a frozen dinner based on the Heart Foundation Tick. When I tried to point out a similar meal that had better ingredients he refused due to its tick-less packaging. I stayed silent on the irony of someone who has a classic lactose allergy choosing a milk that has higher lactose than its full fat counterparts. As for the chips, why bother mentioning the “lite” actually referred to the flavour and well, if you cant have clogged arteries in your ninth decade of life, when can you?