Tag Archives: cardiovascular disease

Eat your Fresh Fruit! – for better cardiovascular health: Latest New England Journal April 11, 2016

A recent study released in the April 10 edition of The New England Journal of Medicine demonstrated that fresh fruit consumption was associated with decreased blood pressure and decreased blood glucose.

Fresh Fruit Consumption and Major Cardiovascular disease in China

Increased fresh fruit consumption was associated with decreased risk of cardiovascular disease, decreased cardiovascular death, decreased coronary events, decreased hemorrhagic stroke, and decreased ischemic strokes.

fruits1

Fruit and vegetable consumption and mortality from all causes, cardiovascular disease, and cancer_ systematic review and dose-response meta-analysis of prospective cohort studies

Increased consumption of fruit and vegetables for the primary prevention of cardiovascular diseases.

Dietary Nitrate Lowers Blood Pressure

Fruit and vegetable consumption and all-cause, cancer and CVD mortality analysis of Health Survey for England data.

Fruit and Vegetable Consumption and Risk of CAD – a metanalysis of cohort studies

Quantity and variety in fruit and vegetable intake and risk of coronary heart disease

Greater Total Antioxidant Capacity from Diet and Supplements Is Associated with a Less Atherogenic Blood Profile in U.S. Adults

Novel insights of dietary polyphenols and obesity

Cruciferous vegetable consumption is associated with a reduced risk of total and Cardiovascular disease mortality

The NEJM study released in this issue death with Chinese populations, some 450,000 Chinese in fact, with no prior stroke or hypertension to avoid confounding factors. IN Western populations, an inverse association had been seen in patients eating 80 gm of fruit a day, leading to a 5% decrease in cardiovascular death.

A low level of fruit intake is associated with a major increased cardiovascular risk rate. The study above chose China, since vegetable intake is high but fresh-fruit intake is much lower.  Cardiovascular disease causes 17 million deaths a year and is especially high in lower income countries. The effect of adding fruit to the diet of people with low consumption rate can detect larger effects.

Findings:

The association between the level of fruit consumption and cardiovascular risk in our study (a 40% lower risk of cardiovascular death and a 34% lower risk of major coronary events among participants who consumed fresh fruit daily as compared with those who never or rarely consumed fresh fruit) was much stronger than the associations observed in previous studies. < Current NEJM study April 2016.    This study involved some 512,000 people who had low intake of fruit already, making it easy to detect positive benefits. None of the patients had hypertension or Diabetes, and thus were not on any confounding medications. The study also took into account regression dilution bias (changes in baseline characteristics of a population during a study) that may impact findings. 

Fruit is high in fiber, potassium, folate, phytochemicals, and antioxidants all of which may mediate the positive impact of fruit intake.

Conclusion:

In conclusion, our evaluation of the relationship between fresh fruit consumption and cardiovascular disease in China showed that the level of fruit consumption was inversely associated with blood pressure and blood glucose levels.

Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010 a systematic analysis for the Global Burden of Disease Study 2010.

Up-regulating the Human Intestinal Microbiome Using Whole Plant foods, polyphenols and fiber

Health benefits of fruit and vegetables are from additive and synergistic combinations of phytochemicals

What is Xenohormesis

White Pitaya (Hylocereus undatus) Juice attenuates insulin resistance and hepatic steatosis in obese mice

Greater Total Antioxidant Capacity from Diet and Supplements Is Associated with a Less Atherogenic Blood Profile in U.S. Adults b

Feeding the brain and nurturing the mind linking nutrition and the gut microbiota to brain development

Cultivating healthy growth and nutrition through the gut microbiota.

 

 

 

Insane medicine – Vitamin D supplements help reduce cancer and cardiovascular risk

Vitamin D supplementation has huge beneficial health effects. First, lets discuss the physiology of Vitamin D and the effects of deficiency.

Vitamin D

The process starts with ingestion of Vitamin D2 (ergocalciferol) from plant sterols or yeast or with Vitamin D3 (cholecalciferol) obtained from oily fish.. UVB irradiation of skin 7-dehydrocholesterol can also produce vitamin D. These vitamin D precursors go to the liver where they are converted to 25-hydroxyvitamin D (which is what your doctor tests for to see if you are deficient in vitamin D!). 25-hydroxyvitamin D is transferred to the kidney where it is converted to the most active form, 1,25 dihydroxyvitamin D.
vitamin D review vitamin D

The active 1,25-dihydroxyvitamin D will increase calcium absorption by the intestines which increases our calcium reserves
vitamin D balance vitamin D vitamin D deficiency vitamin D metabolism and deficiency vitamin D effects

 

Vitamin D (1,25-dihydroxyvitamin D) has multiple roles in the body as shown above. There are over 300 different binding sites for Vitamin D throughout the human genome with receptors present in all human tissues.  The parathyroid glans in the neck secrete PTH to activate and regulate vitamin D.

  • Risk factors for vitamin D deficiency include age>65, breastfeeding mothers, insufficient sunlight exposure, certain medications (anticonvulsants, steroids, others), obesity, physical inactivity, liver and kidney disease, and dark pigmented skin. Vitamin D deficiency was historically associated with rickets ( a bone disease)
    Insane Medicine - rickets due to vitamin D deficiency
    Insane Medicine – rickets due to vitamin D deficiency.

    Of course rickets is rare in the U.S. due to fortified foods.

  • Studies are clear that vitamin D is important for health and prevention. There is an inverse association of 25-hydroxyvitamin D serum levels with risk of death due to cardiovascular disease and cancer. In other words, low vitamin D  levels in the body are associated with higher cardiac events and higher risk of cancer!!
  • Supplementation with vitamin D3 reduces overall mortality in older adults!
  • Vitamin D deficiency is based on a blood level of less than 20 ng/mL of 25-hydroxy vitamin D. It appears that correcting vitamin D levels may be on par with health risks such as smoking, alcohol consumption, and physical inactivity!
  • Based on calculations from one study, 12.8% of all deaths in the U.S. can be attributed to vitamin D deficiency. So for every 10 ng/ml decline in serum vitamin D, there appears to be a 16% increase in all cause mortality.  Supplementing with vitamin D3 decreased all cause mortality by 11%. There appears to be no benefit or protection  by supplementing with vitamin D2. Vitamin D2 is less potent and active than vitamin D3. It may be that calcium is needed to be used with vitamin D2 to be effective.
  • You can obtain enough vitamin D by exposure to sunlight (UVB) for 15 minutes a day if you are light skinned. Dark skin requires up to an hour of exposure to create enough daily vitamin D. Our body produces vitamin D in the skin and does so at higher levels in the summer time. Obviously, in the winter time, we are at risk of deficiency due to less skin exposure. Sun block will prevent UVB from reaching our skin and therefore will prevent the skin from creating vitamin D.
  • Vitamin D toxicity (levels greater than 150 ng/ml) result from high intake of vitamin D (greater than 10,000 units/day)
  • The bottom line: Get your 600-800 IU of vitamin D3 every day. Vitamin D3 is the best form of vitamin D. Boosting your vitamin D levels can decrease your cardiac and cancer risks!
  • http://www.vitamincouncil.org/   <–Vitamin D information!
  • Chowdury R, et al Vitamin D and risk of cause of specific death. BMJ 2014;348:g1903.doi: 10.1136/bmj.g1903

Insane Medicine – A few points on cardiovascular health and interventions

Here’s some general cardiovascular stuff that is useful:

  • There is now a trend to treat your hypertension and cholesterol based on risk factors rather than just specific targets. Looking at the overall cardiovascular risk is more important tan focusing on just one factor.  The decision to treat cholesterol issues should be based on not just the absolute LDL – cholesterol number but also the coexisting problems, such as obesity or hypertension. It is important to modify other lifestyle issues including losing weight, maintaining regular exercise, eating a low-salt diet, and taking your prescribed medications. Look at the overall picture and not just a single parameter.
  • Be certain to stay active. Check with your doctor about the safety of exercise for you before you start on a program. Engage in aerobic activity such as walking or jogging at least four to five times a week and be certain to mix this with muscle-strengthening exercise at least twice a week. Get moving!30-60 minutes a day, and be certain to use good form, standing upright and keeping your back straight, walking on even surfaces so you don’t fall, with good heel-strike and arm swing to maintain balance. Wear comfortable, well-fitted shoes. Stretch after a brief walk and be careful to do the stretching appropriately without any bouncing so you don’t damage your muscles. As winter approaches, you may need to exercise indoors due to the cold. Consider working out a variety of muscle groups to spice it up and keep you interested. This stimulates other muscle groups to maintain overall fitness. You thereby avoid burnout and keep motivated! Consider indoor sports that you can add to your regimen such as swimming, indoor rowing, stair-climbing machines, ellipticals, aerobics, yoga, and racquetball. Keep social. Get a training partner to keep things fun.
  • Be certain to stay on the best diet, rich in fruits, vegetables, whole grains, and lean proteins with low saturated and trans-fats as well as low cholesterol and sodium. Avoid processed foods and added sugar. Keep your Vitamin D intake at the appropriate levels, with 600 IU a day being recommended for ages 51-70 and 800 IU a day for ages over 70. The goal is a blood level of more than 30 nanograms per milliliter. Sources of foods wit Vitamin D include salmon, swordfish, tuna, canned sardines, milk, eggs, yogurt, orange juice, and cereals fortified with it. Vitamin D provides cardiovascular, neurological, and immune system health. People with high levels of vitamin D have had lower in-hospital death and morbidity rates.
  • Try to get 8 hours of sleep a night.

Insane Medicine – Lineoleic acid decreases cardiovascular death risk

Insane Medicine - Omega fatty acids
Insane Medicine – Omega fatty acids come in two flavors – omega-3 and omega-6!
Insane Medicine - fat pyramid
Insane Medicine – fat pyramid

 

  • Omega-6 fatty acids are also important for heart health. Evidence suggest that linoleic acid, an omega-6 fatty acid, when found in higher levels in the blood, decreases the chance of death from cardiovascular disease .
  • Sources of linoleic acid are: walnut oil, sesame oil, sunflower oil, corn oil, safflower oil.