Why food alone wont prevent heart disease

Imagine a day where 3 jumbo jets were shot out of the sky killing everyone on board. A tragedy indeed. Now imagine that happening again the very next day. How could this be?! And the next day, another 3 jumbo jets shot down... what the heck is going on here!? Who's shooting down these massive airplanes full of innocent people?

Imagine the above scenario going on day in, day out, for decades. That is exactly what is happening in our world. It's not a jumbo jet getting shot out of the sky, but an equivalent number of people are dying each and every day due to cardiovascular disease.It's a travesty. It's really a shame that nothing can be done to stop this... You'd think that there would be some energy and resources going towards figuring out how to prevent such a massive quantity of innocent people from dying every single day.

 

Oh... actually... we already did that.

We already determined how to completely prevent, and in a very powerful way reverse heart disease.

What drug is it, you might be wondering?

 

Surely everybody has to be prescribed this life-saving substance! Or is it a surgical intervention? We need to figure out how to get everyone into the operating room, right? Well, it turns out there are plenty of drugs and surgical procedures that have been developed to treat and prevent the symptoms of cardiovascular disease. But even with these interventions being dished out left and right like snickers at halloween, 3 jumbo jets are shot down each and every day. 
The most powerful drug is not a drug

The intervention that I am talking about, that actually proves most effective in preventing and reversing heart disease is FOOD. Whole foods, in their natural form, coming straight from the earth.

Heart disease was one the first chronic conditions that was proven to be reversed by diet and lifestyle. The study of nutritional science amongst a population of cardiovascular patients has helped show the immense power that food has in healing the body. We have learned that food isn't like medicine, it is by far the best medicine, far better than any synthetic compound that could be designed and manufactured in a laboratory. 

You might wonder, how could an intervention of diet and lifestyle be so powerful in the treatment of heart disease? The answer is quite simple. Heart disease is caused by dietary and lifestyle factors. So, the only true way to cure heart disease is by removing the very factors that caused the condition, replacing them with a more health-promoting alternative. 

Understanding the cardiovascular system

Before we dive into the risk factors for heart disease, let's get a basic understanding of what's going on in the body...

Normal Endothelium > Dysfunctional Endothelium > Fatty Streak > Atheroma > Complex lesion 

This is the progression of cardiovascular disease.

Can you believe that nearly 100% of children age 10 have fatty streaks in their blood vessels?

That means heart disease is pretty much universal, but it doesn't have to progress! As things progress, plaques, or atheromas, form in the vascular system. These plaques can rupture, jamming the blood flow to the heart causing a heart attack, or to the brain causing a stroke. The presence of plaques in arteries also impedes blood flow.

This is especially important when looking at the arteries of the heart, as the active heart muscle requires a continual flow of freshly oxygenated, nutrient-rich blood. An impedance of blood flow causes chest pain, or angina, which is a common symptom of heart disease. Note that over 50% of people who die from a heart attack actually have NO prior symptoms. So, if you do experience chest pain or shortness of breath on exertion, classic signs of cardiovascular disease, get yourself a checkup - and continue reading!

Now, let's take a look at the primary risk factors of heart disease...

  • Cholesterol (1,2)
  • Hypertension (3)
  • Obesity (4,5)
  • Physical inactivity (6)
  • Smoking (7)
  • Family history (8, 9, 10)

Notice that 5 of these 6 risk factors are for the most part directly addressable through diet and lifestyle.

CHOLESTEROL is largely misunderstood, even in today's modern world. Still studies are revealed that claim no correlation between levels of cholesterol in your blood and cardiovascular disease. Additional reports show that dietary cholesterol has little to no impact on total cholesterol in your blood. So that means that you can eat the bacon and eggs for breakfast and a steak for dinner, right? Well, it turns out that these studies show skewed data, as is the case many times in medical research, performed in a system where powerful biases and financial interests dictate outcomes. Without getting too much in the weeds, we can follow the truth to understand that cholesterol does indeed matter, and dietary cholesterol is indeed a significant player in total blood cholesterol. AND, not all cholesterol is the same. Things like lipoprotein type and particle size matter very much, which may have a genetic basis. 

HYPERTENSION or high blood pressure is also very important to consider and understand. For a long the heart was viewed as a pump, sending blood through tubes and ultimately back to the heart. This simplistic view similar to a plumbing system led experts to focus solely on the pump for decades. It turns out that the blood vessels themselves play a huge part in determining the pressure in the system. If vessels are rigid and constricted, a rise in blood pressure naturally follows. If vessels are relaxed and flexible, a lower blood pressure is easily maintained. This understanding leads us to focus more on maintaining healthy vascular system than simply a healthy heart muscle (while the two of course do go hand in hand). A resilient vascular system comes naturally when we have a surplus of antioxidants that maintain a healthy lining of the blood vessels. Additionally, relaxation is key, as stress and tension send out hormones and signals that constrict the vessels and quickly raise blood pressure. 

OBESITY is so often associated with cardiovascular disease because the two conditions share underlying dietary and lifestyle causes. Obesity gets even closer to the cause of heart disease due to the fact that fat cells actually secrete hormones that directly impact cardiovascular function. These hormones, called adipokines, actually function in a way so that they predominantly effect the tissues they are in closest proximity with, which is the heart. 

SMOKING is associated with heart disease due to the oxidative damage that regular smoking can cause. This oxidative damage has a fast-acting, direct impact on endothelial function, or the dynamic nature of the inside of the vascular system. Additionally, as smoking clearly impacts lung function as well, the heart subsequently suffer as well due to pressure and fluid dynamics of the cardiopulmonary system. 

PHYSICAL INACTIVITY, or lack of physical activity, is associated with a weak heart. Since the heart itself is indeed a muscle, it makes sense that we need to keep this sacred muscle strong and resilient. This is done through physical exercise. Specifically, aerobic exercise, or raising the heart rate just moderately, is key. 

FAMILY HISTORY does play a role, though it may not be as close as medical researchers once thought. There is a condition, hypobetalipoproteinemia, where levels of cholesterol are extremely low. It turns out this is protects the cardiovascular system. On the other hand, familial hypercholesterolemia (high cholesterol) increases cardiovascular risk for obvious reasons. Besides these rare genetic conditions, the connection of family history and heart disease is primarily in the susceptibility and expression of lipoprotein subtleties. While these subtleties are important, our diet and lifestyle remains the most powerful factor in determining our genetic fate. I don't regularly align with Dr. Oz, but he was spot on when he said, “Your genetics loads the gun, your lifestyle pulls the trigger." 

Now comes the fun part: reversing heart disease with food, naturally

After you put down the cigarettes - or whatever else you're smoking - the baseline diet is whole plant foods that come from the earth - fruits, vegetables, whole grains, legumes, nuts and seeds. Actually, even if, or especially if, you are still smoking, bring these foods into your diet. The focus is on reducing cholesterol, losing weight, lowering blood pressure, and exercising. While it's important to remove dietary sources of cholesterol (meat, dairy, eggs), it's also important to know that the liver produces cholesterol endogenously to maintain necessary levels for proper physiologic functioning. If cholesterol stays elevated after removing meat, dairy, and eggs, it's important to continue eating cholesterol lowering foods that also naturally support the liver in healing and restoring balance.

Foods to lower cholesterol (11, 12, 13)STOP EATING CHOLESTEROL which is found in animal products (meat, dairy, eggs)NUTS/SEEDS (such as hemp, flax, chia, sesame, sunflower, and pumpkin) contain phytosterols that inhibit the absorption of cholesterol in the gutHIGH FIBER foods (such as oats, okra, eggplant, beans - anything slimy) help to shuttle cholesterol through the gut and into the toilet 

Antioxidant rich foods (14, 15, 16)

AMLA (indian gooseberry) is one of the highest sources of dietary antioxidants

WILD BLUEBERRIES (and any other berry) is also a super source of antioxidants and phytochemicals

GREENS of any sort are always important to have abundantly in the diet

COLORFUL FRUITS AND VEGGIES - eat the rainbow daily 

To lower blood pressure (17, 18, 19)

HIBISCUS tea helps relax blood vessels by inhibits calcium influx into cells (which causes muscle contraction).

CELERY JUICE is a powerful diuretic that flushes excess fluid from the body, while also cleansing the liver.

BEETS are rich in nitrates that when metabolized, help to relax blood vessels.

Magnesium And of course, remember your stress... but don't stress over your stress!

What about Love? 

This leads us to maybe the most important component of heart health - which is love and connection. 

To understand this, let's go back to Roseto, Pennsylvania in the 1960's...(20) 

While incidence of heart disease was rising all around the country at this time, it was noticed that this small town in rural Pennsylvania had less than half the rate of heart attack and dealth compared to every surrounding town. They looked at the water supply - it was the same.They looked for potential occupational factors - they were about the same. They looked at socioeconomic status - that was about the same. They looked at racial and genetic factors - that was the same, though Roseto was predominantly Italian, and maintained a strong cultural connection to Italian traditions.

Researchers noticed how tight nit the families and community was in Roseto, really maintaining close relationships. They were connected and nourished by the love and support of the community. Even though they smoked cigars, drank wine, ate high cholesterol foods like fried meats, salami and cheese, and worked in toxic environments (slate quaries with gases and dusts), they were free of other life stressors. Even though there was actually anti-ethnic discrimination, there was zero crime, and a strong sense of community. This story was dissected in the book, The Power of Clan (which covered the town from 1935-1984) and concluded that the magic of Roseto was the total avoidance of isolated individuals crushed by the problems of life. They avoided internalization of stress.

They had a stable and predictable support system. So, the take away...?Eat nourishing foods. But most importantly, maintain nourishing connections and relationships that allow you to naturally express yourself and avoid bottling up stressful feelings and emotions. To listen to our discussion on this topic, check out https://alter.health/episode55 

References
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  2. Cohen JC, Boerwinkle E, Mosley TH, Hobbs HH. Sequence variations in PCSK9, low LDL, and protection against coronary heart disease. N Engl J Med. 2006;354(12):1264-72.

  3. P J Elmer, E OBarzanek, W M Vollmer, D Simons-Morton, V J Stevens, D R Young, P H Lin, C Champagne, D W Harsha, L P Svetkey, J Ard, P J Brantely, M A Proschan, T P Erlinger, L J Appel, PREMIER Collaborative Research Group. Effects of comprehensive lifestyle modification on diet, weight, physical fitness, and blood pressure control: 18-month results of a randomized trial. 2006 Apr 4;144(7):485-95.

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  7. Centers for Disease Control and Prevention (US); National Center for Chronic Disease Prevention and Health Promotion (US); Office on Smoking and Health (US). How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease: A Report of the Surgeon General. Atlanta (GA): Centers for Disease Control and Prevention (US); 2010. 6, Cardiovascular Diseases.Available from: https://www.ncbi.nlm.nih.gov/books/NBK53012/

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  10. Welty FK. Hypobetalipoproteinemia and abetalipoproteinemia. Curr Opin Lipidol. 2014;25(3):161-8.

  11. Timothy PC, Mark A, Andrew WB. Cholesterol-lowering phytosterols: factors affecting their use and efficacy. Nutrition and Dietary Supplements. 2010 July;2:59-72.

  12. Jew S, AbuMweis SS, Jones PJ. Evolution of the human diet: linking our ancestral diet to modern functional foods as a means of chronic disease prevention. J Med Food. 2009 Oct;12(5):925-34.

  13. Meinertz H, Nilausen K, Faergeman O. Effects of dietary proteins on plasma lipoprotein levels in normal subjects: interaction with dietary cholesterol. J Nutr Sci Vitaminol (Tokyo). 1990 Oct; 36 Suppl 2:S157-64.

  14. S. Rautiainen, E. B. Levitan, N. Orsini, A. AAkesson, R. Morgenstern, M. A. Mittleman, A. Wolk. Total antioxidant capacity from diet and risk of myocardial infarction: A prospective cohort of women. Am. J. Med. 2012 125(10):974 - 980.

  15. Usharani P, Fatima N, Muralidhar N. Effects of Phyllanthus emblica extract on endothelial dysfunction and biomarkers of oxidative stress in patients with type 2 diabetes mellitus: a randomized, double-blind, controlled study. Diabetes Metab Syndr Obes. 2013;6:275-84. Published 2013 Jul 26. doi:10.2147/DMSO.S46341

  16. Seals DR, Kaplon RE, Gioscia-Ryan RA, LaRocca TJ. You're only as old as your arteries: translational strategies for preserving vascular endothelial function with aging. Physiology (Bethesda). 2014;29(4):250-64.

  17. Hopkins AL, Lamm MG, Funk JL, Ritenbaugh C. Hibiscus sabdariffa L. in the treatment of hypertension and hyperlipidemia: a comprehensive review of animal and human studies. Fitoterapia. 2013;85:84-94.

  18. Al-Asmari AK, Athar MT, Kadasah SG. An Updated Phytopharmacological Review on Medicinal Plant of Arab Region: Apium graveolens Linn. Pharmacogn Rev. 2017;11(21):13-18.

  19. Bahadoran Z, Mirmiran P, Kabir A, Azizi F, Ghasemi A. The Nitrate-Independent Blood Pressure-Lowering Effect of Beetroot Juice: A Systematic Review and Meta-Analysis. Adv Nutr. 2017;8(6):830-838. Published 2017 Nov 7. doi:10.3945/an.117.016717

  20. Bruhn JG, Wolf S. RK, Kirkwood B. The Power of Clan: The Influence of Human Relationships on Heart Disease. Transaction Publishers; 1993.

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