February is Heart month, but before we get into all the tips that help protect you from heart disease, let’s take a look at some stats sure to make your heart skip a beat.
From the Heart & Stroke Foundation website.
- Every 7 minutes in Canada, someone dies from heart disease or stroke
- Heart disease and stroke are two of the three leading causes of death in Canada.
- In 2008 cardiovascular disease accounted for:
29% of all deaths in Canada (69,703 deaths – or more than 69,500)
- 28% of all male deaths
- 29.7% of all female deaths
- In 2008, of all cardiovascular deaths
- 54% were due to ischemic heart disease
- 20% were due to stroke
- 23% were due to heart attack
(Statistics Canada, 2011c)
- The average annual mortality rate for congestive heart failure is 10% per year with a 50% five-year survival rate. (CCS, 2001).
- There are estimated 50,000 strokes in Canada each year. That’s one stroke every 10 minutes (Hakim, Silver, & Hodgson, 1998).
- Stroke costs the Canadian economy $3.6 billion a year in physician services, hospital costs, lost wages, and decreased productivity (2000 statistic) (PHAC, 2009).
- Heart disease and stroke costs the Canadian economy more than $20.9 billion every year in physician services, hospital costs, lost wages and decreased productivity (Conference Board of Canada, 2010).
CURRENT ATHEROSCLEROSIS TESTING IS FLAWED
You can see from the stats above that heart disease is no joke. Unfortunately, with the influence of our government, third party regulating agencies, medical school curriculum, big food companies and the media, we can’t expect these numbers to decrease much in the near future. The reason such stats won’t change much (at least not in our favour) is the fact the traditional lipid profile testing many of our family doctors prescribe to, is outdated as these tests only measure LDL-C (“C” stands for cholesterol), HDL and triglycerides.
High cholesterol levels are mistakenly thought of as the precursor to heart disease when in actuality, inflammation, blood sugar dysregulation and stress are the most common culprits. There are more detailed tests available, such as the Vertical Auto Profile (VAP) test, which provides an in depth lipoprotein particle analysis, giving us a much better understanding of the risk of cardiovascular disease.
Since our blood is water soluble, cholesterol, which is fat soluble, must travel throughout the blood with other fats and, in this case, particles called, lipoproteins (fat and protein molecules). One of the best analogies to describe this process which plays a crucial role in the potential of inflammation and atherosclerosis is a taxi cab. For this instance, lipoproteins will be our taxis on the road. There are car’s that can carry one to four total passengers or vans that can carry one to eight total passengers. They will transport the passengers (cholesterol, triglycerides and even antioxidants) to their destination. Sometimes both the car and van taxis carry a full load and other times they don’t. If the taxis continually carry few total cholesterol passengers, the body feels the need to create more taxi’s to transport more cholesterol. With more and more cars and vans on the road, there is greater potential for accidents that could send taxis flying off the road and crashing into the guardrails (arteriole walls). With each crash, more and more inflammation is created, and often the smaller taxi cars get stuck in the arteriole walls, at which point they oxidize, which also creates inflammation.
With more detailed lipoprotein particle testing, which assess both the importance of particle size (taxi car vs. taxi van) and particle number (the total number of taxis on the road)1 patients will fat somewhere within the following three categories.
Pattern A: This is ideal, resulting in a low number of small dense LDL particles
(taxi cars), a high number of large LDL particles (taxi vans), and a high
number of HDL particles.
Pattern B: A high risk for heart disease from an increased number of small dense
LDL particles, decreased number of HDL particles, and an increased
number of triglycerides (monounsaturated, polyunsaturated and saturated
Pattern A/B: Falls somewhere in the middle.
WHERE THE PROBLEM ALL BEGAN
Up until recently, much of today’s science was based on researcher, Ancel Keys, 22 country heart disease and dietary fat study, or at least this is where it all started. Key’s has been accused of cherry picking the six countries that would support his hypothesis of saturated fat causing heart disease. However, as it turns out, one could have picked six entirely different countries and shown the complete opposite, in that eating dietary fat had very little connection with the risk of dying from heart disease. Keys didn’t get it all wrong though as he didn’t believe cholesterol was a factor in heart disease. If anyone is interested in “geeking out” for a few minutes, I highly recommend reading this blog post titled “The Truth About Ancel Keys: We’ve All Got It Wrong” by Denise Minger. Unfortunately, the damage was already done.2 The US government had heard all it needed to, apparently too busy to wait for all the complete research results. Instead, they prematurely decided to mandate that cholesterol and saturated fat were bad, leading to the American Heart Association (AHA) recommending that we should follow a low fat, high carbohydrate diet, which influenced medical school curriculum, leading to the birth of the ‘low fat craze’ and the abundance of low fat products routinely seen on grocery store shelves in the late 70’s to today. When the low fat craze was born, the Centre for Disease Control (CDC) estimated that 40% of the American population was overweight, compared to 68% in 2008. There were 4.4 million hospital discharges for cardiovascular disease in 1976 compared to 6.2 million in 2008.3
So what’s so bad about following a low fat, high carbohydrate diet? For starters, the fat that had once naturally occurred in products was replaced with extra sugars (such as dairy products) and manmade trans and hydrogenated fats (like margarine). We were told to replace saturated fats, trans fats and cholesterol with the so called “Heart Healthy” fats, which included corn, vegetable, safflower, sunflower, soy and canola oils. We now know these oils are actually the factor in the development in heart disease, and are found in all processed foods and in restaurant food. These cooking oils with lower smoke temperatures are heated easily, oxidizing to become highly toxic to our bodies, causing inflammation, one of the true causes of heart disease.
Higher carbohydrate diets, especially those coming from refined sugars, raise the risk for both type 2 diabetes and heart disease by promoting metabolic syndrome (or Syndrome X), which is diagnosed if you have three out of the following five factors;
- High blood pressure
- Insulin and leptin resistance
- Elevated triglycerides
- Visceral fat accumulation
- Low HDL
Dr. Ronald Kraus’s crossover study shows that a low fat, high carbohydrate diet reduces HDL and increases the small dense LDL particles.4
7 HEART HEALTHY TIPS TO PREVENT HEART DISEASE
How do we reverse the damage created out of negligence by our government and its agencies? It’s quite easy actually, try the following;
1. Consume saturated fat5 and cholesterol from coconut oil, grass fed organic meats, free range organic eggs and *raw dairy. These foods actually reduce the “bad” small dense LDL particles.
*Unfortunately, with our archaic dairy regulations here in Canada, acquiring raw dairy is next to impossible.
2. Consume cold water fish such as salmon, mackerel, herring and sardines as these are excellent sources of eicosapentaenoic acid and docosahexaenoic acid (EPA and DHA for short). These are the long-chain omega-3 fatty acids, proven to be the real deal when it comes to reducing inflammation and supporting heart health.
3. Monounsaturated fats found in olives, olive oil, macadamia nuts, and avocados have been shown to decrease small dense LDL and triglycerides as well as increase HDL. They also decrease oxidized LDL, reduce overall oxidation and inflammation, lower blood pressure, decrease the chance of blood clots, and they may lessen the rate of heart disease.6
4. Reduce carbohydrates especially from processed foods and refined sugars, along with industrialized omega-6 seed and vegetable oils (corn, soy, vegetable, safflower, sunflower and canola oil) as these oils increase small dense LDL particles.
5. Soluble ﬁber attaches to bile acids (made from cholesterol) and it increases the number of LDL receptors in the liver, encouraging the removal of LDL and improving insulin sensitivity while increasing the feeling of satiety. Soluble ﬁber can be found in foods such as nuts and seeds, macadamia, hazelnuts and almonds being best as they contain the lowest traces of omega-6 polyunsaturated fatty acids, a concern if your diet is already high in omega-6’s, fruits and vegetables, whole grains and legumes (if you can digest either/both).
6. Antioxidants from food protect against heart disease, as well as oxidative stress. “Eat the Rainbow” of fruits and vegetables, along with free range organic eggs, grass fed organic meats – especially organ meats as they are high in important antioxidants not found abundantly in plant foods. This includes coenzyme Q10 (CoQ10) and retinol a preformed vitamin A that is already in absorbable form. Coincidentally, the use of statin drugs cuts off CoQ10, known as the heart nutrient and responsible for producing energy. Statin drugs don’t sound like such a good idea now do they?
7. Polyphenols are another group of antioxidants. They are chemical compounds that come mostly from plants, fungi and some animal sources. Some examples include teas (green tea), chocolate, blueberries, olives, olive oil and resveratrol (red wine), and are great for breaking up free radicals, diminishing inflammation, lowering LDL cholesterol, decreasing blood pressure and improving insulin sensitivity.
*One of my favourite antioxidant fruit, loaded with polyphenols is the pomegranate. Infact, I wrote a blog post about the benefits of pomegranates not long ago and included a video on how to easily extract their seeds. You can view the post and video here.
Two non food related tips that are important in heart health are exercise and sleep. Exercise is a crucial factor in reducing Pattern B (as described above) and adequate sleep, quality being just as important if not more important as quantity, to help your body repair and build. Sleeping in a pitch black cool room, that is free of electronics, while keeping your head away from electrical outlets is recommended.
WHAT’S UP, DOC?
Unless you are a middle-aged man diagnosed with coronary heart disease, and whose HDL levels are low, I would recommend getting a second opinion if your doctor wants to prescribe a statin drug to you solely because your standard lipid profile test showed elevated LDL-C numbers. Following the diet and lifestyle tips I have outlined above can prevent 90% of cardiovascular disease.7 According to the INTERHEART study, which examined cardiovascular risk factors in 51 countries, nine out of the 10 strongest risk factors for heart disease are reversible by changes in diet and lifestyle.8 Harvard Medical School Professor of Medicine, Frank Hu, MD, MPH, PhD, explains, “It is now increasingly recognized that the low fat campaign has been based on little scientific evidence and may have caused unintended health consequences.”9
1. Superko HR, Gadesam RR. “Is it LDL particle size or Number that correlates with risk for cardiovascular disease?” Current Atherosclerosis Reports (2008) Vol 10, issue 5 377-385
2. Yerushalmy, J, and HE Hilleboe. “Fat in the Diet and Mortality from Heart Disease: A Methodological Note.” NY State J Med 57(14) (1957): 2343-54; PubMed PMID:13441073
3. Ogden, C, Carroll M. “Prevalence of overweight, obesity, and extreme obesity among adults: United States, trends 1960-1962 through 2007-2008.” CDC National Center for Health Statistics. June 2009
4. Dreon DM, Fernstrom HA, Miller B, Krauss RM. “Low-density lipoprotein subclass patterns and lipoprotein response to a reduced-fat diet in men.” Faseb J Jan 8, 1994; (1): 121-126
5 & 6. Siri-Tarino PW, Sun Q, Hu FB, Krauss RM. “Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease.” American Journal of Clinical Nutrition 91(3)(2010):535-46
7 & 8. Yusuf S, Hawken S, Ounpuu S, Dans T, Avezum A, et al. “Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet 364(9438) (2004):937-52
9. Hu, FB, JE Manson, and WC Willett. “Types of Dietary Fat and Risk of Coronary Heart Disease: A Critical Review.” J Am Coll Nutr 20(1) (2001):5-19; review.
Nathane Jackson is a veteran health and wellness authority, specializing in holistic living. He has a decade worth of knowledge as a personal trainer, strength & conditioning coach and holistic nutritionist and is dedicated to improving all aspects of health starting at the cellular level by combining nutrition, functional exercise, and restorative practices to help his clients strengthen their mind, body and spirit.
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