Because of my work in Integrative Medicine I often cross paths with “mind-body” professionals who correctly emphasize the fact that our body is greatly influenced by what we believe in , what we think, and how resilient we are. If we could apply this concept to our Health Care system we would see dramatic results and lower costs. Unfortunately, most patients are not ready to hear this; some may even feel that they are pejoratively being told that their physical complaints “are all in their head.”
To complicate matters, a significant number of “mind-body” providers may not consider that the body also influences the mind. If this were not so, this would be the only example in physics were things only flow one way. The end result is that most patients do not enjoy the benefit of a balanced approach that highlights the clear link between mood and food. In other words, bad foods (lots of trans-fats[1] and refined sugars[2]) lead to bad moods.[3] After all, our brain and heart need good fuel to emote. Hugo Rodier, MD
“Two week warning” on impending heart attack?
We are all familiar with the story: Joe Blow goes in for a physical where he is told he is in tiptop shape, only to die of a heart attack a few days later. What is going on? Doctors cannot do invasive tests on routine physicals, particularly when no history or routine labs raise any flags. Besides, ½ of people with a heart attack have normal serum cholesterol. This is why a remarkable study raises the hope that patients could be warned of an impending heart attack. A new test assesses the state of cells lining the inside wall of arteries.[4] There has been so much research on these wall cells that now scientists refer to them as an “organ,” the endothelium.[5] If these cells are seen freely floating inside arteries, the risk of an impending heart event in the next two weeks goes up dramatically, even when there is no chest pain or any other suspicious symptoms.[6]
But, it is intriguing how the greatest warning of a heart attack looming in the future, perhaps not in two weeks, is completely ignored by most people: a beer belly hanging over your belt.[7]
Don’t eat your way into a “surprise heart attack.” Eat more leafy-greens, work on your addiction to processed foods,[8] get plenty of sleep,[9] watch less TV, exercise more,[10] avoid pollution,[11] and optimize relationships.[12] Sure, that is a lot to ask; this is why this new “warning” test may buy you time to get on cardiovascular drugs. Hopefully, it will also motivate you to step back from the abyss.
Energy and the heart
All organs need an optimal supply of energy to perform. All cells have special organelles within, the mitochondria, to transform the food we eat into the energy needed. It turns out that binging on sugar affects (oxidizes) the mitochondria, which may lead to endothelial problems. The mechanism of action seems to be Nitric Oxide, NO, which may be improved by the amino acid arginine and lots of leafy green vegetables:
“Moderate low glucose exposure rapidly impairs NO bioavailability and endothelial function in the human endothelium and that pharmacological AMP kinase activation inhibit this effect in an NO-dependent manner.”[13]
In time, we may see “Mitochondrial Oxidative Stress in Aortic Stiffening With Age.”[14] As predicted, this problem is worse in polluted environments,[15] obesity and diabetes.[16] In past issues we have presented antioxidants that may help reduce oxidative stress in the mitochondria: alpha lipoic acid from Broccoli, and CoQ10 from Spinach and Sardines.
Still, the best energy for the heart is.. Love.[17] Check out these recent articles:
“Risk of Acute Myocardial Infarction After the Death of a Significant Person in One’s Life / Clinical Perspective : The Determinants of Myocardial Infarction Onset Study,”
J. Circulation. 2012;125:491
“Socioeconomic Status, Cardiovascular Risk Factors, and Subclinical Atherosclerosis in Young Adults: The Cardiovascular Risk in Young Finns Study,” J. Arterioscler Thromb Vasc Biol. 2012;32:815
“High education in young adults is associated with favorable cardiovascular risk factor profile and 6-year change of risk factors. Most importantly, the progression of carotid atherosclerosis was slower among individuals with higher educational level.”
More recent articles on cardiovascular health
“Usefulness of the High Triglyceride-to-HDL Cholesterol Ratio to Identify Cardiometabolic Risk Factors and Preclinical Signs of Organ Damage in Outpatient Children,”
J. Diabetes Care January 2012 35:158
“A Meta-Analysis Shows That Docosahexaenoic Acid from Algal Oil Reduces Serum Triglycerides and Increases HDL-Cholesterol and LDL-Cholesterol in Persons without Coronary Heart Disease,” J. Nutrition 2012;142: 1 99
“Long-Term Weight Loss and Prevention of Cardiovascular Disease,” J. Circulation 2011;124:2801
“Genetic determinants of blood pressure responses to caffeine drinking,”
Am J Clin Nutr 2012;95:1 241
“Atherosclerosis Predictor? Circulating Levels of Persistent Organic Pollutants Linked to Arterial Effects,” J. Environ Health Perspect 2012;120:a34
“Flavonoid intake and cardiovascular disease mortality in a prospective cohort of US adults,”
Am J Clin Nutr 2012;95:454
“Randomized controlled study of the effect of a butter naturally enriched in trans fatty acids on blood lipids in healthy women,” (HDL goes down) Am J Clin Nutr 2012;95:318
“Differential effects of polyphenols and alcohol of red wine on the expression of adhesion molecules and inflammatory cytokines related to atherosclerosis: a randomized clinical trial,”
Am J Clin Nutr 2012;95:326
“Consumption of fried foods and risk of coronary heart disease: Spanish cohort of the European Prospective Investigation into Cancer and Nutrition study, BMJ 2012;344:e363
“Tomato-Based Food Products Are Related to Clinically Modest Improvements in Selected Coronary Biomarkers in Women,” J. Nutrition 2012;142:326
“Vitamin D Inadequacy Is Associated with Significant Coronary Artery Stenosis in a Community-Based Elderly Cohort: The Korean Longitudinal Study on Health and Aging,”
JCEM 2012;97: 169
“Legume Consumption Is Inversely Associated with Serum Concentrations of Adhesion Molecules and Inflammatory Biomarkers among Iranian Women,” J. Nutrition 2012;142:334
“(+) Association of Testosterone Levels With Endothelial Function in Men: Results From a Population-Based Study,” J. Arterioscler Thromb Vasc Biol. 2012;32:481
“Dietary Intakes of Zinc and Heme Iron from Red Meat, but Not from Other Sources, Are Associated with Greater Risk of Metabolic Syndrome and Cardiovascular Disease,” J. Nutrition 2012;142:526
“Obesity and heart health influenced by urban design,” Epidemiology and Prevention/Nutrition, Physical Activity and Metabolism Scientific Sessions, San Diego, 2012
Telegraphed articles
Prenatal pesticides are linked to early breast growth, J. Andrology March 9th Epub
“Effect of Exercise Training on Depressive Symptoms Among Patients With Chronic Illness,” J. Arch Int Med 2012;172:101
“Overweight doctors less likely to address obesity,” J. Obesity Epub March 19th 2012
Bilingual people are smarter. Learning a language decreases risk of Alzheimer’s Disease, NYT 3/18/12
Vitamin D helps macrophages clear amyloid in the brain of Alzheimer’s patients, J. Alzheimer’s Disease 2012;29:51
Vitamin D deficiency linked to infants’ food allergies, Am Acad Allergy Asthma Imm Annual Mtg, Orlando, 2012
Toasted Skin Syndrome from heated car seats (“Toasted Buns” would be a better name.) J Arch Derm Feb 22nd 2012
Circumcision reduces the risk of prostate cancer, J. Cancer 3/12/12
[1] J. PLoS One, March 26th 2012 Epub
[2] JAMA 2008;299:2751 & J. Diabetes Care 2008;31:2368
[3] Canadian J. Psychiatry 2012;57:85
[4] “Effect of Intensive Lifestyle Changes on Endothelial Function and on Inflammatory Markers of Atherosclerosis,” American J. Cardiology 2010;105:362
[5] “Microvascular Function Predicts Cardiovascular Events in Primary Prevention: Long-Term Results From the Firefighters and Their Endothelium (FATE) Study,” J. Circulation. 2011;123:163
[6] J. Science Traditional Medicine , March 22nd 2012; reported in New York Times
[7] “Hypertriglyceridemic waist: a simple clinical phenotype associated with coronary artery disease in women,” Journal Metabolism Clinical and Experimental 2012;61:56
[8] “Do Functional Foods Have a Role in the Prevention of Cardiovascular Disease?” J. Circulation. 2011;124:538
[9] “Acute Sleep Deprivation Enhances the Brain’s Response to Hedonic Food Stimuli: An fMRI Study,” J. Clinical Endocrinology Metabolism 2012 97: E443
[10] Epidemiology and Prevention/Nutrition, Physical Activity and Metabolism Scientific Sessions, San Diego 2012
[11] “Association between serum concentrations of persistent organic pollutants and self-reported cardiovascular disease prevalence: results from the National Health and Nutrition Examination Survey,” 1999-2002. J. Environ Health Perspect. 2007;115(8):1204
[12] Google “Rosetto, Pennsylvania heart disease.”
[13] “Acute Exposure to Low Glucose Rapidly Induces Endothelial Dysfunction and Mitochondrial Oxidative Stress: Role for AMP Kinase,” J. Arterioscler Thromb Vasc Biol. 2012;32:712
[14] J. Arterioscler Thromb Vasc Biol. 2012;32:745
[15] “Increased Mitochondrial DNA Copy Number in Occupations Associated with Low-Dose Benzene Exposure,” J. Environ Health Perspect 2012;120:210
[16] “Metabolomic Profiling of Fatty Acid and Amino Acid Metabolism in Youth With Obesity and Type 2 Diabetes: Evidence for enhanced mitochondrial oxidation,” J. Diabetes Care 2012;35:605
[17] Book “The Heart’s Code,” Paul Pearsall; Broadway Books, 1998
