Heart Disease: A Functional Approach

When I was first dreaming of what sort of blog post should be my first I certainly hadn’t thought of Heart Disease… microbiome, SIBO, IBS or Fecal Transplants would’ve been my guess. But, when your my Gramps was entered into the hospital for angioplasty my Type A brain went into overdrive and the only thing I could do was dive head first into the most up to date and relevant information to make him a plan.
Now, Gramps is a pretty conventional guy. He’s married to an old school nurse and is used to the “treat the symptoms rather than root cause” approach. He’s been on and off statins and various other drugs for a number of years, likes to drink and insists on shopping at Walmart. I’ve got my work cut out for me, but I hope that if I lay it all out some of this information will be useful to him and anyone else in similar circumstances.
In regards to preventing heart disease there are many studies that show just how powerful lifestyle intervention can be. For example, The Canadian led InterHeart study, published in the Lancet in 2004, followed 30 000 people and found that changing diet and lifestyle could prevent at least 90% of all heart disease [1]. 
But, why would this approach be preferable to Cholesterol or Blood Pressure Lowering Medication like Statins, ACE inhibitors or Beta Blockers? Because diet and lifestyle addresses the root cause of heart disease. Your body doesn’t display symptoms, such as high LDL cholesterol or atherosclerosis (hardening of the arteries), for no reason. This is a sign that something is out of balance in the body. 
Previously, the reason for Arterial Plaque formation was thought to be high cholesterol alone, or in response to injury. More recently, experts are concluding that atherosclerosis is both an inflammatory disease and lipid disorder combined [2]. Reasons for Heart Disease to occur could include: Blood Sugar Imbalance, Metabolic toxins inducing Inflammation, Chronic Infections such as H-Pylori or viral infections, Gut Dysbiosis/Leaky Gut, Poor Thyroid Function (even subclinical hypothyroidism), environmental or heavy metal toxicity, and Familial (Genetic). 

“Fun Fact: Prior to the 80’s Doctors would use low doses of thyroid hormone to treat high cholesterol even when the patient had relatively normal thyroid numbers [3]” 

To further clarify the importance of addressing root cause: A Meta-analysis of 11 statin trials found that despite significantly lowering cholesterol levels, there was no difference in the lifespan between the two groups. Furthermore, all but one of the trials providing evidence on Statin use were sponsored by the pharmaceutical industry, who as we know have a vested interest in getting more folks to use their products [4].
And finally, the benefit of addressing heart disease at its root is that most other chronic disease will be simultaneously addressed/prevented, making you feel better without any harsh side-effects. 

“Disregarding the underlying causes and treating only risk factors is somewhat like mopping up the floor around an overflowing sink instead of turning off the faucet, which is why medications usually have to be taken for a lifetime. When the underlying lifestyle causes are addressed, patients often are able to stop taking medication and avoid surgery (under their doctor’s supervision, of course).” – Dr. Hyman, MD

Dietary Recommendations to Help Prevent Heart Disease

1. Avoid Blood Sugar Imbalances:

  • Insulin Resistance and blood sugar imbalance is associated with increased risk for heart disease
  • Eat protein with every snack/meal, especially at breakfast. For even better balance aim to have fat, fibre AND protein with every snack/meal.
  • Avoid white flour and processed sugar. If you intend to use a sweetener, use a healthy option such as honey, dates, or maple syrup.
  • Reduce alcohol consumption. Alcohol reduces insulin sensitivity, increases triglycerides and fat in the liver and interferes with blood sugar levels
  • Don’t let yourself get too hungry. Eat every 3-4 hours if necessary to keep insulin and blood sugar in balance
  • Don’t eat within 3 hours of going to bed

2. Eat High Fibre Foods

  • At least 50 g / day. Such foods include beans, vegetables, nuts, seeds and fruit
  • Ground Flax is especially beneficial for accelerating the regression of atherosclerotic plaque [5] 

3. Avoid processed food and drink, including sodas, fruit juices, and diet drinks.

4. Don’t fear Saturated Fat!

Many sources (those still living in the Stone-Age) will tell you to focus on lean meats and vegetable oils in order to reduce your saturated fat intake, quoting research such as that done by Ancel Keys (now shown to be faulty science). However, we know now that the saturated fat/cholesterol – heart disease hypothesis is largely a myth [6]. This dietary switch would result in lowering of total cholesterol levels, yet, the research now indicates that dietary saturated fat and cholesterol no longer need to be avoided as part of a heart healthy diet. An increase in Dietary cholesterol can even protect against cardiac mortality and reduce progression of coronary atherosclerosis [7][8].

  • In fact, replacing saturated fat with vegetable oils has the effect of driving up inflammation, which can lead to heart disease
  • Reducing cholesterol levels has been shown to have zeroeffect in preventing/reversing heart disease
  • There is evidence to suggest that a higher fat and lower carb diet can be beneficial in preventing progression of heart disease
  • Healthy sources of saturated fat include grass fed meat, wild meats, grass-fed butter, cheese, lard and ghee. 
  • Note: the intake of non-grass fed or organic animal products would negate the benefits of the saturated fat due to the presence of unnatural hormones, antibiotics and toxins given to factory farmed animals

5. Increase Omega 3 Intake:

  • Sources include Wild Seafood, anchovies, mackerel, oysters, Grass-fed meats, flax, walnut and hemp oils
  • Note: eating Factory Farmed Atlantic Salmon would negate the benefits due to presence of unnatural toxins
  • Omega-3 supplementation can reduce total mortality and sudden death in patients who have already had a heart attack. Statins reduce the effectiveness of Omega 3 fats [9]. 

6. Eliminate all Hydrogenated Fat

  • Hydrogenated fats are found in margarine, shortening, processed oils and many baked goods and processed foods
  • Replace Hydrogenated fat with olive oil, cold pressed sesame or previously mentioned nut oils

7. Eat at least 8-10 servings of colorful fruits and vegetables a day, which will reduce oxidation and inflammation, and contribute to disease prevention due to their mineral, fiber, phytonutrient, and anti-oxidant contents.

  • Leafy Greens and Natto can provide Vitamin K, which can reduce aortic calcification and improve blood vessel flexibility – benefitting the aorta, heart valves and coronary arteries 
  • Bioflavenoids such as lycopene, quercetin and lutein improve capillary lining permeability and integrity

Additional Heart Unfriendly Things To Avoid

No discussion of preventing cardiac mortality would be complete without discussing things that need to be removed in order to reduce risk, such as:

  • NSAIDs: Drugs like aspirin, ibuprofen, and Tylenol, have well-known association with increased cardiac mortality. Review six studies on the topic here: NSAID Cardiotoxicity.
  • Statin Drugs: It is the height of irony that the very category of drugs promoted to millions globally as the standard of care for primary and secondary prevention of cardiovascular disease and cardiac mortality are actually cardiotoxic agents, linked to no less than 300 adverse health effects. Statin drugs have devastating health effects. Explore the research here: Statin Drug Health Effects.
  • Wheat: while this connection is rarely discussed, even by those who promote grain-free and wheat free diets, wheat has profound cardiotoxic potential, along with over 200 documented adverse health effects: Wheat Toxicity. And why wouldn’t it, when the very countries that eat the most of it have the highest rate of cardiovascular disease and heart-related deaths? For an in-depth explanation read this article: Wheat’s Cardiotoxicity: As Serious As A Heart Attack.

Exerpt from:© (2018) GreenMedInfo LLC[12].

Other Recommendations:

1. Exercise

  • 30-45 minutes of cardiovascular exercise, interval or strength training at least 6 times/week. 

“Exercise is a necessity, not a luxury, in preventing almost all chronic disease, from heart disease to cancer, from dementia to diabetes, from osteoporosis to osteoarthritis. You cannot age successfully without it. It is how we are designed.” – Dr. Hyman MD

2. Practice Stress Reduction

  • Stress contributes to heart disease by creating inflammation, raising blood sugar and blood pressure and even making your blood more likely to clot
  • Try yoga, tai chi, meditation, breathing exercises or Vitamin Nature

3. Co-Q10

  • If you are taking or have taken Statins you should know that they deplete the body’s stores of Coenzyme Q10. Try supplementing with 100 mg/day
  • Common side effects of statins include muscle pain and aching, or liver malfunction (make sure to have liver checked regularly if on statins)

4. Niacin

  • High does (1000-3000) can be helpful for raising good cholesterol (HDL) and lowering triglycerides

5. Vitamin D

  • Being in the lowest 25% of Vitamin D levels in associated with a 26% increased rate of all-cause mortality, with the effect being even more pronounced with cardiovascular mortality [10]. 
  • Soak up some sun or try supplementing with a good D3 

6. Magnesium

  • Cardiovascular risks are lower in individuals who excrete higher levels of magnesium.
  • Good options include chlorophyll, kale or a bioavailable supplement

7. Address Leaky Gut

  • Have a health practitioner with Functional Medicine Training test for infections or overgrowth and determine the best route of treatment
  • Leaky Gut and overgrowth can contribute to obesity, hormone imbalance, autointoxication, malnutrition and inflammation

Four Natural Compounds Which May Unclog the Arteries

  • Pomegranate: this remarkable fruit has been found in a human clinical study to reverse the carotid artery thickness (i.e. blockage) by up to 29% within 1 year. [ix] There are a broad range of mechanisms that have been identified which may be responsible for this effect, including: 1) lowering blood pressure 2) fighting infection (plaque in arteries often contains bacteria and viruses) 3) preventing cholesterol oxidation 4) reducing inflammation.[x]
  • Arginine: Preclinical and clinical research indicates that this amino acid not only prevents the progression of atherosclerosis but also reverses pathologies associated with the process. (see also: Clogged Arteries and Arginine). One of the mechanisms in which it accomplishes this feat is by increasing the production of nitric oxide which is normally depressed in blood vessels where the inner lining has been damaged (endothelium) resulting in dysfunction. (To optimize protein digestion find out whether you have low stomach acid that may be impacting digestion)
  • Garlic: Not only has garlic been found to reduce a multitude of risk factors associated with arteriosclerosis, the thickening and hardening of the arteries, but it also significantly reduces the risk of heart attack and stroke.[xi]  In vitro research has confirmed that garlic inhibits arteriosclerotic plaque formation.[xii]  Aged garlic extract has also been studied to inhibit the progression of coronary artery calcification in patients receiving statin therapy.[xiii] And let us not forget, garlic’s benefits are extremely broad. We have identified over 150 diseases that this remarkable culinary and medicinal herb has been confirmed to be of potential value in treating and preventing and which can be viewed here: Garlic Health Benefits.
  • B-Complex: One of the few vitamin categories that has been confirmed in human studies to not only reduce the progression of plaque buildup in the arteries but actually reverse it is B-complex. A 2009 study published in the journal Stroke found that high dose B-complex vitamin supplementation significantly reduces the progression of early-stage subclinical atherosclerosis in healthy individuals.[xiv] More remarkably, a 2005 study published in the journal Atherosclerosis found a B-vitamin formula decreased the carotid artery thickness in patients at risk for cerebral ischemia.[xv] Another possible explanation for these positive effects is the role B-vitamins have in reducing the production of homocysteine, an artery and otherwise blood vessel scarring amino acid.[xvi]
Exerpt from: © (2018) GreenMedInfo LLC[12].

[1] Yusuf S, Hawken S, Ounpuu S, et al; INTERHEART Study Investigators. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet. 2004;364(9438):937-952.
[2]Steinberg D. Atherogenesis in perspective: hypercholesterolemia and inflammation as partners in crime. Nature Med. 2002;8(11):1211-1217. 
[3] Effects of Thyroid Dysfunction on Lipid ProfileC.V Rizos, M.S Elisaf, E.N LiberopoulosOpen Cardiovasc Med J. 2011; 5: 76–84.  Published online 2011 Feb 24
[4] Ray KK, Seshasai SRK, Erqou S, et al. Statins and All-Cause Mortality in High-Risk Primary PreventionA Meta-analysis of 11 Randomized Controlled Trials Involving 65 229 Participants. Arch Intern Med.2010;170(12):1024–1031. doi:10.1001/archinternmed.2010.182
[5] Andrew A Francis, Justin F Deniset, Jose A Austria, Renee K Lavallee, Graham G Maddaford, Thomas E Hedley, Elena Dibrov, Grant N Pierce (2013) The Effects of Dietary Flaxseed on Atherosclerotic Plaque Regression.Epub 2013 Apr 12. PMID: 23585134
[6] Ramsden Christopher E, Zamora Daisy, Majchrzak-Hong Sharon, Faurot Keturah R, Broste Steven K, Frantz Robert P et al. Re-evaluation of the traditional diet-heart hypothesis: analysis of recovered data from Minnesota Coronary Experiment (1968-73)  BMJ  2016;  353 :i1246
[7] Nissen SE, Tardif JC, Nicholls SJ, Revkin JH, Shear CL, et al. Effect of torcetrapib on the progression of coronary atherosclerosis. N Engl J Med. 2007;356(13):1304-1316. 
[8] Newton RS, Pitas RE, Jensen RG. Effect of diet on fatty acids in the lipoprotein cholesterol esters of type IIa and normal individuals. Lipids. 1975;10(12):858- 862. 
[9]Michal L Melamed, Erin D Michos, Wendy Post, Brad Astor. 25-hydroxyvitamin D levels and the risk of mortality in the general population. Arch Intern Med. 2008 Aug 11;168(15):1629-37. PMID: 18695076
[10] [v] Adit A Ginde, Robert Scragg, Robert S Schwartz, Carlos A Camargo. Prospective study of serum 25-hydroxyvitamin D level, cardiovascular disease mortality, and all-cause mortality in older U.S. adults. J Am Geriatr Soc. 2009 Sep;57(9):1595-603. Epub 2009 Jun 22. PMID: 19549021
[11] Bland, Jeffrey, MD (2007) Functional Medicine Update. ISSN 1092-1761
Vol. 27, No. 7 http://jeffreybland.com/wp-content/uploads/2017/08/fmu-4.pdf
[12] Sayer Ji, Founder (2018) 7 Ways To Prevent and Even Reverse Heart Disease With Nutrition. GreenMedInfo LLC

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