A recent study published in the journal Diabetes Care has found that low doses of the omega-3 fatty acids eicosapentaenoic acid (EPA), docosaheaxaenoic acid (DHA), and alpha-linolenic acid (ALA) reduced the risk of heart arrhythmia-related events in diabetic patients who had previously suffered a heart attack.

1,014 diabetic patients, aged 60 to 80 years old, were randomized into four groups and consumed margarine that contained either 223 mg EPA and 149 mg DHA, 1.9 g ALA, both EPA/DHA and ALA, or no omega-3 fatty acids every day for 40 months. The group that consumed the margarine with EPA/DHA and ALA experienced an 84 percent lower risk of arrhythmia-related events and a 72 percent lower risk of arrhythmia-related events and fatal coronary events when compared to the group consuming the plain margarine. Heart arrhythmia is an irregular heartbeat, and can lead to cardiac arrest.

The authors of the study suggest a few possible reasons why these omega-3s might be helpful in diabetics with heart disease. One, they might play a role in regulating insulin sensitivity, an important factor in diabetes. Two, they may help to lower blood sugar levels. And three, their anti-inflammatory properties may help to reverse insulin resistance. All these factors can lead to heart disease if unaddressed.

More studies will be done to determine the precise role each omega-3 plays in heart arrhythmia and heart disease, but this study adds to the thousands of studies illustrating the heart-healthy benefits of omega-3 oils.

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Renew You Challenge

Let’s start this week off right!

Weekly challenge (I mean opportunity!) to help set you off on the right foot and in the right direction for bringing health to your week. You could even add it to your calendar.  Join us! 

The new MyPlate icon that represents the new U.S. Dietary Guidelines is a step in the right direction as far as food recommending goes, but it still falls short of what I call—and what many people call—healthy eating.

A recent study has found that Americans only achieve at least 70 percent of the guideline recommendations seven days each year. So if Americans are not even able to meet these guidelines, how difficult will it be to make even greater improvements in diet? Clearly, something has got to change.

A recent editorial in the New England Journal of Medicine criticizes the new MyPlate Guidelines, saying that the food industry greatly influenced the new recommendations. The editorial, which came from two Harvard public health professors, questioned the allowance for up to half of grains to come from refined grains. Refined grains are a big part of why over two-thirds of this country is overweight or obese, and why so many people have diabetes and heart disease. Refined grains should be eliminated completely, in my opinion.

Other recommendations were not made as clearly as they could have in the new MyPlate recommendations. The editorial stated, “A clearer message would have been that Americans must reduce consumption of red meat, cheese, butter, and sugar, but that message would have offended powerful industries.”

This week, when planning your meals, fill your plate with plenty of vegetables, lean proteins, and healthy fats. Snack on fruits like berries. Consume whole grains, as well, but don’t make them the focus of your meals. And get the sugar out of your diet—it really doesn’t belong there.

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Colorectal cancer is the third most commonly diagnosed cancer, and the third leading cause of cancer death in men and women in the United States. A recent study published in the British Journal of Cancer, involving over 5,000 women from the Women’s Health Initiative study, has found a link between high blood sugar levels and colorectal cancer in postmenopausal women.¹

At the beginning of the study, and on several more occasions over 12 years, fasting blood sugar and insulin levels were measured. At the end of the 12-year study, 81 women out of over 5,000 had developed colorectal cancer. Women with the highest blood glucose levels were twice as likely to have developed colorectal cancer as the women with the lowest levels.

The next step, the researchers stated, is to find the mechanism, or to find out how high blood sugar leads to colorectal cancer. The lead researcher, Geoffrey Kabat, Ph.D., states, “It’s possible that elevated glucose levels are linked to increased blood levels of growth factors and inflammatory factors that spur the growth of intestinal polyps, some of which later develop into cancer.” Other studies have found a link between elevated insulin levels, which occur as a result of prolonged elevation of blood sugar levels, and colorectal cancer.²

Elevated blood sugar does a whole lot more than lead to colorectal cancer. High blood sugar leads to insulin resistance, metabolic syndrome, type 2 diabetes, gestational diabetes, heart disease, non-alcoholic fatty liver disease (NAFLD), Alzheimer’s disease, and more. Furthermore, insulin resistance increases fat deposition which will lead to further production of inflammatory cytokines and more inflammation throughout the body.

Maintaining healthy blood sugar levels is crucial for optimal health. I recommend a glucose and insulin tolerance test, measuring glucose and insulin at one and two hours. Also, the A1c test is will help to measure how well blood sugar levels are managed over time, as it’s a measure of your average blood sugar level for the past two to three months.

If your blood glucose and insulin levels are out of normal range, you’re in trouble. In fact, if you are overweight, or if you have abdominal fat, you’re in trouble. Belly fat is considered to be an organ of its own,³ churning out pro-inflammatory cytokines, and contributing to many different chronic diseases. If you are overweight or have belly fat, it’s likely you also have elevated blood sugar or insulin, or that you’re heading in that direction, which leads down a path of chronic disease.

The Standard American Diet (SAD) is high in grain-based carbohydrates and low in vegetable-based carbohydrates, high in refined sugars and low in fiber, and high in unhealthy fats and low in healthy fats. All of these factors contribute to poor health. Elevated blood sugar and insulin levels occur as a result of eating the SAD diet. Change your diet if it’s not high in vegetables, healthy fats, leans proteins, seeds and nuts. These foods will help protect against high blood sugar levels.

References

1. G.C. Kabat, et al., “A longitudinal study of serum insulin and glucose levels in relation to colorectal cancer risk among postmenopausal women.” Brit J Cancer.2011 Nov 29; advanced online pub.
2. M.J. Gunter, et al., “Insulin, insulin-like growth factor-I, endogenous estradiol, and risk of colorectal cancer in postmenopausal women.” Cancer Res. 2008 Jan 1;68(1):329-37.
3. E.E. Kershaw and J.S. Flier, “Adipose tissue as an endocrine organ.” J Clin Endocrinol Metab. 2004 Jun;89(6):2548-56.

Leonard Smith, M.D.
Dr. Leonard Smith is a prominent Board-Certified, general, gastrointestinal and vascular surgeon who had a successful private practice for 25 years. In addition to his active surgery practice, he also incorporated lifestyle, diet, supplementation, exercise, detoxification, and stress management into many of the therapies he would prescribe. Many of his patients with cancer, cardiovascular disease, and other serious illnesses did so well under his treatment regimes that he began to devote most of his career to foundational health care and preventive medicine.

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People with high blood pressure are generally advised to reduce their intake of dietary salt. The average U.S. salt consumption is about 3,400 mg per day, but the latest Dietary Guidelines for Americans recommend keeping sodium intake below 2,300 mg per day for healthy people, and under 1,500 mg for people with high blood pressure and for those at risk of high blood pressure, most notably blacks and people over age 50. These groups make up about 70 percent of the U.S. population. The American Heart Association recommends that everyone should consume less than 1,500 mg of sodium per day.

These recommendations come from the results of the DASH (Dietary Approaches to Stop Hypertension) studies, which have found that a reduction of salt intake to below 1,500 mg per day is an effective method for reducing blood pressure.¹ Whether or not the reduction of dietary salt leads to further cardiovascular benefits has been a subject of debate, however.

In July of this year, a controversial² Cochrane Review published in the American Journal of Hypertension found that recommendations for a reduction in salt intake did lead to reduced salt consumption and a small reduction in blood pressure after six months, but that, “cutting down on the amount of salt has no clear benefits in terms of likelihood of dying or experiencing cardiovascular disease,” concluded the study.³ In fact, one finding of the study was an increase in the risk of death in people with congestive heart failure. The lead researcher stated, “We believe that we didn’t see big benefits in this study because the people in the trials we analyzed only reduced their salt intake by a moderate amount, so the effect on blood pressure and heart disease was not large.”

The saga continues with a recent Cochrane Review, also published in the American Journal of Hypertension, which reviewed 167 studies and found that reduction of dietary salt intake resulted in a modest 1 percent decrease in blood pressure in Caucasians with normal blood pressure and a 3.5 percent decrease in Caucasians with high blood pressure.⁴ Further, the study also found that salt reduction increased renin, aldosterone, adrenaline and noradrenaline (all hormones that affect blood pressure), in addition to raising cholesterol by 2.5 percent and triglycerides by 7 percent. These potentially harmful effects call into question the recommendation to reduce salt intake in Caucasians on cardiovascular risk overall.

The major source of sodium in the Standard American Diet (SAD) comes from processed food—cheese, bread, pizza, and grain-based foods and desserts being the main sources. This is a problem in itself. Perhaps it’s not the sodium that is the major contributor to cardiovascular risk, but rather the overall poor quality of the diet. Processed foods, refined grains, sugars, and chemical additives have turned the American diet into a ticking time bomb for heart disease—and most all chronic disease, for that matter. Remember that salt, in its natural form (from the sea) contains an array of minerals that help support nutrient sufficiency in the diet. Sea salt, like any salt, should be consumed in moderation—don’t overdo it, but you might not want to reduce levels as drastically as have been recommended.

The good news is there are other ways to eat a tasty (or even spicy) moderate amount of salt in your food:  Herbamare is a product which contains sea salt, lemon, fennel, leek, onions, chives, parsley, dill, basil, carrots, garlic, bay leaves,  marjoram, rosemary, thyme, chili, and kelp. Some varieties have hotter chili for those who like it. In addition, adding more kelp, nori, or dulse, all sea vegetables, adds more minerals (including iodine) in a natural form that would be beneficial for most everyone.  Through the use of medicinal foods like these, eating can be a joy that balances salt and herbs, providing much more than just table salt. And now for dessert:  It turns out that dark chocolate and almonds are quite beneficial in lowering blood pressure as well.

References

1. F.M. Sacks, et al., “Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. DASH-Sodium Collaborative Research Group.” N Engl J Med. 2001 Jan 4;344(1):3-10.
2. F.J. He and G.A. MacGregor, “Salt reduction lowers cardiovascular risk: meta-analysis of outcome trials.” Lancet. 2011 Jul 30;378(9789):380-2.
3. R.S. Taylor, et al., “Reduced dietary salt for the prevention of cardiovascular disease: a meta-analysis of randomized controlled trials (Cochrane review).” Am J Hypertens. 2011 Aug;24(8):843-53.
4. G. Jurgens and N.A. Graudal, “Effects of low sodium diet versus high sodium diet on blood pressure, renin, aldosterone, catecholamines, cholesterols, and triglyceride.” Cochrane Database Syst Rev. 2004;(1):CD004022.

Leonard Smith, M.D.
Dr. Leonard Smith is a prominent Board-Certified, general, gastrointestinal and vascular surgeon who had a successful private practice for 25 years. In addition to his active surgery practice, he also incorporated lifestyle, diet, supplementation, exercise, detoxification, and stress management into many of the therapies he would prescribe. Many of his patients with cancer, cardiovascular disease, and other serious illnesses did so well under his treatment regimes that he began to devote most of his career to foundational health care and preventive medicine.

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The benefits of omega-3 oils from fish were first noticed in Inuit populations of Greenland. Researchers noticed that these people consumed high amounts of fat, yet did not develop heart disease or experience heart attacks like people in the Western world. Thus began studies of the Inuit diet in which beneficial omega-3 fatty acids from fish—EPA and DHA—were found to be the heart-protective components.

Many thousands of studies later, the benefits of omega-3 fish oil are still being found in many different areas of health. In a new study of Yup’ik Eskimos in Alaska, researchers evaluated the effects of a high-fat fish-based diet on disease markers in obese Eskimos. The rate of obesity in these people is similar to that in the lower US—the difference is the source of dietary fat. In the US, saturated and trans fats are high in the diet, and healthy polyunsaturated fats, like omega-3s, are low.  

In obese Yup’ik Eskimos with the highest blood levels of EPA and DHA, blood triglyceride and C-reactive protein (a measure of overall inflammation) were the same as normal weight people. In those Eskimos with the lowest EPA and DHA levels, however, blood triglyceride and CRP levels were high. High triglycerides and CRP levels are risk factors for the development of cardiovascular disease and possibly diabetes.

Results of this study suggest that omega-3 fatty acids EPA and DHA found in fish may have health protecting effects even in obese people. More studies are needed to confirm these results, but this study is promising.

Now, don’t get carried away and think you can eat all the fatty foods you want and just pop a fish oil supplement. Instead choose healthy fats as part of your diet with plenty of fish on the menu, and supplement that with omega-3s from fish oil to be sure you’re getting enough of these great fats. Just be sure to look for a fish oil that meets International Fish Oil Standards (IFOS—look for the IFOS seal on the bottle).

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Renew You Challenge

Let’s start this week off right!

Weekly challenge (I mean opportunity!) to help set you off on the right foot and in the right direction for bringing health to your week. You could even add it to your calendar. Join us!

Many people are familiar with the term “omega-3.” And many people also know that good sources of omega-3 are fish and flaxseeds. But did you know that these two sources contain different types of omega-3? That’s right. Flaxseed contains the omega-3 called alpha-linolenic acid (ALA) and fish contains two different types of omega-3: docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA).

ALA actually converts into EPA, which then can convert into DHA (and vice versa). These conversions, however, occur on a very limited basis. ALA only converts to EPA at a rate of between 8 and 20 percent, and only converts to DHA (by way of EPA) at a rate of between 0.5 and 9 percent. Many people take omega-3 in the ALA form, like flaxseed oil, thinking that they are getting all the benefits of omega-3s, but they’re not getting the whole story. Certainly ALA is a beneficial omega-3. I don’t refute that. But most of the benefits of ALA are thought to be due to its eventual conversion into EPA and DHA—especially when it comes to heart health.

A recent study published in the American Journal of Clinical Nutrition highlights this point. Data based on 3,277 healthy Danish adults found that a higher intake of ALA over 23 years was not associated with a reduction in risk of ischemic heart disease—the most common form of heart disease, and the most common cause of death in the U.S. But intake of other long-chain omega-3s—like EPA and DHA—was associated with a reduced risk.

The researchers found that intakes ranging from 0.45 to 11.2 grams per day were associated with a 38 percent reduced risk of ischemic heart disease for women. This is a large range, certainly, and higher doses of EPA and DHA should only be taken under the consult of a doctor. But the American Heart Association does recommend that people consume the equivalent of 500 mg per day of EPA and DHA (not ALA) if they are healthy and want to maintain heart health; 1 gram per day if they have coronary heart disease; and 2 to 4 grams per day if they have high triglycerides.

This week, if you are taking an omega-3 supplement, take a look at the label and see how much EPA and DHA you are getting. This is what you should be looking for in a high-quality omega-3.

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The science behind omega-3s—especially EPA ad DHA, the omega-3s found in fish—is particularly strong for cardiovascular benefits. In fact, the American Heart Association recommends that healthy adults consume the equivalent of 500 mg daily of EPA and DHA; that people with heart disease consume 1,000 mg of EPA and DHA daily; and that patients who need to lower triglyceride levels consume 2 to 4 grams of EPA and DHA daily.

The reasons why fish oil is so heart healthy are many. In addition to helping lower triglyceride levels, omega-3s from fish oil have also been found to reduce blood clots and improve blood pressure, heart rate and vascular function. On top of that, a recent meta-analysis (a study which compiles data across many studies—in this case 10 randomized, controlled, human clinical trials) found that omega-3 intake was effective in reducing arterial stiffness, also known as hardening of the arteries.

Arterial stiffness is associated with an increased risk of cardiovascular events like heart attack and stroke. It is the result of atherosclerosis, the buildup of plaque in the artery wall, and is more common with age. “Reduction in arterial stiffness by omega-3 may account for some of its purported cardio-protective effects,” stated researchers.

Fish oil supplements are not all created equal. The most beneficial omega-3s found in fish oil are EPA and DHA. Be sure you are getting the most of your fish oil—read the label and add up the amounts of EPA + DHA. That’s what you’re looking for when it comes to a good fish oil supplement.

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Belly fat is usually detectible—people generally have a good idea if they tend to accumulate fat in their midsection, as opposed to their hips and bottom. But how do you know if your liver is fat? Well, abdominal fat and liver fat often go hand in hand. In fact, fat from the liver can be sent to the belly, and vice versa. Often, an underlying feature of both of these is inflammation, which may come from the gut. Nutrients and other substances—including fat, toxins and inflammatory compounds—are absorbed from the small intestine and travel straight to the liver via the portal vein.

A recent study found that obese individuals with high amounts of abdominal fat and liver fat are at increased risk for heart disease. The researchers found that liver fat is strongly associated with increased secretion of very-low-density lipoproteins (VLDL), which contain the highest amounts of triglycerides, known to increase heart disease risk.

It has long been known that abdominal fat can be dangerous. The increasing knowledge about the dangers of liver fat adds to the story, as these two go hand in hand, each setting the body up to be more susceptible to metabolic syndrome, type 2 diabetes and heart disease. Together, belly and liver fat mean trouble.

Both liver and abdominal fat can be reduced with exercise and weight loss. These steps, in addition to addressing any underlying gut dysfunction that may be contributing inflammation to the liver, can help reverse these metabolic precursors to heart disease.

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Renew You Challenge

It’s Monday again and let’s start this week off right!

Weekly challenge (I mean, opportunity!) to help set you off on the right foot and in the right direction for bringing health to your week. You could even add it to your calendar. Join us!

A recent study to be published in the Journal of Clinical Endocrinology & Metabolism found that consuming fructose or high fructose corn syrup for two weeks at the upper acceptable recommended levels (according The Dietary Guidelines for Americans 2010—25 percent of total daily calories) increased blood levels of cholesterol and triglycerides—both risk factors for heart disease.

Researchers tested three forms of sugar—fructose, high fructose corn syrup and glucose. Only the fructose groups were found to have a negative effect. Glucose is the basic unit of sugar that is used by the body, but it is derived from other dietary sugars like fructose and sucrose.

The researchers stated, “Our findings provide evidence that the upper limit of 25 percent of daily calories consumed as added sugars as suggested by The Dietary Guidelines for Americans 2010 may need to be re-evaluated.” In contrast to these guidelines, the American Heart Association recommends that only five percent of total calories come from added sugar. This study may serve to help bridge the gap between both recommendations.

Excess sugar consumption is not difficult to reach in today’s world, and can have a host of negative health consequences. This week, take a closer look at the foods you eat. Read the ingredient labels of packaged foods and try to avoid products that contain added sugars in the ingredient list. Be careful, though, these sugars like to arrive in disguise under a host of names. Here’s a list to look out for:

•Agave nectar

•Brown sugar

•Cane crystals

•Cane sugar

•Corn sweetener

•Corn syrup

•Crystalline fructose

•Dextrose

•Evaporated cane juice

•Fructose

•Fruit juice concentrates

•Glucose

•High-fructose corn syrup

•Honey

•Invert sugar

•Lactose

•Maltose

•Malt syrup

•Molasses

•Raw sugar

•Sucrose

•Sugar

•Syrup

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Recent findings by Harvard researchers in the Women’s Health Study (which involved more than 17,000 female health professionals) indicate that women whose work is highly stressful are at a 40 percent increased risk of developing heart disease compared to their less-stressed colleagues. The study also showed that women who worry about job loss are more likely to have high blood pressure, unhealthy cholesterol levels and be obese.

More studies back this up. A large study in Denmark found a higher risk for heart disease among women aged 51 and older who were under greater work pressure. Another study in Beijing found that women with job strain had increased thickness of the carotid artery—a sign of cardiovascular disease.

The effects of stress, and especially chronic stress, are far-reaching. The body is designed to respond to stress by increasing blood pressure, speeding heart rate, quickening breathing, and slowing digestion. Did you know that stress even alters the microbial balance in the digestive tract? Chronic stress has these same effects, but over a longer time period. The result? Chronic disease.

There are some aspects about work-related stress that cannot be changed. We all know that. How we handle the stress is another story. Stress-reducing therapies such as relaxation techniques, meditation, or yoga can be helpful. Regular exercise is another stress reducer, and is also good for the heart. Reducing stress outside of work can also help lessen the stress load.

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