Heart Disease Prevention - A Complete Nutritional Approach

Michael Lam, MD, MPH
www.DrLam.com

Introduction

At least 14 million Americans have heart disease and more than 2,600 die every day from heart attacks in the United States alone. Cardiovascular disease afflicts around 15% of adults in their late 30s to 40s, about 50% of 55 to 64 year-olds, and 65% will be afflicted in the next decade of their lives.

After 20 years of aggressive drug therapy and promotion of low-fat diets, the tide on cardiovascular disease has not reversed. Obviously, this elusive condition is far more complicated than we ever imagined. It is clear that there are other factors that have not been addressed.

Cause of Cardiovascular Disease

For decades, the public at large has been taught that the key culprit of heart disease is high cholesterol in our blood that comes from a diet that is high in cholesterol. This notion must be downgraded.

Consider the following:

Polar bears, for example, maintain total blood cholesterol of over 400 mg/dl and they seldom develop heart attacks.

Eskimos are relatively free of heart disease. They eat animal fats from fish and marine animals liberally.

The Okinawans are the longest living population group in the world. The average life span for Okinawan women is 84 years. Their diet consists of an intake of fish 2-3 times a week and a high intake of vegetables. Their cholesterol intake on the whole is more than most.

People in North India consume 17 times more animal fat but have 7 times fewer incidences of heart disease compared to people in southern India.

In the Framingham study, men and women consumed an average cholesterol intake of 700 mg and 500 mg per day respectively (one egg provides 200 mg). The average serum concentration of cholesterol for men and women with higher than average cholesterol intake was found to be 237 and 245 mg/dl respectively. Subjects with lower than average intakes had an average serum concentration of 237mg/dl for men and 241 mg/dl for women. The actual number difference insignificant. Statistically, studies have shown that people who consume 4 eggs per week actually have average serum cholesterol (193 mg/dl), which is the same as those who reported consuming only 1 egg per week (197 mg/dl). Clearly dietary cholesterol in and of itself is not the critical link to heart disease risks as we once thought.

Today, few experts deny that the low-fat message of the past three decades is radically oversimplified. If nothing else, it effectively ignores the fact that mono-unsaturated fats like olive oil is full of omega-3 fatty acid, is good for health and must be consumed in large amounts. Bad fats such as overcooked saturated fats from meat or trans-fat from processed food should be avoided.

While a diet high in unhealthy fat can promote heart disease, it is only one of many factors that increase cardiovascular risk. Science is telling us that in fact, it is only a minor reason. Other than the familiar hypercholesteremia, the main reason for high blood cholesterol is excessive metabolism of oxygen and sugar in our blood stream due to the polluted environment, and a diet high in refined carbohydrate, trans-fat, and a stressful lifestyle. This leads to free radical generation that in turn damages the endothelial wall of the blood vessel. The body has an intrinsic repair mechanism to overcome the damage, but it needs the proper nutrients to get the job done. Some nutrients are made internally, while others need to be supplied externally. In the case of blood vessel repair, the key is ascorbic acid. It cannot be made endogenously and has to be taken in externally from food sources.

Sad to say, but the food we eat today is far different from that of our grandparents. Today's diet simply cannot provide all the nutrients needed by the body to repair the damaged endothelium. Our soils are depleted of nutrients, the amount of chemicals and preservatives are at an unprecedented high level, and the high heat we use to cook our food with is nothing short of extreme. The wholesome meal that our grandparents ate is now replaced by frozen and processed food when we are not able to go to a fast food restaurant. Even the 65 mg of Vitamin C in one orange gets only fractionally delivered to our body by the time it makes the journey from the orchard to our kitchen. Our body was never designed to take in large quantity of glucose from the breakdown of pastas, breads, French fries, cookies, and soda over several years. It simply does not have the ability to process those foods properly without residual damaging effects.

Lacking the specific nutrients in order to carry out the repair process properly, the body puts its emergency repair team into action. It instructs the liver to produce cholesterol (a sticky and waxy substance) as a surrogate in its attempt to repair damaged arteries by covering the damaged areas. The cholesterol that is produced travels from the liver to the damaged areas as LDL (bad) cholesterol. It is further converted into oxidized LDL cholesterol and sets off a cascading inflammatory reaction. This eventually leads to a thrombus formation, the reduction of nitric oxide synthesis, a high blood pressure, and ultimately the blockage of blood vessels which can result in heart attacks or strokes.

A high cholesterol blood level can therefore be viewed as a sign of underlying vascular wall dysfunction at the endothelium and defect in our insulin's activity against glucose. Unfortunately, this has gone unrecognized. Instead, the cholesterol myth has lead researchers to focus on stopping the production of cholesterol from the liver by the use of drugs.