Increased risk of cardiovascular death is associated with intermittent fasting

Intermittent fasting, a diet pattern that involves alternating between periods of fasting and eating, can lower blood pressure and help some people lose weight, past research has indicated. 

 But an analysis presented Monday at the American Heart Association’s scientific sessions in Chicago challenges the notion that intermittent fasting is good for heart health. Instead, researchers from Shanghai Jiao Tong University School of Medicine in China found that people who restricted food consumption to less than eight hours per day had a 91% higher risk of dying from cardiovascular disease over a median period of eight years, relative to people who ate across 12 to 16 hours.

TAVR: Most exciting innovations in heart care

TAVR Heart Procedure Called “Transformative” for Your Aortic Valve

A minimally invasive technique for aortic valve replacement has emerged as one of the most exciting innovations in heart care in decades.

Transcatheter aortic valve replacement (TAVR) allows doctors to insert a prosthetic valve inside a damaged valve in the cath lab. It’s a lifesaving option for patients with severe aortic stenosis (AS), for whom surgery is considered too risky. But it’s not yet ready for everyone.

Heart Health: Nutritional value more important than calorie count

It's time to kick the habit of counting calories and look at the overall nutritional value of foods to promote better heart health and curb obesity, say experts.

Simple dietary adjustments such as boosting omega-3 fatty acid, olive oil and nut intake have all been associated with significant, positive changes to heart health in a short time, say the researchers in an editorial in the journal Open Heart.

FDA Approves New Cholesterol Drug

The Food and Drug Administration has approved the first of a new class of cholesterol drugs aimed at helping people with a hard-to-treat, inherited form of high cholesterol.

The drug, called Praluent, must be injected, so it won't be as easy to take as a pill. Because it's in a class of biotech drugs called monoclonal antibodies, it will be pricey — $14,000 a year.

It's in a new class of drugs known as proprotein convertase subtilisin kexin type 9 (PCSK9) inhibitors. It targets PCSK9, a protein that affects the liver's ability to take LDL or "bad" cholesterol out of the blood.

Niacin: B vitamin reduces risk of heart attacks and other disease

Niacin is one of the B vitamins, sometimes also known as B3. It is white powder soluble in water and more resistant to destruction that any of the other B complex vitamins. Niacin includes nicotinic acid and nicotinamide also sometimes call niacinamide. Both forms of niacin perform basically the same functions but nicotinic acid has the additional capability of lowering blood cholesterol levels. It also produces side effects not found with nicotinamide.

Niacin is carried in the blood and is found in all tissues but most abundantly in the liver, Kidney, heart, tissues brain and muscles. A lack of niacin can cause cell damage anywhere in the body.

Like the other B vitamins niacin is crucial for the body’s usage of enzymes which provides the body energy and the building blocks for cell reproduction and repair. It is known to be involved in more than 200 enzymes reactions in the body involving the metabolism of carbohydrates, fats and proteins.

New heart health guidelines focus on statins

Millions more Americans could end up taking cholesterol-lowering statin drugs under new recommendations released on Tuesday that advocate a dramatic shift in the way doctors assess and treat cardiovascular risk.

Roughly a quarter of Americans age 45 and older already take statins, which include familiar brands such as Lipitor and Zocor, to treat high cholesterol. But that number could grow sharply under far-reaching guidelines detailed by the American Heart Association and the American College of Cardiology.

At the core of the recommendations, which resulted from a four-year review of medical research, lies a new formula intended to help physicians calculate the chances of heart attacks and stroke in patients, particularly those in certain risk categories.

That represents a sea change from the approach that has persisted for more than a decade, of focusing intently on the level of a patient’s low-density lipoproteins (LDL) — the “bad cholesterol.”

Instead, the new guidelines encourage doctors to consider age, weight, blood pressure and other factors, such as whether patients smoke or have diabetes. If a person appears to have even a moderate risk of a heart attack or stroke, he or she should be prescribed statins, regardless of LDL score.

“It’s really about your global risk,” said Donald Lloyd-Jones, chair of the Department of Preventive Medicine at Northwestern University and one of 20 experts on the committee that wrote the new guidelines. “There were a number of people at substantial risk who, under the old paradigm, were not being captured.”

Heart disease remains the nation’s leading killer of men and women. About one in every four deaths in the United States, or about 600,000 annually, are attributed to heart disease, according to the Centres for Disease Control and Prevention. More than 700,000 Americans suffer heart attacks each year, and the costs of coronary heart disease — from health care to lost productivity — exceed $100 billion (Dh367 billion) annually, the agency has said. In addition, strokes kill another 130,000 people a year.

The new recommendations call for prescribing statins to an estimated 33 million Americans who don’t have cardiovascular disease but who have a 7.5 per cent or higher risk for a heart attack or stroke over the next decade. Examples of groups that could fall into that category include white women over 60 who smoke and African American men over 50 with high blood pressure.

Roger Blumenthal, director of the Ciccarone Preventive Cardiology Centre at Johns Hopkins University, said about 50 or 60 per cent of African American men and a third of white men in their 50s probably will qualify for treatment under the new regime. African American men tend to have higher blood pressure than their white counterparts. Similarly, a majority of black women in their 60s and a third of white women the same age are likely to end up on the medications, along with most men in their 70s and older.

That doesn’t mean every man over 70 will be put on statins, said Blumenthal, who represents the American College of Cardiology on a committee at the National Institutes of Health that is helping to foster the adoption of the new guidelines. Primary-care physicians and cardiologists will use the guidelines as a starting point in treating their patients. But overall, the doctors said they expect a significant increase in the number of people taking statins, and a decrease in the use of other drugs that are prescribed along with them in an attempt to lower LDL levels.

The four risk groups include previous victims of heart attack, stroke or cardiovascular disease; people with an LDL of 190 or higher; people with diabetes; and anyone over 40 with a 7.5 per cent risk of a heart attack in the next 10 years.

Jonathan Reiner, a cardiologist at George Washington University Hospital who has treated former vice-president Richard Cheney, said the previous philosophy of focusing almost exclusively on lowering LDL levels, often by prescribing multiple drugs, was not based on “a lot of robust data”. The new approach “is reinforcing what the clinical trials have shown, and are trying to move clinicians away from practices that are not based on clinical evidence.”

He said the new guidelines might make life easier for heart patients, who currently must have their blood tested several times a year to ensure that they are meeting, or heading toward, their best possible cholesterol score. Now that may not be necessary, he said.

That’s not to say that cholesterol scores no longer matter, but rather they should be only one of numerous factors in determining who should be taking statins.

“Lower [LDL] is better, and no one’s arguing that, but once you have a reason to treat someone, they should be treated fully,” said Kim Williams, vice-president of the American College of Cardiology. “That’s really one of the bottom lines of this.”

Statins aren’t entirely without risks. Muscle soreness and fatigue are the most common side effects of taking the drugs. Other, less likely, consequences include liver damage, digestive problems, rashes or flushing, elevated blood sugar or Type 2 diabetes, and memory loss. In addition, once a person begins taking statins, he is likely to remain on them for the rest of his life.

Lloyd-Jones, the Northwestern doctor who helped develop the new guidelines, said there’s overwhelming consensus in the medical world that statins are effective and safe. “If these were unsafe drugs, we certainly wouldn’t have put the threshold where we did,” he said.

He said that while wider use of statins will probably prevent heart attacks and strokes and improve the quality of life for more patients, on Tuesday’s recommendations aren’t going to solve the nation’s looming cardiovascular crisis.

“Underlying all this is the fact we must get better with our lifestyle choices. There’s a tsunami of cardiovascular disease that’s coming, in large part because of the obesity epidemic,” Lloyd-Jones said. “This is only one piece. But there’s clearly a lot more to do.”

source — Washington Post

Heart problems in childrens

Seldom do we worry about our kids falling prey to heart problems. They have always been a subject of concern for the aged, but not for happy-go-lucky kids who dance around with joy. Your child, if diagnosed with heart disease, can indeed be a thing of worry. You need to understand your child’s condition and what you can expect in the coming months.

There are two major types of heart problems that affect children. One is congenital, which is by birth and the other is acquired or due to unhealthy lifestyle or infection. Congenital heart disease is when a child is born with an abnormally-structured heart.

Dr. Zainul Abedin Hamdulay, M.S., M.Ch., D.N.B. (Consultant Cardiothoracic Surgeon) Consultant to Lilavati, Breach Candy, Wockhardt and Prince Aly Khan Hospitals, Mumbai says, “Congenital problems occur as the baby’s heart develops during pregnancy in the mother’s womb. Congenital Heart Defect (CHD) is a defect in the structure of the heart and blood vessels of a new born. It is the most commonly occurring heart defect in children.”

This defect depends on the conditions present at birth that can affect the way the heart functions. One of the most common birth defects, it is also a major cause of lifelong disability and infant death.

The other is Rheumatic Heart Disease (RHD) or a condition of damaged heart valves. It is caused by rheumatic fever, which is a result of untreated bacterial infection.

Symptoms

Children show symptoms and signs of congestive cardiac failure such as breathlessness, failure to thrive, poor feeding, excessive sweating and multiple admissions for lung infections.

Sometimes CHD can be simple and need not require complicated surgeries and medications. Situations wherein there is a small hole between the heart chambers that close on its own may not need any surgery or even at times medication.

If the disease is complex, such as contraction of the aorta wherein there is a tight narrowing in the aorta (the main blood vessel supplying oxygenated blood) restricting blood flow to the lower part of the body, then it requires immediate surgery. A surgery over a period of time may have to be performed to avoid unfortunate circumstances.

“If at all a child has encountered a health problem, immediately consult a paediatrician. It is best to get kids treated completely for fever and infections so that they do not become victims of RHD,” says Dr. Hamdulay.

It is also important to pay attention to what your child eats. Make sure they consume healthy and hygienic food. Physical hygiene is also important, especially cleaning the teeth properly.

Abnormal heart sound or heart murmur when listening to the heartbeat can also indicate trouble in toddlers.

Treatment

“The treatment and medicines used and how well the baby responds to them depends on the congenital heart condition. Many defects need to be followed carefully. Some will heal over time, while others will need to be treated,” Dr. Hamdulay.

Some congenital heart diseases can be treated with medication alone. Others need to be treated with one or more heart surgeries.

As congenital heart disease is a birth defect, it cannot be avoided. Thus, care should be taken when your child is in the womb. It is important to:

1. Inform your doctor about your pregnancy before starting any medication.

2. Avoid smoking and alcohol intake.

3. Get vaccinated for flu or fever.

4. Avoid contact with people who have infection.

5. Have your blood sugar checked and maintain it.

6. It is also advised to go for 2D echo to assess the heart condition of the baby in womb.

Viral infections of the heart

HEALTH MATTERS: Viral infections of the heart occur from time to time

A friend of mine started retaining fluid, and his doctor told him that he had a viral infection of the heart. I’ve heard of viruses causing colds, but not heart problems. Can you explain?

Q. A friend of mine started retaining fluid, and his doctor told him that he had a viral infection of the heart. I’ve heard of viruses causing colds, but not heart problems. Can you explain?

A. Viral infection of the heart is not common but does occur from time to time. It turns out that everyday viruses that are all around us can on occasion get into the body and start multiplying in the muscle that composes the heart.

When this occurs, the heart muscle may become damaged and can’t squeeze as vigorously as normal; this causes fluid retention in the lungs and the feet. Most such infections cure themselves, but treatment is needed if there are symptoms of heart failure; we use diuretics (pills) that remove the excess water in the body, and other medicines to strengthen the beating of the heart muscle.

In certain circumstances, we remove a small sample of heart muscle — a process that we call a biopsy — using a tube that we insert through a small nick in the skin overlying a large vein. The tube is then threaded back to the heart so the biopsy can be taken. Depending on the findings after the biopsy specimen is examined under the microscope, other treatments may be indicated.

Most patients eventually recover, but some are left with chronic heart failure symptoms. In very advanced cases — which is not the norm — a heart transplant may be needed. Hopefully, your friend will follow the usual course of complete recovery.

Q. I’ve heard high blood pressure referred to as the “Silent Killer.” How so?

A. High blood pressure is a major cause of heart disease and stroke and a major contributor to mortality. It is one of the important causes of blockages of the coronary arteries and thus heart attacks. It also causes strokes both by promoting blockages in the arteries going to the brain and by causing bleeding into the brain tissue itself.

It can cause kidney failure as well. So hypertension (the technical term for high blood pressure) causes increased mortality through a variety of mechanisms. Unfortunately, until it is too late, hypertension often causes no symptoms; most people are unaware that they have high blood pressure unless they have their blood pressure measured. That’s the “silent” part.

That’s why it is so important for everyone to have their blood pressure measured periodically and for people with hypertension to follow medical instructions to reduce their elevated blood pressure. All hypertensive patients should limit their salt intake, lose weight if overweight and engage in sensible exercise.

Most, however, will also require medication, and many need more than one type of pill to achieve optimal control. But almost everyone can find a medical program that works and is tolerable. So get your blood pressure checked — and if it is elevated, be sure to follow through with any needed lifestyle changes along with careful adherence to any prescribed medications. Let’s no longer be quiet about the “Silent Killer.”

Wynne is vice president for health affairs at the University of North Dakota, dean of the School of Medicine and Health Sciences, and a professor of medicine. He is a cardiologist by training.

Submit a question to Health Matters at healthmatters@med.und.edu or Health Matters, 501 North Columbia Road, Stop 9037, Grand Forks, ND 58202-9037. Remember, no personal details, please.

The content of this column is for informational purposes only and does not substitute for professional medical advice or care. The information provided herein should not be used for diagnosing or treating a health problem or disease. If you have or suspect you may have a health problem, you should consult your health care provider. Never disregard professional medical advice or delay in seeking it because of something you have read in this column.

source: grandforksherald

D-Ribose Increases Energy in Heart Tissues Dramatically

Foods to fix high cholesterol levels

It's easy to eat your way to an alarmingly high cholesterol level.

The reverse is true too- changing what you eat can lower your cholesterol and improve the amanda of fats floating through your bloodstream.Fresh fruits and vegetables , whole grains and good fats are all part of a heart - healthy diet. But some foods are particularly good at helping bring down cholesterol level.

How?

Some cholesterol-lowering foods deliver a good dose of soluble fiber,which binds cholesterol and it's precursor in the digestive system and drags them out of the body before they get into circulation. Others provide polyunsaturated fats,which directly lower LDL.And those with plant stanols and sterols keep the body from absorbing cholesterol.

Here are 5 of these foods.

1) Oats:- An easy way to start lowering cholesterol is to choose oatmeal or a cold oat - based cereal like cherries--for breakfast. It gives you one to two grams of soluble fiber. And a banana or some strawberries for another half gram.

2) Beans:- Beans are especially rich in soluble fiber. They also take a while for the body to digest,meaning you feel full for longer after a meal.That's one reason beans are a useful food for folks trying to lose weight with so many choices--from navy and kidney beans to lentils,garbanzos,black-eyed peas, and beyond- and so many ways to prepare them,beans are a very versatile food.

3) Nuts :- A bushel of studies shows that eating almonds,walnuts,peanuts and other nuts is good for the heart. Eating two ounces of nuts a day can slightly lower LDL on the order of 5%. Nuts have additional nutrients that protect the heart in other ways.

4) Foods fortified with sterols and stanols :- Sterols and stanols extracted from plants gum up the body's ability to absorb cholesterol from food. Companies are adding them to foods ranging from margarine and granola bars to orange juice and chocolates. They are also available as supplements.Getting two grams of plant sterols or stanols a day can lower LDL cholesterol by 10%.

5) Fatty Fish :- Eating fish two or three times a week can lower LDL in ways by replacing meat which has LDL boosting saturated fats, and by delivering LDL-lowering omega3 fats.

Omega3s reduce triglycerides in the bloodstream and also protect heart by helping prevent the onset of abnormal heart rhythm.

But Stay Away From..........

To keep cholesterol level where you want them to be ,limit intake of saturated fats. The saturated fats found in red meat,milk and other dairy products and cocoanut & palm oils directly boost LDL. So one way to lower your LDL is to cut back on saturated fat.Try substituting extra-lean ground beef for regular; low fat or skim milk for whole milk, olive oil or vegetable oil margarine for butter, baked fish or chicken for fried.

Trans fat :- Trans fat are a byproduct of the chemical reaction that turns liquid vegetable oil into solid margarine or shortening and that prevents liquid vegetable oils from turning rancid. Trans fats boost LDL as much as saturated fat do. They also lower protective HDL ,rev up in inflammation and increase the tendency for blood cots to form inside blood vessels. Although trans fats were once ubiquitous in prepared foods,many companies now use trans-free alternatives. Some restaurants and fastfood chains have yet to make the switch.

Heart Healthy Recipe: Vegetable Lentil Soup

The foods we consume play a huge role in maintaining good heart health. So, fuel your body with this vitamin-rich, fibre-filled heart loving soup. It is rich in protein and includes a variety of vegetables like garlic, onions and tomatoes, which will improve your cardiovascular health. This recipe was shared by Registered Dietician, Akansha Jhalani.

Ingredients:

• 2 cups of boiled lentils

• 1 small onion, finely chopped

• 1 small tomato, finely chopped

• 3 cloves of garlic

• 2 stalks of celery, chopped

• 1 small sweet potato-boiled, deskinned and cut into peices

• 1 tsp olive oil

• 2 tsps of coriander leaves

• Salt, paprika and pepper to taste

Method:

1. Heat the olive oil in a pot and add onions to it. Sauté until brown.

2. To this, add the garlic, celery, paprika and sauté for a bit

3. Add the sweet potato, tomatoes and lentils to this pot with 2 small cups of water, simmer and cook for 5 minutes

4. Add salt and pepper to this and top it up with coriander leaves

5. Serve immediately

source: healthmeup

D-Ribose Increases Energy in Heart Tissues Dramatically

Bad sleep leads to heartbeat irregularities

Sleep-disordered breathing is known to have potentially harmful effects on the heart. A detailed study shows how different type of sleep apnea can be linked to specific heart rhythm abnormalities. The findings underline the urgency of intervention in cases of sleep-disordered breathing.

Sleep-disordered breathing can have an impact on heart health. A study based upon measurements in a sleep lab shows clear relationships between certain types of breathing abnormalities and specific heart rhythm problems.

Sleep apnea, where the patient stops breathing many times in the night, is a common problem which can increase the risk of heart disease. But there are many types of sleep apnea and they can only be diagnosed by polysomnography, which measures breathing patterns during sleep. This approach can link breathing problems more firmly with heart problems and help better diagnosis and treatment.

Researchers at Case Western University School of Medicine studied nearly 3,000 men who underwent polysomnography. The number of times they ceased breathing or did shallow breathing was recorded, along with oxygen levels in the blood. Heart arrhythmias were also recorded.

Having more episodes of paused or shallow breathing was linked to arrhythmias involving either the upper chambers, the atria, or the lower chambers, known as the ventricles. Obstructive sleep apnea, the most common type of sleep-disordered breathing, was linked most often with ventricular arrhythmias. But central sleep apnea, which is linked to malfunctioning in brain signals controlling breathing, is more likely to be linked to arrhythmias involving the atria. The more severe the breathing problem, the bigger the effect on the heart.

The researchers think that hypoxia – or lowered levels of oxygen in the blood – may be a factor linking sleep-disordered breathing and heart problems. Another factor could be the impact of disordered breathing on the nervous system. Sleep-disordered breathing requires careful diagnosis and treatment to reduce the impact on long-term heart health.

Loneliness affects sleep, heart health

Researchers found that loneliness impacted people’s quality of sleep and cardiac function.

Researchers from universities in Illinois, Ohio and Arizona conducted two separate studies to determine how loneliness might impact health. In the first study, 89 college students were divided into two groups: the top 20 percent who were feeling the most lonely, and the bottom 20 percent who were feeling the least lonely. A loneliness questionnaire was also completed by a group of 25 older adults in the second study. Researchers then measured a number of the participants’ health characteristics, including the quality of their sleep.

Results from both studies showed that the non-lonely participants had better sleep patterns and overall cardiac function (e.g., higher cardiac output) than lonely participants. Among the older participants, loneliness was also associated with a greater rise in blood pressure. The authors concluded that “cardiovascular activation and sleep dysfunction [both] warrant special attention” in future research studies.

source: tele-management

Scientists Use Stem Cells To Grow Human Heart Tissue

PARIS, France — Scientists said Tuesday they had used stem cells to grow human heart tissue that contracted spontaneously in a petri dish -- marking progress in the quest to manufacture transplant organs.

A team from the University of Pittsburgh, Pennsylvania, used induced pluripotent stem (iPS) cells generated from human skin cells to create precursor heart cells called MCPs.

iPS cells are mature human cells "reprogrammed" into a versatile, primitive state from which they can be prompted to develop into any kind of cell of the body.

The primitive heart cells created in this way were attached to a mouse heart "scaffold" from which the researchers had removed all mouse heart cells, they wrote in the journal Nature Communications.

The scaffold is a network of non-living tissue composed of proteins and carbohydrates to which cells adhere and grow on.

Placed on the 3D scaffold, the precursor cells grew and developed into heart muscle, and after 20 days of blood supply the reconstructed mouse organ "began contracting again at the rate of 40 to 50 beats per minute," said a University of Pittsburgh statement.

"It is still far from making a whole human heart," added senior researcher Lei Yang.

Ways have to be found to make the heart contract strongly enough to pump blood effectively and to rebuild the heart's electrical conduction system.

"However, we provide a novel resource of cells -- iPS cell-derived MCPs -- for future heart tissue engineering," Yang told AFP by email.

"We hope our study would be used in the future to replace a piece of tissue damaged by a heart attack, or perhaps an entire organ, in patients with heart disease."

According to the World Health Organisation, an estimated 17 million people die of cardiovascular ailments every year, most of them from heart disease.

Due to a shortage of donor organs, "end-stage heart failure is irreversible," said the study.

More than half of patients with heart disease do not benefit from drugs.

"Heart tissue engineering holds a great promise... based on the reconstruction of patient-specific cardiac muscle," the researchers wrote.

Last month, scientists in Japan said they had grown functional human liver tissue from stem cells in a similar process.

Creating lab-grown tissue to replenish organs damaged by accident or disease is a Holy Grail for the pioneering field of stem cell research.

Until a few years ago, when iPS cells were created, the only way to obtain stem cells was to harvest them from human embryos.

This was controversial because it required the destruction of the embryo, a process to which religious conservatives and others object.

source: authintmail

How to minimize your risk of heart problems

The column is part of a series running in conjunction with the Healthy Living Lecture Series hosted by the University of Alaska Fairbanks.

As a practicing cardiologist, I have witnessed a significant change in the type and age of individuals presenting to the hospital with acute coronary syndromes — heart attack, angina pectoris, sudden cardiac death. The patients are younger and no longer are predominately male but are now are commonly female. These patients might or might not have typical risk factors of diabetes, hypertension and tobacco use.

Heart attack (myocardial infarction) in most cases is a result of the rupture of unstable plaque. This vulnerable plaque can be stabilized or reversed by various means. My upcoming lecture is titled “Nutrition Strategies for a Healthy, Long Life.” I shall review our current understanding of plaque development and discuss the consequences of plaque rupture.

How do we determine risk of having plaque. At what age should we worry?

An individual at low risk will have the following:

1. Total cholesterol less than 150mg

2. Blood pressure less than or equal to 120/80 mmHg

3. No diabetes

4. No smoking

5. No premature family history, no metabolic syndrome. I shall define metabolic syndrome in my lecture.

Recent research has confirmed that free radicals play an important role in plaque development. I shall define free radicals and discuss the role of free radicals in health and disease. Should we eradicate our bodies of free radicals? How should we go about neutralizing free radicals?

Antioxidants have been evaluated in studies and have not been found to be beneficial when given as supplements. Ecological studies have, however, demonstrated that intake of antioxidants in the form of phytochemicals may prevent and reverse cardiovascular disease. I shall discuss phytochemicals and explain their role in neutralizing free radicals. How do foods compare in phytochemical potency? What about protein? What about carbohydrates? What about fat?

There are many different diets to choose from to initiate weight reduction. We certainly should try to maintain an ideal body weight. Obesity is associated with coronary heart disease, diabetes, dyslipidemia, hypertension, pancreatitis, cancer (breast, uterus, cervix, colon, esophagus, pancreas, kidney and prostate), phlebitis, stroke, nonalcoholic fatty liver disease, cataracts, gall bladder disease, gynecological abnormalities, osteoarthritis, gout and skin disease.

Portion sizes have changed dramatically during the past 60 years. Obesity rates have climbed to an all-time high with 70 percent of Americans being overweight and in several states greater than 30 percent of individuals being obese.

Obesity is defined by body mass index. This is a measurement that associates one’s weight and height. The body mass in kilograms is divided by the square of one’s height in meters. A BMI of 25 is the upper boundary of a healthy weight. A BMI of above 25 up to 30 defines overweight. A BMI above 30 up to 40 defines obesity. A BMI above 40 up to 50 defines morbid obesity. A BMI obove 50 defines super obesity or malignant obesity.

How should we combat obesity ?

I shall discuss several popular diets and review diets with evidence for plaque reversal.

Please come and learn more in a lecture entitled “Nutrition Strategies for a Healthy, Long Life,” to be presented on Tuesday as part of the Healthy Living Lecture Series at 7 p.m. at the University of Alaska Fairbanks’s Murie (life sciences) Building. I look forward to seeing you there.

Dr. Romel C. Wrenn is a doctor of internal medicine, general cardiology, interventional cardiology and cardiovascular CT.

D-Ribose Increases Energy in Heart Tissues Dramatically

How Statins Might Damage Your Heart

Sadly, a quarter of the U.S. population over age 45 takes statin drugs, the pharmaceutical industry’s Number One money maker, largely due to relentless advertising, which a recent study found may be driving high cholesterol over diagnosis and over-treatment.

But over 900 studies prove that statin drugs – HMG-CoA reductase inhibitors blocking liver enzymes from making cholesterol – actually cause muscle problems and even increased cancer risk. Worse, while millions take statins to “protect their heart health,” these drugs are clinically proven to be detrimental.

A 2012 study in the journal Atherosclerosis linked statin use with a 52 percent increase in calcified coronary plaque incidence – the hallmark of death via heart disease!

Statins Can Undo the Benefits of Exercise

New research by the Journal of the American College of Cardiology reveals that while exercise is one of the best things you can do to maintain healthy cholesterol levels, statin drugs negate most of the benefits, making people even less fit than before.

The New York Times reported:

“(Statin) drugs routinely are prescribed for those with high cholesterol and other risk factors for heart disease … those who are sedentary, overweight, middle-aged… are also the people most likely to be put on statins, possibly undoing some of the good of their workouts.”

Trial participants included 37 overweight, sedentary individuals with metabolic problems, divided into two groups: One group was given daily 40-mg doses of simvastatin (Zocor); the other group received no medication. After a supervised 12-week exercise program:

Unmedicated volunteers improved their aerobic fitness by more than 10 percent. Mitochondrial content activity increased by 13 percent.
Volunteers taking the statins improved their fitness by an average of 1.5 percent, although some had reduced aerobic capacity. Mitochondrial content activity decreased by 4.5 percent.

Senior study author John P. Thyfault, professor of nutrition and exercise physiology at the University of Missouri, noted:

“Low aerobic fitness is one of the best predictors of premature death. And if statins prevent people from raising their fitness through exercise, then that is a concern.”

How Statins Might Damage Your Heart

The key to understanding this phenomenon lies in understanding what statins do to your mitochondria — the energy chamber of your cells, responsible for all metabolic functions. The primary fuel for your mitochondria, Coenzyme Q10 (CoQ10), is one of the primary mechanisms of harm from statins, related to CoQ10 depletion.

A 2011 review published in Applied Physiology, Nutrition and Metabolism observed that exercise induces mitochondrial enzyme changes, which can increase cellular energy production and decrease chronic disease risk.

Researchers stated:

“Increasing evidence now suggests that exercise can induce mitochondrial biogenesis in a wide range of tissues not normally associated with the metabolic demands of exercise. Perturbations [changes] in mitochondrial content and (or) function have been linked to a wide variety of diseases, in multiple tissues, and exercise may serve as a potent approach by which to prevent and (or) treat these pathologies.”

Increasing mitochondrial activity is crucial, because free radicals from toxic exposures to chemicals, pollutants, etc., can overwhelm your body’s defenses, leading to:

Oxidative cell and tissue damage
Destroyed cellular proteins, lipids and DNA
Lowered threshold for physical exercise
Impaired ability to utilize carbohydrates and fat for energy
Insulin resistance
Excessive weight gain
Accelerated aging

If You’re on a Statin Drug, You MUST Take CoQ10…

A recent study in the European Journal of Pharmacology showed ubiquinol effectively rescued cells from damage caused by the statin drug simvastatin, thereby protecting muscle cells from myopathies.

If you take a statin drug without CoQ10 supplementation — or ideally, the far more effective reduced form, Ubiquinol — your health is at serious risk. CoQ10 is used by every cell in your body, but especially your heart cells. Cardiac muscle cells have up to 200 times more mitochondria and therefore 200 times more CoQ10 requirements.

Premature aging, another side effect of statin drugs and too little CoQ10, accelerates DNA damage, leads to fatigue, muscle weakness, soreness and, ultimately, heart failure.

A recent study found that, compared to those given a placebo, patients with statin-associated myopathy who took CoQ10 and selenium supplementation experienced significantly less pain, fatigue and muscle weakness.

Beware the Hazards of Statin Drugs!

If you’re a woman, listen up: Statins are classified as a “pregnancy Category X medication,” meaning, it causes serious birth defects, and should NEVER be used if you’re pregnant or planning a pregnancy.

Last year, the FDA announced it’s considering additional warning labels for statin drugs because of all the potential health risks associated with them. In all, statin drugs have been directly linked to over 300 side effects, including:

Cognitive loss
Neuropathy
Anemia
Acidosis
Frequent fevers
Cataracts
Sexual dysfunction
An increase in cancer risk
Pancreatic dysfunction
Immune system suppression

Muscle problems, polyneuropathy (nerve damage in the hands and feet), and rhabdomyolysis, a serious degenerative muscle tissue condition, Hepatic dysfunction (Due to the potential increase in liver enzymes, patients must be monitored for normal liver function)

How to Optimize Your Cholesterol Levels Naturally

Too little cholesterol increases your risk for cancer, memory loss, Parkinson’s disease, hormonal imbalances, stroke, depression, suicide, and violent behavior.

The most effective way to optimize your cholesterol profile and prevent heart disease is natural – via diet and exercise. My primary recommendations for cholesterol regulation include:

Eliminating grains and fructose from your diet. Use my Nutrition Plan to help determine your ideal diet and eat more of your food raw.

Start intermittent fasting to radically improve your ability to burn fat as your primary fuel while improving your insulin and leptin signaling.

Get plenty of high-quality, animal-based omega-3 fats, such as krill oil, and reduce your consumption of trans fats and vegetable oils.

Include heart-healthy foods in your diet: olive oil, coconut and coconut oil, organic raw dairy products and eggs, avocados, raw nuts and seeds, and organic grass-fed meats.

If you’re currently taking a statin drug and are worried about the side effects, please consult with a knowledgeable health care practitioner who can help you to optimize your heart health naturally, without the use of these dangerous drugs.

D-Ribose Increases Energy in Heart Tissues Dramatically

source: care2

Non-alcoholic drinks also benefit heart health

Research shows that non-alcoholic beer seems to have the same benefits on the stickiness of blood as does regular beer.
We already know that moderate consumption of alcohol reduces the tendency of blood platelets to clump together and so makes the blood less likely to clot. This helps reduce the risk of heart disease. The benefits have been put down to alcohol itself and to compounds in drinks like red wine, including resveratrol.

In a study, a team in Germany has found that some of the same advantages are associated with non-alcoholic beer. They gave a group of 12 young healthy male volunteers three liters of either non-alcoholic beer, regular beer, or alcohol and water mixture of the same strength. Blood samples were taken for analysis before and at 1.5, 3.5 and 24 hours after consumption. All the three fluids reduced platelet activation. The non-alcoholic beer had an additional benefit – it reduces thrombin generation. Thrombin is a protein which is key to the formation of a clot. Again, this would reduce the risk of blood clotting and heart disease. It’s not known why non-alcoholic beer has this effect. However, it may be a good option for those who want to get the heart benefits of alcohol but avoid the risks of alcohol abuse.

How having pets helps heart disease

Pet ownership is increasingly being recognized as an important component of a heart healthy lifestyle, according to a recently released statement from the American Heart Association (AHA) published in the journal, Circulation, May 9.

A group of cardiologists recruited by the AHA recently reviewed literature linking cardiovascular health and outcomes with owning a pet and concluded that owning a pet is “probably associated” with a reduced risk of heart disease for people with no pre-existing history of cardiac disease, along with improved survival rates among those patients with coronary artery disease.

Dr. Glenn Levine, a professor at Baylor College of Medicine, along with his colleagues recommend that people have a dog or cat as a way to lower the risk of heart disease. This occurs by people becoming more physically active, which ultimately can lower blood pressure, cholesterol, as well as lead to lower levels of stress.

Studies in the past have demonstrated that the close relationship along with a pet’s companionship can reduce levels of stress hormones (cortisol, epinephrine, and growth hormone), while enabling people to deal with emotional, as well as stressful situations.

Some employers have recognized the fact that some people actually perform better at their jobs in the presence of their pets, which may ultimately be linked to reduction of stress along with blood pressure. When feasible, some employers have allowed their workers to bring their dogs into the work setting to help alleviate anxiety.

Furthermore, a number of patients who are on blood pressure medication have seen their dose requirements reduced as a result of the calming and positive emotional effects a pet may have on them.

One study in particular found that those people who adopted dogs reduced their blood pressure significantly, while another study found that dog owners were more likely to achieve recommended levels of exercise and maintain an active healthy lifestyle compared with non dog owners. Other studies have also discovered that people who didn’t actually own dogs themselves, but walked them frequently, were less likely to be obese.

However, according data from the Centers for Disease Control (CDC) people who own pets are just as likely to be overweight as people without pets. While owning a pet cannot prevent heart disease, caring for them generally entails owners getting more frequent exercise, which may reduce blood pressure, cholesterol, weight as well as stress in general and lead to better heart health.

However, adopting a pet, while continuing to lead a sedentary life style, eating junk food and smoking is certainly not a way to reduce your risk for cardiac disease. While the AHA is optimistic about the benefits of pet ownership, it is not advising people to simply go out and get a pet and expect to reduce their cardiovascular risk. But if you already own a pet, especially a dog, the panel states you can reduce your risk of heart disease compared to those who do not have a pet.

In fact, while its interesting that people with heart disease did demonstrate a modest survival benefit if they had a pet, more in depth investigation is necessary to understand if the additional longevity was a result of reduced stress, increased exercise or a benefit of both combined.

Levine also explains that we need to understand whether adopting a pet can lead to a reduction in cardiovascular risk in those with pre-existing disease. He believes that more research and higher quality studies are necessary. Overall, the studies do not prove that owning a pet directly leads to a reduction in heart disease risk.

As Levine states, “it may be simply that the healthier people are the ones that have pets, not that having a pet actually leads to or causes a reduction in cardiovascular risk”.

source: forbes

Top 5 big lifestyle changes for heart health

Today’s problem for the health-conscious person is information overload; new health studies pour out daily from newspapers, radio stations, and television networks. Just how true are the studies? How compelling are the facts they claim? After reading countless scientific articles, listening to hundreds of international experts, and keeping an ear open when patients tell me about their experiences, I’ve identified the only five lifestyle changes with compelling evidence behind them. Taken together, these steps provide about 80% protection from heart attacks, as well as stroke and cancer, and this message comes from three major studies organized by the Harvard Medical School and published in highly rated journals.

(1) Unfortunately, the image of smoking as ‘sexy’, which was promoted for years in the USA and elsewhere, still lingers; young women remain the group least likely to give up smoking. But giving up smoking (or not starting in the first place) it essential. It confers just over one-third of the lifestyle benefits associated with healthy living.

(2) “Exercise is the elixir of life,” says Richard Verrier, from the Harvard School of Public Health. You need at least thirty minutes of moderate to vigorous exercise daily — ideally every day, but five days per week will do. How much effort should you put into it? A simple criterion: you should be sweating by the end of it.

(3) We know that the Western diet (with its high intake of fat, sugars, and calories) damages the arterial endothelium and promotes obesity, diabetes, and heart attacks. There are several validated, health promoting diets which counteract this, including the Prudent diet (which emphasises a high intake of vegetables, fruit, legumes, whole grains, fish and poultry), the DASH BP-reducing diet (similar, but with the addition of salt restriction; ideal for the many people with hypertension) and the Healthy Eating diet (again similar, but using a numerical index to score components). The Mediterranean diet may be the best of all of these, being immortalised by the declaration that it now belongs to the Intangible Cultural Heritage of Europe. Furthermore, in April 2013 in probably the largest and longest diet study ever undertaken, five years of the Mediterranean diet with high olive oil and nuts reduced heart attacks, strokes and (of note) total mortality in 7447 persons , all versus a standard low fat diet.

(4) Consistent studies show that fat around the middle — abdominal fat — is closely linked to increased heart disease and diabetes. Therefore a health body weight, indicated by a body mass index (BMI) of 25 or below, is vital for keeping the heart healthy. Fat tissue is not only cosmetically undesirable, but produces a variety of hormones, each of which is capable of adverse effects. For example, release of these hormones from fat tissue into the blood can trigger a series of chemical changes that eventually produce more fat. In brief, fat produces fat.

(5) Moderate alcohol, the fifth protective factor (and part of the Mediterranean diet) is a two-faced friend. A little helps, but more than that harms substantially. The ‘red wine’ hypothesis, which states that the beverage has benefits extending beyond its alcohol content, may also have some truth in it; deep red grape juice has the same effect of inhibiting blood clots, but only in higher doses. A fine Pinot Noir — the author’s favourite — may therefore be safely considered as one of the ‘big five’, but only in small doses.

source: oup

11 years girl undergoes open heart surgery in Delhi Hospital

New Delhi, April 25 (IANS) An 11-year-old girl from Africa, who had sickle cell disease, underwent a rare open heart surgery, doctors at a hospital here claimed Thursday.

Ayesha Sadiq was diagnosed with a disorder of the heart valve, which caused outflow of the blood from the right side to be obstructed. She also had sickle cell disease, a genetic disorder.

Sickle cell disease is a condition in which the haemoglobin in the blood is of an abnormal kind, resulting in a high tendency for blood to clot within the body under conditions of stress. This can lead to stroke, renal failure and even death.

The girl was operated upon by surgeons at the BLK Super Specialty Hospital.

According to Neeraj Bhalla, senior consultant, cardiologist, at BLK, though a procedure was carried out without any complications, the result was not too satisfactory. That is what compelled them to go for open heart surgery.

"Even after our continuous efforts, there was no decline of the obstruction across the valve. We realized that the child probably had major obstruction and might need open heart surgery," said Bhalla.

"The surgery was that much more risky as it carried a higher threat of blood clotting because of the sickle cell disease," he added.

According to doctors, the entire blood of the girl was changed prior to the surgery and the abnormal blood was drained.

"Open heart surgery then proceeded in routine fashion and recovery was uneventful," said Sushant Srivastava, cardiac surgeon at BLK.

Low-fat Ornish Diet Helps Reverse Heart Disease

The Mediterranean diet and the Ornish spectrum reversing heart disease plan both help boost heart health. Which should you choose?

What’s the best diet to keep you healthy through the years or, better yet, reverse health problems caused by decades of poor eating habits? The debate seemed to be settled in February with a landmark study showing that the Mediterranean diet — which includes fat from olive oil, fish, and nuts, and a moderate amount of wine — led to 30 percent fewer heart disease deaths, strokes, and heart attacks than a low-fat diet in people over age 55 who hadn’t yet developed heart disease.

Nutrition researchers who had been extolling the virtues of “heart-healthy” monounsaturated fats and fish oil for decades felt vindicated. But those who had previously demonstrated that very low-fat diets with no vegetable oils or animal fats can help manage diabetes and reverse heart disease weren’t convinced. The control group in the Mediterranean diet study, which was supposed to follow a low-fat diet, didn’t actually adhere to the principles of low-fat eating, they said.

No one disputes the overlapping virtues of both diets: plentiful quantities of fruits, vegetables, legumes, and whole grains with virtually no red meat, sweets, or processed snack foods. But is it better for your heart if you sauté those vegetables in olive oil, or steam them? “The two diets have never been compared in head-to-head trials,” said Kathy McManus, director of nutrition at Brigham and Women’s Hospital.

In trying to determine which type of eating plan is best for you and will provide the most protection against heart disease and other ills, consider the following questions.

In the February study that was published in the New England Journal of Medicine, researchers found that the Mediterranean diet worked pretty well to lower the likelihood of heart attacks and strokes in a group of nearly 7,500 Spaniards who didn’t have heart disease but were at increased risk: They were overweight and had type 2 diabetes or at least three other heart disease risk factors such as smoking, high cholesterol, and high blood pressure.

Very-low-fat diets, which usually limit fat to 10 to 20 percent of total calories, have largely been tested on populations who already have diseases that could shorten their life span. More than two decades ago, small trials demonstrated that a vegan diet combined with exercise, emotional support, and stress management techniques reduced artery plaque and heart attacks in those with established heart disease. Follow-up studies suggested that the lifestyle plan might keep type 2 diabetes and prostate cancer under control.

“An ounce of prevention equals a pound of cure,” said Dr. Dean Ornish, founder and president of the nonprofit Preventive Medicine Research Institute in Sausalito, Calif., who created the diet and lifestyle program. “If you’re just trying to prevent disease, the Mediterranean diet is fine, but if you’re trying to reverse it, you have to go further.”

Study participants often have a difficult time making significant dietary changes and sticking with them over the long haul.

Ornish’s research included highly motivated patients who were worried about dying from a second heart attack, but even so, about 30 percent of participants quit his program within five years.

In the Mediterranean diet study, getting participants to give up burgers and fries for fish, beans, and quinoa wasn’t easy either, said Dr. Miguel Martínez-González, one of the study coauthors. “We had quarterly visits with participants where the dietitians negotiated small changes to be attained in the next three months,” he said. “There was flexibility.”

What do you hope to accomplish from your eating plan?

If you’ve already been diagnosed with heart disease, you might want to try the Ornish plan for reversing disease. Many heart patients also lose significant amounts of weight when they make such an extreme overhaul.

“I’m not going back, and I really don’t miss the meat, chicken, or sweets,” said Michael Rubino, who lost about 40 pounds on the Ornish plan. He’s been on it since last June after he went into cardiac arrest at his Boston gym.

Katherine Tucker, a professor of nutritional epidemiology at Northeastern University in Boston, said it’s possible that the low-fat Ornish plan might be more beneficial for those with heart disease. “People who have had heart attacks might have a genetic predisposition to having more damaging effects on their arteries from higher fat diets,” she said, but more research is needed to confirm this.

She recommends following the Mediterranean diet for heart disease prevention, however, because it’s easier for most people to stick with permanently.

Researchers have also found health benefits such as reversal of hypertension from the Dietary Approaches to Stop Hypertension (DASH) diet. It includes about 20 to 35 percent of calories from fat — somewhat less than the 30 to 40 percent of calories allowed on the Mediterranean diet plan and more than what’s allowed on the Ornish plan. The DASH plan has the same emphasis on fruits, vegetables, and whole grains but limits sodium intake and alcohol and emphasizes potassium-rich foods such as bananas. It also includes plenty of animal protein such as lean beef, low-fat dairy, and chicken, so it might be easier for some people to follow.

What type of professional support will you get?

People who participate in clinical trials testing specific diets nearly always get help from dietitians and sometimes even get free food delivered — a far cry from the real world.

Ornish said that people who are most successful at adopting his plan long-term usually require 72 hours of training with an exercise physiologist and registered dietitian. Medicare now offers coverage for these educational sessions for heart disease patients, usually reimbursing about 80 percent of the $80 per hour cost.

The Mediterranean diet may take less time to learn, but still may require a few hours of counseling from a dietitian, said McManus. Medicare and many other insurance plans cover professional counseling four times a year for those with type 1 and type 2 diabetes. Those who are obese with a body mass index of 30 or greater can also get coverage under a mandate in the federal health law.

“It takes a while to adapt depending on a person’s baseline diet,” McManus said. “Someone may need to switch from butter to olive oil and move from an animal-based meal to a more plant-based one that includes very small amounts of chicken or lean meat.”

How willing are you to make big changes?

Both the Ornish and Mediterranean diets require significant makeovers if you’re following a typical American-style diet, but the Mediterranean diet is likely closer to what you’re already eating now.

“I never feel like I’m depriving myself,” said Abby Sloane, 27, who switched to the Mediterranean diet five years ago and dropped 90 pounds, which she’s kept off. She said it wasn’t too difficult to switch from nachos and chips to whole grains and hummus after finding recipes on the website from the Boston-based nutrition education organization Oldways, where she now works.

“It’s not really a diet; it’s a lifestyle change,” Sloane said. “I didn’t want something that I tried for a few months. I wanted to change my life.”

D-Ribose Increases Energy in Heart Tissues Dramatically

source: bostonglobe