Dr. Jonny Bowden

Tag: heart health

  • What is Cardiometabolic Health, Anyway?

     

    One of the hazards of seeing health information online is that we frequently encounter buzzwords of questionable use. Some of these terms are frankly dumb, ultimately useless, and will be deservedly forgotten by the next news cycle.

    But some of them—like cardiometabolic— are actually worth paying attention to.

    The term cardiometabolic is usually used as a descriptor, as in “cardiometabolic health” or “cardiometabolic disease”. In fact, cardiometabolic health has now become a lot more than a buzz term. It’s an important (and attainable) goal for many people seeking optimal health and longevity.

    Let me explain.

    “Cardiometabolic” refers to a cluster of conditions (like high blood pressure) that aren’t by themselves diseases but are the underlying conditions which frequently lead to serious illness. None of these conditions are “good” things to have, but when several of them are clustered together in the same person, it becomes, as they say, a “thing”, and that person is now said to have Cardiometabolic Syndrome (CMS).

    Cardiometabolic Syndrome is a “thing”

    CMS used to be called Metabolic Syndrome and is also known as pre-diabetes. (They’re exactly the same thing.) The cluster of conditions was first named “Syndrome X” back in the 80’s by Gerald Reaven, MD,  the Stanford researcher who first discovered their importance. “Syndrome X”, eventually morphed into Metabolic Syndrome, and is now known as Cardiometabolic Syndrome. Both the Endocrine Society and the World Health Organization now officially recognize CMS as a disease entity, and according to all the latest research, it is a global health threat of staggering proportions.

    So what are the five conditions that define cardiometabolic syndrome?

    1. High blood pressure
    2. Abdominal obesity (waist higher than 35 for women, 40 for men)
    3. High fasting blood sugar
    4. Low HDL cholesterol
    5. Insulin resistance*

    *(Insulin resistance is so central to this discussion that I’ll give it its own newsletter soon. I think it’s the metabolic plague of the 21st century and one of the most important and overlooked risk factors for all kinds of conditions you definitely don’t want to have.)

    And while it isn’t part of the official list of the five bad guys, a strong argument could be made for including a sixth villain: High triglycerides. (I’ll talk about that in a future blog. I’m convinced it’s just as important as the other five.)

    If you have any (or several, or all) of these conditions, you need to pay attention. And if you don’t know if you have one or more of these, you need to find out. (I’ll be talking more about how to do that in future blogs).

    For now, get out your most recent blood test take a look at the following numbers, and see if they are “in range”:

    1. Fasting blood sugar (glucose)
    2. Triglycerides
    3. HDL cholesterol
    4. Fasting insulin (if you were lucky enough to have found a doctor wise enough to order that test for you).

    Then measure your waistline. If it’s over 35” (for a woman) or over 40” (for a man) you meet the technical criteria for the fifth condition that defines CMS– abdominal obesity.

    In future blogs, we’ll be talking about what each of these metrics tells us, how to make sense of that information, and—most important—what you can do to improve any of the numbers you’re not happy with.

    The good news is that—with the possible exception of HDL—all of them can be significantly improved with lifestyle redirection.

    Spoiler alert: The big guns in your arsenal are food, supplements, sleep, sun, and stress-reduction!

    More to come!

    Stay healthy,

    jb

     

  • Has the Cholesterol Test Outlived its Usefulness?

    Has the Cholesterol Test Outlived its Usefulness?

    Ten years ago, cardiologist Steven Sinatra, M.D., and I came together to write a book called The Great Cholesterol Myth, which, as you can imagine, was a pretty controversial name for a book. It landed us on the Dr. Oz show where I said, “Trying to reduce the risk of heart disease by lowering your LDL cholesterol is like trying to reduce the calories on your whopper by taking off the lettuce.”

    That statement is even truer today than it was a decade ago.

    A lot has changed in the way conventional medicine views cholesterol and heart disease since 2010. We now have technology that allows us to clearly identify at least 13 different subtypes of cholesterol, many of which behave in unique ways in the body. Being able to measure cholesterol with much greater specificity than ever before is good news indeed, because it gives us much more information and far greater accuracy when it comes to predicting future cardiovascular events.

    The sad news is doctors are mostly still measuring cholesterol the old-fashioned way. That’s equivalent to doing long division with a pad and pencil when you’ve got a smartphone available—it’s slow, cumbersome, and frequently inaccurate. We discuss this at length in the new, revised, and updated version of The Great Cholesterol Myth, which comes out in October 2020 and is available now for preorder.

    In the new book, we talk about the sophisticated lab tests that now exist to tease out risk factors that have been hiding in plain sight for decades—factors we now understand are directly and profoundly connected to heart disease.

    There are now at least a dozen cardiac markers that we can test that influence the likelihood of you getting heart disease. And best of all, many of these risk factors can be strongly modified by our own life choices. Spoiler alert: One of the most important of these risk factors is insulin resistance, which most doctors don’t even know to check for, and can almost completely be reversed by diet. (I’ll be discussing insulin resistance and its role in heart disease in my next few columns.)

    And it’s not just insulin resistance that points the way to oncoming heart disease, which it does far more effectively and accurately than LDL (“bad”) cholesterol ever did. Every year we meet more and more physicians at conferences who are realizing the importance of inflammation and oxidation in making arteries vulnerable to plaque. Every year we meet more and more physicians who have come around to the notion that nutrition and diet—the redheaded stepsister of traditional medical education—can be powerful allies in the fight against heart disease (and not, as previously believed, by adhering to a low-fat diet!). And every year we meet more physicians who have come to question the usefulness of statins (the major class of drugs used to lower cholesterol). Statins lower cholesterol just fine! The question is whether they prevent deaths.

    And the answer, sadly, is no.

    The connection between diabetes and heart disease—sugar, anyone?—is the central thesis of the new edition of the book. Insulin resistance is something that nearly always precedes (or accompanies) type 2 diabetes. And—as we argue in the book—diabetes is almost always an early warning sign for heart disease.

    Understanding insulin resistance—and how to prevent, treat, and even reverse it—is one of the most important things you can do if you want to prevent heart disease. In the new book, we argue that if you catch insulin resistance early enough, you can prevent heart disease—for many, if not most, people. One study we talk about in the book showed treating insulin resistance properly could prevent as many as 42% of all heart attacks.

    Now for the bad news: Most doctors don’t know this. Even worse, most are still prescribing powerful drugs for a condition known as “high cholesterol” which is really not a medical condition at all, but a number on a lab test—a lab test that, in 2020, has long been past its expiration date.

    It’s time to stop concentrating on lowering LDL cholesterol and start paying attention to how we can lower the risk of heart disease.

    They are not the same thing.

  • Heart-Protective Carrot-Ginger Soup with Chives

    Heart-Protective Carrot-Ginger Soup with Chives

    The following recipe is from The Great Cholesterol Myth Cookbook by Jonny Bowden, Stephen Sinatra, and Deidre Rawlings.

     

    Roasted vegetable tomato soupTangy, tasty, and warming from the inside out, the combination of carrots with ginger will delight not only your taste buds but your entire digestive system. This soup is packed with the antioxidants vitamin A and beta-carotene, together with tons of fiber and B-complex vitamins, it doesn’t get better than this for high-energy, nutrient dense soup.

     

    Ingredients:

    • 2 tablespoons extra-virgin olive oil or coconut oil
    • 1 large onion, chopped
    • 6 large carrots, chopped
    • 2 cups chopped butternut squash, skin on
    • 5 cups vegetable stock
    • 1/2 teaspoon salt, Celtic or sea
    • 1 teaspoon chopped fresh ginger, peeled
    • 1/4 teaspoon each ground cumin, coriander powder, and garlic powder
    • 1 cup chopped fresh parsley
    • 6 tablespoons plain yogurt
    • 2 tablespoons chopped fresh chives

     

    Instructions:

    Melt the oil in a large pot. Add the onions and cook for several minutes over medium heat until they begin to sweat. Add the carrots and butternut squash and cook for about 3 minutes. Add the vegetable stock, salt, ginger, cumin, and coriander and garlic powders. Bring to a boil, reduce the heat, and simmer, about 15 to 20 minutes, or until you can pierce the pieces easily with a fork.

    Purée the soup in a blender or food processor with the parsley. Serve with 1 tablespoon of yogurt in each bowl and top with fresh chives.

    Yield: 6 servings

    Note: Ginger is a stimulating herb that gets the blood flowing and the circulation going. Because of this, it can make you feel warm when nothing else seems to do the trick.

  • Infographic: Heart-Healthy Moving Advice

    Infographic: Heart-Healthy Moving Advice

    Heart-Healthy Moving

    Infographic design and illustration by Kena Ravel for MyMove

  • Why Lowering Cholesterol Won’t Prevent Heart Disease

    Why Lowering Cholesterol Won’t Prevent Heart Disease

    Trying to prevent heart disease by lowering cholesterol is like trying to prevent obesity by cutting the lettuce out of your Big Mac.

    Surprised? Read on.

    Recently, cardiologist Stephen Sinatra and I came together to write a book—“The Great Cholesterol Myth: Why Lowering Cholesterol Won’t Prevent Heart Disease and the Statin-Free Plan That Will” (now the number 1 best-seller on Amazon in the category of heart disease).

    We believe that a weird admixture of…

    • misinformation
    • scientifically questionable studies
    • corporate greed
    • and deceptive marketing

    …has conspired to create one of the most indestructible and damaging myths in medical history:

    that cholesterol causes heart disease.

    The real tragedy is that by putting all our attention on cholesterol, we’ve virtually ignored the real causes of heart disease:

    • inflammation
    • oxidative damage
    • stress
    • sugar

    These are things we can actually do something about using food, supplements and lifestyle changes, none of which have the costs—nor the considerable side effects—of drugs.

    First, let’s start with some surprising facts.

    • Cholesterol is a minor player in heart disease
    • Cholesterol levels are a poor predictor of heart attacks
    • Half of heart attacks happen to people with normal cholesterol
    • Half the people with elevated cholesterol have healthy hearts
    • Lowering cholesterol has an extremely limited benefit

    I haven’t come to these conclusions lightly, and I wouldn’t expect you to take them at face value. The case against cholesterol as a cause of heart disease (or even as an important marker for it) has been crumbling steadily for decades, but getting the information out there is difficult. (The two top cholesterol lowering medications, Lipitor and Zocor, together bring in roughly 34 billion dollars a year for their makers, who have a strong vested interest in keeping the cholesterol theory alive. And they’re hardly the only ones who do.)

    But if you’re willing to consider breaking with conventional thinking for a minute, consider the following study, just one of the many we discuss in the book.

    The Lyon Diet-Heart Study

    In the 1990’s, French researchers decided to run an experiment- known as the Lyon Diet-Heart Study— to test the effect of different diets on heart disease.

    They took two groups of men who had every risk factor for heart disease imaginable. All of them had survived a heart attack. They had high cholesterol, they smoked, they didn’t exercise and they had high levels of stress.

    • Half the men were advised to eat the American Heart Association “prudent diet”  (low saturated fat and cholesterol)
    • The other half were advised to eat a Mediterranean diet high in fish, omega-3’s, vegetables and monounsaturated fat like olive oil

    The study was stopped midway because the reduction in heart attacks in the Mediterranean group was so pronounced—70%!!—that researchers decided it was unethical to continue.

    So what do you think happened to the cholesterol levels in the men who ate the Mediterranean diet and had 70% reduction in deaths? You’d think they must have dropped like a rock, right?

    Think again. Their cholesterol levels didn’t budge, and were just as high when the study was stopped as they were when the study began. The men just stopped dying. Cholesterol had nothing to do with it.

    So if cholesterol isn’t the cause of heart disease, what is?

    The Real Cause of Heart Disease

    Here’s the short answer: The primary cause of heart disease is inflammation. Small injuries to the vascular wall that can be caused by anything from high blood pressure to toxins attract all sorts of metabolic riff-raff, from bacteria to oxidized (damaged) LDL particles; the immune system sends inflammatory cytokines to the area, and more oxidation and inflammation takes place eventually resulting in the growth of plaque and, ultimately, to an increased risk for heart disease. If there were no inflammation, the arteries would be clear.

    The following is my seven point program for reducing the risk of heart disease. Note that lowering cholesterol isn’t on it. Note also that managing stress is.

    Stress is a powerful contributor to heart disease. The stress hormones create inflammatory events that may explain why 40% of atherosclerotic patients have no other risk factors.

    Pay attention to these seven action items, and you just may find that you don’t need to worry quite so much about cholesterol after all.

    1. Eat an anti-inflammatory diet. The fruit and vegetable kingdom is teeming with natural anti-inflammatories like quercetin (apples and onions) and curcumin (turmeric). Drink green tea and pomegranate juice. Balance your protein and fat with tons of vegetables. And eat dark chocolate—it’s cocoa flavanols help lower blood pressure and keep the cardiovascular system healthy.
    2. Reduce grains, starches, sugar and omega-6’s (vegetable oils).  Every one of these has the power to increase inflammation—a lot!
    3. Manage Your Stress. Stress is an enormous risk factor for heart disease, and is inflammatory as well. Find a way to manage it. Anything from regular walks in the park to deep breathing exercises to warm baths can help.
    4. Exercise. It’s probably the best anti-aging (and heart protective) drug on the planet
    5. Drink only in moderation. And if you don’t process the word “moderation” very well, don’t drink at all.
    6. Don’t smoke. Probably the number one recommendation for heart disease prevention.
    7. Supplement with antioxidants, vitamin C, Coenzyme Q10, omega-3’s, curcumin, citrus bergamont. Antioxidants like vitamin C protect against oxidative damage (one of the promoters of heart disease) while omega-3’s are one of the most anti-inflammatory molecule on earth. Curcumin does just about everything—it’s an anti-inflammatory and antioxidant.

    The Statin Scam

    And one more thing—if your doctor wants to put you on a statin drug, push back. Ask for the newer (and far more important) cholesterol particle tests, which go well beyond old-fashioned measurements like “good” and “bad” cholesterol and actually tell you what type of LDL you have. (LDL-a is pretty harmless; LDL-b is not.) If you’re a woman, be aware that there’s no evidence that statin drugs save lives in women (or children!) Know that in a number of studies, statin users have a higher risk for diabetes. And that in older people, higher cholesterol is actually protective. (If your doctor doubts that, refer him to the Framingham Study!)

    Statin drugs have many potential side effects, including muscle pain and weakness, memory loss, diminished libido and fatigue. Finally, know that the only population for which a modest—repeat, modest—benefit for statin drugs has been consistently shown is middle aged men with existing cardiovascular disease (previous heart attack). And many health professionals suspect that even this extremely modest benefit is probably due to the anti-inflammatory nature of statins, rather than their ability to lower cholesterol.

    The Bottom Line

    Lowering cholesterol and lowering the risk of heart disease are very far from the same thing.

    The latter is important.

    The former is almost irrelevant.

  • Mediterranean Diet…The Best Diet Ever? Not So Fast!

    Mediterranean Diet…The Best Diet Ever? Not So Fast!

    Last week, the New England Journal of Medicine published a study which, according to the fawning mainstream press, proved “conclusively” that the best diet in the world was the Mediterranean diet, that it protected everyone from heart disease and stroke, and that everyone in the world should be on it.

    Except the study showed no such thing.

    Now, don’t get me wrong. I’m a big fan of the concept of Mediterranean eating, even though I’ve never seen anyone definitively define what “The Mediterranean Diet” actually is. (Check the definitions: most are squishy and vague with phrases like “higher in vegetables” or “lower in dairy”.) We do know that in all styles of Mediterranean eating there is way less sugar. And there’s lots of olive oil, nuts and other good stuff.

    We also know that Mediterranean folks eat their big meal of the day in the middle of afternoon. And that they take naps. And that the men talk about their feelings. (A lot.) And they get lots of sun. And that all of these things have a great deal of impact, though that’s not what gets mentioned when the press talks about “The Mediterranean Diet”.

    But I digress.

    Back to the study. What the researchers actually did was create three groups of people. Group one ate what is generally thought of as a Mediterranean-type diet, but supplemented with lots of extra-virgin olive oil. Group two ate the same diet, but supplemented with lots of nuts. And group three ate the standard, American, low-fat high-carb diet that the diet dictocrats have been pushing on us for decades. The one recommended by such groups as the American Heart Association and the god-awful moribund American Dietetic Association (or whatever it is they’re calling themselves these days to try to reinvent themselves as contemporary. Good luck with that.)

    Here’s what the results showed with laser-sharp clarity: The low-fat diet is a complete and utter failure.

    Both “Mediterranean diet” groups did well on measures of cardiovascular health, and there wasn’t much difference between the two groups. But the low-fat group did horribly. In fact, they did so badly that in the middle of the study, the researchers intervened, and tried to give the low-fat group more instruction and attention to bring them up to speed. Didn’t matter. They bombed anyway.

    Side note that was missed in all the media reporting: The researchers clearly state that they believe the excellent results achieved by both “Mediterranean” groups were largely driven by the supplemental nuts and the supplemental extra-virgin olive oil. Not necessarily the “diet” itself.

    So what have we learned, class?

    We’ve learned that the American, low-fat diet stinks. And that nuts and olive oil are extremely healthy foods.

    As far as the Mediterranean diet being the “best” diet ever, that’s still up for grabs. This study certainly didn’t show that, as it didn’t pit the “Mediterranean diet” against any other diet but the low-fat one; there was no group doing a “paleo” diet, or a “high-protein” diet or a “raw foods” diet.

    And we still don’t have a good definition of the Mediterranean diet. (As my mentor, the great Robert Crayhon once quipped, “People think the “Mediterranean Diet” means adding a bunch of olive oil to your corn flakes”.) And we still don’t know which aspects of the so-called Mediterranean lifestyle are the ones that really produce the results. Is it the olive oil? The nuts? The vegetables? The low level of red meat? The fact that they eat slowly and in the middle of the day? Maybe it’s all of those things, maybe it’s just some of them… this study certainly didn’t address that question, so we can’t say for sure.

    What we can say is this: No diet, ever, in the history of the world, has been higher in sugar and processed carbohydrate junk foods than the one that most people in America consume on a daily basis.

    And no diet is better designed to produce the epidemic of obesity, diabetes and heart disease we are currently witnessing.

    My own personal opinion is you could design a dozen diet studies showing the superiority of a dozen different diets (from Atkins to Ornish to Zone) as long as you compare each of them to the crap we’re eating now.

    With a bar that low, almost any diet is going to look like a superstar.

  • Reduce Your Heart Attack Risk 50% with Water

    Reduce Your Heart Attack Risk 50% with Water

    A study in the American Journal of Epidemiology found that guys who drank five or more glasses of water had only a 46% chance of having a fatal heart attack, and women had only 59% risk, compared to people who drank two or less glasses of water daily.

    It gets even better (or worse, depending on how you look at it). Women who drank two or less glasses of something other than water – such as tea, a soft drink, or juice – had a 147% greater risk for a fatal heart attack than women who drank five or more glasses of water. (Guys, you had a 46% greater risk if you skipped the water for another drink.)

    Now, if those stats confuse you, I’ll sum it up: drink more water and reduce your risk for a heart attack.

    Even after researchers adjusted for other risk factors, these numbers still held intact.

    Researchers here looked at coronary heart disease and fluid intake stats in 8,280 male and 12,017 female participants. Overall, these participants had 246 “coronary heart disease events” (128 in men and 118 in women) over the six-year follow-up period.

    More than any other factor in this study, water intake determined fatal heart disease risk.

    According to lead researcher Dr. Jacqueline Chan, this was the “first study to record the association between high water intake and reduced risk of coronary heart disease… [B]y drinking more plain water, healthy people… reduced their risk of dying from a heart attack by half or more.”

    Chan notes there isn’t much evidence about the eight-glasses rule. She still wants people not to rely on tea, coffee, and other diuretics that can raise blood viscosity, and focus instead on plain water.

    Consider the statistics and you’ll understand her position.

    Your body is about 83% water, your brain and muscles are about three-quarters water, and even your bones pack 22% water. Water contributes to every single metabolic process in your body, including absorbing nutrients and removing toxic waste.

    Dehydration, on the other hand, can elevate at least four independent risk factors for heart disease: whole blood viscosity, plasma viscosity, hematocrit, and fibrinogen. Heart attacks occur more frequently in the morning, when your blood is thicker because of water loss while you’re sleeping.

    I don’t know about you, but that’s enough reason for me to crank up my water quota.

    Maybe you’re not concerned about a heart attack. But I bet I’ll get your attention when I say that not drinking enough water can make you fat.

    That’s because even when you’re mildly dehydrated, you can raise your stress hormone cortisol 1 – 2%. Among the many things cortisol does is store fat and break down muscle.

    Now, you’re going to hear naysayers claim the dehydration issue is overhyped. They argue there’s no double-blind, placebo-based study to show you need eight glasses of water every day.

    Others claim you get enough water from the tea, coffee, and Diet Coke you drink, so there’s no need to bother with boring water.

    Nonsense, I reply to these critics.

    I believe more water is better. Ideally, I would like you to drink half your weight in water ounces. So if you weigh 200 pounds, you need to drink 100 ounces of water a day. No kidding.

    If you’re shaking your head that doing so is impossible, I’m going to give you an easy tip to meet your water quota.

    Buy a liter-sized Sigg, Klean Kanteen, or other stainless steel water bottle. Fill it up three times, and sip on it, throughout your day.

    Bam! You’re done. See how easy that was?

    You’ll save money, the environment, and you won’t even have to worry about those pesky chemicals leaching from plastic bottles.

    Best of all, you’ll stay hydrated and provide the countless benefits water provides for your body.

  • Daily Habit Increases Heart Disease Risk By 20%

    Daily Habit Increases Heart Disease Risk By 20%

    A new study in the journal Circulation found men who consumed a 12-ounce sugar-sweetened drink every day had a 20% higher risk of heart disease compared to men who didn’t drink them.

    The study tracked primarily Caucasian middle-aged men, all in healthcare professions, for 22 years. Every two years, these participants completed questionnaires that inquired about diet and other lifestyle factors.

    Participants also gave a blood sample, which measured various lipids and proteins that provide markers for heart disease:

    • the inflammation marker C-reactive protein (CRP)
    • triglycerides
    • high-density lipoproteins (HDL cholesterol)

    No surprise in the findings…

    The men who daily gulped a sugary drink had higher triglyceride and CRP levels, as well as lower HDL levels, compared to non-sugar beverage drinkers.

    Researchers found that neither men who only occasionally drink these sugary beverages (maybe every few weeks), nor those who consume artificially sweetened drinks, increase their risk for heart disease.

    The American Heart Association recommends no more than about 150 calories for men and 100 for women every day to come from sugary drinks.

    My advice would be not to touch these drinks, period. They provide little if any nutrients and empty calories.

    I’m not just talking about soda here. I see people who know Coke is bad buy fruit juice or an energy drink that manufacturers market as healthy.

    Reality check: some of these juices and energy drinks pack more sugar than a Coke.

    Same deal with tea. I’m all for drinking green tea, but not when it’s loaded with sugar and other preservatives like many bottled teas are.

    And don’t be misled by “healthy” sugars. You might think you’re making a healthier choice with organic cane sugar or whatever, but your pancreas doesn’t know the difference.

    Whether it’s high-fructose corn syrup or organic whatever, you’re going to raise your blood sugar, which means you raise insulin. Insulin stores fat and creates all sorts of metabolic havoc that leads to diabetes, heart disease, and other complications.

    And while we’re talking sugars that are marketed as healthy…

    Can we please put this agave nonsense to rest?

    Health food stores are stocked with agave-sweetened drinks and foods, and it’s the biggest marketing scam of the past few years.

    Agave is about 90% fructose, which doesn’t raise insulin levels but creates even worse damage. Your liver poorly metabolizes fructose, which eventually can lead to fatty liver and inflammation. Fructose eventually gets repackaged as triglycerides, which store quite nicely around your waist.

    So nix the agave, okay?

    I also don’t recommend artificially sweetened drinks. Many contain aspartame, a potential neurotoxin that creates a lot of trouble for people.

    My point is, read your labels. Manufacturers hide sugar and artificial sweeteners under innocuous names. Learn them, and learn to put anything that doesn’t meet your standards back on the shelf.

    If you’re at a gas station or wherever and need a cold drink, look for one sweetened with stevia or xylitol. These are both beneficial natural sweeteners that don’t raise blood sugar levels or stress the liver.

    Lemon or lime flavored seltzer waters and mineral waters are also a great idea.

    Of course, if you’re at a Starbucks or your favorite coffee place, you can order green tea or coffee, either iced or hot. Just specify unsweetened, since some of the iced drinks come pre-made with sugar.

    Your best bet would be to brew your own tea at home. Make a gallon pitcher of green tea, sweeten it with stevia or xylitol, and carry it in a Sigg bottle when you’re out. You’ll save money and improve your health.

     

  • Dark Chocolate Is Good For Your Heart

    Dark Chocolate Is Good For Your Heart

    A new study just came out adding to the growing body of research pointing to the conclusion that dark chocolate is a serious health food.

    You’ve heard me go on about the health benefits of dark chocolate more times than we both can count. But the research just keeps coming in, and dark chocolate keeps looking better and better!

    We already know from a previous study published in the Journal of the American College of Cardiology that women with the highest weekly chocolate intake (45 grams a week or more) had about 1/3 the number of strokes as women who consumed the least amount of chocolate.

    We also know that dark chocolate:

    The new study—published in the Journal of Nutrition—examined the effect of flavonoid-rich cocoa on major cardiovascular risk factors including:

    • blood pressure
    • cholesterol, BMI (a measure of overweight)
    • C-Reactive Protein (a measure of inflammation)
    • fasting blood sugar
    • fasting insulin
    • insulin sensitivity/insulin resistance

    The researchers performed what’s called a meta-analysis, which is a study of other studies; researchers gather a whole bunch of papers (in this case twenty four) pool the information and look for consistent trends and findings.

    In this case, they found that flavonoid rich cocoa definitely affects a whole bunch of cardiovascular risk factors. Flavonoid-rich cocoa consumption significantly improved blood pressure, insulin resistance and lipid profiles.

    Researchers have long suspected that the health benefits of dark chocolate are due to the high flavonoid content of cocoa. Flavonoids are plant chemicals with multiple health benefits- they’re antioxidants and anti-inflammatories. The specific flavonoids found in dark chocolate are called flavanols, and are believed to be responsible for the benefits.

    The flavanols in cocoa also do something else that’s very important. They modulate a compound in the body called nitric oxide. Nitric oxide  is critical for healthy blood flow and healthy blood pressure and is a very important compound in the area of cardiovascular health. One reason that chocolate lowers blood pressure may well be that flavanol-rich cocoa actually supports the body’s ability to synthesize nitric oxide.

    Remember, all chocolate is not created equal! To get the kinds of benefits on cardiovascular health that the studies all point to, you must consume dark chocolate with a high cocoa content (60% or more, preferably 65-70%). As the percentage of cocoa goes up, the chocolate bar tastes less sweet and more bitter.

    A 100% dark cocoa bar is almost inedible;  but a bar with around 60-75% still tastes great and yet doesn’t tend to spark cravings the way a high-sugar bar would. Remember that commercial chocolate bars—milk chocolate, white chocolate, low-cocoa dark chocolate—tend t0.o be filled with sugar and chemicals. For the real deal, go for the organic kind and make sure the cocoa content is high so you’re assured of getting all those beneficial flavanols!

  • Heart Disease: Genetics or Lifestyle?

    Heart Disease: Genetics or Lifestyle?

    Guest article from Life Extension Institute:

    On November 15, 2010, the American Heart Association Scientific Sessions 2010 featured presentations of the results of two studies which indicate that lifestyle has a greater impact on whether one will develop cardiovascular disease than being genetically predisposed to acquire the disease.

    In the first study, researchers at Northwestern University Feinberg School of Medicine evaluated data from 2,336 men and women aged 18 to 30 upon enrollment in the Coronary Artery Risk Development in Young Adults longitudinal study sponsored by the National Heart, Lung and Blood Institute. Diet, physical activity, alcohol intake, smoking status, weight, and blood pressure and glucose levels were assessed at the beginning of the study and at the seventh and twentieth years of follow-up.

    Among participants who maintained five healthy lifestyle factors (having a healthy body mass index, limiting alcohol consumption, consuming healthy amounts of potassium, calcium and fiber and a low intake of saturated fat; participating in regular exercise, and never smoking) 60 percent had a low risk profile for cardiovascular disease after 20 years. That percentage dropped to 37 percent for those who had four factors, 30 percent for three factors, 17 percent for two and 6 percent for one or none. Separate analyses for men, women, Caucasians and African-Americans turned up similar findings.

    The second study, also conducted at Northwestern University, analyzed three generations of families enrolled in the Framingham Heart Study. The researchers determined that the majority of cardiovascular disease that developed in the subjects was caused by lifestyle factors, with only a small proportion due to heredity. “What you do and how you live is going to have a larger impact on whether you are in ideal cardiovascular health than your genes or how you were raised,” lead author and Feinberg School postdoctoral fellow in preventive medicine Norrina Allen concluded.

    “Health behaviors can trump a lot of your genetics,” noted Donald Lloyd-Jones, MD, who is the chair and professor of preventive medicine at Northwestern Medicine and a cardiologist at Northwestern Memorial Hospital. “This research shows people have control over their heart health. The earlier they start making healthy choices, the more likely they are to maintain a low-risk profile for heart disease.

    “We really need to encourage individuals to improve their behavior and lifestyle and create a public health environment so people can make healthy choices,” he added. “We need to make it possible for people to walk more and safely in their neighborhoods and buy fresh affordable fruit and vegetables in the local grocery store. We need physical activity back in schools, widely applied indoor smoking bans and reduced sodium content in the processed foods we eat. We also need to educate people to reduce their calorie intake. It’s a partnership between individuals making behavior changes but also public health changes that will improve the environment and allow people to make those healthy choices.”

    Dr. Jonny comments:

    If I had a dollar for every person who’s ever told me, with a fatalistic sigh, “It’s in my genes.. nothing I can do about it”, I’d be typing this from an ocean villa in St. Martin.

    Here’s the truth about genes.

    Genes are not “fixed entities” that predetermine outcomes. (There are very, very few diseases that are determined by a single gene. Huntington’s Chorea is one- you can count the others on one hand).

    Genes are plastic, meaning they can be turned on or off, modified and changed, “expressed” or “not expressed” depending on their interaction with the environment. The emerging science of “Nutrigenomics” is about investigating the interaction between genes and nutrients. The bottom line- as the guest article points out- is that what you do, how you live and what you eat has far more of an impact on your life than your actual genes do.

    Earlier research from the Nurses Health Study showed that five factors- surprisingly similar to the five factors found in the above mentioned study—can lower heart disease risk by over 80%. There isn’t a drug in the world that can do that. The five factors?

    1. Maintain a healthy body weight
    2. Eat a Mediterranean style diet high in fish
    3. Exercise regularly
    4. Don’t smoke
    5. Alcohol in moderation (2 drinks max for guys, 1 drink max for women on a daily basis)

    My favorite supplements for protecting the heart are Fish Oil, Magnesium and Coenzyme Q10. (If you’re on a statin drug, you MUST take CoQ10 on a daily basis!) If you have any kind of heart disease, you should probably add to those three D-Ribose and Carnitine. (Cardiologist Steve Sinatra, MD recommends CoQ10, carnitine, ribose and magnesium as the “awesome foursome” for heart disease. I agree wholeheartedly.)