Heart Health Breakthroughs
From the medical journals this month, a lot of important new about heart health. Topics include 4 Major Risk Factors for Heart Disease that can be modified; How and Why eating fish lowers heart rate (and which kind is best to eat); How hormone balancing, including DHEA, fights heart disease; Study shows that diet change works as well as drugs for lowering cholesterol.
Big Fat Lies! A deficiency of Omega-3 Fatty Acid OR an imbalance of Omega-6 to Omega-3 ratio is associated with heart irregularities, breast cancer, difficulty losing weight and more.
Sex hormone balance. New studies continue to show the danger of conventional hormone therapy (though this has been known for over a decade), but other studies show benefit of natural hormone replacement therapy. Find out what the difference is and how to go about improving your hormone levels.
Risks and Benefits of Soy Soy and soy-related foods have health benefits including cholesterol-lower and anti-cancer effects BUT there are definite cautions as well. Learn more about this up-and-coming food source.
Body/Mind: The Shaman’s Lesson of Worth What I learned from a Native American Medicine Man may prove of value to you as well.
Member News and Notes
Upcoming topics: What else would you like to see in future editions? Keep those requests and letters coming.
Heart Health Breakthroughs
From the medical journals in the past month come these heart-healthy findings:
- The Top 4 major heart disease risks can be modified, and isn’t this great news since heart disease is the major cause of death in our country! Nine out of ten people who suffer a heart attack were found to have at least one of these modifiable risks, including cigarette smoking, diabetes, high blood pressure or high cholesterol levels. It was previously believed that these 4 factors accounted for about 50% of fatal heart attacks, but two studies published this week now estimate the number to be between 87-100%. (Journal of the American Medical Association, August 18, 2003)
- Eating fatty fish helps keep heart rate low, which in turn decreases the risk of sudden cardiac death. The exact mechanism is not yet known, but I predict it will be discovered to be due to the "essential" nature of the correct Omega-6:Omega-3 fatty acid ratio. (See "Big Fat Lies", below). (Circulation: Journal of the American Heart Association, August 12, 2003)
- Diet works as well as drugs for lowering cholesterol levels. The test diets included fiber and soy protein, and worked as well at lowering cholesterol as the major "statin" drugs. There are several advantages to the dietary approach, namely lower cost and most importantly, no nasty side effects. (Statin drugs can damage the liver, hence the need for regular blood tests to monitor liver function). (Journal of the American Medical Association, July 23/30, 2003)
- DHEA May Fight Heart Disease. A study of middle-aged men taking DHEA found that insulin sensitivity and endothelial function both improved. (Endothelium is the lining of the blood vessels, the area where plaque accumulates). Since both of these factors are known to contribute to atherosclerosis, it is believed that DHEA will be shown to be beneficial to the heart. (Journal of Clinical Endocrinology and Metabolism, July 23, 2003). Dr. Myatt’s Note: Please read the article on "Sex Hormone Balance," below, and DO NOT attempt to take hormone supplementation without guidance. This study is promising but preliminary, and it is possible to drive estrogen and other sex hormones too high with excessive DHEA intake.
- Type "A" Behavior Triggers Heart Disease. Those who have "Type A" behaviors---- impatient, competitive, uptight, holding grudges--- are heart attacks waiting to happen, and happen much sooner than they would in a person with similar physical risk factors but non-type A personalities. (Psychosomatic Medicine, July, 2003). The bottom line? Practice relaxation techniques, physical activity to burn off excess "hyper" energy, forgiveness--- whatever it takes to ease you into a less stressful personality and behavior mode.
Big Fat Lies!
Unlike carbohydrates, fats are an essential macronutrient and also the most misunderstood. The term "fat" actually refers to an entire family of fatty acids, each with very different biological functions. Only two fatty acids are essential, but the way in which all interact with each other plays an important role in how Essential Fatty Acids (EFA’s) are utilized. Deficiencies, excesses or relative deficiencies of EFA’s are now known to have serious health consequences. Because imbalanced dietary fats are strongly associated with many diseases, any diet aiming for optimal health must correct fat intake. A number of books address the importance of EFA’s, also called "Omegas," but most contain elements of spurious science.
The New Keto Diet dives deeper into the description and prescription for optimizing fat intake than any diet ever before, shattering some widely held but incorrect beliefs about certain fats and setting the record straight on others. Let’s look at some of the Big Fat Lies about fat that no other diet book has correctly explained, including:
TRANS fats are the real villains among dietary fats, interfering with absorption of the Essential Fatty Acids, damaging cell membranes, elevating cholesterol level and altering the way normal cell membranes function. Trans fats are prevalent in the American diet, including many weight loss and "health" diets, but their intake should be drastically minimized for health reasons. In fact, the FDA recently passed a law requiring the amounts of trans fats to be listed separately on food nutrition labels.
Saturated fats, the kind we get from eating steak, butter, cheese and eggs, are NOT unhealthy as they have been portrayed. In fact, they are so important that the human body produces them internally. Dietary saturated fat intake is not only safe but also necessary. Because "sat fats" do not compete with the EFA’s for absorption, do not turn "trans" or rancid, and maintain their chemical composition when heated, they are preferable for frying and high-heat cooking. The old belief that "saturated fats are unhealthy" was actually started many years ago based on some unscientific "science," the edible oil industry in this country (who magnified the unsavory science in ads to discredit coconut oil and improve sales of domestic oils such as corn and cottonseed), and one wealthy businessman who mistakenly blamed his heart disease on saturated fats and paid for a huge, negative marketing campaign. Saturated fats are not villains, and some sat fats, such as coconut oil, have significant health benefits. (Coconut oil is antimicrobial, antiviral, is excellent for cooking for the reasons listed above, and can be used easily and directly as a calorie source, hence, it "burns" faster and "hotter" than many other types of calories).
Further, the belief that monounsaturated oils (such as olive oil) are healthful and desirable is another Big Fat Lie. In truth, they are the white bread of the fatty acid family. Although better than Trans fats, "monos" serve no purpose in the body, are not essential, compete with the Essential Fatty Acids for utilization, and can turn into Trans fats with cooking.
Omega-6 Fatty Acids are an Essential Fatty Acid (EFA) that needs to be balanced with it’s EFA partner, Omega-3, for optimal health. The American diet contains far too much of this essential fat and most people should not be taking supplements of O-6 oils.
Omega-3 Fatty Acids, the other EFA, must partner with O-6 in a 4:1 to 10:1 ratio. Unfortunately, this EFA is exceptionally low in virtually every diet, from the Standard American Diet to Atkin’s to Pritiken, and especially the USDA food pyramid. No one has told us the truth, the whole truth, and nothing but the truth regarding optimal fat intake until now. On a truly healthful diet (primarily The New Keto Diet), you can have your steak (its "Omega Ratio" makes it far healthier than chicken), lavish butter on your broccoli and bathe your artichoke in mayonnaise, but that dainty olive oil vinaigrette that most would advise should be replaced by a healthier flax oil dressing.
One of the best ways to help prevent and treat heart disease is to eat a diet low in trans fats and replace foods rich in trans and omega-6 fats with those that are rich in omega-3 fatty acids. EPA and DHA found in fish oil help reduce risk factors for heart disease including high cholesterol and high blood pressure. There is also strong evidence that these substances can help prevent and treat atherosclerosis by inhibiting the development of plaque and blood clots, each of which tends to clog arteries. Studies of heart attack survivors have found that daily omega-3 fatty acid supplements dramatically reduce the risk of death, subsequent heart attacks, and stroke. Similarly, people who eat an ALA-rich diet are less likely to suffer a fatal heart attack.
Strong evidence from population-based studies suggests that omega-3 fatty acid intake (primarily from fish), helps protect against stroke caused by plaque buildup and blood clots in the arteries that lead to the brain. In fact, eating at least two servings of fish per week can reduce the risk of stroke by as much as 50%. However, people who eat more than three grams of omega-3 fatty acids per day (equivalent to 3 servings of fish per day) may be at an increased risk for hemorrhagic stroke, a potentially fatal type of stroke in which an artery in the brain leaks or ruptures. Keep in mind that 80% of strokes are due to blood clots, and only 20% are hemorrhagic. Further, it is weak blood vessels, not thin blood, that cause this rarer type of stroke. (Grape seed extract, available in supplement form, helps strengthen blood vessels among its other benefits).
People who have trouble losing weight when dieting, including those who are resistant to weight loss on a ketogenic (Atkins’) diet, are likely to have a deficiency of Omega-3 fatty Acids OR an imbalanced ratio of O-6 to O-3. Improving this ratio of Essential Fatty Acid intake in the diet, without additional restriction on carbohydrates or calories, is often the key to unlocking this "metabolic resistance."
Most clinical studies investigating the use of omega-3 fatty acid supplements for inflammatory joint conditions have focused almost entirely on rheumatoid arthritis. Several articles reviewing the research in this area conclude that omega-3 fatty acid supplements reduce tenderness in joints, decrease morning stiffness, and allow for a reduction in the amount of medication needed for people with rheumatoid arthritis.
In addition, laboratory studies suggest that diets rich in omega-3 fatty acids (and low in omega-6 fatty acids) may benefit people with other inflammatory disorders, such as osteoarthritis. In fact, several test tube studies of cartilage-containing cells have found that omega-3 fatty acids decrease inflammation and reduce the activity of enzymes that destroy cartilage. In some participants, symptoms worsened before they improved.
People who do not get enough omega-3 fatty acids or do not maintain a healthy balance of omega-3 to omega-6 fatty acids in their diet may be at an increased risk for depression. The omega-3 fatty acids are important components of nerve cell membranes. They help nerve cells communicate with each other, which is an essential step in maintaining good mental health.
Levels of omega-3 fatty acids were found to be measurably low and the ratio of omega-6 to omega-3 fatty acids were particularly high in a study of patients hospitalized for depression. In a study of people with depression, those who ate a healthy diet consisting of fatty fish two to three times per week for 5 years experienced a significant reduction in feelings of depression and hostility.
A questionnaire administered to more than 3,000 people over the age of 49 found that those who consumed more fish in their diet were less likely to have macular degeneration (a serious age-related eye condition that can progress to blindness) than those who consumed less fish. Similarly, a study comparing 350 people with macular degeneration to 500 without found that those with a healthy dietary balance of omega-3 and omega-6 fatty acids and higher intake of fish in their diets were less likely to have this particular eye disorder. Another larger study confirms that EPA and DHA from fish, four or more times per week, may reduce the risk of developing macular degeneration.
Consuming significant amounts of foods rich in omega-3 fatty acids appears to reduce the risk of colorectal cancer. For example, Eskimos, who tend to follow a high fat diet but eat significant amounts of fish rich in omega-3 fatty acids, have a low rate of colorectal cancer. Animal studies and laboratory studies have found that omega-3 fatty acids prevent worsening of colon cancer while omega-6 fatty acids promote the growth of colon tumors. Daily consumption of EPA and DHA also appeared to slow or even reverse the progression of colon cancer in people with early stages of the disease.
Women who regularly consume foods rich in omega-3 fatty acids appear to be less likely to develop breast cancer. In addition, the risk of dying from breast cancer may be significantly less for those who eat large quantities of omega-3 from fish and brown kelp seaweed (common in Japan). This is particularly true among women who substitute fish for meat. The balance between omega-3 and omega-6 fatty acids appears to play an important role in the development and growth of breast cancer. The tissue levels of women with breast cancer are found to contain much lower levels of Omega-3 fatty acids than breast tissue from healthy controls.
Some researchers hypothesize that omega-3 fatty acids in combination with other nutrients (namely, vitamin C, vitamin E, beta-carotene, selenium, and coenzyme Q10) may prove to be of particular value for preventing and treating breast cancer.
Laboratory and animal studies indicate that omega-3 fatty acids (specifically, DHA and EPA) may inhibit the growth of prostate cancer. Similarly, population based studies of groups of men suggest that a low-fat diet with the addition of omega-3 fatty acids from fish or fish oil help prevent the development of prostate cancer. Like breast cancer, the balance of omega-3 to omega-6 fatty acids appears to be particularly important for reducing the risk of this condition.
Preliminary evidence suggests that omega-3 fatty acids may also prove beneficial in protecting against infections, ulcers, migraine headaches, preterm labor, asthma, emphysema, psoriasis, glaucoma, Lyme disease, lupus, and panic attacks.
Fish oils and plant oils are the primary dietary source of omega-3 fatty acids. EPA and DHA are found in cold-water fish such as salmon, mackerel, halibut, sardines, and herring. ALA is found in flaxseeds & flaxseed oil. FISH and FLAX are the best sources. Other oils that contain significant amounts of Omega-3 are not recommended because they are also high in Omega-6. these include: canola (rapeseed) oil, soybeans, soybean oil, pumpkin seeds, pumpkin seed oil, purslane, walnuts, and walnut oil.
In addition to the dietary sources described, EPA and DHA can be taken in the form of fish oil Capsules. Flaxseed, flaxseed oil, and fish oil should be kept refrigerated. Whole flaxseeds should be ground within 1 week of use to ensure maximum potency.
Be sure to buy omega-3 fatty acid supplements made by established companies who certify that their products are free of heavy metals such as mercury.
How to Take It
1 TBS. ground flax seed per day AND 1 TBS. flax oil per day OR 2 TBS. flax oil per day. (This corresponds to about 12 flax oil Capsules.
Flaxseed: 1 TBS two to three times per day or 2 to 4 tsp one time per day. Grind before eating and take with lots of water.
EPA and DHA
The adequate daily intake of EPA and DHA for adults should be at least 220 mg of each per day. Two to three servings of fatty fish per week (roughly 1,250 mg EPA and DHA per day) are generally recommended to treat certain health conditions.
Fish oil supplements
3,000 to 4,000 mg standardized fish oils per day. (This amount corresponds to roughly 2 to 3 servings of fatty fish per week.)
Typically, a 1,000 mg fish oil Capsule has 180 mg EPA and 120 mg DHA
ALA. Do NOT use cod liver oil on a regular basis, as it’s high vitamin A & D levels can become toxic. A physician should monitor high intakes of these fat-soluble vitamins. Regular EPA-containing fish oils do not contain vitamin A & D.
If you are currently being treated with any of the following medications, you should not use omega-3 fatty acid supplements without first talking to your healthcare provider.
Omega-3 fatty acids may increase the blood-thinning effects of aspirin or warfarin. While the combination of aspirin and omega-3 fatty acids may actually be helpful under certain circumstances (such as heart disease), they should only be taken together under the guidance and supervision of a knowledgeable nutritionally-oriented physician.
Taking omega-3 fatty acids during cyclosporine therapy may reduce toxic side effects (such as high blood pressure and kidney damage) associated with this medication in transplant patients.
Etretinate and Topical Steroids
The addition of omega-3 fatty acids (specifically EPA) to a drug regimen of etretinate and topical corticosteroids may improve symptoms of psoriasis.
Following certain nutritional guidelines, including increasing the amount of omega-3 fatty acids in your diet and reducing the omega-6 to omega-3 ratio, may allow a group of cholesterol lowering medications known as "statins" (such as atorvastatin, lovastatin, and simvastatin) to work more effectively.
Nonsteroidal Anti-inflammatory Drugs (NSAIDs)
In an animal study, treatment with omega-3 fatty acids reduced the risk of ulcers from nonsteroidal anti-inflammatory drugs (NSAIDs). More research is needed to evaluate whether omega-3 fatty acids would have the same effects in people.
Sex Hormone Balance
The so-called "sex hormones," including estrogens, testosterone, progesterone, DHEA, DHT, appear to play an important role in keeping us health, preventing many known age-related changes. When they are in healthful balance, they also appear to help prevent hormone-related cancers, heart disease, age-related memory changes, osteoporosis and a host of other ills. This is the reason that women, particularly, have been prescribed hormone replacement therapy (HRT) after menopause.
Although it was well-known when I first started practicing medicine 14 years ago, only this year have we "officially" acknowledged that conventional hormone replacement therapy can be dangerous. In fact, such HRT can actually INCREASE the risk of heart disease and breast cancer. Fortunately for men, we have not tended to use HRT at middle age.
In contradistinction, natural Hormone Replacement Therapy (n-HRT) appears to have numerous positive benefits for both women AND men. A decline in these sex hormones is highly associated with undesirable metabolic changes of aging, and altering the levels toward a more "youthful" profile can be seen to reverse or slow the aging process. (See the "Heart Healthy" note on DHEA, above).
In women, youthful hormone balance is associated with lower heart disease risk, protection from osteoporosis, breast cancer, depression and age-related memory changes, to name a few.
In men, youthful hormone balance is associated with increased virility and protection from heart disease, prostate cancer, depression and osteoporosis (yes, men get it to), to name a few.
The key difference between HRT and n-HRT is that n-HRT attempts to duplicate a normal hormone profile of a youthful body. Conventional HRT makes absolutely NO attempt to imitate nature, usually giving high doses of the most potent form of estrogen, which is the likely reason for its dismal failure.
Anyone past the age of 40, both men and women, may benefit from n-HRT. Because the "hormone milieu" is a complicated mix in each individual, the only safe and sane way to take hormones is to have a baseline hormone profile performed, and replacement therapy prescribed by an holistic physician. Because of the broad array of physical functions affected by sex hormone balance, this simple measure of evaluation and n-HRT is worth considering for anyone who wants to delay the aging process and enjoy better health past middle age.
Soy: Risks and Benefits
Like most things in nature, the humble soy bean (Glycine max) can be healthful in moderation, harmful in excess. Because soy and soy products (tofu, miso, soy flour) are currently gaining a lot of media attention and popularity, it is important to understand the risks and benefits of this food and supplement.
Soy contains substances called protease inhibitors. In small to moderate amounts, these substances help prevent cancer and are also useful in controlling cancer. Soy has estrogenic effects, though much weaker than the human estrogen equivalent. For this reason, soy can increase the estrogen effect in someone who is deficient, or decrease the estrogen effect in one who has an excess. (Because it competes for the same receptors as the stronger mammalian estrogens, giving then less available places to bind). Soy may also improve cholesterol levels when eaten with some regularity. Believe me, you’ll be reading and hearing a lot more about this food in the months ahead, but please exercise moderation. Much of what you hear is "hype," some is valuable medical advice.
Soy is a "goitrogen," capable of inhibiting thyroid function when consumed in large amounts. In fact, I have seen some particularly sensitive people experience thyroid suppression when eating soy even in modest doses.
Further, soy is a type of protein that many people do not digest and tolerate well. It is especially likely to aggravate irritable bowel symptoms, causing gas and diarrhea, in those who are sensitive to it.
SO, who should eat soy? It appears to be a healthy and even helpful food for many people, 3 to 4 servings per week is my recommendation. If you experience bowel discomfort from eating soy, then this food is not for you. If you elect to eat larger amounts per week than this, consider having your thyroid function tested when you first add more soy to your diet, then again in 3 months to see if it has adversely affected your thyroid hormones levels.
For those who wish to obtain the benefits of soy (such as women desiring alternative to convention hormone replacement, or those with hormone-related cancers under their holistic physician’s guidance), soy supplements can be taken. These contain the isolated active ingredients of soy, primarily genistein and diadzein, without the gut-disturbing proteins that bother many.
I consider soy a useful protein source with positive health benefits when consumed in moderation. Just don’t fall for the plethora of media and soy-growers of America "over-hype" and fall prey to excess. "All things in moderation, including moderation"!
The Shaman's Lesson of Worth
I was a starry-eyed first year resident when I met the old man, a Shaman (medicine man and spiritual advisor) to his Native tribe in the four corner's area of New Mexico. It had long been my goal to study with such a healer and learn the "secrets" of the Shaman's ways. Now here I was, face-to-face with just such a One.
A young man came to see the Shaman about a health problem. From his appearance and description, I guessed him to be no more than twenty. He complained bitterly about the "strange sights" he saw on occasion. By Western standards, schizophrenia was a likely diagnosis. The young man clearly needed help. The Shaman told him that help was available, but that a week-long ceremony would be necessary. Then the Shaman told him the cost. The young man shook his head dejectedly and left. I questioned the Shaman.
What was the fee for the ceremony, and why had the young man gone away without treatment? I wanted to know. The Shaman explained that his fees were approximately equivalent to $6000 in Western money, but that people paid in other means of exchange like goats, sheep, baskets and food items. The man left because he did not have the required fee. Sensing that I was upset by this, the Shaman explained that the young man would return for treatment after he raised the necessary funds.
"But why don't you help him now and let him pay later?" I wanted to know. "Aren't there some people that are too poor to afford your services? Do you ever give your services away for free?"
"Never," he assured me. Then the old man sat me down and carefully explained his reasoning.
"Health is a valuable commodity," he began, looking to see if I agreed. I nodded. "Like other valuable commodities, the people who want it dearly enough will work to get it. As they work, they increase their appreciation of its value. When I give a man a healing service without a fee, he associates 'free' with 'not valuable.' The potency of any treatment is not only in the treatment, but also in a person's belief in its value. When someone pays dearly for a ceremony, they show that they appreciate the value of my treatment. More importantly, they show themselves how much they value their health. A man who values his health will work hard to win it back, and he is more likely to recover." He paused to let me take his words in.
"But what if someone really can't afford your treatment?" I persisted.
"People can always afford my ceremonies if they value their health. A poor man will recruit his family to help him raise the necessary funds. If he has no family, he will petition the community to help him raise the necessary funds. By doing this, he will not only value the ceremony he receives, but he will feel the support and good wishes of the community for his recovery. Anyone who truly wants to get well can always find a way to afford the healing ceremony." With that, the old man stood to indicate that we were through for the day.
In years since, the Shaman's words have returned to haunt me. How many times have I heard people complain about the cost of supplements, or of my services, while they drive Mercedes, eat out twice a week, own a vacation home in the mountains and subscribe to cable T.V.? I believe that the old Shaman was right. The people who value their health will work to get it. They will pay to get it. And they will value it dearly when it returns.