In the previous article we started a functional overview of cardiac risk.  We briefly looked at established risk markers and suggested that we place greater emphasis on indicators for inflammation, such as C-reactive protein, homocysteine, and fasting insulin, and reduce our infatuation with absolute lipid levels.  Some current studies actually suggest that lowering cholesterol levels may even increase risk for stroke.  We should at least temper our mainstream dependence on magic numbers for cholesterol by looking more closely at the relationships between lipid fractions, such as the total cholesterol to HDL (high density lipoprotein) ratio or the triglyceride to HDL ratio.  Both elevated triglyceride levels and the triglyceride to HDL ratio can be considered markers for insulin resistance, and as we pointed out last time insulin resistance should be considered a primary cause of impaired heart health.

Can we manage insulin resistance, or better yet, can we eliminate it?  Absolutely!  Even when insulin resistance has progressed to the point of Type II diabetes the consequences to our overall health can still be reversed.  I’m not implying that this reversal comes without cost- it requires changing the inappropriate eating and lifestyle habits we’ve developed over a lifetime of cultural imprinting.  Let’s think of a healthy lifestyle as a balance between intake and output, between calories and nutrients consumed and calories and nutrients spent both in physical activity and in maintaining our basic functions.  To balance this equation, we generally must work on both sides- improve our diets and increase our physical activity.

I strongly recommend reading The Paleo Diet by Loren Cordain, PhD.  There are countless books sold and theories espoused in the marketplace but I am convinced that none of them come closer to an ideal model for our health than this.  Briefly, in this healthy lifestyle diet we would consume (free range, organic) lean meats, poultry, fish, eggs, a broad variety of non-starchy vegetables, whole fruits, nuts, and seeds.  OK, that part isn’t too hard.  What we would eliminate (at the very least, significantly reduce) is often harder:  milk and dairy products, grains, legumes, processed foods and sugars.    Rather than use the remainder of this article to explain the benefits of Paleolithic eating and answer your inevitable questions (No milk? No bread?? You’ve got to be kidding!) let me just encourage you to try the book, or better yet, try the diet- and don’t forget to exercise!

Now let’s turn our attention to reviewing some of the natural agents that have been established as having therapeutic value in reducing overall cardiac risk.  This list will not be exhaustive and I’ll be brief in my descriptions of mechanisms, not because of limited data but due to limited space.   Order of appearance doesn’t imply priority- each agent may have greater or lesser value for you based on your unique biochemistry.  So here goes…

Vitamin C is required for rebuilding and repair, in part because it is necessary for cross-collagen linkage.  This mechanism is vital for maintaining the integrity of blood vessel walls.  One theory of plaque formation holds that localized deficiency of vitamin C in coronary arteries is the primary culprit, and at least one published study demonstrated dissolution of existing plaque due to vitamin C supplementation over several months.  I suggest a minimum of 1,500mg to 2,000mg daily in divided doses for cardiac risk prevention.

Vitamin E has been extensively studied; some authors indicate up to 40% reduction in cardiac risk with 400iu daily of vitamin E alone.  Choose d-alpha tocopherol (or better yet a mixed tocopherol form) for greatest activity.  Vitamin E apparently prevents oxidation of LDL; oxidized LDL is the major lipid that adheres to the vessel wall in plaque formation.

Folic acid, vitamin B6, and vitamin B12 are often considered a team for reducing homocysteine elevation.  Homocysteine is an amino acid produced by normal metabolic function and is a known inflammatory trigger.  If we are unable to break it down rapidly the resultant increases have been identified as a significant marker for heart disease.  Adequate folic acid levels prevent this increase by allowing complete homocysteine metabolism.  Although lower levels certainly have value, natural physicians often suggest 5mg to 10mg daily as a supplement.

CoEnzyme Q10 is necessary for the release of energy from ATP in the mitochondria of all cells but is particularly important for the heart muscle.  It has been demonstrated to increase cardiac efficiency to the extent that cardiomyopathy patients on heart transplant lists improved enough to avoid transplant (published studies).  In many hypertensive patients CoQ10 has also shown value in reducing blood pressure.  Doses vary depending on impairment but generally are effective at 100mg a day. Another nutrient that increases cardiac efficiency is carnitine, an amino acid that transports fats across membranes.   

Fish oils improve circulation by reducing platelet aggregation (clot formation) as well as increasing HDL (good cholesterol).  Magnesium is necessary for regulating heart rate, blood pressure, and proper utilization and excretion of calcium.  (The plaque that clogs our arteries is formed from oxidized lipids bound to excess calcium.)  Alpha-lipoic acid and chromium reduce insulin resistance, policosanol, pantethine, guggulipid, and plant sterols safely lower elevated cholesterol levels, and the list goes on.   

If some authority tells you “there’s no data on that natural stuff” they haven’t looked- there are literally thousands of studies published in medical journals around the world.  The strongest message, though, is this: we are responsible for our own good health.  Your heart health is in your hands, on your plate, and on the path before your feet.  It’s your choice…