Category Archives: cardiovascular disease

The role of omega-3 in heart health

Deaths caused by cardiovascular disease are generally premature and could easily, in some cases, be prevented by making lifestyle changes that include adopting a healthy lifestyle and increasing physical activity.

The role of lipid lowering (cholesterol and triglyceride) in reducing the risk of mortality and morbidity from cardiovascular disease is well documented. The cardiovascular benefits of omega-3, certainly in terms of cholesterol and triglyceride management, are probably the most researched of all the dietary nutrients known to influence cardiovascular disease risk. With the recent approval of the use of pure eicosapentaenoic acid (EPA) as a prescription treatment for hypertriglyceridemia [1] and with overwhelming evidence for EPA’s role over docosahexaenoic acid (DHA) in cholesterol management, [2] consumers should be aware of the differential effects of the two main omega-3s, EPA and DHA, on cardiovascular disease risk factors and why they should choose isolated EPA over generic fish oil.

EPA and lipid management

Whilst fish oil provides a convenient dietary intervention for maintaining heart health, the differential effects of the two main long-chain omega-3s, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) on cardiovascular disease risk factors means that not all fish oil products are equal in their action.

Firstly, generic oils generally contain around 30% total omega-3 and are therefore not considered viable as a therapeutic. For example, the optimal triglyceride-lowering doses of omega-3 are 3-4g/day, with little evidence to support lipid-altering efficacy in doses of less than 1g/day. [3] In addition to providing a soluble means for transporting cholesterol and triglycerides through the blood, lipoproteins have cell-targeting signals that direct the lipids they carry to certain tissues.

Pharmepa Step 1: Restore (E-EPA 90) contains the purest ethyl-EPA concentrate available without prescription

Whilst high density lipoproteins (HDL) correlate with better health outcomes, effectively clearing cholesterol from the system, low density lipoproteins (LDL) are, in contrast, considered the cholesterol ‘bad boy’ and are responsible for the detrimental effects associated with total cholesterol.

Both EPA and DHA decrease triglyceride levels, and whilst EPA lowers LDL levels, DHA appears to increase LDL levels [4, 5]. Given that products that contain a mixture of EPA and DHA may increase LDL levels, the benefits of a pure EPA product understandably extend to both cholesterol and triglyceride management. Indeed, the cholesterol-lowering ability of pure EPA at a dose of 1.8 grams in a study of approximately 19,000 statin-treated patients with hypercholesterolaemia was shown to reduce the 5-year cumulative risk of major coronary events by 19%. Igennus’ Pharmepa Step 1: Restore (E-EPA 90) contains the purest ethyl-EPA concentrate available (90%) without prescription, delivers 1g pure EPA in just two easy-to-swallow capsules, and is ideal for those individuals wanting to manage cholesterol and triglyceride levels.

AA to EPA ratio and cardiovascular health

In addition to altering lipid metabolism, omega-3 may also improve cardiovascular health by inhibiting inflammatory products derived from the key pro-inflammatory fatty acid arachidonic acid (AA). AA and EPA are converted through phospholipase A2, cyclooxygenase (COX) and lipooxygenase (LOX) to prostaglandins, thromboxanes and leukotrienes, as well as various hydroxyl-fatty acids, and the AA to EPA ratio provides an established risk factor for numerous inflammatory-related conditions, including poor cardiovascular health. Indeed, inflammation is an important process in the development of cardiovascular disease; chronic inflammation, characterised by elevated plasma levels of inflammatory markers such as C-reactive protein (CRP) and IL-6, are commonly found in subjects at high cardiovascular risk, including type2 diabetics and patients with coronary heart disease. [6] Supplementing with EPA, in addition to triglyceride and cholesterol improvement, increases EPA blood levels, improves the AA to EPA ratio (which directly correlates with changes in improved LDL levels) and reduces cardiovascular related inflammation. [7]

In summary, EPA, unlike DHA, lowers levels of triglyceride, lowers ‘bad’ cholesterol and increases ‘good’ cholesterol, whilst reducing inflammation via management of the AA to EPA ratio. By providing pure isolated EPA at the concentrations required for therapeutic outcomes, Igennus’ Pharmepa range of EPA products are ideal health supplements for managing optimal heart health by managing lipid levels and modulating dysregulated inflammation. The prescription-strength ethyl-EPA Pharmepa Restore & MaintainTM  protocol is an innovative two-step treatment programme formulated to re-establish a healthy inflammatory status within the body. Step 1 counteracts an unhealthy AA to EPA ratio – the direct measure of inflammatory status, and step 2 ensures long-term balance for optimal cardiovascular health benefits.

References

1.  Ballantyne CM, Braeckman RA, Soni PN: Icosapent ethyl for the treatment of hypertriglyceridemia. Expert opinion on pharmacotherapy 2013, 14:1409-1416.

2. Yokoyama M, Origasa H, Matsuzaki M, Matsuzawa Y, Saito Y, Ishikawa Y, Oikawa S, Sasaki J, Hishida H, Itakura H, et al: Effects of eicosapentaenoic acid on major coronary events in hypercholesterolaemic patients (JELIS): a randomised open-label, blinded endpoint analysis. Lancet 2007, 369:1090-1098.

3. Pirillo A, Catapano AL: Omega-3 polyunsaturated fatty acids in the treatment of hypertriglyceridaemia. International journal of cardiology 2013.

4. Itakura H, Yokoyama M, Matsuzaki M, Saito Y, Origasa H, Ishikawa Y, Oikawa S, Sasaki J, Hishida H, Kita T, et al: The change in low-density lipoprotein cholesterol concentration is positively related to plasma docosahexaenoic acid but not eicosapentaenoic acid. Journal of atherosclerosis and thrombosis 2012, 19:673-679.

5. Cottin SC, Sanders TA, Hall WL: The differential effects of EPA and DHA on cardiovascular risk factors. The Proceedings of the Nutrition Society 2011, 70:215-231.

6. Brevetti G, Giugliano G, Brevetti L, Hiatt WR: Inflammation in peripheral artery disease. Circulation 2010, 122:1862-1875.

7. Tani S, Nagao K, Matsumoto M, Hirayama A: Highly Purified Eicosapentaenoic Acid May Increase Low-Density Lipoprotein Particle Size by Improving Triglyceride Metabolism in Patients With Hypertriglyceridemia. Circulation journal : official journal of the Japanese Circulation Society 2013.

 

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Beetroot Juice Found to Lower Blood Pressure

A new study published just last month in the journal Hypertension suggests that drinking just one glass of beetroot a day can reduce blood pressure.

The study was conducted by researchers at Queen Mary University of London, Barts and The London School of Medicine and Dentistry. It involved eight women and seven men who had high blood pressure and who were not taking blood pressure medication.

Blood pressure is normally given as two numbers, which represent ‘systolic’ and ‘diastolic’ pressure levels. The first number, the systolic level, is a measure of the pressure created in the arteries when the heart beats. Normal systolic blood pressure is 120 millimeters of mercury (mm Hg) or below. The second number, the diastolic level, represents the pressure in the arteries when the heart rests between beats. Normal diastolic blood pressure is 80 mm Hg or below.

The study participants all had raised systolic blood pressure of between 140 and 159 mm Hg.

The beetroot juice in the study provided about 0.2g of dietary nitrate, levels that might be provided by two beetroots. Nitrate reduces blood pressure by widening the passageways for blood. The body converts dietary nitrate into a chemical called nitrite and then to nitric oxide in the blood. Nitric oxide is a gas that widens blood vessels and aids blood flow.

The study involved eight women and seven men who had a systolic blood pressure between 140 to 159 millimeters of mercury (mm Hg), did not have other medical complications and were not taking blood pressure medication. The study participants drank 250 mL of beetroot juice or water containing a low amount of nitrate, and had their blood pressure monitored over the next 24 hours.

Compared with the placebo group, participants drinking beetroot juice had reduced systolic and diastolic blood pressure. The reduction was highest three to six hours after drinking the juice. Interestingly, blood pressure was still reduced 24 hours later, even after levels of nitrate circulating in the blood had returned to normal.

Study leader Amrita Ahluwalia, Ph.D., professor of vascular pharmacology at The Barts and The London Medical School, was surprised by how little nitrate was needed to produce these results. “This study shows that compared to individuals with healthy blood pressure much less nitrate is needed to produce the kinds of decreases in blood pressure that might provide clinical benefits in people who need to lower their blood pressure.”

High Nitrate lettuce is a good source of nitrate
High Nitrate lettuce is a good source of nitrate

Those drinking beetroot juice should be aware that this juice can cause a temporary pink colouration of urine and stools, which can be a little alarming but is completely harmless. Of course beetroot is not the only nitrate-rich vegetable. For those who don’t enjoy the taste, try nitrate-rich lettuce, rocket, spinach, celery, cabbage or fennel.

Increasing dietary intakes of nitrates is simple. Try adding beetroot juice to a smoothie, or lunch on beetroot soup. Use spinach and lettuce as salad bases, or snack on celery with hummus or peanut butter during the daytime. At dinner, include nitrate-rich vegetables such as bok choy, cabbage, leeks and broccoli.

“Our hope is that increasing one’s intake of vegetables with a high dietary nitrate content, such as green leafy vegetables or beetroot, might be a lifestyle approach that one could easily employ to improve cardiovascular health,” said Amrita Ahluwalia. She nevertheless advises caution in interpreting the results of this small study, as “we are still uncertain as to whether this effect is maintained in the long term.” It is hoped these preliminary findings might pave the way for more larger-scale studies in this area.

References

1. American Heart Association (2013, April 15). Drinking cup of beetroot juice daily may help lower blood pressure. ScienceDaily. Retrieved 28/04/13

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Pomegranate: the heart-healthy fruit

A new study, published in the Journal of Nutritional Science, has found that pomegranate juice can reduce key cardiovascular risk factors in overweight adults (1). While the fruit’s impressive antioxidant content has been credited with its success, this study reveals that there might be another secret to the fruit’s benefits.

pomegranate
Pomegranate can help to reduce insulin levels and blood pressure.

Pomegranate juice has already been shown to have some remarkable health benefits with clinical studies showing it can reduce blood pressure, improve blood sugar control and even reduce the thickness of arteries. These studies have attributed the heart-healthy effects of pomegranate to its extraordinarily high antioxidant value (2), which is certainly a huge benefit. However, this study looked at the effects of pomegranate juice on cortisol levels.

Cortisol is a hormone released by the adrenal gland in response to stress. Excessive levels of cortisol are linked to both high blood pressure and insulin resistance (3,4).

In addition to measuring cortisol levels, the researchers also measured several markers of heart disease, including blood pressure, arterial elasticity, insulin resistance and blood sugar levels.

The study was a randomised cross-over design, meaning that each volunteer essentially serves as his or her own ‘control’ making the study results more reliable. In this case, the male and female volunteers were randomly assigned to receive pomegranate juice or a placebo drink for 4 weeks. After a 1-week break, the groups were then swapped, so that everybody had been tested with both the pomegranate and the placebo drink.

At the end of the study, it was found that the pomegranate juice was linked with a significant reduction in blood pressure, as well as a decrease in insulin levels and insulin resistance. Interestingly, there was also a reduction in the cortisol levels of the juice drinkers, and an increase in levels of cortisone, which is the inactivated form of cortisol. It appears that pomegranate juice might actually boost health by preventing cortisone from being converted to active cortisol.

In short, the study suggests that the benefits of pomegranate juice and not simply a result of its impressive antioxidant content. It also appears to lower cortisol levels, which in turn has a direct effect on the heart and blood vessels.

Cardiovascular disease remains the UK’s biggest killer. According to the British Heart Foundation, this disease is responsible for one third of deaths of both men and women in Britain.

One of the biggest concerns about cardiovascular disease is that it can go undetected for many years, causing the illness to be labelled a ‘silent killer’. In fact, often the first symptom is a stroke or a heart attack meaning that sufferers may then face invasive but necessary treatments such as bypass surgery or angioplasty.

For this reason, small and simple measures to reduce your risk of cardiovascular disease are invaluable. As positive results have been found by drinking as little as 2 ounces of pomegranate juice daily (5), a daily serving of pomegranate juice might just be a change worth making.

Written by Nadia Mason, BSc MBANT NTCC CNHC.

References

1. Catherine Tsang, Nacer F. Smail, S. Almoosawi, I. Davidson and Emad A. S. Al-Dujaili. (2012) Intake of polyphenol-rich pomegranate pure juice influences urinary glucocorticoids, blood pressure and homeostasis model assessment of insulin resistance in human volunteers.  J Nutr Sci, 1:9

2. Seeram NP, Aviram M, Zhang Y, et al. (2008) Comparison of antioxidant potency of commonly consumed polyphenol-rich beverages in the United States. J Agric Food Chem 56, 1415–1422

3. Duclos M, Pereira PM, Barat P, et al. (2005) Increased cortisol bioavailability, abdominal obesity and the metabolic syndrome in obese women. Obes Res 13, 1157–1166.

4. Kidambi S, Kitchen JM, Grim CE, et al. (2007) Association of adrenal steroids with hypertension and the metabolic syndrome in blacks. Hypertension 49, 704–711.

5. 8. Aviram M, Dornfeld L. Pomegranate juice consumption inhibits serum angiotensin converting enzyme activity and reduces systolic blood pressure. Atherosclerosis. 2001 Sep;158(1):195-8.

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Dietary magnesium reduces risk of stroke

Recent research published in the American Journal of Clinical Nutrition has found new evidence of a link between magnesium intake and risk of stroke.

The research was conducted at the Karolinska Institute in Stockholm, Sweden. It took the form of a meta-analysis, whereby researchers collect and analyse data from many previous relevant studies. In all, the researchers took data from studies conducted from 1996 to 2011, involving more than 240,000 adults. Each study tracked adults from Europe, Asia or the United States, and lasted an average of 12 years. The data tracked how much magnesium each person took, and how many people suffered a stroke.

Leafy vegetables contain high levels of dietary magnesium
Leafy vegetables, such as cabbage, spinach and kale, contain high levels of dietary magnesium (2.)

The research team found that those with a higher level of dietary magnesium were less likely to experience a stroke. In fact, the risk of stroke was reduced by 8% for each additional 100 milligrams of magnesium a person consumed each day.

“Dietary magnesium intake is inversely associated with risk of stroke, specifically ischemic stroke”, concluded lead researched Susanna Larsson, adding that “the results suggest that people should eat a healthy diet with magnesium-rich foods such as green leafy vegetables, nuts, beans and whole grains.”

Larsson also maintains that the other dietary factors might also have influenced the findings. After all, those whose diets are high in magnesium-rich foods are also likely to have higher intake or absorption of other nutrients, such as dietary fibre and folate. Hopefully, further large controlled trials of magnesium supplementation will clarify the link.

There are of course a number of reasons why magnesium in particular may help reduce the risk of stroke. Strokes are said to be caused by conditions such as hypertension, atherosclerosis and diabetic complications, all of which are linked with low magnesium. This mineral is essential for keeping blood vessels strong and preventing blood from clotting. The UK recommended intake for magnesium is currently 270mg for women and 300mg for men, although it is estimated that many of us in the UK do not manage to reach these levels in our diet.

The best way to ensure that you are getting enough dietary magnesium is to follow the below guidelines:

• Eat a wide variety of vegetables daily, including greens such as kale, spinach and chard.
• Include beans, legumes, nuts and seeds as magnesium-rich sources of protein.
• Include a variety of wholegrains, such as oats, buckwheat, barley, rye and quinoa.
• Choose animal foods that are magnesium-rich, such as halibut and mackerel.

Written by Nadia Mason, BSc MBANT NTCC CNHC

Reference
(1.) Larsson S, Orsini N and Wolk A. Dietary magnesium intake and risk of stroke: a meta-analysis of prospective studies. American Journal of Clinical Nutrition. Feb 2012.

(2.) Image courtesy of Dan

 

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The sunshine vitamin: Vitamin D and healthy immunity

New research supports the link between vitamin D and a healthy immune system.  The recent study of almost 7,000 adults in the UK has confirmed a link between Vitamin D levels and the risk of infection (1).

Vitamin D - The Sunshine Vitamin
New research supports the link between vitamin D and a healthy immune system. (5)

Natural sunshine can provide our bodies with up to 10,000iu vitamin D each day.  This ‘sunshine vitamin’ helps to boost the body’s defences by increasing levels of ‘anti-microbial peptides’.  Working like natural antibiotics, these peptides mount an attack against unwanted infections.

During the winter months, infections such as colds, flu and chest infections are common.  It is believed that this increased risk of infection is due in part to the lower levels of vitamin D that we receive in the colder months.

There is however increasing concern over vitamin D levels throughout the year. After all, most of us are careful to protect our skin from the sun during the summer months, a sensible measure to help prevent burning, premature skin ageing and to protect against skin cancer.
The study, conducted by researchers from University College London, looked at the relationship between Vitamin D levels and infection. Higher levels of vitamin D were linked with lower risk of infection.

For each 10nmol/l (4ng/ml) increase in vitamin D, the risk of infection dropped by 7 per cent.  The researchers discovered a further link between higher vitamin D levels and better lung function.

While this particular study was epidemiological in nature, it will be interesting to see how future controlled trials will further our understanding.  After all, vitamin D not only supports the immune system and bone health.  More recently, deficiency has been linked with cardiovascular disease, impaired glucose tolerance, poor muscle development and certain types of cancer (2).  The Department of Health now recommends that certain groups in the UK population should take daily vitamin D supplements (3).  These groups are:

• all children aged six months to five years old
• all pregnant and breastfeeding women
• all people aged 65 and over
• people who are not exposed to much sun, such as those who are confined indoors for long periods

BioCare BioMulsion D
BioCare’s BioMulsion D provides 2000iu vitamin D in just two drops

• people with darker skins such as people of African-Caribbean and South Asian origin

While vitamin D can be obtained in the diet through oily fish such as salmon and sardines, it is generally believed that supplementation is the most viable way of ensuring adequate intake.  A recent European policy document concludes that “only vitamin D supplements or vitamin D enriched food products are truly viable options for optimising the vitamin D status” (4).

Bolstering your vitamin D levels can be as simple as spending some time outdoors every day, while ensuring that you eat vitamin D enriched foods such as breakfast cereals, milk, margarine and soy drinks.  Those who would like to take an easily absorbed supplement might consider an emulsified liquid vitamin D such as Biocare’s BioMulsion D which provides 2000iu vitamin D in just two drops.

 

Written by Nadia Mason

References:

1. Berry DJ, et al. Vitamin D status has a linear association with seasonal infections and lung function in British adults. British Journal of Nutrition. Available on CJO June 2011 doi:10.1017/S0007114511001991

2. Vieth R, Bischoff-Ferrari H, Boucher BJ, Dawson-Hughes B, Garland CF, Heaney RP, Holick MF, Hollis BW, Lamberg-Allardt C, McGrath JJ, Norman AW, Scragg R, Whiting SJ, Willett WC, Zittermann A. The urgent need to recommend an intake of vitamin D that is effective.  Am J Clin Nutr 2007;85:649–50. 

3. NHS Choices. “Vitamins and Minerals – Vitamin D”.  Web article. Visited on 30th June 2011.

4. The Standing Committee of European Doctors. Vitamin D Nutritional Policy in Europe.  March 2010. Visited on 30th June 2011.

5. Image Ccourtesy of  digitalart.

 

 

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Folate might impact cholesterol levels

Folate (the naturally occurring form of folic acid), a B vitamin, is one that I have written a lot about, it has been linked to heart health, mood, pregnancy outcomes and much more.  In July I wrote about the B vitamins, folate and vitamin B12, being linked to heart disease

There has been a lot of research interest in the links between B vitamins and risk of cardiovascular disease (stroke and heart disease) over the last decade.  The rationale behind this is that there is evidence to suggest that elevated homocysteine levels are a risk factor for heart disease and low levels of the B vitamins B6, folate and B12 are linked to raised homocysteine levels.  For more information on homocysteine please click here

A recently published study(1) has found that folate may also be linked to cholesterol levels (another potential risk factor for heart disease).  The study looked at data for blood vitamin B12 and folate levels in over 1700 individuals.  They found that higher folate levels were associated with lower levels of low density lipoprotein cholesterol (LDL-cholesterol, the so called ‘bad’ cholesterol which has been linked to an increased risk of heart disease).  They also found that higher levels of folate were linked to higher levels of ‘good’ cholesterol, high density lipoprotein cholesterol (HDL-cholesterol).  The study authors also compared the individuals of the highest with those of the lowest levels of folate. They found that individuals with the highest folate  had higher levels of HDL-cholesterol, lower levels of LDL-cholesterol and a lower LDL-C: HDL-C- ratio, this is indicative of a favourable cholesterol profile.  In this study Vitamin B12 was not associated with the cholesterol profile.

The study authors call for more research to further investigate the link between folate and cholesterol levels.  The current study only provides a potential link, it does not prove that low folate levels are linked to raised LDL cholesterol levels.  The study does provide further evidence to suggest that there may also be a link between cholesterol and homocysteine levels, other studies have also suggested such a link.  These are very complex interactions and further research to elucidate links could provide really useful information on how diet can be used to reduce the risks of heart disease.

At the present time there is no conclusive evidence to suggest that B vitamins can reduce the risk of heart disease and supplements cannot be recommended as a preventative measure.  Having a good level of B vitamins in the diet is, however, important for health.  Vitamin B6 is found in foods like potatoes, bananas, beans and chickpeas, avocados, fish and poultry.  Vitamin B12 is found mainly in meat, fish and poultry.  Eggs and cheese also contain B12 as does brewer’s yeast.  Folic acid is found in beans, green vegetables and wholegrains. 

Supplements should never be seen as an alternative to a healthy diet and it is wise to check with you doctor before starting any new supplement regiment.  If you are thinking about taking a vitamin B supplement I would always suggest a broad spectrum supplement that supplies adequate, but not megadose, levels of all of the B vitamins (not single nutrient supplements), these vitamins work best together as a team

(1)Semmler A et al.  2010.  Plasma folate levels are associated with the lipoprotein profile: a retrospective database analysis.  Nutrition Journal.  9:31E-pub prior to print.  doi:10.1186/1475-2891-9-31 Published 28 July 2010

Written by Ani Kowal
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Study finds fish oil may be useful for overweight teenagers

Oily fish, such as salmon, trout, mackerel and sardines, and fish oil supplements provide the body with the long chain omega 3 fatty acids (EPA and DHA) that are so important for health and which I write about so frequently.  In adults there is indication that fish oil is important for heart health, it can help to lower blood pressure and seems to have beneficial effects on cholesterol levels. 

A newly published study (1) has found that fish oil supplements might be useful for lowering blood pressure in overweight teenage children.  This could be important for heart health in later life.

 

The study researchers wanted to investigate whether fish oil affects cardiovascular (heart) risk factors during the time of adolescent growth spurt (1).  The study was small, involving 78 teenage boys, aged 13-25, who were slightly overweight.  The boys were given either fish oil, which provided 1.5g of long chain omega 3 fatty acids daily, or vegetable oil (the control group) for 16 weeks.  Neither group knew whether they were taking the fish oil or the vegetable oil since the oils were ‘hidden’ in bread.

After 16 weeks (1) the group eating the fish oil infused bread had higher concentrations of the long chain omega 3 fatty acids EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) in their red blood cells than the group eating the vegetable oil bread, indicating that the fish oil was being well absorbed and incorporated into the body.  The systolic blood pressure was around 3.8mm Hg lower and diastolic blood pressure was around 2.6 mm Hg lower in the fish oil group compared with the control group.  The changes in red blood cell EPA content were inversely correlated with the changes in systolic and diastolic blood pressure i.e. the higher the EPA content in the blood the greater the reduction in blood pressure.

Systolic blood pressure, represented by the top number in a blood pressure reading, is the measure of the phase of the heartbeat when the heart contracts and pumps blood into the arteries.  Diastolic blood pressure, represented by the bottom number in a blood pressure reading, is the measure of the phase of the heartbeat when the heart muscle relaxes and allows the chambers to fill with blood. 

The findings are significant since, in adults a drop in blood pressure of 3 mm Hg corresponds to at least a 15% reduction in the risk of stroke.  In addition to this, blood pressure has been shown to track into adulthood: children and teenagers with higher blood pressure seem more likely to suffer from high blood pressure later in life.  High blood pressure is a risk factor for stroke and heart disease.  More research is certainly needed before any recommendations can be made for fish oil supplementation for heart protection in children however, research showing the benefits of omega 3 fatty acids for health is vast and ever growing.  It would seem sensible to introduce young children to the taste of oily fish early in life and to make oily fish a regular (twice weekly) part of the diet, especially since here in the UK many individuals do not include fish as a regular part of their weekly diet.  If you want to consider a fish oil supplement for yourself or your children it would be worth checking with a medical doctor prior to starting a new regimen.

(1)Pedersen MH et al.  Effects of Fish Oil Supplementation on Markers of the Metabolic Syndrome.  The Journal of Pediatrics.  E-pub prior to print online May 17, 2010. doi:10.1016/j.jpeds.2010.04.001

Written by Ani Kowal

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A diet high in B vitamins might be linked to a lower risk of heart disease and stroke

A recent Japanese study (1) has found that eating more foods which contain the B-vitamins B6 and folate may reduce the risk of death from stroke and heart disease in women and may reduce the risk of heart failure in men.

 

There has been a lot of research interest in the links between B vitamins and risk of cardiovascular disease (stroke and heart disease) over the last decade.  The rationale behind this is that there is evidence to suggest that elevated homocysteine levels are a risk factor for heart disease.  As mentioned in previous posts, homocysteine is produced when the amino acid (the building blocks of protein) methionine is broken down in the body.  Normal levels of homocysteine are important to help build and maintain body tissues, however elevated concentrations in the blood can be harmful and have been associated with an increased risk of heart disease and other disorders.  At normal levels homocystein can be converted in the body into a harmless substance called cystanthionine.  The conversion of homocysteine into this harmless substance depends upon various B vitamins  (B6, B12 and folic acid).  Having good levels of these B vitamins appears to be a very good way of preventing high homocysteine levels and low levels of B vitamins have been associated with raised homocysteine levels.  The evidence, however is controversial and not yet solid.

In this study(1) over 23,000 men and 35,000  women, age 40 to 79 years, completed a specialised food frequency questionnaire. During an average of 14-years follow-up, there were 986 deaths from stroke, 424 from coronary heart disease, and 2087 from cardiovascular disease.  The researchers analysed the results and found that higher dietary folate and vitamin B6 intakes were associated with a reduced risk of death from heart failure for men and with a reduced risk of death from stroke, coronary heart disease, and total cardiovascular disease for women.  In this particular study no association was found between vitamin B12 intake and mortality risk.

 

The findings on the value of B vitamins were consistent with studies in Europe and North America.  The study only shows association, a direct causal link hasn’t been established, but evidence has shown that too much homocysteine may damage the inner lining of arteries and can promote the formation of blood clots (2).

Vitamin B6 is found in foods like potatoes, bananas, beans and chickpeas, avocados, fish and poultry.  Vitamin B12 is found mainly in meat, fish and poultry.  Eggs and cheese also contain B12 as does brewer’s yeast.  Many vegetarians and vegans have very low intakes of this vital nutrient and may wish to consider a multi-B vitamin supplement.  Folic acid is found in beans, green vegetables and wholegrains.  Supplements should never be seen as an alternative to a healthy diet and it is wise to check with you doctor before starting any new supplement regiment.  If you are thinking about taking a vitamin B supplement I would always suggest a broad spectrum supplement that supplies adequate, but not megadose, levels of all of the B vitamins (not single nutrient supplements), these vitamins work best together as a team

(1)Renzhe Cui et al.  2010.  Japan Collaborative Cohort Study Group. Dietary Folate and Vitamin B6 and B12 Intake in Relation to Mortality From Cardiovascular Diseases. Japan Collaborative Cohort Study. Stroke, 2010; DOI: 10.1161/STROKEAHA.110.578906

(2)Press release American Heart Association (2010, April 15). Diet high in B vitamins lowers heart risks in Japanese study. ScienceDaily. Retrieved April 17, 2010, from http://www.sciencedaily.com­ /releases/2010/04/100415161933.htm

Written by Ani Kowal

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Low levels of vitamins and minerals may increase the risk of cardiovascular disease

From the 16th-19th June 2010 the World Congress of Cardiology Scientific Sessions were held in Neijing, China .  New data presented there (1) and released to the press via the World Heart Federation has demonstrated that multiple micronutrient levels can predict the risk of cardiovascular disease (heart disease and stroke).

The World Congress of Cardiology Scientific Sessions is the official congress of the World Heart Federation and is held every two years. Through the Congress the World Heart Federation offers an international stage for the latest developments in science and public outreach in the field of cardiovascular health. The World Congress of Cardiology places emphasis on the complementary nature of science and public outreach and strives to spread the message that through individual, community and patient-care interventions, the growing epidemic of cardiovascular diseases can be prevented(1)

The data (1) showed that reduced multiple micronutrient, vitamin and mineral, intakes were associated with a 1.4 times higher risk of death from cardiovascular disease (CVD) in White Americans, 1.3 times higher risk in African Americans and 1.6 times higher risk in Mexican Americans.  The study involved over 9, 400 participants aged 45 and older.  Dr. Longjian Liu, MD, PhD, FAHA, Associate Professor of Epidemiology, Drexel University School of Public Health, Philadelphia, USA said: “This study is the first to demonstrate that multiple micronutrients have significant predicting effects on the risk of CVD and all-cause mortality among White Americans and minority populations,”, he went on to add that “These data suggest that people should ensure that they are maintaining healthy micronutrient levels to help reduce their future risk of CVD.”  (1)

Vitamins and minerals (micronutrients) are vital for health and are involved in the efficient functioning of all body processes, including heart function.  Inflammation plays a major role in cardiovascular diseases and it seems that a good micronutrient status is important in keeping inflammation in the body low, probably by reducing oxidative stress  in the body.  Eating a wide variety of vegetables, fruits and wholegrains daily is important since they contain a huge array of vitamins, minerals and bioflavonoids (bioactive plant chemicals).  Many of the vitamins and bioflavonoids found in these foods act as antioxidants in the body and this may be one way that that prevent disease.  Antioxidants protect the body from attack by destructive molecules known as ‘free radicals’, they protect against ‘oxidative stress’ in the body.  It has been noted in previous studies (e.g. 2)Healthy subjects of any age with a high daily intake of fruits and vegetables have higher antioxidant levels, lower levels of biomarkers of oxidative stress, and better cognitive performance than healthy subjects of any age consuming low amounts of fruits and vegetables. Modification of nutritional habits aimed at increasing intake of fruits and vegetables should be encouraged to lower prevalence of cognitive impairment in later life(2)

Eating a healthful, balanced diet is important for the prevention of many conditions.  Providing the body with good, nutrient rich, food will help to ensure that all the nutrients needed for its efficient functioning are present.  Supplements can never be seen as an alternative to healthy eating but if you feel that your diet consistently falls short of nutrients you might wish to consider taking a high quality, low dose multivitamin and mineral supplement.  It is always best to check with a medical doctor prior to starting any supplementation regimen.  

About the World Heart Federation:
The World Heart Federation is dedicated to leading the global fight against heart disease and stroke with a focus on low- and middle-income countries via a united community of more than 200 member organizations. With its members, the World Heart Federation works to build global commitment to addressing cardiovascular health at the policy level, generates and exchanges ideas, shares best practice, advances scientific knowledge and promotes knowledge transfer to tackle cardiovascular disease – the world’s number one killer. It is a growing membership organization that brings together the strength of medical societies and heart foundations from more than 100 countries. Through our collective efforts we can help people all over the world to lead longer and better heart-healthy lives. For more information, please visit www.worldheart.org(1)

(1)Press release.  LOW VITAMIN AND MINERAL LEVELS INCREASE RISK OF CARDIOVASCULAR DISEASE.  18.06.2010.  08:30.  http://www.world-heart-federation.org/press/press-releases/detail/article/low-vitamin-and-mineral-levels-increase-risk-of-cardiovascular-disease/

(2) Polidori MC et al. 2009.  High fruit and vegetable intake is positively correlated with antioxidant status and cognitive performance in healthy subjects. J Alzheimers Dis. 17:4

Written by Ani Kowal

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