Preventing and healing cardiovascular disease through diet & lifestyle

May 15, 2016 at 11:29 pm (Uncategorized) (, , , , , , , , )

Is dietary fat really a contributing factor to developing cardiovascular disease? This question has been debated over the past years by scientists, physicians, and diet advocates. In this article, Dean Ornish in Defense of the Dietary Fat – Heart Disease Link, Dr. Dean Ornish, MD, who has done extensive study on heart disease for the past 30+ years which includes diet & lifestyle changes, details some aspects of diet, cardiovascular risk factors, and research study outcomes.

Highlights of the article:

“We found a dose-response correlation at both 1 year[2] and 5 years[3]between the degree of adherence to both the lifestyle program as a whole and the diet, in terms of cholesterol milligrams and fat grams consumed, and changes in the arteries.” Dr. Ornish used PET scans on his patients to show that reduction in clogged arteries from diet & lifestyle changes.

“It has never been just about fat; it is a whole-foods, plant-based diet. It’s fruits, vegetables, whole grains, legumes, soy products in their natural, unrefined form, that is low in fat, low in sugar, and low in refined carbs.”Though Dr. Ornish’s diet has been called “low fat” by some, it’s a healthy, balanced diet with unprocessed food in its pure form.

“The British Medical Journal published an article[9] saying that saturated fat is not linked with heart disease but trans fats are…If you actually look at the raw data (the most accurate because it is not subject to bias) in the report (they didn’t even put this in the abstract) there was a highly significant correlation between the intake of saturated fat and total mortality, cardiovascular mortality, diabetes, etc.”

Saturated fats come from animal products.

Some people suggest that eating better quality meats, like grass-fed meats are healthier. According to Dr. Ornish, “[the] only study done[15] that has even come close to that was to show that the omega-3 fatty acids were a little bit higher in grass-fed beef, but that is not the best way to get omega-3 fatty acids.”

“We found the same dose-response correlation between adherence and the degree of change not only in heart diseases but also in prostate cancer,[16] in gene expression,[17] and in telomere length[18] (the ends of our chromosomes that control aging). It was the same lifestyle intervention, and the more people changed, the better they got at any age.”

“We found an average reduction in LDL-C of 40% in the Lifestyle Heart Trial without drugs.” Here is the landmark study by Dr. Ornish: Intensive Lifestyle Changes for Reversal of Coronary Heart Disease. The objective: To determine the feasibility of patients to sustain intensive lifestyle changes for a total of 5 years and the effects of these lifestyle changes (without lipid-lowering drugs) on coronary heart disease. The conclusions: More regression of coronary atherosclerosis occurred after 5 years than after 1 year in the experimental group. In contrast, in the control group, coronary atherosclerosis continued to progress and more than twice as many cardiac events occurred.

In short, LDL is a type of cholesterol-carrying molecule that takes cholesterol to the cells and HDL takes cholesterol from the cells back to the liver. LDL typically is deemed as “bad” and HDL as “good”; however, every cell needs cholesterol in their structure to function. High LDL levels have been shown by some studies to contribute to cardiovascular disease, including stroke and heart attacks, and high HDL levels have been shown by some studies to contribute to reducing the risks for such health effects.

Dr. Ornish states: “We used to have this very simplistic view that HDL-C is good and LDL-C is bad, but several studies have shown that raising HDL-C actually increased cardiac events and increased premature mortality.[28] Not everything that raises your HDL-C is good and not everything that lowers it is bad. HDL is part of the reverse cholesterol transport mechanism, and it is like garbage men: If you are eating a lot of fat and cholesterol—”garbage”—(as most Americans are), your body has to make more garbage men to get rid of it. But when you reduce the amount of dietary fat and cholesterol by going on a really healthy diet, it is almost as if your body says, “Hey, not as much garbage, don’t need to make as many garbage men. We know that because in our studies, the HDL-C did go down a little bit, but the LDL-C went down way more and these patients reversed the progression of their coronary heart disease.”

He noted that some of the popular diets now, like Paleo diet, may claim to lower LDL or raise HDL, but these risk factors do not equate to disease prevention. There are not long-term studies done on these diets showing actual improvement in blood vessels 5 years down the road as the Lifestyle Heart Trial has done.

When asked why more doctors are not promoting healthy eating and lifestyle changes: “We [MDs] were trained to use drugs and surgery. We are reimbursed to use drugs and surgery, and so we use drugs and surgery….no matter how good the science is, if it is not reimbursable, it is not sustainable.” Dr. Ornish embarked on a “16-year journey to ask Medicare to pay for this program, which they are now doing in a new benefit category: intensive cardiac rehabilitation”.

If you’re interested in knowing your cholesterol levels, ask your doctor to run a comprehensive cardiovascular assessment that will test beyond the basic lipid panel, which typically shows only total cholesterol, HDL, and LDL. The comprehensive version shows different types of subparticles, like HDL2, HDL3, Lipoprotein(a), LP-PLA2, homocysteine, etc. which are important for determining cardiovascular health.

Lipoprotein(a) is the most significant indicator for cerebral infarction/stroke (Scientific American 1992;266(6):54-60 ) and an accurate measure for carotid atherosclerosis, which is an indicator for coronary artery disease (CAD).

LP-PLA2 activity predicts risk for 5-year cardiac mortality independently from established risk factors and indicates risk for cardiac death in patients with low and medium-high hsCRP (inflammatory marker) concentrations (Clin Chem. 2007 Aug;53(8):1440-7). It also is more strongly predictive of CAD risk than C-reactive protein (CRP) in postmenopausal women (Thomas H, Horne BD, Anderson JL, et al. Lipoprotein-associated phospholipase A2 may differentially predict the presence of angiographic coronary artery disease and coronary death across glycemic categories.)

Homocysteine is implicated in the development and progression of cardiovascular disease – coronary artery disease, peripheral artery disease, stroke, or venous thrombosis (NEJM 1997;337:230-6). Acute psychological stress, low folate, vitamin B6 and B12, high meat consumption, and low stomach acid (hypochlorhydria) are a few risk factors that contribute to elevated homocysteine levels.

Genetic variants may also contribute to elevated homocysteine, i.e. MTHFR and COMP. These can be tested via genetic testing and treated by a healthcare provider. Typically, activated versions of folate and B12 are given. For more information on MTHFR, read here: MTHFR.

A few evidence based natural therapies:

  • to reduce Lp(a): a study of 51 patients on 120 mg/day CoQ10 had a 31% decline in Lp(a). Int J Cardiol 1999;68:23-29
  • to reduce homocysteine: address stress, lower meat consumption, address hypochlorhydria; take folate, B6, B12 (best to work a medical professional who can test your levels, i.e. naturopathic physician). A study done showed best benefit (50% reduction of homocysteine levels post-treatment) from a combination treatment of folate, B6 and B12 than from mono-therapy of the vitamins:  650 mpg folate, 12.2 mg B-6, 400 mcg B-12 (J Nutr. 1994,124:1927-33).
  • to decrease overall cholesterol, LDL & triglycerides, and increase HDL: niacin at a dosage of 2,000 mg/day, decreased cholesterol by 12.1%, LDL cholesterol by 16.7%, triglycerides by 34.5%; HDL cholesterol increased by 25.8%.” Am J Cardiol 1998;82:35U-38U

There are so many great natural therapies to prevent and treat cardiovascular disease. It’s best to work with a professional healthcare provider, i.e. MD, ND, DO, etc; however, NDs (naturopathic physicians) are the only primary care-trained providers who receive 40+ hours of nutrition classes and countless hours learning natural healing therapies (herbal medicine, mind body medicine, etc) in their curriculum. To find a naturopathic physician near you, look here: Find a ND.

Wishing you great health & happiness!

~ Venessa Madrigal, ND


Permalink Leave a Comment