Presentation on theme: "Take charge of your heart"— Presentation transcript:
1Take charge of your heart Nicole Derse, B.Scs. Med, C.N.C.Preventative, Functional & Nutritional MedicineCenter for Optimal Health
2Functional MedicineFunctional Medicine is a science based system of personalized medicine that focuses on the root cause of chronic illness and correction of these underlying dysfunctions rather that treating the symptoms
5Heart Disease TodayHeart Disease is the leading cause of death for men and women. 600,000 Americans die from heart disease each.Every 34 seconds some in America has a heart attackAccording to the American Heart Association, 1 in 3 adults has some form of cardiovascular diseaseCoronary heart disease cost America 109 billion dollars annually.
6Traditional Risk Factors Hypertension, obesity, cigarette smoking, diabetes, physical inactivity, family history of premature CAD, age (men >44 yrs; women >54 yrs), and abnormal serum lipids.These traditional risk factors do not fully account for the individual risk for the development of cardiovascular disease.Over 50% of heart attack victimsand 80% of patients with CADhave normal cholesterol levels.
9Damage to your arteries Healthy arteries are flexible, strong and elastic.Their inner lining is smooth so that blood flows freely, supplying vital organs and tissues with adequate nutrients and oxygen.If you have high blood pressure, the increased pressure of blood flowing through your arteries gradually can cause a variety of problems, including:
10Coronary artery disease Coronary artery disease affects the arteries that supply blood to your heart muscle.Arteries narrowed don't allow blood to flow freely through your arteries.Results in chest pain, a heart attack or irregular heart rhythms (arrhythmias).
11Enlarged left heartHigh blood pressure forces your heart to work harder than necessary in order to pump blood to the rest of your body.This causes the left ventricle to thicken or stiffen. This can limit the ventricle's ability to pump blood to your body.This condition increases your risk of heart attack, heart failure and sudden cardiac death.
12Heart failureOver time, the strain on your heart caused by high blood pressure can cause your heart muscle to weaken and work less efficiently.Eventually, your overwhelmed heart simply begins to wear out and fail.Damage from heart attacks adds to this problem.
16Cholesterol is not BAD!Soft, waxy substance found not only in your bloodstream, but also in every cell in your body, where it helps to produce cell membranes, hormones, vitamin D and bile acids that help you to digest fat.Cholesterol also helps in the formation of your memories and is vital for neurological function.Your liver makes about 75 percent of your body's cholesterol
17The Diet-Heart Hypothesis If you eat too much food containing cholesterol and saturated fat, the levels of cholesterol in your blood will rise.The excess cholesterol will be deposited in your artery walls, causing them to thicken and narrow. In time this will block blood supply to the heart (and other organs) causing a heart attack or stroke.
18Cholesterol’s Bad Rap“THE SINGULAR FOCUS on treating cholesterol as a means to prevent heart attacks is leading to the deaths of millions of people because the real underlying cause of the majority of heart disease is not being diagnosed or treated by most physicians.”Mark Hyman, MD
19Cholesterol is a Band-Aid Cholesterol is a response to damage in the arteries.Atherosclerosis is an attempt for the body to send a band-aid (plaque and cholesterol) to an injury sight where an artery has developed a tiny crack.Body is trying to heal itself. This attempt often causes inflammation and swelling of the coronary artery affected, leading to a partial or complete blockage of blood flow.Cholesterol is the patch, not the cause.
22Particle Sizes Better Predictor Instead of looking just at the cholesterol numbers, we need to look at the cholesterol particle size.The real question is: Do you have small or large HDL or LDL particles?Small, dense particles are more atherogenic (more likely to cause the plaque in the arteries that leads to heart attacks), than large buoyant, fluffy cholesterol particles.
24Diabetes PredictorSmall particles are associated with pre-diabetes (or metabolic syndrome) and diabetes and are caused by insulin resistance.Recent research indicates that statins may actually increase diabetes.
254. Oxidative LDLIt’s not just normal cholesterol that is forming plaques in the artery walls but oxidized cholesterol.Oxidation is said to damage cholesterol and then oxidized cholesterol in turn damages artery walls.
26Cholesterol is oxidized when exposed to sunlight, heat and oxygen. It’s cholesterol that has gone rancid, such as that from overcooked, scrambled eggsPresent day food processing methods—like the manufacturing of many commercial oils.It could also include animal products that have been heated or foods fried in oils such as corn oil.
27Anti-Oxidants Vitamin E Beta-Carotene Vitamin C Green Tea Avoid processed oils liquid at room temp besides olive oil.Avoid overcooked eggs, animal products, and fried foods.
29What does HDL do?1/4 to 1/3 of blood cholesterol is carried by HDL. HDL cholesterol is known as "good" cholesterol because high levels seem to protect against heart attack.Low levels of HDL (less than 40 mg/dL) also increase the risk of heart disease.HDL tends to carry cholesterol away from the arteries and back to the liver, where it's passed from the body.HDL removes excess cholesterol from arterial plaque, slowing its buildup.
30Sizes & NumbersSmaller, dense HDL particles are less efficient at clearing cholesterol. A smaller HDL particle size has been associated with oxidative stress, hyperglycemia, and high TGs.A low number of HDLL particles is associated with metabolic syndrome and increased risk of CHD.
31Factors of Low LDL’sSmoking, Overweight, Sedentary Lifestyle, & Poor Diet, and Hypothyroidism
32Dietary SupportIncrease fiber intake by eating more fresh fruits, vegetables and whole grains, while reducing intake of saturated and trans fats.At least twice per week, consume fish high in omega-3 fatty acids, such as salmon, herring, trout, mackerel, water-packed albacore tuna and water-packed sardines or use vegetarian sources such as flaxseed. Niacin (Nicotinic Acid) up to 3,000mg dailyGarlic, 6grams raw or in capsule form
34What are they?TG’s play a major role in transporting fats and providing energy.In excess, TGs represent an independent risk factor for heart attack, heart disease, & CV related death, as well as for insulin resistance and metabolic syndrome.High TGs directly impact LDL density and size and contribute to lower levels of HDL-C, all of which promote atherogenesis.
35These get elevated when eating to many grains sugars, not exercising, smoking, or consuming alcohol, or being overweight.
37Vitamin DLow levels of Vitamin D have been linked to higher levels of Heart Disease and early deathOptimal levels of Vitamin D (>50 nm/l lowers risk of early death by as much as 80%. ‘Vitamin D is actually a hormone and is important in blood in immune/inflammation regulation as well as blood sugar regulation.Get your levels checked. Most people do not take enough.25 (OH) Vitamin D3-most accurate test
38Increasing Vitamin D Absorption It is also important to take your Vitamin D with food because it is fat soluble and make sure you take it with Vitamin K to enhance absorption.Especially if you are taking Calcium and Vitamin D and not Vitamin K you could actually be putting yourself at higher risk of HA.
40Vitamin K1 Vitamin K1 (phylloquinone): Found in green vegetables Goes directly to your liver and helps you maintain a healthy blood clotting system.It is also vitamin K1 that keeps your own blood vessels from calcifying, and helps your bones retain calcium and develop the right crystalline structure.
41Vitamin K2 Vitamin K2 (menaquinone, MK: Bacteria produce this type of vitamin K.K2 goes straight to vessel walls, bones, and tissues other than your liver.Studies found K2 is better and preventing calcification of arteries than K1It is present in fermented foods, particularly cheese and the Japanese food natto, the richest source of K2.
43Hemoglobin A1CLowering blood sugar levels could reduce the risk of coronary heart disease according to researchers at the Johns Hopkins.The researchers found that HbA1c predicts heart disease risk in both diabetics and non-diabetics.An elevated blood glucose level is the defining feature of diabetes, but until now it was unclear whether elevated glucose levels contributed independently to increasing heart-disease risk..
44HbA1c: Hemoglobin A1CHbA1c levels were taken from a study of 16,000 participants. Researchers tracked study participants for years to acquire coronary heart disease events, hospitalizations and deaths.In participants with diabetes, the researchers found a graded association between HbA1c and increasing coronary heart disease risk. Each 1- percentage-point increase in HbA1c level was associated with a 14 percent increase in heart disease risk
45They found that those study participants without diabetes but who had “high normal” HbA1c were at an increased heart disease risk, even after accounting for other factors such as age, cholesterol level, blood pressure, BMI and smoking.
47How does this happen??When you eat too much sugar, flour and white rice, your insulin levels spike.When this happens, your cells become resistant to its effects. So you pump out more and more insulin, become even MORE resistant to its effects, and end up in the vicious cycle of insulin resistance.
48Statins and Insulin…Patients who lowered their cholesterol with statins had higher levels of insulin, while those who lowered their cholesterol through diet had lower insulin levels.Elevated insulin levels are the first step on the road to diabetes — they make you gain weight around the middle, cause high blood pressure, increase inflammation, and promote stickiness of the blood.Each of these conditions, in turn, contributes to heart attacks and heart disease.
50NO More Heart DiseaseNO is one of the most significant molecules in the human body.It has an influence of every organ. It relaxes the blood vessels, reduces blood pressure, lowering your risk of HA or stroke.We become deficient in this when our tissues get damages by age, an unhealthy lifestyle, illness, a toxic environment, sometimes genetics.
51THE HEART OF THE MATTER•The endothelial cells manufacturing the NO that guards against many common diseases. By controlling blood flow, they can help regulate blood pressure.•Once plaque forms in the arteries, it is difficult to undo the damage. Thus, prevention is key, and NO can play and important role in keeping plaques at bay.•By interfering with platelet aggregation, NO minimizes the risk of strokes.
52How to Increase NO Test to assess ADMA: Asymetric Di-Methyl Arginine L-Ariginine: Amino Acid that get converted to NO in the body.Antioxidants to help support stress on cellsVitamin C
54Natures Anti-Inflammatory Omega-3 FA reduce inflammation throughout the body.May decrease triglycerides lower blood pressure, reduce blood clotting, boost immunity and improve arthritis symptoms.Eating one to two servings a week of fish, particularly fish that's rich in omega-3 fatty acids, appears to reduce the risk of heart disease, particularly sudden cardiac death.
56Roles of EstrogenEstrogen is a group of hormones that are essential to sexual and reproductive systems in females.Help the body to retain fluids and salts, and helping to prevent certain diseases.Negative effects of estrogen can occur when the body contains too little or too much.Examples of these include increased weight gain, increased chances of heart disease, and increased chances of breast cancer.
57Estrogen has 400 functions It increases your metabolic rate, enhances energy, improves insulin sensitivity, and regulates body temperature In the cardiovascular systemMaintain the elasticity of your arteriesDilates your small arteriesIncreases blood flowInhibits platelet stickiness,Decreases the accumulation of plaque on your arteriesDecreases blood pressure, decreases LDL (bad cholesterol) and prevents its oxidation
59Too much of a good thing… Excess estrogen promotes abnormal blood clotsExcess estrogen in men is also common and can lead to heart attacks and atherosclerosis, which is the thickening of the arteries.Get hormone levels checkAlways chose bio-identical hormone replacement therapy over HRT.
61Benefits of Testosterone Fights DepressionDecreases Body FatIncreases muscle massStrengthens the heart and bonesIncrease libido and erectionsOverweight men tend to havelower rates of testosterone and higher levels of estrogen
62Testosterone Imbalance Aging bodies produce less testosterone while more of their beneficial testosterone is converted into estradiol.The pathological result is an altering of the ratio of testosterone to estrogen, creating estrogen dominance.This imbalance of estrogen overload and testosterone insufficiency is an often overlooked cause of cardiovascular disease.
63Hormones and the HeartA study published last year compared blood levels of testosterone and estradiol in men suffering from acute HA with those who had previously suffered a HA.The results showed significantly higher levels of estrogen in both groups of heart attack patients compared with those without coronary disease. Heart attack victims also had decreased testosterone levels.
65Too Much of a good thing… Fibrinogen is a protein that helps your blood clot .Fibrinogen making blood thick and stickyStudies published in the American Heart Association’s journal Circulation found that people with high levels of fibrinogen were more than twice as likely to die of a heart attack as those with low levels.
66Toss the aspirin…Aspirin will help reduce levels of fibrinogen but at what cost???Natural alternatives to Aspirin, like Nattokinase, from fermented soybeans, can safely lower levels of fibrinogen through its anti-clotting and anti-inflammatory activity.Omega 3 Fatty Acids help to reduce fibrinogen levelsExcessive Fatigue, irritability, and hopelessness increases fibrinogen.
68CRP is a protein produced within the liver and atherosclerotic arteries. CRP is an independent risk marker for coronary events in individuals without overt hyperlipidemia.Increased levels of CRP are associated with increased risk of cardiac death in patients with previous MI, CAD, peripheral artery disease, and diabetes, suggesting a key role for inflammation in the development of these conditions.Levels of CRP tend to be higher in hypertension, metabolic syndrome, and aging.
69InterventionsMediterranean diet, high in fruits and vegetables and low in saturated fatsFiberOmega 3 FAVitamin A, C, D, EAntioxidantsChocolate
71HomocysteineAmino acid found in the blood that we get usually from eating meat.High levels of this can lead to early development of HD and blood level disease.Everyone should have this test done. Some doc will say this is more of a predictor than cholesterol.High levels of Hcy are independently associated with risk of atherosclerosis and cardiac events and stroke.Hcy is directly capable of injuring endothelial cells.Functional Biomarker for Folate and B12 levels in the blood.
72Dietary Considerations Minimize coffee intakeAvoid processed foods and trans fats.Emphasize Mediterranean-type diet; foods rich in choline, whole grains, spinach, beets & other vegetablesNote: B12 deficiency is possible with low stomach acid or vegan diet.
73Supplemental Support… Folic acid (or 5-MTHF, 2-5 mg/d) vitamins B12, B6, riboflavin, magnesiumConsider CoQ10L-carnitineN-acetylcysteine (NAC) may displace Hcy from binding to arterial walls
74Heart Healthy Diet…Food is by far the most powerful clinical intervention in chronic disease.Motto to live by: If it is made from a plant it is ok, if it made in a plant its not.
75NutrigenomicsPlant based diet: a whole, unprocessed predominately plant based• Low Glycemic Load – the overall balance of the meal• Proper Fatty Acid Composition – high level of healthy omega-3 fats vs. omega-6 fats, low in saturated fats and no trans fats.• High Phytonutrient Density – high level of phytonutrients and antioxidants• Healthy Protein – lean, healthy predominately plant based proteins, or pasture raised animal products
76Nutrigenomics continued • Low Allergenic Burden – low in foods that are highly allergenic (gluten, dairy and others based on personalized prescription)• Low Toxic Burden – minimizes toxic burden of food, e.g. no/low added hormones,pesticides, antibiotics or any other artificial additives• Healthy pH Balance – provides proper balance between acidity and alkalinity• Healthy Salt-Potassium Ratio – low in salt and high in potassium• High Fiber Content – high in fiber to help slow the insulin response and optimize digestive health
77Top 25 Foods for the Heart Carrots Spinach Broccoli. Sweet potato Red bell peppersAsparagusOrangesTomatoesAcorn squashCantaloupePapayaDark chocolateTea SalmonFlaxseed (ground)OatmealBlack or Kidney BeansAlmondsWalnutsRed wineTunaOrganic TofuBrown riceOrganic Soy milkBlueberries
81Combination of analyses of organic acids, fatty acids, vitamins, minerals, and antioxidants, with a specific focus on amino acid absorption and imbalances.• Vitamin D & K• Fibrinogen• Homocysteine• Coenzyme Q10• Fasting Insulin• C-reactive protein
82Prevent a Broken HeartTake Charge of Your Heart, Your Health, & Your Life!