In the Part 1 of this series, we discussed the truth about cholesterol and the primary mechanisms behind the build-up of arterial plaque, which clogs the arteries and ultimately promotes heart disease. Contrary to prevailing myths, neither saturated fat nor dietary cholesterol factor into this pathogenesis. Here in Part 2, we will look at which foods promote heart health and which foods to avoid. Additionally, we will examine several nutraceutical products that are highly beneficial with respect to heart health.
We have been told for decades to avoid foods that have high levels of saturated fat — meat, butter, coconut oil, eggs, etc. Within the scientific literature, however, there has never been strong evidence supporting this advice. To the contrary, saturated fat, in moderation, is an important part of a healthy diet. Moreover, the sources of fat that have been recommended as replacements for saturated fat, namely vegetable oils, are inflammatory and detrimental to heart health.
As we saw in Part 1, LDL cholesterol is not necessarily unhealthy. It depends on the size of the LDL particles. Small-particle LDL does accumulate along the arterial walls, but large particle LDL, also known as «fluffy» LDL, does not accumulate. Research shows that saturated fat consumption increases only large-particle LDL.1 These large, fluffy LDL molecules are not associated with cardiovascular disease.2 So what drives small-particle LDL? The primary offenders are trans fats, the excessive consumption of sugar and other rapidly digestible dietary carbohydrates, and the excessive consumption of omega-6 (found in seed oils like corn, soy, canola, sunflower, grapeseed, etc.).3, 4
The available research indicates that a heart-healthy diet is lower in carbohydrates, with increased energy from protein and healthy sources of fat. Notably, sugar should be eliminated or greatly reduced. Listed below are general guidelines for good and bad sources of fat:
As discussed in Part 1, free radical damage from reactive oxygen species (ROS) is one of the primary contributors to arterial plaque build-up and systemic inflammation, both of which factor prominently in cardiovascular disease. Since antioxidants neutralize free radicals, every heart healthy diet should contain an abundance of antioxidant-rich foods. The following foods are highly advisable:
Omega-3 is one of the most heavily researched molecules with respect to heart health. It exerts strong anti-inflammatory properties, primarily by modifying the production of eicosanoids. Additionally, in clinical trials, omega-3 supplements have been shown to improve flow-mediated arterial dilation.5 Omega-3, as discussed in my «Brain Health» series, has multiple forms, including ALA, EPA, and DHA. EPA and DHA exhibit the strongest anti-inflammatory effects. Whereas ALA is found in many seeds and nuts, EPA and DHA are found only in animal foods (and in supplement form). Accordingly, we should regularly consume oily fish, such as mackerel and sardines, while also considering omega-3 supplementation.
One recommended omega-3 product is Natura Health Products’ «Complete Omega Essentials», which combines pharmaceutical grade fish oil concentrate (anchovy, sardine, and mackerel) with borage seed oil and sea buckthorn berry oil. Borage seed oil is also high in tocopherols and phenolic compounds, both of which contribute to its high resistance to oxidation and antioxidant activity. Borage seed oil is shown to support bone health, to modulate the immune response, and to encourage healthy skin. Sea buckthorn oil, extracted using Natura’s supercritical fluid extraction method, which uses the whole berry, including the seed, contributes an abundance of carotenoids, tocopherols, and phytosterols and omega fatty acids.
The foundations of heart health will always be a proper diet and a healthy, active lifestyle, inclusive of exercise and exclusive of smoking and pervasive, long-term stress. Nevertheless, there are also many powerful, heart-protective nutraceutical formulas, which can be considered, depending on one’s condition. The following review summarizes some of these formulas/molecules.
Berberine is a plant alkaloid derived from many plants, including Berbis vulgara, which has been used in Traditional Chinese Medicine for centuries for its antimicrobial properties, blood sugar balancing properties, and its ability to enhance insulin sensitivity. During the past several decades, berberine has been tested in numerous clinical trials, particularly for the management of diabetes, which is closely related to heart disease. Berberine has been shown to be just as effective as the popular drug metformin in reducing fasting blood glucose, postprandial blood glucose, fasting insulin, LDL-C (LDL-P was not measured in this study), and triglycerides.6 Berberine also exhibits strong anti-inflammatory properties, primarily by inhibiting the expression of inflammatory cytokines.7
This nutraceutical combines numerous cardio-specific botanicals with key nutritional agents to maintain healthy heart function while maintaining blood pressure levels within the normal range. Three botanicals used in this product — hawthorn, arjuna, and olive leaf — provide essential flavonoids, glycosides and phenolic compounds that nourish and strengthen the heart. Concurrently, the product’s L-carnitine and magnesium support cellular energy production through increased mitochondrial efficiency. Finally, the product’s patented grapeseed extract works synergistically with the other ingredients to support the body’s ability to regulate arterial, capillary, and venous blood flow.
As discussed in Part 1 of this series, elevated levels of homocysteine can damage the arterial walls, thereby contributing to atherosclerosis. Elevated homocysteine is an independent risk factor for the hardening of the arteries, coronary heart disease, stroke, peripheral vascular disease and other conditions associated with abnormal blood clotting.8 Additionally, when homocysteine is elevated, it reduces nitric oxide (NO) production, which can increase the risk of hypertension and erectile dysfunction.
Homocysteine is produced when the body metabolizes methionine, a common amino acid found in most protein-containing foods. Under normal conditions, the breakdown products of methionine metabolism are recycled back into methionine via a pathway that involves enzyme conversions dependent on various B vitamins, including folate and the methylcobalamin form of vitamin B12. Any obstructions in this pathway lead to increased homocysteine levels. Homocysteine Supreme is an excellent nutraceutical formula that synergistically combines several key B vitamins with other heart-beneficial molecules, including zinc, trimethylglycine (TMG), serine, and N-Acetyl-L-Cysteine (NAC).
L-Carnitine is a molecule that plays a critical role in energy production. Specifically, L-carnitine transports long-chain fatty acids into the mitochondria of the cells so they can be burned and converted into energy. Additionally, it transports toxins produced in this metabolic process away from the cells. L-carnitine occurs naturally in the body, particularly in the skeletal cells and cardiac muscle tissues. In clinical trials, L-carnitine supplementation was shown to:9, 10, 11, 12
CoQ10 is an endogenously synthesized and diet-supplied lipid-soluble cofactor. With respect to heart health and cardiovascular disease, CoQ10 has three primary functions:13
CoQ10 appears in the body in two forms, ubiquinone and ubiquinol. These names are derived from the word «ubiquitous», a nod to the prevalence of these molecules throughout the entire body. The body converts ubiquinone into ubiquinol, but several factors, including ageing, cardiovascular disease, and some medications (such as statins), impede this conversion.14, 15
Previously, the ubiquinol form of CoQ10 was not available in supplement form. Thanks to technological breakthroughs, however, scientists have created a process by which ubiquinol can remain stable outside of the body and can be absorbed as such in supplement form. As a powerful antioxidant that exhibits many cardio-protective properties, the ubiquinol form of CoQ10 supplements is advisable for many people. The current leading manufacture of ubiquinol CoQ10 is Kaneka Nutrients, a company based in Japan.
Calcification (hardening) of the soft tissues throughout the body is inevitable as we age. This includes the brain, heart, arteries, kidneys, testis, liver, spleen, joints, eyes, ears, and more. Coronary artery calcification (CAC) is strongly correlated with the degree of atherosclerosis and one’s risk of future cardiac events.16
One of the best interventions against calcification is disodium EDTA (EDTA-2Na), a proven calcium-chelating agent.17 Via a slow-drip infusion that lasts about 2 hours, EDTA therapy can effectively remove decades of accumulated calcium. A minimum of 10 sessions is advised to obtain such results. Additionally, EDTA therapy works by making the blood more fluid (thinner), thereby bringing more blood and oxygen to all cells throughout the entire body. Alternatively, there is also a liposomal version of EDTA, which also delivers superb results. The product, called Liposomal EDTA with R-Lipoic Acid, features nano-sized liposomal delivery, making it highly absorbable orally, with the very small liposomes allowing for intracellular delivery of their encapsulated contents.
In 2013, the Journal of the American Medical Association published the results of the Trial to Assess Chelation Therapy (TACT), a $31.6 million study funded by the US National Institutes of Health (NIH).18 The study proved that EDTA chelation therapy provides benefits for myocardial infarction patients, including reducing the risk of adverse cardiovascular outcomes. Additionally, patients with diabetes exhibited lower risk of cardiovascular events such as heart attack, stroke, hospitalization for angina, and coronary revascularization.19 TACT2, the follow-up study, also funded by NIH, is currently in progress.