Lifestyle Changes Before Statins for Individuals wiith High CRP

Recent studies, notably the JUPITER study published in the New England Journal of Medicine, reinforces the evidence that reducing the level of inflammation in the arteries as measured by C-Reactive Protein (CRP) levels may reduce the development of arterial plaque. The Jupiter study also was focused on the role of cholesterol-lowering medication (the statin, Crestor) to reduce both LDL (bad) cholesterol and CRP. The positive results of the study suggested that many more people --- even those with otherwise good cholesterol levels but with high CRP levels---be prescribed these medications.

Not so fast, suggests Doctor Roger Blumenthal, director of the Johns Hopkins Center for Prevention of Heart Disease. In an online interview, Dr Blumenthal emphasizes that lifestyle changes, including dietary changes, are the appropriate course of action.

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Mediterranean Diet Works As A Whole System

Researchers continue to find an association between the Mediterranean diet and increased longevity.

"Overall diet is more important than individual components, with emphasis on moderate—but not excessive—wine consumption, particularly during meals, preference for olive oil as the main added lipid, low consumption of meat, and high consumption of vegetables, fruits, and legumes," author Dr Dimitrios Trichopoulos (Harvard School of Public Health, Boston, MA).

The researchers examined data from healthy individuals in Greece who participated in the European Prospective Investigation into Cancer and Nutrition (EPIC) trial.
The researchers looked at data from the Greek segment of EPIC, from over 23 000 healthy men and women aged 20 to 86 at enrollment. As is typical in the Greek population, many individuals were overweight or obese and many men were smokers. Most were moderately active.

This work confirms that it is not one single component of the Mediterranean diet that is driving reduced risk of mortality. "In order to promote longevity, people have to do several things at the same time. They just can't focus on one food—just eat blueberries or take a folic-acid pill. It's a whole lifestyle, whole diet approach for health promotion," say Dr. Teresa Fung of the Harvard School of Public Health.

Report to Doctors: Dietary Interventions for Cholesterol Lowering Effective but Underutilized

Dietary intervention to lower serum LDL-cholesterol (LDL-C) is effective, yet underutilzsed in general family practice, reports a June 2009 article published in the Australian Family Physicians journal.

A year long trial showed an average LDL cholesterol lowering of 13%, with about one-third of subjects achieving a reduction greater than 20%. An important difference in the results related to the individual's adherence to dietary advice. The most effective dietary strategies are replacing saturated and trans fatty acids with poly- and monounsaturated fats and increasing intake of plant sterols. Losing weight and increasing soluble fibre and soy protein intake can also lower serum cholesterol and may be considered when recommending a nutritionally balanced, cholesterol lowering diet.

Major Study Looks to Nutritional Supplements & Heart Health

Boston researchers are launching a large, national trial of vitamin D and fish oil to see whether the dietary supplements reduce the risk of developing cancer or cardiovascular disease. They are also testing the idea that lower levels of vitamin D might explain higher rates of these diseases among African-Americans.

Boston researchers are launching a large, national trial of vitamin D and fish oil to see whether the dietary supplements reduce the risk of developing cancer or cardiovascular disease. They are also testing the idea that lower levels of vitamin D might explain higher rates of these diseases among African-Americans.

Dr. JoAnn Manson and Dr. Julie Buring, both of Harvard Medical School and Brigham and Women’s Hospital, hope to enroll 20,000 healthy older people in the $20 million study funded by the National Institutes of Health.

One quarter of the participants will be black. The researchers believe higher rates of cancer, heart disease, and stroke among blacks, compared with whites, might be related to dark skin’s lower ability to make vitamin D from absorbing sunlight, and they want to establish whether taking vitamin D supplements could reduce or eliminate these disparities.

“African-Americans have a higher risk of vitamin D deficiency and a greater frequency of certain types of cancer and diabetes and hypertension, so I think that it will be of great importance to look at whether something as simple as taking a vitamin D supplement can narrow these health gaps,’’ said Manson, who believes the study is one of the first large-scale randomized trials to target a specific group at higher risk for a deficiency of nutrients. “It would be wonderful if something as simple as a vitamin D pill could narrow that health gap.’’

Women over 65 and men over 60 with no history of cancer or cardiovascular disease will be randomly assigned into four groups.

Some will take daily pills with about 2,000 international units of vitamin D and about 1 gram of fish oil. Others will take pills containing no active ingredients. In the two other groups, participants will get one of the supplements and one placebo. “I think it’s important to be cautiously optimistic and not jump on the bandwagon to take megadoses of supplements before a clinical trial helps to clarify their role.’’

Treatment will last five years. Participants will not need to travel to Boston because study forms and pills will be mailed, according to www.vitalstudy.org, the website for the study.

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Selected nutrients already have been found to promote cardiovascular health, notably plant sterol, soluble fibers from oatmeal, barley, psyllium and beans, and mono and polyunsatured fats in place of saturated fats. For more information on nutritional approaches to cardiovascular health, go to Kardea Nutrition. For heart health cooking recipes incorporating these key nutrients, go to Kardea Gourmet

Cardiovascular Disease: The Number 1 Killer of Women

So you think that cardiovascular disease is primarily a problem for men. Think again: More than 500,000 women in the U.S. die each year of cardiovascular disease, making it their No. 1 killer.

In fact, for a variety of complex reasons, the condition is more often fatal in women than in men and is more likely to leave women severely disabled by a stroke or congestive heart failure.

True, women don't usually start showing signs until their 60s--about 10 years after men first develop symptoms. And hormones seem to play a protective role in women before menopause.

But the common belief that premenopausal women are immune to heart problems is just plain wrong. Heart attacks strike 9,000 women younger than 45 each year.

The more scientists learn about a woman's heart and what can go wrong with it, the more they realize that females aren't just small males. There are subtle but important differences in how women's cardiovascular systems respond to stress, hormones, excess saturated fat and toxins like tobacco. There are also some pretty big differences in how aggressively doctors treat women with heart trouble--even in the emergency room when they are in most desperate need of help.

"The vast majority of heart attacks in women could be prevented with a combination of lifestyle modifications and medication," says Dr. JoAnn Manson at the Brigham and Women's Hospital in Boston. "Just making use of existing information could nearly eradicate the disease."

Of course, neither men nor women can do anything about their age or the genes they were born with. (If your father had a heart attack before 55 or your mother had a heart attack before 65, you should pay special attention to your heart health.) And it's still unclear why heart disease seems to strike men and women so differently. Structurally, their hearts and arteries are basically the same; women's hearts are smaller, but in proportion to their bodies. So doctors are pretty sure that any differences are matters of degree rather than kind.

Cardiologists are confident that they understand how heart attacks occur in men. The trouble usually begins when a fatty deposit or plaque, which has taken decades to build up on the inside of a coronary artery, becomes unstable and bursts, triggering a clot that blocks a blood vessel. Doctors can see these plaques during a fairly invasive procedure called an angiogram, in which a catheter is threaded through an artery in the groin or leg up to the arteries of the heart and a dye is then released to make any blockages easier to spot.

Although the research is controversial, some evidence suggests that bursting plaques may not be as important for women as for men. Doctors have long puzzled over the fact that some of their female heart-attack patients--usually those who have not yet gone through menopause--show few signs of artery-clogging plaques on their angiograms. Perhaps their blockages don't occur in the major arteries of the heart, where angiograms are performed and bypasses are most effective. Perhaps blood flow is restricted in the smaller vessels that branch off the coronary arteries. And perhaps the problem isn't plaques at all but the fact that these smaller blood vessels are somehow more prone to spasm, snapping shut at the slightest stress or trigger, cutting off the flow of blood to parts of the heart.

It's also possible that plaques--whether in the main coronary arteries or the smaller vessels--behave differently in women. Unlike men, women tend to distribute all the "garbage" associated with atherosclerosis--such as saturated fat and oxidized waste products--more evenly throughout the arteries. The process is analogous to the way men and women gain weight, says Dr. Noel Bairey Merz of the Cedars-Sinai Medical Center in Los Angeles. "When men get fat, it all goes to their belly," she says. "When women get fat, they tend to get fat all over--fat at the ankles, fat in the sides, fat in the upper arms." So although women generally avoid the monster plaques that kill so many men in early middle age, the continuing buildup in women's arteries may come back to haunt them in their 50s, 60s, 70s and 80s.

Plaques are another reason for women to throw away their cigarettes, as smoking seems to turn stable plaques into unstable ones. "If you look at the plaque under a microscope, it doesn't appear to be the kind of plaque that can become unstable and rupture," says Dr. Robert Bonow of the American Heart Association. "But the surface has become eroded, exposing the material beneath the surface to the blood, which causes blood clots. And it turns out that the women who have this plaque erosion tend to be women who smoked." Those clots can travel through the bloodstream, wreaking havoc in the heart or the brain.

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Plant Sterols & Omega-3s Combine To Boost Heart Health

A combination of fish oil and plant sterols demonstrated over a 22% reduction in overall cardiovascular risk. In the September 2008 publication in Atherosclerosis, the researchers reported that they failed to demonstrate similar result for individuals taking fish oil alone.

The study's authors', Michelle A Micallef, University of Newcastle, and Manohar L, Garg, Hunter Medical Research Institute, write, "to date, this is the first study to investigate the combined cardioprotective effects of these two functional foods" in individuals with high cholesterol but without history of heart disease. The authors' conclude that the combine use of fish oil and plant sterol therapy is "an ideal alternative or adjunct to pharmacological treatments, for maximum cardioprotection ih high risk individuals."

Kardea Nutrition delivers a system of products that enable combination therapy, offering delicious foods and quality supplement. The Kardea system extends beyond fish oils and plant sterols to include cholesterol-lowering fiber and monounsaturated-rich extra-virgin olive oil.