As Valentine’s Day approaches, we remember to focus on our heart. What we want, what we can put out to make the world a better place, and taking care of the physical heart at our center. An article in the Lancet dating back to 2004 concluded that exercise, optimal nutrition, healthy body weight, moderate red wine consumption, and smoking cessation could reduce cardiovascular disease by a whopping 80%. Numerous papers and directives since that time have reiterated this, including those by the American Heart Association, the CDC, and others. Yet we still use medication as our primary means of managing heart issues; statin drugs for high cholesterol and blood pressure medications.
The U. S. Department of Health and Human Services just released its most recent Dietary Guidelines for Americans, a publication that comes out every 5 years. Notably, it has removed cholesterol as a nutrient of concern and no longer suggests that Americans should avoid cholesterol as part of a healthy lifestyle. The reason is because “evidence shows no appreciable relationship between dietary and serum cholesterol”.
Cholesterol is made by the liver. It is important to the health of the cell membrane, is a constituent of bile, and forms the basis on which our hormones are made. Very high cholesterol should be addressed, but the over-emphasis on cholesterol as a risk of heart disease may not be warranted. What do we do in the gray area where cholesterol is trending up or moderately elevated? Some think statins are the only answer. Yet statins have serious side effects. They have long been known to cause muscle and liver issues. In the last several years the FDA has added warnings for increased blood sugar and dementia. Do we still think statins are worth the risk?
Blood pressure is another conundrum. The current medical model encourages us to monitor our blood pressure when it begins to trend up. Without intervention, we then sit by and “watch” until we finally need medication. Many nutrients have been studied for the lowering of blood pressure, as have weight loss programs, stress reduction, smoking cessation, and better nutrition. Our focus here will be on optimal nutrition.
Newer research focuses on chronic inflammation, oxidation, and immune dysfunction as a key determinants of heart disease. Going forward, we will see nutritional and drug treatments focused on these issues. Below we discuss the most important nutrients for maintaining a healthy heart. These nutrients focus on traditional risk factors like high blood pressure and cholesterol, but also address the root cause of these issues.
Omega-3 & Other Healthy Fats. It would be hard to list all of the benefits of the omega-3 fats from fish oil. At a very basic level fish oil bolsters the health of your cell membranes, ensuring proper absorption of nutrients into the cell and proper communication between cells. This helps not only with heart disease, but literally any condition that you have. Fish oil boosts low HDL, reduces triglycerides and lowers C-reactive protein (CRP), an inflammatory marker. Omega-3s are found in fatty fish such as salmon, cod, mackerel, anchovies and sardines, but you must eat them at least 3 times per week. Grass-fed beef is another good source. For those that do not these foods into their diet, 500-1200 mg of supplemental omega-3 per day is adequate. If you already have some risks for heart disease, your practitioner may suggest 3000-10,000 mg per day.
Other healthy fats include those found in flax seed, olive oil, avocado, chia seeds, hemp seeds and nuts. While saturated fat should be limited, it is okay to have red meat that is organic, grass-fed and pasture-raised 2 times per week. Trans- fats and hydrogenated oils should be strictly avoided as they provoke an inflammatory response.
Magnesium. Low magnesium levels are the greatest predictor of heart disease risk, according to a 2013 study that reviewed cardiovascular studies over the past seven decades. A deficiency of this macronutrient is very common in those with heart disease and the population at large. For blood pressure that is trending upward (greater than 120/80), this is the first nutrient you should look to. Magnesium relaxes the blood vessels, has a calming effect on the nerves, assists in managing blood sugar (a factor in inflammation), and balances calcium. Magnesium is used in 300 biochemical reactions in the body and therefore is a nutrient that you don’t want to be deficient in! Doses of 250-800 mg per day are safe, depending on your size, diet, and conditions you are trying to address. Magnesium can have a laxative effect because it relaxes the muscles, so start at a lower dose and build from there. Magnesium glycinate is a form that is easier on the stomach. Foods that are high in magnesium include nuts, dark, leafy greens, kelp, avocado and dark chocolate.
Vitamin K2. Vitamin K2, particularly its MK-7 form, removes calcium from the arteries and deposits it in the bone. Calcium that is not directed to bone can build up in the blood causing plaque, high blood pressure, stroke and even heart attacks. Vitamin K has several different forms. Vitamin K1 is in dark, leafy greens and is relatively easy to get through the diet. Vitamin K2 and its various forms are mainly present in a Japanese food called natto, some other fermented foods, and animal livers. Since the American diet is generally low in these food sources, supplementing with K2 can greatly benefit heart health. Dosages in the range of 45-150 mcg are usually recommended.
CoQ10. This coenzyme is a factor in the energy-making process in every cell of the body. It is very important to the pumping action of the heart. It is also a strong antioxidant, helping to clear toxins from the blood vessels. Ironically, CoQ10 is depleted by several drugs used to treat heart disease including statins, beta blockers, and diuretics. CoQ10 has been shown in some studies to reduce blood pressure and improve congestive heart failure. It also reduces the inflammatory marker CRP. For preventative benefit or to replace what is lost with prescription drugs, dosages of 100-300 mg are typically recommended. If your doctor is using CoQ10 to treat congestive heart failure, dosages may be much higher.
Vitamin D. Low levels of vitamin D are linked to an increased risk of heart disease. It acts as a hormone, regulating more than 200 genes throughout the body. It is protective against diabetes, a huge factor in the risk of heart disease, and it tempers damaging inflammatory responses. Since Vitamin D is an immune system modulator, it could provide a buffer for damage to the arteries that originates in an immune response. A deficiency of this vitamin can be detected from the 25-hydroxy vitamin D test. Natural doctors recommend levels of 50-80 ng/ml. If you are deficient, you can take 5000 IU’s per day and retest your levels after 2 months. Daily doses for others who are not getting sun exposure are usually 1000-2000 IU’s per day. The best way to get vitamin D is from the sun, but eggs, salmon, mushrooms, and milk are decent sources. Always choose dairy products from grass-fed, organic sources.
Curcumin from turmeric. Curcumin is a powerful anti-inflammatory and antioxidant. It also assists the liver in detoxification. Many recent studies support the benefit of curcumin in fighting chronic inflammation, and we can expect to see more use of this herb in the treatment of the underlying inflammation and oxidation associated with heart disease.
D-Ribose and Taurine. D-Ribose and taurine can be used to provide energy to the heart where advanced disease has occurred. Heart disease takes a toll on the tissues and impairs the production of ATP, the body’s main source of energy. D- ribose is a simple sugar that is not stored by the body that can speed up healing by increasing the energy available to the heart. The recommended dose is 5 grams. Taurine is an amino acid found in large concentrations in the heart. It can be used to support congestive heart failure, high blood pressure, and high cholesterol. The recommended dose is 3 grams.
Fiber. Fiber consumption of at least 30 grams a day is important to heart health. Most Americans get 12-14 grams a day. Fiber is a superstar for heart health. It reduces cholesterol, lowers triglycerides, and reduces CRP. It binds heavy metals and other toxins in the digestive tract that can cause damage to blood vessels. Using a fiber supplement each night before bed is a great way to boost fiber intake and manage your blood sugar. Fruits and vegetables, a high quality fiber supplement, or flax seeds, chia seeds, hemp, or nuts, are all great ways to add fiber to your diet. Apples are considered a superfood for the heart due to the pectin fiber they contain, along with being high in potassium.
B Vitamins. The B vitamins help us break down our food, produce energy, and nourish the nerves, thus reducing stress. Certain B vitamins are also directly related to the management of heart disease risk. High homocysteine, an inflammation marker related to heart disease, can be reduced by supplementing with vitamins B6, B12 and folic acid. Pantothenic acid, or vitamin B5, lowers cholesterol by blocking an enzyme involved in the production of cholesterol in the liver. It is also an excellent nutrient for the adrenal glands and thus counters a negative response to stress. If you are taking individual B vitamins to help with specific issues, then you may need to take a high-potency B complex.
Potassium. Next to magnesium, potassium is probably one of the best nutrients for managing blood pressure. Potassium and sodium work together to maintain water balance, a factor in blood pressure. In a typical American diet, the sodium /potassium ratio is out of balance. Since supplements are only available in doses of 99 mg, it is best to get potassium from food sources. The best sources are coconut water (400-600mg), avocado, potato, and many fruits. To reduce your salt intake restrict packaged foods, most of which are loaded with sodium. A high quality salt that is high in minerals can then be added to whole foods that you eat.
Be Aware of Drug Nutrient Depletions
If your doctor has decided that a drug best addresses your heart condition, be aware that drugs can deplete nutrients in the body. Ironically, these nutrients are often beneficial for heart health. If you are unaware what class of drugs you are on, a google search is an easy way to find out:
- Diuretics—Decrease potassium, magnesium, phosphorous, sodium, chloride, zinc, iodide, CoQ10, folate, B12, B6, thiamine and selenium. Herbs like uva ursi and dandelion can be used to decrease water in the system and also have nutritive benefits.
- Beta blockers—Decrease CoQ10. As noted above, CoQ10 is crucial to heart health and supplementation is necessary to make up for the depletion.
- ACE Inhibitors—Decrease zinc, exposing you to immune issues, low testosterone, slower wound healing and anxiety.
- Angiotensin Receptor Blockers—Decrease zinc, same issues as noted above.
- Statins—Decrease CoQ10, selenium, omega-3s, Vitamins E, A, & D, carnitine, and free thyroid hormone. The warnings on this drug say it all—muscle issues, liver problems, increased blood sugar and dementia—there’s got to be a better way!
Remember the “Four Ps” that will begin to define our health care system going forward; Predictive, Preventive, Personalized, and most importantly Participatory. If you want to prevent disease, you need to take an active role in your health. There’s no more going to the doctor with a “fix me” attitude. We all need to advocate for our own health and make decisions based on all of the information we have, not just what the doctor ordered. I hope we have given you some information that you can incorporate into your diet to ensure a healthy heart. Have a wonderful Valentine’s Day!