Butter Is Still Better

If there is anything better than butter in a baked potato or on a scone that I haven’t yet come across it, but I know that the margarine industry has spent a lot of time and money in persuading as that it is bad for our health. As I keep on saying (or nagging, if you prefer) there is nothing wrong with butter it’s all about the quantity you are using and if you want a healthy heart then switching to the new range of margarines that have been enriched with omega-3 fatty acids will not make a difference — in fact could make it worse.

A study carried out by Wageningen University in the Netherlands over a three-year period showed that using such margarines did not prevent second heart attacks in older men and women at risk for worsening heart disease. The initial results appeared to show that switching to such margarines did initially reduce cardiac events, but by 30 months the evidence of that benefit had disappeared, said Daan Kromhout, MPH, PhD, the lead researcher. He reported their results at the recent European Society of Cardiology meeting and their findings were simultaneously published online by the New England Journal of Medicine.

These findings have surprised some cardiologists as most of the data on omega-3 fatty acids come from epidemiologic studies and those were positive. Alfred Bove, MD, of Temple University in Philadelphia has likened the situation to hormone therapy, which had been widely recommended to reduce cardiovascular risk in postmenopausal women based on data from epidemiologic studies. Subsequent evidence however showed that HRT can be a major risk factor for heart attacks in women are relying solely on research — in whatever field — is never a good idea.

The margarines used in the trial were supplied by Unilever, and included the well-known “I Can’t Believe It’s Not Butter,” which I have to confess I have no trouble believing as I can see no resemblance in taste at all. This research should not be used to downplay the role of Omega 3 in the prevention and treatment of not only heart disease but also Type 2 Diabetes and depression, because it is clearly an important element in our diet. However this definitely indicates that margarine is not the vehicle to introduce it to your diet. Better sources include oily fish such as salmon and Flax seeds and walnuts.

Vitamin D Supplements Can Help Reduce Heart Disease Risk

There is an ongoing and endless argument in the medical world about whether nutritional supplements have any real value in the west so it’s good to hear good news for once. It was reported at the American College of Cardiology’s annual scientific session in Atlanta, Georgia this month that treating Vitamin D deficiency can significantly reduce the risk of heart disease.

Vitamin D is certainly recommended to reduce bone disease and fractures, but this is the first time it has been suggested to treat heart disease. Two new studies undertaken at the Intermountain Medical Center Heart Institute in Utah last year have claimed that preventing and treating heart disease in some patients could be as simple as supplementing their diet with extra vitamin D. Doctors recommending supplements, what is the world coming to?!

Researchers demonstrated a clear link between vitamin D deficiency and increased risk for coronary artery disease in studies lasting over a year each and involving over 40,000 patients with low vitamin D levels. In the first study they found that 47 percent of the patients who increased their levels of vitamin D between the two visits showed a reduced risk for cardiovascular disease. The second study was even more impressive as patients who increased their vitamin D levels to 43 nanograms per milliliter of blood or higher had lower rates of death, diabetes, cardiovascular disease, myocardial infarction, heart failure, high blood pressure, depression, and kidney failure.

While exposure to 20-30 minutes of sunlight can provide up to 10,000 IU, of vitamin D you need to be sure to use sunscreen and avoid the hottest parts of the day in order to avoid sunburn and the harmful UV rays associated with skin cancer. Supplements can help boost your levels all year round and although the current RDA Recommended Daily Allowance) for vitamin D is around 400 IU for adults, 1000 IU for babies up to 2 years and between 500 – 1000 for older children the doctors taking part in the two studies feel that the ‘normal’ levels are too low.

They suggested increasing vitamin D intake by 1000 to 5000 international units (IU) a day, depending on a patient’s health and genetic risk for coronary disease. However an excess of vitamin D can cause nausea, vomiting, poor appetite, constipation, weakness and weight loss so always check with your doctor before exceeding the RDA and have a blood test to accurately determine the levels in your blood.

Women with Gout at Increased Heart Risk

Although gout is characterised as a disease of old colonels who have drunk too much port, the reality is it can affect men and women who may never have had a drink in their lives. It is often genetically inherited and although more common in older men and women after the menopause, the most vulnerable group are usually men over 30.

Now equality has caught up and although it is known that gout increases the risk of a heart attack in men what has just been revealed is that women with gout are at greater risk of a heart attack than the men are.

This research (I know, all research to be taken with a pinch of metaphorical, not actual, salt) was recently published in the Annals of Rheumatic Diseases and based on a study of more than 9500 gout patients and 48, 000 people without the disease, aged 65 and older in British Columbia, Canada.

The study took place over 7 years and tracked cardiovascular health and they found that compared with women who did not have gout, those who did were 39% more likely to have a heart attack of any kind and 41% more likely to have a non-fatal heart attack. The surprise in the study was that the risks were significantly higher among the women than among the men as men with gout were only 11% more likely than those without the disease to have a fatal or non-fatal heart attack.

Gout is common and caused by inflammation in the joints as a result of excess uric acid deposits, that are a feature of western diets. Factors that can produce gout include other forms of arthritis obesity, weight gain, high alcohol intake, high blood pressure, poorly functioning kidneys and certain drugs.

If you are wondering if you have it, then look for redness, pain and inflammation of the joints, particularly toes and fingers. Natural remedies suggested to help with gout include dietary help by avoiding alcohol and organ meats, particularly liver, tart cherry juice, celery seed, apple cider vinegar and yoga.

Want to Predict Your Heart Risk with a Web-Based Calculator?

Now if you are too busy to go to the doctor, or tend to avoid them until the last possible minute, a new research tool could be just the thing for you. Cardiff University Medical School has developed an Internet site where you can assess their future risk of having heart disease.

I am all in favour of being proactive and having information is the first step in any process to make changes. Heart disease is the biggest killer in the UK and still many of people do not know they are at risk, but by taking part in this research project you help expand the database of knowledge on heart disease, and you get a free assessment to know where you stand.

They are looking for volunteers aged between 45 and 64 who have not been previously diagnosed with heart disease, had a cardiac event (such as a heart attack or angina) or a stroke. I took the online survey and it is a model of an easy to use site and it doesn’t take long. They will even send you a copy of your results if you want to take them to your doctor, but remember they are a guide to whether you are at risk over the next ten years, not a definitive diagnosis, and hopefully a spur to taking action.

You are not only helping the researchers but for every volunteer who visits the website and completes the study, £1 will be donated to the British Heart Foundation so just go to www.myheartrisk.co.uk to check yourself out.

PS – if you are suffering from angina, also have a look at the item on prostate cancer and nitroglycerin.

Health Bite:

Now if you are feeling guilty over that large box of chocolates you got for Valentine’s Day, and which disappeared faster than you like to admit to – or is that just me – then here’s some good news. Eating chocolate may lower your risk of having a stroke, and lower the risk of death after one, according to an analysis of available research presented at a recent American Academy of Neurology meeting in Toronto.

They hedge their bets by calling for more research, which probably means eating more chocolate and conclude that they are not sure ” whether chocolate truly lowers stroke risk, or whether healthier people are simply more likely to eat chocolate than others”. Well I am healthy and I eat chocolate so I think should volunteer, and if you want facts to back up your chocoholism then remember that it is rich in antioxidants called flavonoids, which may have a protective effect against stroke, and their research showed that those who ate one serving of chocolate per week were 22 percent less likely to have a stroke than people who ate no chocolate and those who ate 50 grams of chocolate once a week were 46 percent less likely to die following a stroke than people who did not eat chocolate.

One study found no link between eating chocolate and risk of stroke or death so go forth and consume with a clear conscience, though remembering that chocolate is also rather high in fat, so that 50 grams a week is probably a good (though stingy) guide.

Music’s role in heart health

I am a great believer in the restorative power of music and have written before about its role in helping reduce blood pressure and anxiety in cancer patients and there carers. Now it seems it can also help aftercare rehabilitation for heart and stroke patients.

One reason why this makes sense is that our blood flow and respiratory rates can actually change their rhythm to be in synch with music according to a study by Italian researchers at Pavia University and published in Circulation: Journal of the American Heart Association. They had found in an earlier study in 2006 that music with faster tempos resulted in increased breathing, heart rate and blood pressure and that when the music was paused there was a fall in all those rates.

Not sure why this is news, they just needed to have asked women who knit in time to music and find themselves racing up a sleeve whenever a military march came on the radio or they were listening to a band concert in the park and the strains of Yesterday reduced their stitch rate by half! Now they have found that swelling crescendos in the volume stimulate our body and that gradual decreases in volume makes us relax. I am sure there is an emotional component here as we respond viscerally to music which then affects our whole body systems but it is clear that music does induce a continuous, dynamic — and to some extent predictable — change in our cardiovascular system and that it is a two way process.

So if you want a healthy heart listen to music that stimulates it a little, and also offers relaxation – for myself I would add in joy as well, but that isn’t covered in the research. If you want to try the experiment for yourself they played their subjects random selections including Beethoven’s Ninth Symphony; an aria from Puccini’s Turandot; a Bach cantata (BMW 169); Va Pensiero from Nabucco; Libiam Nei Lieti Calici from La Traviata — as well as two minutes of silence. The profile of music (crescendo or decrescendo) was continuously tracked by the cardiovascular and respiratory systems and change was particularly marked when the music was rich in emphasis, like opera.

The technical stuff:

Every crescendo in the music led to increased narrowing of blood vessels under the skin, increased blood pressure and heart rate and increased respiration. In each music track the extent of the effect was proportional to the change in music profile.

During the silent pause, changes decreased, with blood vessels under the skin dilating and marked reductions in heart rate and blood pressure. Unlike with music, silence reduced heart rate and other variables, indicating relaxation.

Music phrases around 10 seconds long, like those used in “Va Pensiero” and “Libiam Nei Lieti Calici,” synchronized inherent cardiovascular rhythm, thus modulating cardiovascular control.

We know that music reduces stress, boosts athletic performance and enhances motor skills of people with neurological impairments and is frequently being used as a therapeutic tool for heart and stroke patients. What’s new is that this study shows that alternating between fast and slow music (crescendo and decrescendo within the same music track) may be potentially more effective.

If you are interested in the music that was used in the clinical trial at the Bristol Cancer Help Centre then visit SulisMusic.com

Yet another difference between men and women

Well apart from the obvious ones we all know about; that men need more of the duvet and don’t eat as much as chocolate, it seems our aspirin response is different too. A daily aspirin for those men over 45 and women over 55 is often recommended as a preventive for heart attacks, but it seems that the benefit differs by gender.

Men do get fewer heart attacks with a daily dose, but it doesn’t affect women in the same way. Their benefit lies in the fact it reduces the risk of stroke, not of heart attacks.

New research published this month in the Annals of Internal Medicine has also focused on the possible dangers of regular aspirin use in causing gastrointestinal bleeding. This risk gets higher as the dose increases and the new recommendation is that no more than 75mg a day is just as effective as higher amounts. If you already have heart disease then taking 100mg or more of aspirin a day will not be of any benefit for the existing condition.

Plastic Problems

Plastics are one of those wonderful technical breakthroughs that have proved a huge boon – but we are starting to see the downside, particularly for health. We now have plastic products all around us and as well as being bad for the environment, they do you no favours either. Don’t think you are affected? Do you have a DVD or computer and have any plastic kitchen appliances? Do you wear spectacles or have contact lenses, use reusable plastic containers for your water on the move or use plastic feeding bottles for your baby? Plastics are used in construction materials, paints, as well as in linings for food and drink cans. You literally cannot avoid them.

The health culprit is Bisphenol A, (BPA), an organic chemical which is the essential basic building block for high performance polymer plastics and coatings. Scientists first synthesized it in the late 1800s and just 40 years later it was found to have oestrogenic properties which we now know are linked to cancer. Scientists continued to develop ways to use BPA in making plastic containers and resins that now line most food and soft drink cans.

The problem is that BPA polymer decays over time, so traces of the synthetic oestrogen are released into canned foods, water in plastic bottles and even baby formulas and the dummies and plastic cutlery that children are often given. Research continued into the effects of BPA on animals, and the results showed reproductive and hormone-related problems. It wasn’t at this stage being tested on humans, but the use of plastics was becoming increasingly popular.

In the updated 2008 Risk Assessment Report on BPA published last June, the European Commission concluded that products made from BPA, were safe for consumers and the environment when used as intended. Worldwide, that has been the conclusion of other regulatory bodies including the U.S. Food and Drug Administration and the Japanese Ministry of Health, Labour and Welfare.

So everything is ok – except that it isn’t. In September, in the Journal of the American Medical Association they published a study which concluded that high urinary BPA concentrations might be linked to increased risk of heart disease, type 2 diabetes, and abnormal concentrations of liver enzymes. Is this relevant? Well, according to a Columbia University scientist, more than 90% of Americans have detectable levels of BPA in their urine and I don’t imagine we are that far behind in the UK.

The Journal’s editorial does not hold out any hope of things changing in the near future. They said: “One factor that may be contributing to the refusal of regulatory agencies to take action on BPA in the face of overwhelming evidence of harm from animal studies…is an aggressive disinformation campaign using techniques (‘manufactured doubt’) first developed by the lead, vinyl, and tobacco industries to challenge the reliability of findings published by independent scientists.”

That’s fairly clear, and once again the responsibility for taking care of our health and wellbeing is placed squarely back on the individual’s shoulders. A simple first step is just to eliminate the use of plastics wherever possible, particularly for children, so buy bottled water in glass containers and avoid canned food. China, glass and metal containers offer you a safer alternative for your food and drink so pack away the picnic plates and upgrade to the china ones!

Is chocolate good for your heart?

Well, knowing me as you do you can bet the answer is yes – in fact I haven’t found anything it isn’t good for – though to be honest I haven’t looked very hard! You can imagine my delight when some wonderful Italian researchers recently calculated how much chocolate we need daily to protect against heart disease. Sadly, it’s not much – only 6.7 grams – about the amount you would get from eating two or three small squares of dark chocolate per week = as if that were possible! However, as part of one of the largest health studies ever conducted in Europe, they checked participants’ levels of C-reactive protein (CRP), a marker for chronic inflammation in the body that indicates an increased risk of heart disease. Then they related CRP levels to chocolate intake and found that participants who ate moderate amounts of dark chocolate regularly had significantly lower levels of CRP. Sadly, I feel must also point out that if you do eat more than the equivalent of 6.7 grams of chocolate per day, the beneficial effects on CRP levels seem to disappear. That’s a plus for those self-disciplined souls who can open a bar of chocolate and not consume it all, and a blow for those who can’t!

Heart disease and depression link

Being diagnosed with coronary heart disease can be frightening and stressful, however optimistic the prognosis. It can be a time to revaluate lifestyle, relationships and work and can place enormous pressure on the individual and their family, affecting all aspects of life – including mental health. Now, the American Heart Association has recommended that coronary patients should also be screened early and regularly for depression. They have spoken out because of the growing body of evidence that shows a link between depression in cardiac patients and a poorer long-term outlook.

Many studies have now shown that major depression is associated with worse prognosis in patients with coronary disease. What has also now been confirmed is that more severe depression is associated with the patient having earlier and more severe cardiac events.

In many cases, depression can often be treated with exercise, counselling, good nutrition and cognitive-behavioural therapy. American Psychiatric Association suggests that two questions can identify patients who may need further follow up and treatment. The doctor should ask: ‘Over the past two weeks, how often have you been bothered by the following two symptoms?

1. Little interest or pleasure in doing things

2. Feeling down, depressed, or hopeless

If the answer to either question is yes, they have been bothered by those symptoms then the follow up questions are: ‘how often have you been bothered in the past two weeks by:

1. Trouble falling asleep, staying asleep, or sleeping too much

2. Feeling tired or having little energy

3. Poor appetite or overeating

4. Feeling bad about yourself, that you are a failure, or that you have let yourself or your family down

5. Trouble concentrating on things such as reading the newspaper or watching television

6. Moving or speaking so slowly that other people could have noticed or being so fidgety or restless that you have been moving around a lot more than usual

7. Thinking that you would be better off dead or that you want to hurt yourself in some way.

This is not a definitive way to define depression, but it is a useful tool to evaluate how someone is coping after having a coronary and can help you decide whether or not help is needed.

Often used strategies for patients who have coronary disease and depression are antidepressant drugs, cognitive behavioural therapy, and physical activity, such as aerobic exercise. Diet can also play a part, and most nutritionists would recommend a diet that excluded sugar, caffeine and alcohol.

Cut heart disease – Put on the kettle

I was giving a talk on alternative medicine on a cruise recently and mentioned the many health benefits of green tea – a substance I am very fond of. So, imagine my surprise when I went to the buffet to get a cup and couldn’t find a green tea bag anywhere. I spoke to the catering manager who couldn’t understand it either, but told me suddenly everyone was drinking green tea! So for all those converts, and those who aren’t here is another good reason to head for the green stuff – it can cut your heart disease and stroke risk in HALF! New studies on green tea (or epigallocatechin gallate to give it the proper name) show it has all these benefits:

* Lower your cholesterol counts by 9 points
* Prevent cancer cells from ever forming
* Protect DNA from mutating
* Boost production of disease-fighting T-cells
* Even prevent tooth decay

It has been called the ultimate antioxidant, and to enjoy it at its best let it steep for a couple of minutes then drink without milk or sugar. I often add some fresh mint leaves for taste although you can now buy several different flavoured varieties, and sweeten with honey if it’s not to your taste. However you drink it, try to get one or two cups a day into your routine – your health really will benefit.

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