Cardiovascular disease (heart disease, diseases of the blood vessels and stroke) accounts for the death of more Canadians than any other disease (1). Every 7 minutes in Canada, someone dies from heart disease or stroke. Blood vessels around the heart deliver essential nutrients and oxygen to the heart muscle. Over time, factors can affect a change on the interior of these vessels, roughing the surfaces, encouraging clotting and creating a porridge-like plaque to form.
The build-up of this plaque narrows the passage way for blood, restricting the amount of oxygen and nutrients that can be delivered and the amount of cellular waste that can be removed. The narrowed vessels lose their natural elasticity and become hardened. This is commonly referred to as Atherosclerosis, or “hardening of the arteries”. According to the Heart & Stroke Foundation of Canada risk factors for heart disease are: smoking, alcohol, physical inactivity, obesity, high blood pressure, high blood cholesterol and diabetes.
The Cholesterol Concern
Ambulances cause accidents Every time your commute is slowed to a crawl on the expressway, you will commonly see a crumbled vehicle or two, a tow-truck, police cruiser and as an inevitable result of the 911 call, an ambulance on scene. So, one could assume that, since they are always at the scene, ambulances cause accidents. It seems an absurd notion to those of us in the know, yet this is the same logic used to conclude that cholesterol is the cause of heart disease.
Chicken or egg?
If disease prevention is your primary objective then the question you need to ask is, “What comes first?” In the body everything is inter-connected. A domino cannot fall without creating a cascade of actions and re-actions so rather than chasing symptoms like a chicken with your head cut off, the ultimate goal should always be to discover which came first.
Cholesterol is manufactured by the human liver as an anti-oxidant. Your body will go to great lengths to regulate the amount of cholesterol contained within (which is why cutting dietary cholesterol is often ineffective at lowering blood cholesterol levels.) If your blood cholesterol levels are high then you are likely suffering from some degree of oxidative or “free-radical” damage in the body (2). Free radicals can instigate cellular mutation and lesions in the smooth muscle of arterial vessels (3) and like the ambulance that shows up at the accident to help the injured, cholesterol arrives at the site of the arterial damage, to form an internal type of band-aid over the wound.
The notion that elevated cholesterol alone increases our morbidity from heart disease is misleading. After following almost 5,000 Canadian men for 12 years, Dr. Gilles Dagenais and his team, based in Quebec, were unable to find an associated risk between elevated cholesterol and atherosclerosis (4). A distinction needs to be made between Risk Factor and Cause. Elevated cholesterol should not be seen as a danger in and of itself, but rather as a marker for some underlying issue. By addressing the root cause you can positively change the course of your heart health.
Factors to Consider
- Smoking, alcohol, excess caffeine, chemical food additives, petrochemicals, heavy metals, environmental pollution and consumption of rancid fats can create free radical damage in blood vessels (5). Like a car that sits outside all winter, the exposed metal begins to roughen and rust. When this occurs in blood vessels, the smooth membrane becomes rough and clotting factors, minerals and cholesterol form a patch over the damaged area. This patch can increase in size like a runaway snowball until the passage way for blood flow becomes completely restricted, or the “patch” breaks off and becomes a clot in another area of the vessel (6).
- In a study conducted at the Evans Department of Clinical Research and the Cardiovascular Institute in Boston, Dr. Dieter Kramsch and his colleagues studied over 2 dozen wild rhesus monkeys, divided into 3 control groups (7). Two groups were fed a diet of high cholesterol fodder while the third group was fed regularly. Blood cholesterol levels became increasingly elevated in both groups eating a high-fat diet, however only the group kept sedentary and confined to their cages developed atherosclerosis and coronary heart disease. The group allowed to exercise regularly had no signs of hardened arteries or CVD, in spite of their high fat consumption.
- High Blood Pressure (hypertension) affects 1 in 5 Canadians yet 42 percent of those with the condition do not realize because there are no outward symptoms. Blood pressure can rise as arterial vessels begin to lose elasticity and harden. Hypertension stresses the heart muscle and over time the heart can become weakened and enlarged. Weakened blood vessels begin to form saclike bulges that can rupture and cause stroke.
- In the body, the breakdown of an amino acid called Methionine produces another toxic amino acid (or protein constituent) called Homocysteine. When nutrition is optimal the body is able to easily neutralize and eliminate this by-product. However, if the raw materials to complete this task are not present, Homocysteine can build up in the blood. Several studies suggest that elevated Homocysteine levels are associated with increased risk of vascular disease and atherosclerosis. (8)
- Diabetes is a disease whereby the pancreas does not produce enough insulin and/or the cells do not respond to insulin, making glucose (sugar) in the blood unusable as an energy source, leading to harmful excess. Uncontrolled Diabetes is associated with many heart harming risks including; elevated cholesterol and blood fats, acceleration of atherosclerosis, damage to the heart, capillaries and arteries. The Public Health Agency of Canada states that heart disease will kill 80 percent of those currently living with Diabetes.
Signs & Symptoms
There are many subtle warning signs that can indicate diminished blood flow long before a heart attack or stroke. When minor indicators present themselves, taking corrective action can stop and even reverse degeneration. Key success factors are self-awareness and a proactive approach.
The following is a list of indicators that could be associated with other health concerns but can also be the result of diminished blood flow and arterial degeneration:
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Cold sensation in fingers and/or toes
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Limbs often “fall asleep”, feel numb or heavy
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Cramping in hands when writing
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Sharp, diagonal crease across earlobe
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Cramping or pain in legs after minimal exertion
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Diminished memory
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Persistent, nagging cough
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Ankles swell late in the day
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Urinating more than twice per night
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Hypertension
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Chest pain after physical exertion or emotional stress
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Erectile dysfunction in men
Medical Diagnosis
Because symptoms will vary depending on the severity of the degeneration, a variety of testing methods can be useful in determining the stage and best treatment for heart disease. Testing can include:
- Blood Pressure - Optimal blood pressure is considered 120/80 with mild hypertension beginning at 140/90
- Blood Tests - can measure cholesterol values (LDL, HDL, VLDL), triglycerides, C-Reactive Protein, Fibrinogen and Homocystine levels. Elevation in any of these values can indicate degeneration in the arterial vessels.
- Angiography - During this test, a catheter is inserted through a large artery, usually in the groin, and guided into the heart, where it is used to deliver contrast material into the coronary arteries. This contrast material is visible under x-ray. The test allows physicians to identify the location and severity of a clot within a blood vessel.
- Electrocardiogram - This is an electronic readout of heart function that can reveal damage as a result of restricted blood flow, also known as Ischemic Heart Disease. This is very important because although we are conditioned to fear a major cardiac event (heart attack or myocardial infarction) Ischemic heart disease is responsible for over 50% of Canada’s heart disease deaths, more than double that of MI *
- Intima-Media Thickness - This test uses ultrasound imaging to estimate the thickness of the inner layer of the arteries. An increase in the thickness of this layer over time indicates that degeneration in the vessels is worsening. This technique can also be used to measure the effectiveness of cardiovascular therapies.
Conventional Treatment
Conventional medical treatment will vary depending on the severity of the symptoms and condition presented. Diet and lifestyle recommendations can include; regular physical activity, smoking cessation, reduction of dietary fats in particular saturated and trans-fats. A progressive physician or dietician may recommend increasing dietary fibre and eating fish rich in omega-3 fatty acids regularly.
- In cases where elevated cholesterol is present, cholesterol-lowering medications such as pravastatin (Pravachol®), simvastatin (Zocor®), and atorvastatin (Lipitor®) may be prescribed, along with the lifestyle and diet changes described above.
- In cases where hypertension is present, anti-hypertensive medications such as; beta blockers, calcium channel blockers, ACE inhibitors, angiotensin II receptor blockers, and diuretics may be prescribed.
- If blood clotting is a concern then antithrombotic drugs may be prescribed. Asprin, Clopidogrel (Plavix®), adenosine-diphosphate-receptor inhibitors, anticoagulants such as warfarin, thrombin inhibitors, glycoprotein IIa/IIIb inhibitors, phosphodiesterase inhibitors, and Pentoxifylline are all recommended to reduce platelette aggregation and the blood’s ability to clot. If an arterial lesion ruptures and breaks off from the vessel wall it can travel to critical areas of the body such as heart, lungs or brain and create a sudden blockage resulting in heart attack or stroke.
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In more severe cases, where the lumen’s diameter (the space inside the vessel for blood to pass) has become significantly diminished, then surgical intervention may be recommended. Stints, small tubes and balloons may be inserted into the vessel to keep it open. In other cases, bypass grafting or endartertectomy (removal of the vessel lining) may be recommended.
Dietary Recommendations
The issue of heart disease is complex and without a single solution but one factor that everyone can agree upon is that diet plays a tremendous role. This is wonderful news, considering everyone has 100% control over what they decide to put into their body and when matters of the heart are on the line, it is always a good idea to eat like your life depends on it.
Water - “is the medium for all bodily fluids including blood” (9) and an important factor in blood pressure regulation and blood “stickiness”. Chlorine and fluoride added to tap water can have detrimental effects on the blood vessels and bodily cells (10) so choosing a filter to remove these chemicals, reverse osmosis water and distilled water are your best options (11). Your body weight in pounds, divided in two is the number of ounces of water you need to drink daily for optimal hydration. Hot climates, high altitudes and physical activity increase your need for water. If in doubt, the wetter the better as your experience of thirst is not a good indicator of optimal hydration. (12)
Carbohydrates - rich in fibre and in their natural state are the best options for heart health. This means choosing oats instead of processed cereals for breakfast, whole grain brown rice instead of bread and pasta for dinner, eating a piece of fruit instead of drinking a glass of juice. Whole foods will have a more moderate impact on your blood sugar, keeping it steady and stable rather than way up or way down. These wild fluctuations can lead to Metabolic Syndrome and Diabetes, two risk factors for heart disease (13).
Protein - and its building blocks amino acids are essential for many vital functions in the body including, repair of muscle tissue (including the smooth muscle of arterial vessels) and production of healthy blood cells. Certain animal proteins such as beef, pork and mutton are higher in saturated fat and for this reason leaner meats such as chicken and turkey breast have become favoured over the past few decades. Oily fish rich in heart healthy omega-3 fats are also a popular choice.
Eggs, nature’s “perfect protein” are also our richest source of dietary cholesterol. Although it has been common practise to advise patients with elevated blood cholesterol to avoid egg consumption, a multitude of studies have proven that the intake of cholesterol-rich foods has almost no bearing on blood cholesterol levels (14). The body naturally produces cholesterol and when dietary intake increases, natural production in the body decreases to regulate the total amount. Conversely, when you stop eating cholesterol rich foods your cells increase production to make up for the lack (15).
Essential Fatty Acids - particularly Omega 3 fatty acids (EPA and DHA) found in fatty fish, are essential to heart health. Regular consumption of this important fat has been shown to reduce all-cause mortality in men who have already suffered one heart attack and cut the risk of stroke by up to 50 percent. (16,17) This may be attributed to the properties in fish oil that reduce the “stickiness” of blood, decreasing the risk of clotting, favourable impact on inflammation, blood pressure and blood vessel integrity. (18,19,20)
Sodium - Countless studies have demonstrated a link between excessive salt intake and hypertension. The Heart & Stroke Foundation of Canada estimates that most Canadians are consuming two to three times the recommended daily maximum of 2,300mg or 1 teaspoon. An estimated 80% of the salt consumed in the average Canadian diet is from processed, pre-packaged, frozen, canned and store-bought foods (21).
Keep the spice rack fully stocked as a variety of natural herbs and spices will keep food flavourful while avoiding the sodium over-load.Trade in nutrient-dead processed food for nutrient-dense ingredients as adequate mineral intake (such as calcium and magnesium from fresh fruits and veggies) have been shown to decrease salt sensitivity in both healthy and hypertensive populations (22,23).
Therapeutic Supplementation
When provided with the proper raw materials in therapeutic amounts the human body has a remarkable ability to heal, cleanse and repair damaged vessels. The following key nutrients are required by the body to achieve an “arterial cleansing” effect. (31)
Vitamin A - Enhances immunity by promoting the increased production of T-cells and antibodies. Increases the utilization of the anti-oxidant selenium. Protects epithelial cells and mucous membranes. 22,000 – 40,000IU/daily
Vitamin B1 (Thiamin) - Facilitates the removal of lead from tissues. Required for health of heart tissue. 66 – 200mg/daily Niacin - Helps to dilate or enlarge blood vessels. Helps the body eliminate excess cholesterol. 44 – 70mg/daily
Pantothenic Acid - Necessary for the production of healthy antibodies. 330-550mg/daily Vitamin B6 - Helps prevent the amino acid methionine from breaking down into homocystine. 50-150mg/daily
Folic Acid - Facilitates the removal of excess homocysteine in the blood. 0.04 – 2.2mg/daily Vitamin B12 - Works synergistically with Folic Acid to facilitate the removal of excess homocysteine in the blood. 160 – 550mcg/daily
Choline - Emulsifies fats, keeping them in solution in the blood, preventing them from plugging up in narrowed arteries. Helps prevent blood fats from sticking together. Burns fat in the liver. 440-725mg/daily
Inositol - A general relaxant. 40-55mg/daily Vitamin C - A powerful anti-oxidant and chelating agent. Protects against heavy toxicity and keeps them in solution so they can be eliminated via the urine. Stimulates the production of lipoprotein lipase (LPL). 4,000-4,400mg/daily
Vitamin E - A powerful anti-oxidant that protects against free radicals. Dissolves clots in the bloodstream and helps to prevent clots from forming. Increases the rate at which collateral blood vessels develop around damaged areas. Assist in normalizing viscosity of blood. Helps to prevent platelets from sticking together. 600-650IU/daily
Chromium - A trace mineral essential to the proper metabolism of lipids and sugar. Helps lower serum triglycerides and cholesterol. Magnesium - Helps to keep calcium in solution so that it cannot adhere to artery walls. Helps to regulate heart beat. Counteracts the build up of aluminum in the body. 400-555mg/daily Potassium - Helps to normalize blood pressure and regulate heart rhythm. 400-444mg/daily
Zinc - A free radical inhibitor. Helps the body utilize Vitamin A. 25-33mg/daily Selenium - Incredibly potent antioxidant. Enhances antioxidant capacity of Vitamin E. Counteracts mercury build up in the body. Helps to normalize blood pressure. 200-330mcg/daily
l-Cysteine Hydrochloride - An amino acid that acts as a chelating agent in the excretion of lead from tissues. Assists in the termination of free radicals. 600-1,000mg/daily
dl-Methionine - An amino acid that helps detoxify the body and emulsify fats. A chelating agent and free radical scavenger. 160-550mg/daily
Thymus Glandular Concentrate - Glandular tissue that supports thymus function, supports immunity and helps the body overcome free radical activity. 55-100mg/daily
Healing Herbs
“Cinnamon has a long history of use in both Eastern and Western Cultures as medicine.” (24) Scientific studies have supported the use of cinnamon as a sedative for smooth muscle (like the muscle found in the middle layer of arterial vessels) and circulatory stimulant. A study examining 60 patients with Type II Diabetes for 40 days revealed that consuming 1 to 6 grams of cinnamon daily reduced fasting blood glucose by up to 29 percent, triglycerides by up to 30 percent, LDL cholesterol by up to 27 percent and total cholesterol by up to 26 percent. (25)
Bitter Melon - (Momordica charantia), member of the gourd family of fruit, has green skin and appears something like an ugly, bumpy cucumber. Beneath its unattractive exterior is a white flesh and loosely packed seeds with serrated edges. One of the most popular fruits in South East Asia, Bitter Melon has a long history of medicinal use in both Ayurvedic Healing and Traditional Chinese Medicine. In fact, Bitter Melon has a potent healing capacity that has been scientifically proven to work as well as pharmaceutical drugs for some diabetic patients (26). The health benefits of Bitter Melon are derived from the insulin-like compounds contained in the juice of the fruit which have an exceptional capacity to lower blood-sugar levels without the side effects of insulin, even when consumed in small amounts.
Zwell Lifestyle Recommendations
One of the greatest advantages to fighting heart disease is its slow progression over time. This allows anyone with the motivation to take proactive measures to safe-guard their heart health.
CRON – Eating a diet rich in nutrients and low in calories does not mean depriving or starving yourself. It means making the most of every bite and creating a diet based on whole foods in their natural state. This could be the simplest diet you have ever followed. Just remember nature got it right the first time and anything “man made” like margarine, chocolate-puff cereal or meat from a can is probably offering you more calories than you need with fewer nutrients than you deserve.
CRON diet is naturally low-glycemic, high fibre and anti-oxidant rich; three essential factors in heart healthy eating, weight optimization and vitality.
Stress - Whether from positive or negative sources stress places strain on your system. A car going 120 kilometres / hour on the expressway will burn fuel at a much faster pace than a car puttering along at 50kms. The same is true for a body under stress. Protein, healthy fats and co-factor nutrient (such as vitamins and minerals) will be used up at a higher rate during stressful periods. Production of the stress hormone cortisol increases the rate at which free radicals are released in the body, adding to the increased need for exceptional nutrition. (27) If the diet is inadequate at meeting these demands then deficiencies and degeneration occur.
Sweat – Your body knows two things for sure; growth and decay. Regular strenuous exercise that elevates your blood pressure for at least 20 consecutive minutes 3 times per week offers measurable health benefits including; lowered “bad” cholesterol, increased oxygen capacity and increased life expectancy for hypertensive patients. (28) Exercise uses fatty acids for 80% of the energy needed to complete a given activity. Inactivity sets the stage for unused fatty acids to accumulate in the body and blood vessels. Obesity and overweight are major factors in hypertension. Almost 60 percent of Canadians are currently overweight or obese, an increase of 9.3 percent over the past 25 years. (29) So put down that bag of chips, get off the couch, fill up the ‘Klean Canteen’ and go for a walk. Your heart will thank you.
Connect – As important as it is to feed your body the right stuff, you also require a bountiful diet for your mind. Humans are curious and social animals to the core. Connecting with people and constantly developing interests and ideas is proven to keep you living better, longer. Epidemiological studies demonstrate clear links between depression, anger, hostility, that classic Type A personality and heart disease. (30) So, why not comit and connect to something bigger than yourself - your family, community, church, charity, favorite sport - whatever is important to you – and put those stressful feelings into perspective. Travel, play, flirt, frolic, reach out, and do new things. Appreciation for what you have, how far you’ve come and who you share your life with certainly will do your body good.
Safety Considerations & Contraindications
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This information is meant for educational purposes and is not meant to diagnose, treat or cure disease. If you require medical attention, please seek a licensed health care provider.
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Therapeutic use of natural food constituents (such as vitamins, minerals and herbal extracts) may potentiate the effects of prescription medications. Speak with a licensed health care practitioner about possible interactions.
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Check with your health care professional before beginning any exercise or diet program.
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These recommendations may not be suitable for children, pregnant or lactating women.
References :
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Heart & Stroke Foundation of Canada, 2005 Stats
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The Nutritional Bypass by David Rowland
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Benditt E, Benditt J., Evidence of a monoclonal origin of human atherosclerotic plaques. P Natl Acad Sci USA 70: 1753, 1973.
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Dagenais GR et al. Total and coronary heart disease mortality in relation to major risk factors – Quebec cardiovascular study. Canadian Journal of Cardiology 6, 59-65, 1990
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Cardio Protective Nutrition by David Rowland
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Memmler’s the Human Body in Health & Disease, 10th Edition, Barbara Jansen Cohen
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Kramsch DM et al. Reduction of coronary atherosclerosis by moderate conditioning exercise in monkeys on an atherogenic diet. New England Journal of Medicine 305, 1483-1489, 1981
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Report on Cardio-Protective Nutrition by David Rowland, PhD.
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The Nutrition Desk Reference by Robert Garrison, Jr., MA, R. Ph., Elizabeth Somer, MA., R.D.
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The New Anti-Aging Revolution by Dr. Ronald Katz and Dr. Robert Goldman
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The New Anti-Aging Revolution by Dr. Ronald Katz and Dr. Robert Goldman, pg376
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The Encyclopaedia of Healing Foods by Michael Murray, ND
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Heart & Stroke Foundation of Canada, www.heartandstroke.ca
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Morris JN et al. Diet and plasma cholesterol in 99 bank men. British Medical Journal 1, 571-576, 1963.
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The Nutritional Bypass by David Rowland, PhD.
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Burr ML et al. Effects of changes in fat, fish and fibre intakes on death and myocardial infarction: diet and reinfarctiontrial (DART). Lancet ii: 757-61, 1989.
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Gillum RF et al. The relationship between fish consumption and stroke incidence: The NHANES I Epidemiological Follow-Up study. Arch Intern Med 156: 537-42, 1996
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Mori TA et al. The effects of fish oil on plasma lipids, platelet and neutrophil function in patients with vascular disease. Adv Prostaglandin Thromboxane Leukotriene Res 21:229-32, 1990.
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Appel IJ et al. Does supplementation of diet with ‘fish oil’ reduce blood pressure? A meta-analysis of controlled clinical trials. Arch Intern Med 153 (12) : 1429-38, 1993.
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Kamada T et al. Dietary sardine oil increases erythrocyte membrane fluidity in diabetic patients. Diabetes 35: 604, 1986
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Heart & Stroke Foundation of Canada, www.heartandstroke.ca
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Sowers JR. Dietary cation (micronutrient) effects in salt-sensitive hypertension. Abstract. J Am Coll Nutr 12:594, 1993
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McCarron DA. Role of adequate dietary calcium intake in the prevention and management of salt-sensitive hypertension. Am J Clin Nutr 65 (suppl): 712S-6S, 1997
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Encyclopaedia of Healing Foods by Michael Murray, ND.
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Ahmad, N., M.R. Hassan, H., Halder, K.S. Bennoor. Effects of Momordica charantia (karolla) extracts on Fasting and Postprandial Serum Glucose Levels in NIDDM Patients. Bangladesh Med Res Counc Bull 1999;25(1):11-13
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Study of 60 individuals with Type II diabetes. Peshawar University, Pakistan
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Encyclopaedia of Healing Foods by Michael Murray, ND.
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Encyclopeadia of Natural Medicine by Michael Murray, ND.
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Public Health Agency of Canada. Diabetes in Canada. Health Canada, 2003
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The Nutritional Bypass by David Rowland
Statements about these products and health conditions have not been evaluated by Health Canada or the U.S. Food and Drug Administration and are not intended to diagnose, treat, cure, or prevent disease. For the Complete disclosure statement click here.
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