More evidence that drugs are not the answer: obesity negates benefit of LDL lowering

 

obese womenData collected between 1988 and 2006 and presented at the American Heart Association’s annual meeting last month showed modest improvements in two risk factors for cardiovascular disease: the number of Americans who do not smoke increased from 45% to 50%, and the number of Americans who have achieved optimal (below 100 mg/dl)  LDL levels increased from 22% to 28%.

But these improvements are counteracted by the rapidly growing prevalence of obesity that has occurred in the same time frame. 

American adults’ average body mass index (BMI) went from 26.5 to 28.8 (25 and above is overweight, 30 and above is obese). Incidence of overweight in children went from 20% to 35%.

What have been the consequences of this increase in body weight?

“Obesity is not benign.”

-Dr. Tiffany Powell, lead author of the study1

Obesity robs people of their quality of life as they age – as reported in the International Journal of Obesity, obese individuals had double the rates of disability compared to normal-weight individuals.2

The number of Americans with healthy blood pressure has fallen by 5%. The number of those with good blood sugar control have decreased by 9%. Most alarming is that left ventricular mass in children, a predictive indicator for future heart disease and stroke, has also risen - their hearts are being forced to work too hard to pump blood to their excess body fat.

How will this affect the incidence of cardiovascular disease in this country?

“Many people feel the decline in [heart] risk factors is leveling off and there will be an acceleration of cardiovascular disease.”

-AHA spokesman Dr. Roger Blumenthal1

A large part of the problem is that our society views these factors – hypercholesterolemia, poor blood sugar control, hypertension, obesity – each as a separate issue with its own drug-based method of management. But they are not separate. The truth is, the same nutrient-rich, vegetable-based diet combined with regular exercise is effective in preventing and reversing all of these conditions. 

References:

1. http://www.forbes.com/feeds/hscout/2009/11/17/hscout633216.html?feed=rss_forbeslife_health

2. Walter S et al. Mortality and disability: the effect of overweight and obesity. International Journal of Obesity (2009) 33, 1410–1418

 

Vitamin D and Omega-3 fatty acids work together to reduce coronary calcification

Heart - black & white

Coronary artery calcification is essentially the beginning of bone formation – except it’s happening in the arteries.1-2 Sound scary? It is. Calcification is associated with a 3-4 fold increased risk of death from cardiovascular disease.3 And strangely enough, those who have vascular calcification usually have low bone density or even osteoporosis4 – hard arteries and weak bones??

Previous studies had tested the effects of cholesterol-lowering drugs (statins) on the progression of arterial calcification, and they were found to be ineffective. These scientists were looking for another solution. Vitamin D deficiency is known to produce a risk of cardiovascular disease, but had not been investigated for effects on arterial calcification. Because of the protective effect of Vitamin D on both bone and cardiovascular tissues, scientists thought that Vitamin D might be a player in this complex interplay between bone precursors and blood vessel walls.

Subjects with no previous heart disease symptoms but a high coronary calcium score (CCS) were included in the study. They supplemented with omega-3 fatty acids  and sufficient Vitamin D3 to achieve greater than 50ng/ml serum levels of 25(OH) Vitamin D. The response of these subjects to these therapies varied 18 months later. About half saw a decrease in CCS, and about half experienced no change or a small increase in CCS. Also about half of the subjects experienced slowed atherosclerotic plaque growth.5

What do these results tell us? It is difficult to interpret these results because of the lack of a control (no treatment) group, but it definitely opens the door to more studies on the role of Vitamin D in coronary artery calcification. 

We also don’t know anything about the diets of the subjects of the study. A phytochemical-rich diet plus Vitamin D and omega-3 supplementation could have achieved dramatic improvements in calcium score!

For now, we can now tentatively add coronary calcification to the long list of detrimental consequences of Vitamin D deficiency. Our best protection against these consequences, in addition of course to a high nutrient diet, is a good Vitamin D supplement.

 

References:

1. Fitzpatrick LA et al. Endochondral bone formation in the heart: a possible mechanism of coronary calcification. Endocrinology. 2003 Jun;144(6):2214-9.

2. Aigner T et al. Expression of cartilage-specific markers in calcified and non-calcified

atherosclerotic lesions. Atherosclerosis. 2008 Jan;196(1):37-41. Epub 2007 Feb 28.

3. Rennenberg RJ et al. Vascular calcifications as a marker of increased cardiovascular risk: a meta-analysis. Vasc Health Risk Manag. 2009;5(1):185-97. Epub 2009 Apr 8.

4. Hmamouchi I et al. Low bone mineral density is related to atherosclerosis in postmenopausal Moroccan women. BMC Public Health. 2009 Oct 14;9:388.

5. Davis W et al. Effect of a combined therapeutic approach of intensive lipid management, omega-3 fatty acid supplementation, and increased serum 25 (OH) vitamin D on coronary calcium scores in asymptomatic adults. Am J Ther. 2009 Jul-Aug;16(4):326-32.