Healthy Heart nutrition

• 2 cups bran flakes cereal
• 1 cup organic skim, lowfat, or whole milk
• 2 Tbsp. grapeseed oil
• 1 egg
• 1 Tbsp. honey
• 1/3 cup molasses
• 1 tsp. vanilla extract
• 1 ½ cups whole-wheat flour
• 1 tsp. baking powder
• 2 apples, grated and coated with 1 tsp. cinnamon

1. Preheat oven to 350° F.
2. Spray twelve 2½ -inch muffin cups with nonstick cooking spray.
3. Mix bran cereal and milk in a medium bowl and let stand for 5 minutes.
4. In a large bowl, mix oil, egg, honey, molasses, vanilla extract, and cereal mixture. Add flour and baking powder.
5. Fold in apple-cinnamon mixture.
6. Divide batter into 12 muffin cups. Bake 25 minutes.
7. Eat fresh out of the oven, or freeze individual muffins in freezer bags for the kids to take to school.

Grape juice, like red wine, can help prevent blood clots and improve blood circulation.  Resveratrol, commonly found in grapes and other plants, is being studied for its antioxidant properties and its ability to minimize cardiovascular problems.  The “Dr. Sinatra recommended dosage” of Resveratrol is 2–5 mg daily.

Secondly, drinking flavonoid-rich green tea is an easy way to avoid cardiovascular problems and encourage resistance against chronic degenerative diseases, including chronic hypertension, heart attack and stroke.

While plain green tea itself has a delicate flavor, try it in one of the many formulas combining it with lemongrass and other herbs. Add a little honey and lemon, and I think you will find that this healthy heart nutrition tip really is quite delicious. If you can break your coffee habit in the process, you’ll be doubly rewarded, as you’ll also be reducing the amount of caffeine you ingest.

• 1 Tbsp. flaxseeds, ground
• ½ cup fresh fruit—blueberries, a peach, kiwi, banana, or whatever you like
• 8 oz. organic rice milk, organic skim milk, organic yogurt, or unsweetened juice (you can also use water or a combination)
• 1 serving size (follow directions on package) of soy or whey protein powder

• Age 55 or older
• Heredity/family history
• Men
• History of heart attack and/or stroke
• Medical conditions such as diabetes, high blood pressure levels, vascular disease, atrial fibrillation, and sickle cell anemia
• Drug/alcohol abuse
• Poor diet
• Sedentary lifestyle
• Living in the southeast US (“stroke belt”)
• Low socioeconomic status

Some of the most commonly prescribed drugs for maintaining good cholesterol levels are statins like Zocor (simvastatin), Lipitor (avorastatin), Mevacor (lovastatin), Pravachol (pravastatin), and Lescol (fluvastatin).

These drugs can be dangerous if taken with high levels of long-acting niacin (vitamin B3). Side effects also include dizziness, headache, extreme fatigue, swelling of the ankles, muscle weakness, and liver toxicity.

In both men and women, statins may weaken the heart muscle because they lower CoQ10 levels. In women especially, statin drugs may deplete levels of CoQ10, contributing to a weakened immune system.

Still, if you have moderate to severe heart disease involving multiple vessels, I recommend statin drugs to help you obtain and maintain healthy cholesterol levels. In addition, I recommend the following natural solutions:

• Make sure you take a minimum of 150 mg of standard CoQ10 per day, or 50–60 mg of the hydrosoluble form, to offset the drug’s depleting effect.
• Niacin is one of my favorite cholesterol-lowering agents if you are not on a statin drug, because of its ability to increase HDL cholesterol (the “good” cholesterol) and lower LDL cholesterol levels (the “bad” cholesterol). Low doses in the range of 100–300 mg three times daily are often effective without resulting in side effects of flushing, heartburn or gout attacks. A prescription form called Niaspan (750–1,500 mg) appears to be well-
  tolerated by most people with minimal side effects.
• Tocotrienols are antioxidants in the vitamin E family. Research suggests that they act much like statin drugs, minus the adverse side effects, by interfering with the liver’s ability to produce cholesterol. As little as 50 mg per day can have a positive effect.
• My Pan-Asian Modified Mediterranean-type diet (PAMM) is great for this and for overall cardiovascular nutrition. It’s rich in fiber, healthy fats (omega-3s from fish and fish oil), garlic and onions (two potent cholesterol-busters), and fresh fruits and vegetables. Fiber helps soak up cholesterol and cleanse the colon, preventing rapid absorption of cholesterol.
• Flaxseed is high in alpha linolenic acid and fiber, vital for healthy heart function.
• Soy helps prevent the oxidization of LDL and subsequent buildup of artery-clogging plaque. Soy also can help with reducing cholesterol levels, help ease menopausal symptoms, and may help protect against cancers of the breast and prostate.
• L-arginine—2–4 grams three times a day. TwinLab and Great Earth make good supplements that are widely available in health food stores.

Drugs typically prescribed for reducing cholesterol have no impact on Lp(a) levels. In fact, a study involving these drugs showed an increase in Lp(a) levels! And therein lies the dilemma.

While drugs prescribed to help you attain and maintain healthy cholesterol can reduce LDL, they can’t alter Lp(a). If you find that Lp(a) runs in your family, you must attack it with an alternative approach. Here’s what I recommend:

• Follow my Pan-Asian Modified Mediterranean diet, making sure to eat fresh fish at least two to three times a week. Eat fresh fruits, legumes, cold-water fish such as salmon, sardines, and mackerel or fish oils, particularly docosahexaenoic acid (DHA), which blocks the inflammatory and blood-clotting capabilities of Lp(a). Omit saturated fats. Instead, choose monounsaturated fats like olive oil and polyunsaturated fats like alpha-linolenic acid, found in flaxseed and flaxseed oil.   (These are excellent tips to adhere to for overall cardiovascular nutrition.)
• Take 100 mg of niacin, twice a day. If you experience side effects like flushing, headache, and diarrhea, follow the diet and stop the niacin. You can try a lower dosage at a later date, then slowly increase the dose to 500 mg a day, twice a day for further protection. TwinLabs' quick-acting Niacin is a good product.
• Take 1–2 grams of vitamin C and 100–200 mg of CoQ10 each day.
• Policosanol—20 mg daily at bedtime.
• Exercise regularly.
• Ask your doctor about screening techniques to assess your heart risk factors. If you’re concerned, you and your family members should have your Lp(a) and other risk factors (homocysteine, fibrinogen and serum ferritin) evaluated by your doctor.
• Be aware of other risk factors for cardiovascular problems, including smoking, high blood pressure, obesity, glucose intolerance and repressed emotions, which can have a harmful effect on the health of your heart.

Diabetes. Diabetic women have a higher risk for heart disease than diabetic men. This is because the incidence of diabetes and its complications (including heart disease) is much higher in women. If you are a diabetic woman, your risk for heart disease is five to seven times normal, compared with a risk of only two to three times normal for a diabetic man. For you, proper heart sense means you should increase your physical activity and watch your diet to maintain a healthy body weight.

Overweight. Women have a higher heart disease risk from being overweight than men do. Recent studies indicate that being only 20 pounds overweight doubles your risk of heart disease. If you are overweight, I don’t want you to go on a diet. Instead, get physically active—it’s your most powerful weapon against fat—and begin eating more fresh fruits and vegetables, pasta, fish and lean poultry.  Eating this way is what I call “healthy heart nutrition” and it just makes sense. (See other blog entries for additional advice on cardiovascular nutrition.)

Cholesterol. Women have a higher risk for heart disease than men if they don’t have good cholesterol levels. More specifically, if they have have low levels of HDL (“good” cholesterol) they increase their heart risk factors.

You probably already know that there are two types of cholesterol. LDL is the “bad” cholesterol, which oxidizes in your blood and forms the plaque that clogs arteries. HDL carries LDL out of your blood vessels before it can do its damage. Volumes of data have shown that a high LDL is a powerful risk factor for heart disease in men. But for women, the story is different. Recent research indicates that a low HDL, not a high LDL, is the more significant risk factor for a woman to develop heart disease. (This means that some women may need to increase HDL cholesterol levels.)

The good news is that HDL is sensitive to factors such as smoking, obesity and lack of exercise. If your HDL is low (less than 35 mg/dL) you can raise it by quitting smoking and dropping excess weight through a combination of smart eating, healthy heart nutrition, and physical activity such as walking and dancing. If you are postmenopausal, you might also consider estrogen replacement therapy (ERT), which raises HDL, lowers LDL, and has other beneficial effects on your heart. Have your HDL level checked six weeks after you start an HDL-raising program. Chances are you will see a change for the better.

High Triglycerides. When you get your cholesterol checked, I also want you to have your doctor check to see if you have healthy triglycerides levels. Triglycerides are another type of blood fat. A high triglyceride level is more dangerous for women than for men, so if your triglycerides are elevated (above 200 mg/dL), I want you to put some effort into lowering them, especially if you are a diabetic. This is because if you are a diabetic woman who also has high triglycerides, your risk of developing heart disease increases to 200 times normal. Please stop and think about this. You can lower your triglycerides using the powerful combination of exercise and weight control.

Historically, it was assumed that if you couldn’t keep good cholesterol levels, you were at risk for coronary artery disease and other cardiovascular problems. But there is now evidence that elevated homocysteine levels is another serious heart risk factor. 

Multiple studies have confirmed the connection between high-plasma homocysteine levels and occlusive artery disease, including coronary atherosclerosis, peripheral vascular disease, and carotid artery disease. In fact, some research shows that 42 percent of strokes, 28 percent of peripheral vascular disease, and approximately 30 percent of premature cardiovascular disease are directly related to excessive levels of homocysteine.

High homocysteine levels can be caused by foods—red meat, avocados, sunflower seeds, wild game, poultry, and ricotta cheese. These foods contain the amino acid methionine. If you don’t get enough B vitamins, your body cannot break down methionine, resulting in homocysteine.

These deficiencies can be further exacerbated by caffeine and alcohol, which cause excessive urination and wash out precious B vitamins from our bodies. (That’s why it is so important to adhere to the healthy heart nutrition tips I often share here in this blog.)

Research also shows that five percent of the population may have inherited a rare genetic enzymatic defect that leads to higher homocysteine levels and premature heart disease (which can lead to heart attack and stroke). Because of this new genetic data, the evaluation of serum homocysteine levels should become standard in preventive cardiology, especially in anyone with a family history of premature heart disease.

When Should You Get Your Homocysteine Tested?

If you eat a healthy diet, supplement with vitamins and minerals, exercise, and have no family history of heart disease and or other heart risk factors, then you don’t need to be tested for homocysteine. But if there was a sudden death of a family member at a young age from stroke or heart disease, or if you have heart disease (especially if you are under age 60), you should be tested for homocysteine.

Research has shown that 400 mcg of folic acid a day will help prevent high homocysteine levels. However, to be safe, I recommend 800 mcg folic acid and 20 mg of vitamin B6 per day. Natural sources of folate include dark green leafy vegetables, beans, legumes, oranges, orange juice, and fortified cereals.

Ground flaxseed has the ability to lower your blood pressure levels and to help you to reach good cholesterol levels. It can also reward you with healthier skin, improved digestion, and a cleaner bowel, which results in less energy drain on the liver – the most important filter of the body.

You see, you can get two key types of essential fatty acids from flaxseed because it contains 19 percent activated omega-6s and 48 percent of an omega-3 precursor, alpha linolenic acid. This makes it a perfect food for people who are looking for natural ways to lower blood pressure and maintain overall good health.

In general, freshly ground flaxseed is better than flax oil because you’re assured the oil in the seed is fresh, plus you’re getting extra fiber and plant lignans. Simply grind two tablespoons of flaxseed and sprinkle on food or blend in a breakfast drink three to four times per week.

Click here for a delicious smoothie recipe using flaxseed and here for the recipe for a heart healthy flaxseed bran muffin to go with it!

As a cardiologist and a holistic health practitioner, I take blood pressure levels of every patient who comes into my office. And sadly enough, oftentimes, I find that that their blood pressure levels are too high. As you probably know, high blood pressure levels are often a precursor to serious cardiovascular problems, including heart attack and stroke, so this is a situation that I take very seriously.

Some of these patients, however, tell me that they are doing all they can to control high blood pressure and that when they go home and measure it themselves, their blood pressure levels are normal. Occasionally they’ll ask if the instruments in my office are off, or if my staff misread the result.

The actual problem, however, is a common condition called white-coat hypertension (WCH). It’s used to describe people who become anxious over a visit to a physician, dentist, or medical facility. The visit evokes a fight-or-flight response, and their blood pressure levels go up.

Research has shown that abnormally high blood pressure readings in a medical setting could be more than just a benign byproduct of anxiety.  Although the condition is poorly understood, WCH could be a precursor to high blood pressure levels, poor blood circulation, and other cardiovascular problems.

A Danish study published in the Journal of Human Hypertension found a heightened cardiovascular event risk for patients with WCH over a 10-year period. A Japanese study reported in the journal Hypertension Research suggests that WCH contributes to carotid arteriosclerosis. And in another Japanese medical report, based on eight years of observation, researchers suggest that WCH is a “transitional condition to hypertension” and may carry a “poor cardiovascular prognosis.”

If you experience WCH, I suggest you take the following high blood pressure remedies to get it under control and avoid potential cardiovascular problems:

• Introduce a regular stress-reduction program into your life. That could include activities such as exercise, tai-chi, meditation, or yoga. This is a wonderful way of lowering blood pressure naturally.
• Watch the salt (again). This cardiovascular nutrition tip can’t be stressed enough.
• Start taking blood pressure-friendly supplements on a daily basis—such as fish oil (2,000-3,000 mg), magnesium (400-800 mg), hydrosoluble CoQ10 (50-150 mg), and a garlic supplement high in allicin (500-1,000 mg). You can find these supplements in most health food stores.

One of the many things you can do to control high blood pressure levels is to carefully watch your salt intake. Doing so is one of those simple high blood pressure remedies that doesn’t involve a doctor’s visit or a pill -- and that’s a very good thing!

Your body requires sodium (a component of salt) to regulate fluid balance and distribution, as well as nerve and muscle cell function. But, while you need some sodium, the standard diet includes way too much. This is one of the reasons why so many people have blood pressure levels that are too high and suffer with a myriad of other cardiovascular problems.

The current recommendation for salt consumption is less than 2,400 mg of sodium a day, which amounts to about one teaspoon of salt. Recent research suggests that people ingesting less than 1,500 mg of sodium a day are better able to maintain healthy blood pressure. If you have high blood pressure levels, you should definitely aim for that number. Don’t use salt from the shaker, and read labels to add up the amount you’re taking in.

Many items at fast food restaurants are high in salt, so you can easily exceed the recommended level with one serving.   That’s why I’ve always strongly urged people who are looking for natural ways to lower blood pressure levels, improve blood circulation, or to reduce their risk of heart attack and stroke to avoid fast food restaurants. Going to one once in a while is okay for most people, but regular visits are a sure way to cause cardiovascular problems.

You can easily make up for the reduced salt in your diet by cooking with fresh herbs and spices such as basil, garlic, oregano, rosemary, chives, parsley, and onion. What’s more, all of these flavorings contain natural substances that make them good for any cardiovascular nutrition program, but also good for your overall health.

For decades I’ve been making spaghetti sauce for family and friends. As I prepare the sauce over the course of a day, I repeatedly taste it to make sure that I get it just right.

Twenty or so years ago, I noticed that the day after the meal I had gained a few pounds—and I was unusually thirsty as well. I was perplexed until I investigated and learned that the canned tomatoes, pastes, and purees I was using were high in salt.

Here I was, a cardiologist, as well as a holistic health practitioner, and I hadn’t made the connection. Excess salt contributes to water retention, and that was my problem. Of course, too much salt also makes it difficult to control high blood pressure and contributes toward a myriad of other heart risk factors.

I quickly changed my ways and my spaghetti sauce recipe. I started avoiding foods high in salt, which meant reading labels on foods in the grocery store. (This one act alone is an excellent way to naturally maintain good blood pressure levels.)  Most people don’t think they eat too much salt because they didn’t use a salt shaker. Unfortunately, that’s simply not the case.

The average adult consumes the equivalent of nearly two teaspoons of salt a day—practically two times the upper limit for good health. And the majority of that excess salt is hidden in processed foods, such as canned spaghetti sauces, soups, and dill pickles.

I’ll never forget a patient of mine who had chronic hypertension and ate his fill of canned ham (packed with salt) on Easter Sunday. The next day he was in the emergency room with a hypertensive crisis and acute heart failure. His heart just couldn’t handle the large amount of salt he had consumed.

His was an extraordinary situation, but it underscores the need to be careful with salt intake. So let his story and mine be lessons for you as well. 

Pure flax oil is the world's most abundant source of omega-3 fatty acids, containing an amazing 55 percent by weight. As such, flax oil offers incredible health benefits that should not be discounted.

Specifically, flax contains alpha linolenic acid, which your liver must break down to form the more commonly known omega-3 fatty acids EPA and DHA. There has been debate about whether alpha linolenic acid effectively converts to EPA and DHA. However, research shows that it does.

Research suggests that increased consumption of omega-3 fatty acids can reduce several cardiovascular problems by helping to promote healthy cholesterol levels, as well as healthy triglycerides. They also help keep blood pressure levels in the normal range. In addition, omega-3s help reduce circulatory problems by supporting healthy circulation and blood flow throughout the body.

One of the best ways to reap these benefits from flax by eating ground flaxseed. And yes, you must grind the seeds to release the oil. Otherwise, they'll pass right through you, undigested. I recommend getting a coffee grinder and dedicating it to flaxseed, because you don't want to mix ground coffee and flax. It's not a taste sensation! Also, you must use the flax within hours of grinding it. Once exposed to air, the oil in ground flax goes rancid quickly. (For the same reason, flax oil must be refrigerated.)

You can sprinkle ground flax on just about anything—soups, stews, ice cream, you name it. Above all, avoid cooking with ground flax, because again, the oil will become rancid.

The beauty of flaxseed is that you get significant amounts of protein and fiber in a tiny package. In a typical 2 oz. serving (1/4 cup), you'll get approximately 11 grams of fiber and 10 grams of protein. Exact amounts will vary with the quality of the flaxseed and how it's grown.

Easy Flax Shake

One of the easiest (and tastiest!) ways to get your daily flax is to add it to a shake or smoothie. Here’s one of my favorite versions.

1.    Grind up 2 tablespoons of organic flaxseed.
2.    In a blender, add 8 to 10 ounces of chilled soy milk, ½ a banana, 1 cup of your favorite berries, and the freshly ground flaxseed.
3.    Blend well and enjoy!

In the past I've spoken to the medicinal properties of dark chocolate, as well as its life extension and overall health benefits. Well, more recently, we've received some additional scientific data on the cardio-protective aspects of chocolates and cocoas.

As early as 2000, Internal Medicine News featured three separate studies—all of which concluded that dark chocolate and cocoa might actually be good for your heart. The studies were small, but placebo-controlled and double-blinded, so the data is meaningful even though the sample size is limited. (Maybe they just had trouble finding enough folks willing to share their "choc-a-lot" habits!? )

The researchers made a determination that certainly raises my eyebrows: They found that dark chocolate has a positive impact on platelet activity similar to a baby aspirin! In addition, they identified that dark chocolate has a strong antioxidant effect, is "endothelial cell friendly," and causes relaxation of the inner lining of blood vessels. Who'd have ever guessed it? No wonder we give chocolate hearts to those we love for Valentine's Day.

All kidding aside, there is something in dark chocolate that promotes the formation of nitric oxide and improves blood circulation in your blood vessels. But what is it in chocolate that's so medicinal?

Dark chocolate contains compounds called "procyanidins" that have potent metabolic effects. Research performed at the University of California demonstrated that the polyphenol activity of dark chocolate is similar to a class of antioxidants found in red wine, black and green tea, apples, and onions.

Remember, onions contain quercetin, a potent polyphenol that helps prevent the oxidation of LDL. But recent research has determined that the polyphenols in dark chocolate are more potent than the antioxidants in red wine.

In one study, the 205 mg of procyanidins in 1.5 oz. of chocolate were found to have antioxidant activity comparable to a small glass of red wine. And, as you might be wondering when you're deciding between a white or dark chocolate Easter bunny, not all chocolates are created equal. Dark chocolate health benefits are increased because it has the most polyphenol activity, while white chocolate has essentially zip, nada, zilch!

In fact, one study compared white chocolate to dark chocolate with 10 men and 10 women age 25 to 56 years old. They all fasted overnight. Then the "experimental group" ate an 80-g chocolate bar containing 557 mg of procyanidins, while the "controls" nibbled on a white chocolate bar.

Blood samples taken two hours later revealed that the study group had a definite rise in antioxidant activity, which reverted to normal within six hours. In essence, this finding was similar to previous experimentation with red wine. There was no change in antioxidant activity in the control group.

Dark Chocolate vs. "The Grape"

Two glasses of red wine increase the antioxidant activity in your blood for up to 4 hours, offering you some protection from the harmful effects of lipid peroxidation [excessive free radical stress occurring in blood vessels]. Lipid peroxidation is the first step in the accelerated aging of your blood vessels and increased risk of plaque formation.

Although red wine in moderation (about one 6-oz. glass every other day) is reasonable, the daily intake of red wine can injure liver cells, and result in liver dysfunction. Keep in mind that although the French have a low incidence of heart disease, they also have the highest incidence of cirrhosis in the world.

So, instead of reaching for the red wine, you might want to consider some dark chocolate. With this recent data, even I don't feel as guilty when I treat myself to dark chocolate.

Choc-a-little, Not a Lot

Now, with all this favorable research, do we have a license to eat chocolate at will? Sorry. Remember that chocolate contains sugars, caffeine, and trans fatty acids. As in all things, moderation is the key.

If you have considered chocolate and cocoas an absolute no-no, it's time to reevaluate. The dark chocolate health benefits are increasingly clear and these foods can be consumed safely on a limited basis. But if you're the kind of person to sit down with a large bag of M&Ms and scarf them while watching a movie, you're overdoing a good thing. You'll do yourself more harm than good with such habits.

An additional caution is that dark chocolate can act as a trigger-food or stimulant for people with an irregular heartbeat (arrhythmia). And, if you're diabetic, you must factor in the blood sugar problems that any sweet can cause and decide if chocolate is safe for you. The dark chocolate health benefits are not for everyone.

For the rest of you, the next time you want to have that dark chocolate bar, don't beat yourself up about it. Just savor, enjoy, and know that you're practicing good healthy heart nutrition. You might even have more warm, fuzzy feelings toward others (especially if they gave you the chocolate).