Prevent Heart Attack

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.

• 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.

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.

Many people trying to prevent blood clots are taking the blood thinner, Coumadin. But…

There’s something about Coumadin and its cousins that elicits an “anything-but-that-Doc” response from about half the folks who are on it. Many of my patients have asked to discontinue Coumadin because, in addition to the side effects and fear of bleeding, they dislike the nature of the drug (it’s rat poison in high quantities), as well as the discomfort and inconvenience of blood tests every 4–6 weeks.

In fact, whenever I lecture, someone in the audience always asks: “Is there some alternative to Coumadin?” So, let’s review anticoagulants like Coumadin and try and allay some of your concerns.

Before I discuss alternatives to Coumadin, let me tell you why this is the most frequently prescribed anticoagulant. In a nutshell, Coumadin has an unparalleled ability to thin the blood and prevent blood clots. More specifically, studies have shown that Coumadin can protect you from a stroke if you have:

• Mechanical heart valves (their surfaces encourage blood platelets to stick to them).
• Suffered an embolic stroke, one of three types of stroke caused by a fragment or clot of blood pumped from the heart to the brain.
• Atrial fibrillation (AF), where atria fail to contract; blood forms pools and becomes sluggish.
• Had an extensive heart attack (scar tissue weakens heart muscle tissue, which in turn weakens contraction of the left ventricle, possibly allowing blood to stagnate and clot).

Like any drug, Coumadin has side effects. Although the major one is excessive bleeding (bleeding gums, eye hemorrhages, blood in the urine and even a few bleeds in the brain), other rare reactions include weakness, cold sensations, itchy skin, fever and abdominal discomfort.

Indeed, blood thinning is a double-edged sword. While anticoagulants help prevent thrombotic and embolic strokes, I have to bear in mind that the risk of a stroke-induced hemorrhage is higher for those on Coumadin.

So now you can see why people trying to prevent blood clots struggle with this popular anticoagulant and often ask to trade it in for aspirin or other blood-thinning alternatives.

How Yolan Chose To Prevent Blood Clots

Yolan, 78, suffered with cardiovascular problems and, consequently, had a heart attack a few years ago. She began taking Coumadin but reported that she just didn’t feel right. Yolan experienced several unusual body sensations, which she attributed to the drug.

Against her doctor’s wishes, Yolan went off Coumadin and her symptoms abated. She now takes 324 mg of aspirin every other day (more about aspirin in a moment) and says she feels much better.

I’ve gotta tell you, folks, the decision to go off Coumadin can be a very difficult one; patients and their doctors often struggle together for the right answer. So let me offer some guidelines to help make this decision easier for you.

Coumadin is your best therapy—mandatory even—to prevent blood clots if you have mechanical heart valves. Studies show that it’s more effective than aspirin with other anti-platelet drugs. It should also be your first choice if you’ve suffered an embolic stroke.

Coumadin has been shown to protect patients with left ventricular clots and from AF, which can cause thrombotic strokes. Now, if you have AF, a common cardiac condition—you may wonder if you can take aspirin instead of Coumadin. If you have AF, your best bet is still Coumadin. If you’re not on conventional blood thinners like Coumadin, your risk of stroke is at least 5–6 times greater than those who are. This in itself is a disaster! In fact, approximately 75,000 strokes a year are attributed to AF.

Remember, with AF, the upper chambers of the heart may fail to empty completely, creating a perfect breeding ground for blood clots and poor blood circulation. As clots are formed and pumped out from the heart, they can wander around in the bloodstream until they find a vessel too small to get through and then you can have a major log jam in the brain, the leg, the kidney, in fact, anywhere at all. But the carotid artery is the number one spot to worry about because it’s a direct shot to the brain as the blood is pumped out of the left ventricle.

At least 90 percent of my AF patients take Coumadin; the other 10 percent take aspirin. But aspirin is less effective for preventing clots and strokes, particularly in women and people over 75. The best advice I can give anyone with more than two episodes of AF a year is to take Coumadin. If you have fewer episodes of AF and no other health problems like diabetes, congestive heart failure, leaking heart valves, or an enlarged heart, aspirin is a second choice.

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).

There are many types of arrhythmias, but basically the term refers to an irregular heart rhythm, which can also be noted as an irregular pulse. Essentially, the heartbeat goes off cadence and this irregularity may or may not be felt in your body. Many people are aware of skipping, strongly palpitating, or rapid heartbeats, while other asymptomatic individuals may learn of an arrhythmia at a doctor’s office visit when it shows upon an electrocardiogram.

Arrhythmias are very common and affect both genders and all ages. About 20 or 25 percent of patients with arrhythmias are not in any danger.

To prevent arrhythmias, you’ll need to minimize caffeine, sugar, and alcohol intake. I cannot emphasize this enough. I am a huge wine lover—I even have a wine cellar in my house—but if I had arrhythmia, I’d never touch a drop again.

I also suggest that you develop techniques (such as prayer or meditation) to control stress.

Additionally, there are several supplements that are very effective for straightening out heartbeat irregularities. For otherwise healthy people, the best one-two combination to suppress skipped heartbeats are daily doses of:

• Magnesium (400 mg),
• CoQ10 (100 mg),
• Fish oil (2 grams),
• L-carnitine (500 mg), and
• D-ribose (5–10 grams). 

I receive lots of questions about a variety of heart conditions. And one of the most common I receive is about arrhythmias. Specifically, I am often asked how to determine if, in fact, you have an arrhythmia.

One of the first things you need to do is see a cardiologist so they can determine a baseline electrocardiogram (EKG) and do a Holter monitor evaluation. These are very basic, noninvasive tests that your insurance will pay for. Your arrhythmia may show up on the EKG, but your doctor will still want to assess how often it’s happening with the Holter monitor.

For the Holter, you will have a few (4) adhesive electrode pads placed on your chest.  Wires attached to those electrodes will be connected to a recorder box that you can wear on your belt (or in a sling if you prefer). You will be asked to keep a diary of your activity and your symptoms for the next 24 hours, including any awareness you have of skipped or fast heartbeats. You should also track and document your blood pressure levels.

The recording is then analyzed by advanced computers that show pictures of your heart’s rhythm so that your doctor can see what kind of arrhythmia you have. Fast heartbeats for long time periods can occur with what we medically refer to as atrial fibrillation (AF) and supraventricular tachycardias (SVTs: supraventricular identifies the source of the problem in the conduction system; tachy=fast, cardia = heart).

In the event that there is no arrhythmia during your EKG and you fail to experience any symptoms during the 24 hours of monitoring, you can use an event monitor for a month—a Holter-type device you connect to when your symptoms arise.

Once your doctor identifies the type of arrhythmia you have, he or she can look for underlying causes that need to be addressed, including enlargement of the upper chambers of the heart, aging, valve issues, and more. Should you have frequent episodes of AF, you may need to prevent blood clots that can form if your upper chambers are not pumping effectively during times of arrhythmia. 

Those of you who follow my newsletter or hear me lecture know that I am very bullish on the dangers of wireless technologies in general, and cell phone radiation risks in particular. It’s my personal belief that we’ll soon have the science to defend legitimate concerns that what we cannot see is indeed hurting us.


(The view is from above the head, looking down; ear at bottom of frame)

If you look at the images above, you can see that the younger the skull, the more the brain is penetrated when a cell phone is held against the ear. As parents and grandparents, it only makes sense to exercise caution when it comes to trading convenience and technology against long-term health risks. I applaud countries that are taking a much more cautious approach to encouraging wireless telephony. One Scandinavian legislative impetus even prohibits the use of cell phone by children.

In a recent study, Swedish researchers actually polled some kids and asked if they thought that cell phone use had any impact on their health. Both children and adolescents who were regular cell phone users reported more health problems—especially headaches and asthma—than those who didn’t user them regularly. They also admitted to more problems with concentration and scored lower on measures of well-being.

In addition, investigators did something very scientific. They tested blood samples from adolescents and documented an association between a protein called transthyretin and cell phone use. And while lead investigator Fredrik Soderquist cannot yet make a connection between this specific protein and a cause for concern, it does indicate that the brain is being affected by these wireless devices.

I don’t know about you, but with the increase in brain cancers and acoustic neuromas (tumors of the ear) as of late, I think an ounce of caution may definitely prevent that pound of cure.

This holiday gifting season, many of you will be buying cell phones for gift giving. And many of those cell phones will be going to children. But before you wrap up that phone for your teen, take heed. It’s my experience that most people I meet are totally unaware of the dangers of cell phone radiation.

While hanging out in an airport bookstore this week, I noticed that Prevention Magazine (January 2010) devoted an entire 12-page article to the dangers of the electrosmog around us. On the same rack was Consumer Reports (January 2010), with a cover story on the best and worst cell phone DEALS. I knew I just had to work harder to get the word out to you about the absolute dangers of cell phone use!

I’m really concerned about the amount of wireless exposure all of us are getting with the majority of cell phones that are on the market, and most especially our children, who are totally in the dark about the hidden dangers of cell phone radiation. With all of the tempting “family plans,” their cell phone use has just exploded! Just think how many kids you see on a day-to-day basis—at the bus stop, at the mall, in the schoolyard—holding powerful wireless phones right up against their ears! Even younger kids play games on them while sitting in their car seats or in waiting rooms. It makes me crazed! What are we thinking? This holiday, before you buy a cell phone for a loved one, think about what you are really giving them.

Dr. Sinatra and I travel a lot--sometimes more than 2 weeks a month (which would be really hard on our two dogs had we not such a loving personal friend, dog-lover, and care provider for them.)

This November was an especially busy month, the highlight of which was spending an evening at the home of Suzanne Somers in Palm Springs. Suzanne hosted a warm reception for MDs and others would who had contributed to her recent book Knockout: Interviews with doctors who are curing cancer... and how to prevent it in the first place.
  
What an experience! Imagine an evening mingling and sharing with Suzanne and all the doctors Dr. Sinatra and I most admire when it comes to knocking out cancer: Stan Burzynski, MD; Nicholas Gonzalez MD; James Forsythe, MD; Julie Taguchi, MD; Russell Blaylock, MD; Jonathan Wright, MD; Michael Galitzer, MD, Burton Goldberg... It was such a gift!

Ralph Moss, PhD was unable to join us, but what an opportunity for Dr. Sinatra and I to meet and speak with such like-minded experts in their own specific fields! And what a great introduction to Knockout by our dear friend and colleague Dr. Julian Whitaker; he, too, tells it like it is when it comes to cancer treatment in this country. God bless him!

An entire chapter is devoted to each one of these paradigm-shifting doctors. Each one of them is rich with direct experience, new approaches, as well as HOPE and PROOF that cancer can be knocked out without chemo, radiation, and surgery. And, should you choose these traditional approaches, there are other options you must know about to make them safer, kinder to the body, and more effective. Dr. Sinatra contributed a chapter on the emotional aspects of living with a chronic illness, which is equally important.

Knockout is a must for all of us! Cancer statistics being what they are, we should all have a game plan in mind should we, or a loved one, ever hear those frightening words: ”I’m sorry, but you have cancer.”

Look, there’s no foolin’ a nurse, like me. I know that, like you, I am more likely to die of heart disease or cancer than anything else. That’s just pure statistics (with a tweak of family history, for good measure). And, while being a cardiac nurse, and living with Dr. Sinatra, I am somewhat confident about how I would handle a diagnosis of heart disease, I am way less secure when it comes to cancer!

So for me, this book is the best cancer resource I have yet to find! After sharing her own personal story, Suzanne’s interviews provide readers with all the information she wished she’d had at the time of diagnosis, so they don’t have to search archives and the internet to find answers--or spend hours in waiting rooms looking for the right doctor. I wish this reference had been here for us a year ago when my own daughter was diagnosed with breast cancer; the information is that rich and that hopeful.

A ten-year survivor of breast cancer (and a very beautiful and energetic one to boot!), who better than Suzanne Somers to bring forth the knowledge and experience of this group of dedicated and hardworking physicians who have dared to fight against the “status quo” in cancer treatment: poison, cut, and burn? You’d think folks would be “knocking” her door down to ask: “so, what DID you do?”

But, I know that’s not how things work. No one calls to ask Dr. Sinatra how he saved someone who was “left for dead” with his sometimes “unorthodox” approaches to cardiology either.  Go figure!  It absolutely stymies me why talk show hosts (like Geraldo) would even begin to challenge Suzanne after all she’s been through, let alone who she has consulted and what she has learned. But skepticism being what it is against anything “nontraditional” and non-‘Big Pharma’, they do! (Hmm…I should find the time to checkout who the network sponsors are for those talk show hosts, shouldn’t I? Maybe the purple pill dudes… Maybe the ED guys…)

Cancer is not a death sentence. Knockout (love the title!) frames out strategies for how to live with cancer, manage cancer, and ultimately strike the “knock out” punches that will bring cancer to its knees--for ALL of us. I’m just not so afraid of cancer anymore!

Thanks to Suzanne’s research, and her gutsy determination to get this information out to people--against all odds--I now know what I will do and whom I will consult should I ever hear “those words”. Don’t you want that for yourself and those you love? Don’t you especially want to know your options if you are in treatment for cancer, have ever been diagnosed with cancer, or are looking to know what to do to prevent it in the first place?

 I DO!

I can’t say enough about the health benefits of exercise. It strengthens the heart and circulatory system, builds stamina, and improves mood. It’s also an effective means for lowering blood pressure levels, increasing HDL cholesterol, and improving poor blood circulation.

I’m often asked what the best form of exercise is. I say it’s the one you will consistently do! Walking, dancing, cycling, lifting weights—it doesn’t matter. The goal of exercise is simply to get out and get moving.

That said, I have to admit I’m a big fan of walking. It’s simple, doesn’t require special equipment or a gym membership, and it can help reduce your risk of heart attack and stroke. In a study reported in the Journal of the American Medical Association (JAMA), 4,065 nurses ages 40 to 65, without cardiovascular disease or cancer, completed detailed physical activity questionnaires. The surveys revealed that walking was associated with reduced risk of stroke.

Walking is easy to incorporate in your day. Walk up and down stairs instead of taking elevators. Steadily increase the distance while walking your dog. Instead of parking in the closest space to the store or office entrance, park at the far end of the parking lot. Consider walking short distances for errands instead of driving.

If you’ve been inactive for a while, start slow. Walk 10 minutes every other day for one week. Each week, increase your time by increments of 5 or 10 minutes. Within a month, you’ll be taking 30-minute strolls. Do this every other day, and you’ll have a good workout routine. Five days a week is optimal.

As for speed, you don’t have to maintain a brisk pace. Actual walking speed isn’t as important as we’ve been led to believe. In fact, researchers in the JAMA study I mentioned found that speed didn’t matter; it was the length of time women walked that was significant.

Simple, right? If you agree, lace up those sneakers and get out there. It’s one of the simplest—and most effective—steps you can take (literally) to prevent heart attack, stroke, and other cardiovascular problems.

 

Today I’m going to veer off topic and talk about something that’s become a subject near and dear to my and Jan’s hearts: breast cancer. October is National Breast Cancer Awareness Month and, as most of you know, the pink ribbon is the logo. It has been inspiring to see so many people and businesses contribute to raising funds and awareness about this key women’s health issue. The CDC reports that in 2005, 186,467 women (and 1,764 men) were diagnosed with breast cancer, and 41,116 of them lost their lives to this insidious killer.

My own personal experiences this past year have really brought home the scope of the problem.

Unfortunately, our family and local church parish were both affected deeply when three brave women lost their battles with the disease this past summer and fall. In addition to my friend and colleague Dr. Shari Lieberman, who passed away in June after her 10-year fight, our hometown lost a beloved young mother of 5-year-old triplets, as well as a mother of three, a grandmother, and a devoted kindergarten teacher.

This past year we also championed our own daughter—herself a mother of three—as she went through breast cancer treatment. Recently she and her husband hosted a dinner party to thank all of the people who supported her through her journey. My daughter had saved all the vases from the multitude of flowers she’d received, and for the party filled them with fresh bouquets and handed them out with personalized thank you notes.

Like other fortunate women among our family, friends, and patients, we hope she lives the rest of her life without the cancer recurring. But that possibility is one she will live with for the rest of her life, like other survivors.

Our daughter’s cancer was detected early, and she chose to combine traditional cancer treatment—surgery, chemo, and radiation—with alternative approaches such as acupuncture, Reiki, massage, nutrition, imagery, prayer, and targeted supplements. She saw her naturopath as often as her oncologist, but found it still wasn’t always easy getting the right information about complementary approaches that would both assuage treatment side effects and attack the cancer cells. It shouldn’t be that hard for women to find alternative medical solutions and support.

So, one thing I did this spring to help spread information about nonconventional cancer therapies was contribute a chapter to what I feel is a groundbreaking book that’s now hitting bookstores. It’s entitled Knockout: Interviews with Doctors Who Are Curing Cancer and How to Prevent Getting it in the First Place, by Suzanne Somers. It was my honor to be consulted. Suzanne herself is a 10-year survivor of breast cancer who opted out of traditional medical approaches and took the road less traveled. In building her treatment team, Suzanne had to advocate for herself and search diligently to find health care professionals aligned with her desire to cure herself without toxic agents.

Women need to know that they do have options when it comes to breast cancer. Now, Suzanne is coming forth with this book—motivated by her own personal experience—to offer others vital information about alternative cancer prevention and treatment options so they don’t have to do the same searching and screening that she’s already done. Suzanne has taken a lot of heat on this subject but doesn’t back down in her belief in the promise of an integrative approach to breast cancer. I personally admire and commend Suzanne. She is a living tribute to the path she’s on—one that is alive, vivacious, and inspiring.

This book will be on my Christmas gift list, and I hope that women, as well as those of you who love them, will take the time to give it a read.

 

Just the other day, I sat down to film some video footage for my Web site. One of the questions I answered was, "What's the one thing you would recommend people do to prevent heart disease?"

That's an easy one. Eating better is the best way to minimize your heart risk factors and, ultimately, to prevent heart attack and stroke. Regular exercise, nutritional supplementation, and stress management are important, too, but good cardiovascular nutrition is at the top of my list.

Optimum heart health requires eating the PAMM way—that is, in keeping with my Pan Asian Modified Mediterranean diet. It emphasizes fresh fruits and vegetables, nuts, beans and legumes, healthy fats, and small amounts of lean meats and fish. Best of all, it has an anti-inflammatory effect in the body. A number of studies have confirmed that people whose diets are rich in these foods have a lower incidence of heart disease, and research published earlier this year again showed this eating plan to be associated with reduced risk.

Unfortunately, many of the foods prominent in the American diet are toxic to the cardiovascular system. One of the absolute worst is sugar. I suggest you stay away from it as much as possible—as well as breads, potatoes, pastas, pastries, rice, and other high-glycemic carbohydrates—because they sharply raise insulin levels in the body. You hear about insulin all the time, particularly in the context of diabetes. However, not many people understand that high levels of this hormone also cause inflammation that damages arteries. (This is one of the reasons why people with diabetes are at higher risk for heart disease and other circulatory problems.)

If you're serious about preventing heart disease, start with what you eat. Good cardiovascular nutrition is the cornerstone of good cardiovascular health.

 

More than 30 clinical studies have shown that soy is highly effective as part of a cholesterol-lowering diet. Case in point, an August 1995 meta-analysis from the New England Journal of Medicine found that people who ate an average of 47 grams of soy protein per day had a 13 percent decrease in LDL cholesterol levels, a 10.5 percent decrease in triglycerides, and a nine percent decrease in total cholesterol levels.

A November 2001 issue of Archives of Internal Medicine also found that a high consumption of legumes, including soybeans, meant a lowered risk of coronary heart disease (CHD). They concluded that increased legume intake may be an important part of a dietary approach to preventing CHD.

Additionally, a report in the August 2002 issue of Arteriosclerosis, Thrombosis and Vascular Biology found that a diet rich in tofu and other soy products may help protect postmenopausal women from arterial disease. According to researchers, phytoestrogens were associated with less arterial stiffness among more than 400 postmenopausal women. The benefit was most pronounced among the oldest women, or those who had been postmenopausal the longest.

Surprisingly, even the FDA agrees that soy is beneficial for maintaining good cholesterol levels. In 1999, they authorized of the use of health claims on the labeling of foods containing soy protein, based on research which shows that soy foods may reduce risk of coronary heart disease by lowering blood cholesterol levels. According to the FDA, foods must contain 6.25 grams per serving of soy protein in order to qualify for the claim, and a daily intake of 25 grams is recommended in order to achieve a significant cholesterol-lowering effect. Now that's healthy heart nutrition!

Earlier this week, a new study by Kaiser Permanente reported an association between high cholesterol levels and increased risk of Alzheimer’s disease or dementia. Researchers followed close to 10,000 people for 40 years and found that people who had high or borderline high cholesterol levels at ages 40–45 had much greater chances of significant mental decline later in life. Risk was 66 percent higher for people with high cholesterol (>240 mg/dL), and 25 percent higher for people with borderline high levels (200–239 mg/dL).

Alzheimer’s is a frightening condition, and these results are provocative. I have no doubt whatsoever that somewhere there’s someone saying, “This is another reason why we need to keep reducing cholesterol.”

But when it comes right down to it, these results merely show that people with high cholesterol tended to have a higher incidence of dementia. They don’t prove that reducing cholesterol will prevent future illness.

If there’s one point I want you to take away from this study, it’s this: Cholesterol is no more than a biological marker that can reveal what’s going on in the body. When it’s high, it usually means there’s usually an underlying problem somewhere—and in this case, those problems also may have had an effect on brain health.

For example, the study provided no information about the general health of the participants, so it’s impossible to know if they had health conditions—such as diabetes, metabolic syndrome, or being overweight—that would predispose them to inflammation and higher LDL cholesterol levels. (Inflammation has also been linked to Alzheimer’s, and more closely.) We also don’t know about their lifestyle habits. Did they eat diets high in carbohydrates, sugar, or trans fats? These, too, stoke inflammation, and trans fats, specifically, have been shown to destroy brain cells.

If you have high cholesterol, rest assured that you’re not destined for Alzheimer’s. However, I would encourage you to address the risk factors that are causing your LDL cholesterol levels to rise above the optimum level. Avoid excess sugar by following an   organic Mediterranean-style diet rich in fish, DHA-fortified eggs, whole grains, fruits, and vegetables; keep your blood pressure in check by better managing stress; and lose weight by exercising every day. If you are a man, keep your waistline to less than 40 inches, and if you are a woman, to less than 36 inches (this helps prevent metabolic syndrome). When these fundamental issues are taken care of, not only will your cholesterol level fall, but you will reduce your risk for all age-related disease.

 

You’ve heard me say time and again that reducing cholesterol is not the magic bullet that will prevent heart attack and stroke. I stand by this statement wholeheartedly—but I don’t want you to interpret it to mean that cholesterol is unimportant.

Optimum cardiovascular health requires maintaining a healthy cholesterol ratio—that is, keeping your LDL cholesterol levels (the so-called “bad” cholesterol) in proper balance with your HDL levels (the “good” type of cholesterol). It also calls for minimizing the amount of Lp(a) in your blood, and not letting your triglyceride levels get out of hand.

Although regular exercise and a cholesterol lowering diet will go a long way toward helping you achieve these goals, I also recommend that you try some targeted nutritional supplements for an extra boost. One of them is niacin (vitamin B3). It’s a fantastic nutrient that can help you increase HDL cholesterol, as well as lower both triglycerides and the dangerous subtype of cholesterol known as Lp(a).

These are huge benefits. For me, keeping HDL levels high and Lp(a) down are more significant than lowering LDL or even total cholesterol. Elevated Lp(a) is a serious, widespread, and underemphasized problem, and niacin is probably one of the best nutrients to lower it. And the higher your good cholesterol levels, the more protection you have in your blood vessels.

The only downside to niacin is the flushing sensation it generates. This hot, tingly, pins-and-needles feeling is disconcerting to a lot of people, but it usually lasts no more than 30–60 minutes, and it is most pronounced during the first week or so that you take the supplement (it can also occur when you increase your dosage). You can find no-flush forms of niacin, but they’re not as effective. I would stick with the regular kind.

I recommend taking 1–2 g a day in divided doses with meals. Start with 250 mg and slowly work your way up to minimize the flushing effect. Let me know how it works for you!