The End of a Decline in Heart Disease

Apparently for the past 40 years heart disease has been in decline. However, earlier this month Reuters reported that the trend may be at an end. Researchers from the Mayo Clinic and the University of British Columbia examined the autopsy reports of residents of Olmsted County, Minnesota that died between 1981 and 2004 from unnatural causes.

They found that “declines in the grade of coronary artery disease ended after 1995 and began to climb after 2000.”

While the data do not point to a specific cause of this about face in heart disease, the researchers do note that during this same period of time, Americans’ lifestyle became more sedentary, fast food consumption grew, physical education in schools was reduced and we all increased our consumption of high-fructose corn syrup.

The most disturbing finding in the study was “the youngest age group was the age group with the worse disease[.] This age group will have major problems as they continue to age.”

You can find the Reuters report at:
Autopsies forecast surge in U.S. heart disease | Reuters

Another Cocoa Study Shows Positive Effects on Hypertension

Here’s a study from The Journal of the American Medical Association that shows that cocoa, or more specifically, the polyphenols in cocoa, has a positive effect on blood pressure. It points out several important facts:

• It doesn’t need to be a huge quantity of dark chocolate to have an effect
• The dark chocolate must be taken regularly
• It must be taken on an ongoing basis

The study was performed on a rather small population (44 individuals) with untreated prehypertension (120-139/80-89) or stage 1 hypertension (140-159/90-99) without any other risk factors. According to the study, the prevalence of hypertension decreased from 86% to 68%. The participants were given either 6.3 g of dark chocolate containing 30 mg of polyphenols or the same amount of white chocolate which contained no polyphenols for a period of 18 weeks.

The study also points out that blood nitric oxide levels increased in the test participants. Nitric oxide is what triggers the dilation of the blood vessels and reduces blood pressure.

Here’s the link to the abstract of the study:

JAMA — Abstract: Effects of Low Habitual Cocoa Intake on Blood Pressure and Bioactive Nitric Oxide: A Randomized Controlled Trial, July 4, 2007, Taubert et al. 298 (1): 49

In my opinion, the thing about eating chocolate as a “medicine” is that healthy individuals probably wouldn’t feel any different, even though the polyphenols would be of benefit. Individuals with cardiovascular disease could probably measure an improvement and may feel healthier.

I know that has been the case with me.

Eat Chocolate to Reduce Hypertension?

In the past, I’ve made a few posts regarding dark chocolate and hypertension. Here’s a link to a brief article that reminds us that indeed, research indicates that dark chocolate can improve blood pressure and may improve cholesterol levels and insulin sensitivity.

http://www.ephit.com/coventry_contest/chocolate.htm

The article also points out that processing removes much of the benefits of the chocolate.

If you’d be interested in dark chocolate that is minimally processed (not dutched and is cold pressed), please e-mail me and I’d be happy to send you some information. My contact info is in the “About” page.

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Pills or Food?

My personal feeling has been that eating a food, as close to nature as possible, is better than taking a pill of concentrated essence of whatever. The article below lends credence to that view.

CTV.ca | Antioxidant pills don’t prevent heart disease

The study, done at Brigham & Women’s hospital, followed 8,171 women with three or more risk factors for CVD for over 9 years. Over the course of the study, the women were given either:

• 500 mg vitamin C or a placebo every day
• 600 IU vitamin E or a placebo every other day
• 50 mg beta carotene or a placebo every other day

The researchers found that “There were no overall effects of ascorbic acid, vitamin E, or beta carotene on cardiovascular events among women at high risk for CVD.”

Here’s a link to the abstract of the study.

We’ve seen many studies that show antioxidants have health benefits. However, many of those studies were done in vitro, rather than in vivo. It seems that people are more complex than test tubes!

Many of the clinical trials involving cacao or dark chocolate show health benefits. My own personal experience, while anecdotal, bears out many of the findings. I still plan on posting my experience and results, but not today. One of the reasons I like minimally processed dark chocolate as a “supplement” is that it is a food, rather than a pill that someone has made by attempting to pull out the “good stuff” in the cacao (flavonoids in this case).

Here’s another article that addresses pills v. foods:

The antioxidant myth: a medical fairy tale – health – 05 August 2006 – New Scientist

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Chocolate and Prevention of CVD

Nutrition & Metabolism | Full text | Chocolate and Prevention of Cardiovascular Disease: A Systematic Review

I came across the study above a while ago, but am just getting around to mentioning it in this blog. This study is not primary research, but rather a review of all MEDLINE publications from 1966 through January 2005 looking for “relations between cocoa, cacao, chocolate, stearic acid, flavonoids (including flavonols, catechins, epicatechins, and procynadins) and the risk of cardiovascular disease.”

One of the things they looked at was whether or not the stearic acid content was detrimental to cardiovascular health. Stearic acid is the type of saturated fat found in cacao. The evidence suggests that it is neutral, unlike other saturated fats, which raise total cholesterol levels.

To quote the results of the study:

The body of short-term randomized feeding trials suggests cocoa and chocolate may exert beneficial effects on cardiovascular risk via effects on lowering blood pressure, anti-inflammation, anti-platelet function, higher HDL, decreased LDL oxidation. Additionally, a large body of trials of stearic acid suggests it is indeed cholesterol-neutral. However, epidemiologic studies of serum and dietary stearic acid are inconclusive due to many methodologic limitations. Meanwhile, the large body of prospective studies of flavonoids suggests the flavonoid content of chocolate may reduce risk of cardiovascular mortality. Our updated meta-analysis indicates that intake of flavonoids may lower risk of CHD mortality, RR = 0.81 (95% CI: 0.71–0.92) comparing highest and lowest tertiles.

It’s a good article. Got a lot of big words, but they do a good job of explaining and referencing the research.

I think I’ll go have some healthy dark chocolate.

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Chocolate Sunscreen?

Sounds kinda gross. And wow, would the sand ever stick to you at the beach! Not really:-) This article says the preliminary results of a German study show that eating chocolate rich in cocoa solids and flavonoids (in other words, dark chocolate) can fight skin cancer. Subjects were given cocoa to drink. Half the group got cocoa high in flavonoids, the other half got cocoa that tasted the same, but was much lower in the flavonoids.

All subjects were then exposed to UV light. The subjects that received the cocoa high in flavonoids did not redden as much as the other group and their skin was smoother and moister.

Here’s a link to the article:

Food for Thought: Chocolate as Sunscreen, Science News Online, June 10, 2006

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Cocoa More Important than Penicillin?

Norman Hollenberg, a professor of medicine at Harvard Medical School says that epicatechin, one of the flavonoids in cacao, has such powerful health benefits, it “may rival penicillin and anaesthesia in terms of importance to public health.” He thinks it is so important it should be considered a vitamin.

He has spent years studying the Kuna people in Panama, who drink large amounts of cocoa. He found that four of the five most common killer diseases in the industrialized world are significantly reduced. He attributes that reduction to the high levels of epicatechin in cocoa.

As usual, a link to the article is found below.

ScienceDaily: Cocoa ‘Vitamin’ Health Benefits Could Outshine Penicillin

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Seven Steps to Fight Inflammation

I subscribe to a newsletter from Harvard Medical School. The most recent issue reminds us that inflammation, while an important part of our body’s healing system, can be dangerous, if there is too much of it. Inflammation is involved in atherosclerosis, heart disease, strokes and even some types of dementia. Below is a link to the on-line version of the article.

Harvard Medical School: 7 simple steps to fend off harmful inflammation

The article lists seven dietary steps that will help fight inflammation. Quoting from the article -

Simple changes

What you eat may fan the fires of inflammation. With some small changes — no crazy new foods involved — you can douse them. Here are some suggestions:

1. Get an oil change. Eating a lot of saturated fats and/or trans fats is linked with higher levels of inflammation. Swap them for olive oil, which has potent anti-inflammatory properties, or polyunsaturated fats, especially omega-3 fats from fish.
2. Don’t be so refined. The bolus of blood sugar that accompanies a meal or snack of highly refined carbohydrates (white bread, white rice, French fries, sugar-laden soda, etc.) increases levels of inflammatory messengers called cytokines. Eating whole-grain bread, brown rice, and other whole grains smooths out the after-meal rise in blood sugar and insulin, and dampens cytokine production.
3. Promote produce. The more fruits and vegetables you eat, the lower the burden of inflammation. Why? They contain hundreds, perhaps thousands, of substances that squelch inflammation-rousing free radicals; some act as direct anti-inflammatory agents.
4. Go nuts. Adding walnuts, peanuts, almonds, and other nuts and seeds to your snacks and meals is another tasty way to ease inflammation.
5. Cocoa lovers rejoice? In laboratory studies, cocoa and dark chocolate slow the production of signaling molecules involved in inflammation. The trick is to get them without too much sugar and fat.
6. Alcohol in moderation. A drink a day seems to lower levels of C-reactive protein (CRP), a powerful signal of inflammation. Too much alcohol has the opposite effect on CRP.
7. Spice it up. Herbs and spices such as turmeric, ginger, garlic, basil, pepper, and many others have anti-inflammatory properties.

If you adopt an anti-inflammatory diet, you probably won’t see or feel any different. Angina won’t suddenly disappear or heart failure reverse itself. But you will be doing your heart, arteries, and the rest of you a huge favor that will pay off in many ways.

If you are interested in subscribing to the newsletter, here’s a link to the subscription form:
www.health.harvard.edu/healthbeat

Just a warning – each issue of the newsletter will hit you up to buy a report regarding the subject matter of the newsletter.

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Fight Fat with Fat? Nutty!

Who woulda thunk that you could offset the effects of a meal high in saturated fat by eating another food high in fat–walnuts.

Eating a meal high in saturated fat causes our veins and arteries to narrow, stiffen and the lining to become sticky. This article from RealAge tells us a few things we can do to mitigate the consequences of a high saturated fat meal. Here’s a link to the article:

Not Your Average Nut – RealAge Tip of the Day

Many nutritionists and researchers say replacing some of the fat in our diet with a few nuts will give us an important boost of flavonoids and antioxidants. They say to replace, rather than add, because fat is the most calorie dense of the three main food components (protein, carbohydrates & fats).

The article also mentions the effect of chocolate (dark, of course) on blood vessels. I hope you have deduced that the effects are positive.

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Fat Facts

I’m often asked about the different types of fats & how they interact with blood lipids. Here’s a very good summary of “The Facts on Fats.”

Discovery Health :: The Facts on Fats

In a nutshell:

• trans-fat–really bad (lowers “good” cholesterol, raises “bad” cholesterol)
• saturated fat–bad when overdone (raises total cholesterol)
• mono & polyunsaturated–good in moderation (depending on the source, can lower “bad” cholesterol & raise “good” cholesterol)

A typical American diet overdoes omega-6 fatty acids & is lacking in omega-3 fatty acids, so the last bullet point is actually a good blog subject for another day.

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