The joy of being a medical practitioner honoring traditional scientific methods and pharma as well as natural and integrative research is that there is always something new to consider and incorporate or solidify into treatment plans for patients. In my integrative cardiology practice, I combine standard therapies when needed with lifestyle prescriptions focusing on nutrition, weight management, fasting, and nutraceuticals. Four interesting studies were published and they each garnered some media attention. These studies will be used to further refine my education and treatment of patients seeking to stay young at heart by design.
Study 1: A Win for Broccoli.
There is no dispute that vegetables are good for you. But are some better than others? The aim of this large study was to investigate the associations of total vegetable intake and specific vegetables with a measure of artery health I perform in my clinic, the carotid intimal medial thickness (CIMT) measured by ultrasound of the neck. The study reported on common carotid artery IMT (CCA‐IMT) and carotid plaque severity in a cohort of women ≥70 years. Total vegetable intake was calculated at baseline using a validated food frequency questionnaire. Vegetable types included cruciferous, allium, yellow/orange/red, leafy green, and legumes. In 2001, CCA‐IMT and carotid focal plaque were assessed using carotid ultrasonography. Women consuming ≥3 servings of vegetables each day had a 5.0% lower mean CCA‐IMT(better and younger arteries) and maximum CCA‐IMT compared with participants consuming <2 servings of vegetables. For each 10 g/d higher in cruciferous vegetable intake, there was an associated 0.006 mm lower mean CCA‐IMT and 0.007 mm lower maximum CCA‐IMT. Other vegetable types were not associated with CCA‐IMT. No associations were observed between vegetables and plaque severity. This study provides another reason to eat more vegetables daily and to concentrate on cruciferous vegetables specifically to keep arteries young, thin and flexible.
Study 2: Plant Proteins to Prevent Heart Attacks.
The world seems obsessed with getting adequate protein in their diet (remember, protein is not a food group but a macronutrient and almost all food groups have protein). Is there a difference in plant-derived versus animal-derived protein on health? Researchers studied 81,337 men and women from the Adventist Health Study-2. Diet was assessed between 2002 and 2007, by using a validated food frequency questionnaire. There were 2276 cardiovascular deaths during a mean follow-up time of 9 years. Cardiovascular mortality was 1.61 times higher for the ‘Meat’ protein factor and 40% lower for the ‘Nuts & Seeds’ protein factor. No significant associations were found for the ‘Grains’, ‘Processed Foods’ and ‘Legumes, Fruits & Vegetables’ protein factors. The scientists concluded that differences between the ‘Meat’ and ‘Nuts & Seeds’ protein factors and cardiovascular outcomes were strong and could not be ascribed to other associated nutrients. Healthy diets should focus on plants as protein sources like nuts, seeds, beans, and greens while chicken, beef, ham, turkey and lamb should be reduced (or eliminated).
Study 3: Garlic is a Powerful Artery Tonic.
Garlic exerts a range of effects relevant to human health and most of my patients take aged, odorless garlic tablets daily. However, garlic’s influence on the lining of arteries called the endothelium in remains unknown. Scientists sought to determine the effects of garlic extract (GE) on arterial stiffness and markers of endothelial function. Ninety-two subjects were enrolled in the study. The participants were randomly assigned to receive 400 mg of GE or placebo daily for 3 months. The arterial stiffness index (SI) and markers of endothelial function such as high-sensitivity C-reactive protein (hsCRP), cholesterol (total, LDL, HDL), triglycerides, and plasminogen activator inhibitor 1 (PAI-1), as well as total antioxidant status (TAS) were quantified at baseline and the end of study. At the end of study SI, hsCRP, PAI-1, LDL cholesterol, and TAS were reduced in the GE-supplemented group, but not in the placebo group. This randomized, double-blind, placebo-controlled trial provides further evidence for the healing power of garlic, whether in the diet or whether concentrated in high doses in pills. Prior studies at UCLA showed garlic improved the appearance of heart arteries after a year of therapy determined by CT angiography. This publication demonstrates that supplementation with GE favorably modifies endothelial biomarkers associated with cardiovascular risk and suggests that GE can be used to suppress chronic inflammation.
Study 4: There is No ‘Safe’ Body Fat.
The idea that an “apple” shaped body with a bulging belly is more dangerous than a “pear” shaped body with larger buttocks and a slimmer waist is often used to advise patients on weight management. To examine this further, researchers combined the data from 7 previously published weight‐loss studies and examined the relationship between regional fat and lean tissue loss with changes in cardiovascular disease risk factors in 399 participants. During the weight-loss period, changes in regional fat, whether in the abdomen or the gluteal region, were positively associated with beneficial changes in glucose, insulin, total cholesterol, triglycerides, low‐density lipoprotein cholesterol and systolic and diastolic blood pressure. Loss of both leg fat and arm lean tissue (muscle) were strongly associated with improvements in markers of disease. The scientists concluded that loss of leg fat and leg lean tissue was directly associated with beneficial changes in cardiovascular disease risk markers. Furthermore, loss of lean tissue may not have an adverse effect on cardiovascular disease risk. They observed that loss of fat and lean tissue in any region was associated with a reduction in cardiovascular risk factors. While some weight-loss strategies have been shown to reduce visceral fat and not lean muscle mass, worrying about the inevitable loss of lean tissue with weight loss may be misplaced.
