Alarm Bells
Ringing

The Heart of the Matter

The headline from the press release announces the grim findings: “Sudden cardiac deaths are increasing in young people, especially among women”. The report, from the U.S. Centers for Disease Control and Prevention, released March 1, 2001, documents a decade-long rise in ischemic heart disease and cardiomyopathy in young adults between the ages of 15 and 34, with an alarming 30 percent increase in women.

Presented during the American Hears Association's Annual Conference on Cardiovascular Disease Epidemiology and Prevention, the study fingers lifestyle factors, including smoking, poor dietary habits, lack of physical activity, and adolescent obesity, as the likely causes [].

Not long ago, common wisdom held that heart disease was a malady of the elderly. Today we call see that it's just not so. Heart disease starts in childhood. The patterns of diet and exercise that develop during our early years cast the mold for lifelong habits. Research shows that children, during their early development, possess sensitive ‘windows’ for nutritional programming. Dietary patterns established during their early years will imprint long-term consequences[]. Birth weight and weight-at-one-year are now recognized as predictive markers for cardiovascular disease in adulthood[].

Even more worrisome is recent evidence of atherosclerosis (hardening of the arteries) in infants and children two to fifteen years of age. A 1998 study, reported in the New England Journal of Medicine, found that the prevalence of atherosclerosis begins in childhood and increases with age. The findings show that the disease affects about 30 percent of adolescents between the ages of 16 to 20 years, 50 percent of young adults between 21 to 25 years, and 75 percent of adults 26 to 39 [].

That's right -- read those numbers again. By the time we reach the ripe young age of 40, three-quarters of us have cardiovascular disease, most without any knowledge of the fact. For many, our first warning barely precedes our last breach. Does it have to be like this? Not on your life!

It's hard to believe, but cardiovascular disease, the nation's Public Enemy #1, is a manmade problem. The first clinical report on cardiovascular disease in America was published in the Journal of the American Medical Association in 1912. The disease was so rare it took ten years co find []. Yet, in less than 100 years, the changes wrought to our lifestyle, environment, and to the food we eat have made this disease the number one killer in North America.

Homocysteine - the Heart Breaker

Elevated blood levels of a simple, sulfur-containing amino acid may be the dark force behind heart disease and many other degenerative diseases of our modern world. It's estimated that 10 to 1 5 percent of heart attacks and strokes may be caused by elevated homocysteine levels alone [].

Recent studies show that high levels of homocysteine are responsible for the development of the fatty cholesterol plaques that lead to atherosclerosis or hardening of the arteries. It is believed that high levels of homocysteine irritate the inner walls of the arteries. creating small oxidative lesions. The body, in its attempt to repair the damage, patches the tear with cholesterol. which acts as a sealing compound []. Problems arise if the LDL cholesterol has. Itself, been oxidized by the homocysteine. Oxidized LDL cholesterol (also known as the ‘really bad stuff’) stimulates specialized immune system cells, called macrophages, to swing into action. The macrophages stuff themselves with oxidized cholesterol and turn into pathologic foam cells. These foam cells then stick to the arterial wall, leading to the development of fatty atherosclerotic streaks []. In diabetic, oxidized LDL cholesterol becomes glycosylated (complexed with sugar), rendering it even more prone to hardening of the arteries []. This is one of the reasons that diabetics often exhibit advanced cardiovascular deterioration.

The 1992 Physician's Health Study, conducted by Meir Scampfer [], Harvard School of Public Health, looked at blood homocysteine levels in 15000 physicians. The authors concluded that even mildly elevated levels of homocysteine are directly related to heart disease. Subsequent studies confirm that high levels of homocysteine place people at increased cardiovascular risk of heart disease []. It is estimated that for every 10 percent increase in blood homocysteine levels there is a similar increase in the risk of heart disease []. Other studies indicate that people with elevated blood homocysteine face four times the risk of peripheral vascular disease (damage to the blood vessels of the body, outside the heart) than do people with normal levels [].

The massive Framingham cohorts study [], which followed twins over a 26 year period, showed a significant increase in carotid artery stenosis (narrowing of the main arteries of the neck) consistent with elevated homocysteine levels. Other studies confirm a positive link between blood homocysteine levels and the risks of arteriosclerosis (hardening of the arteries without plaque formation []) and myocardial infarction (sudden heart attack []). High homocysicinc levels are also implicated in the development of peripheral vascular disease [], diabetes [], arthritis, kidney disease, cancer, and neural tube birth defects [].

The Homocysteine - Vitamin Equation

Homocysteine is also a neurotoxin. It destroys the myelin sheath protecting nerve cells and causes them to ‘short-circuit’, much like a frayed electrical wire. Many neurological diseases, such as depression, schizophrenia, multiple sclerosis, Parkinson's disease, Alzheimer's dementia, and age-related cognitive decline, are associated with high levels of homiocysteine and low levels of the B complex vitamins []. In fact, recent studies confirm that deficiencies in vitamin B12 and folate art dangerously common in older people, who often suffer from many of the above-mentioned degenerative diseases [].

Vitamin B6 helps the body convert homocysteine into two other amino acids, cysteine and taurine. Ac the sane time, vitamin B12 and folate change homocysteine back to its precursor, methionine. In the absence of these three important vitamins, blood homocysteine builds to harmful levels and the damage begins; but supplement with any of the three and homocysteine levels fall. One study, reported in Neutraceutical Revolution, written by osteopathic physician Richard Firshein, found that supplementing with all three vitamins reduced homocysteine levels by 50 percent.

The scientific evidence rests its case. Homocysteine is, indeed, a ‘heart breaker’. High blood levels of this simple amino acid have cut short many dreams - and all for the want of three inexpensive vitamins.

E for Essential

The strongest association with heart disease appears to be a deficiency in vitamin E. Supplementation with 400 – 800 International Units (IU) of this inexpensive vitamin has been shown to reduce the incidence of heart attack by 77 percent. Reversal of the development of cholesterol plaques has also been noted with dietary supplementation of the various forms of vitamin E (alpha and beta-tocopherol and the tocotrienols) []. If you're still in doubt about the efficacy of vitamin E, just ask a cardiologist. Over 90 percent of them testify to taking vitamin E supplements on a daily basis (interestingly, only 75 percent of them actually prescribe it to their patients).

All said, optimal nutrition, combined with lifestyle changes -- including smoking cessation and daily physical exercise -- is an essential component in a holistic approach to sound cardiac health.

Epidemic of the New Millennium

The figures are so daunting, the economic impact so staggering, that it almost suspends belief. Throughout the world, governments are being jolted into action. More Than 15 million Americans and two million Canadians have it, and tens of millions exhibit preclinical symptoms, most without any knowledge of the fact.

Diabetes, the epidemic of the new millennium, now accounts for 28 percent of all new serious kidney disease and is a primary cause of adult blindness and non-trauma-related limb amputation []. Virtually unseen in children until recently; the starling rise of adult-onset (type II) diabetes in young people has prompted the American Diabetes Association to issue a public statement declaring type II diabetes in children “an emerging epidemic” [].

Obesity is a hallmark of the disease. A predisposition to abdominal fat, particularly over the beltline, contributes to its early onset []. In fact, over 85 percent of children and most adults with the disease are obese at the time of diagnosis.

Diabetes is often underestimated as a simple sugar imbalance that can be readily corrected. In fact, it is a complex medical disorder, where a confluence of social, behavioral, dietary and lifestyle factors unmask all underlying genetic susceptibility. The disease has serious long-term implications for cardiovascular health, kidney function, nerve function and eyesight. Because expression of the disease devolves largely on lifestyle issues, including diet, weight control and exercise, management of the disease is complex and challenging,