Nutrition & Diet
AUTHOR: Gary Italia, DC, DABCN, PhD
Heart disease is the number one killer of both men and women. Still 60% of women believe that cancer is their greatest health risk. Antioxidants have been shown to be very helpful in preventing cardiovascular disease. If heart disease can be reduced, the population as a whole should benefit from greater longevity.
What are the facts about cardiovascular disease?
The major cause of death in industrialized countries is cardiovascular disease (CVD), which consists of heart disease and stroke. Heart disease is the leading cause of death in the U.S.; stroke is the third leading cause. With the exception of 1918, CVD has been the number one killer since 1900—that’s more than a century. It is estimated that 60,800,000 Americans, 1 in 5 males and females, have one or more types of CVD. This can include heart disease, stroke, angina, and high blood pressure.
Approximately 2,600 Americans die per day from CVD. In 1998, the total was 949,619. It also accounts for 40.6% of all deaths in the U.S. It is estimated that 500,000 Americans have a new or recurring stroke each year, with stroke killing150,000 people per year.
How can I decrease my odds of getting cardiovascular disease (CVD)?
It is thought that the risk of CVD can decrease by 80% if people maintain proper weight, follow a prudent diet, do not smoke, and participate in regular exercise.
Does reducing CVD make that much of a difference?
It has been estimated that if all major forms of CVD were eliminated, life expectancy would increase by approximately seven years. Some even estimate a rise in total life expectancy of 10 years.
Is cholesterol important in heart disease?
Cholesterol plays a very important role in the formation of CVD. The risk of heart attack is highest in men and women who have low HDL levels and high total cholesterol levels. A 10% decrease in cholesterol levels can result in a 20%–30% decrease in CVD.
How many people have high cholesterol levels?
Approximately 20% of Americans have high blood cholesterol levels and 31% have borderline high levels. About 40.6 million Americans have total cholesterol levels of 240 mg/dl or above, which is considered high risk in adults. Although some variations in laboratory reference ranges may exist, you are considered to be at high risk of heart disease if your cholesterol levels are above 240 mg/dl. Your are at moderate risk if your levels are between 200 mg/dl and 240 mg/dl and low risk if your levels are below 200 mg/dl.
What is so bad about cholesterol?
Cholesterol is vital and necessary for many normal functions in the body. The problem with cholesterol occurs when too much of it is oxidized. It is thought that free radicals can cause this oxidation or breakdown to the structure of the LDL cholesterol. The oxidized LDL cholesterol can then affect processes that lead to CVD. For example, it can speed up the damage to the blood vessels and change the diameter of the blood vessel, both of which lead to the formation of heart disease. It does this through endothelial damage, reperfusion, and ischemia.
Oxidized LDL cholesterol can also enter the blood vessel walls, which is considered to be an essential step in the formation of CVD. Oxidized LDL has been shown to increase uptake of LDL by foam cells, alter vascular tone and formation of auto-antibodies, and accelerate endothelial damage. It is not so much the cholesterol that is bad, it is the breakdown that occurs to it from free radical attack that makes it bad. What makes the situation even worse is that the heart appears to be very susceptible to damage from free radicals. Therefore, cholesterol levels need to be controlled and the amount of cholesterol that is exposed to free radicals needs to be kept to a minimum. Remember that antioxidants can help destroy free radicals and thus keep the cholesterol from being broken down.
What is the relationship between cardiovascular disease and antioxidants?
Low plasma levels of all essential antioxidants are associated with an increased risk of subsequent death from heart disease. A study of Finnish men over 60 years of age demonstrated that a deficiency of vitamin C is a risk factor for heart disease. Another researcher after reviewing data on approximately 3,000 people over 12 years found that if levels of vitamin C are low, the likelihood of heart disease is high. It also appears that the more vitamin C a person consumes, the less risk of death from heart disease and all other causes.
In a study of more than 11,000 people, it was shown that men who consumed more than 300 mg of vitamin C per day had a 45% lower risk of death from cardiovascular disease than those who consumed less than 50 mg per day. Women had a 25% lowered risk of death. When vitamin C is combined with vitamin E, a lower risk of death from all causes and death from heart disease is present.
High blood levels of vitamin E and high dietary intake of vitamin E have been associated with a decreased risk of heart disease, stroke, and the heart plaquing processes. Taking at least 100 mg of vitamin E per day for two years has been shown to cause a significant decrease in the risk of heart disease. Many other studies have shown a strong relationship between low blood levels of vitamin E and heart disease. One study of 5,000 men and women age 30 to 69 years over a 14-year period demonstrated that the more dietary vitamin E that was consumed, the lower the death rate from heart disease.
In a study of more than 121,000 females in the U.S., it was found that the higher the vitamin E levels, the lower the risk of death from heart disease. Another women’s health study showed that the more vitamin E consumed from the diet, the less risk of death from heart disease. This finding was supported by research that followed more than 34,000 women with similar results. Vitamin E intake has also been shown to decrease the progression of lesions found in the arteries of the heart.
There are many, many more studies that have similar findings, and it is not possible for me to list all of them in this section. The point, however, is that vitamin E and vitamin C can help reduce the risk of heart disease as well as death rates from heart disease.
In light of the evidence, do you think I should take vitamin E supplements?
As long as there are no contraindications in your medical history to vitamin E, it is my opinion that most if not all people should take a vitamin E supplement. Vitamin E has been shown to have a favorable effect on possible causes of heart disease, including the oxidation of LDL cholesterol, increased platelet adhesiveness, and arterial stiffness. Vitamin E can not only affect these causes, but can also stabilize and neutralize the free radicals previously mentioned that damage the heart tissue.
The higher the vitamin E levels in a person, the less likely the person will die from heart disease. Therefore, many experts believe that vitamin E supplements are useful in protecting against cardiovascular disease. For example, older people who take daily vitamin E supplements are 40% less likely to die from heart disease than those who do not. Many of the beneficial effects have been seen with a supplement dose of 200–500 IU per day.
Are there other antioxidants that can benefit my heart?
Selenium is an important antioxidant that often works together with vitamin E. People who live in areas of the U.S. where selenium levels are low are three times more likely to die of heart disease than those living in states with high levels of selenium. Coenzyme Q10, ubiquinone is found in the mitochondria and plasma membranes, including low-density lipoproteins. It is involved in the production of ATP energy, acting as an electron acceptor and proton donor. In its reduced form, it is thought to regenerate vitamin E and act as an antioxidant. People who have heart disease appear to have low levels of ubiquinone. Studies have shown that patients with heart disease have 25% less CoQ10 in their blood compared to those without heart disease. In addition, ubiquinone has also been shown to prevent the oxidation of LDL cholesterol better than vitamin E or beta-carotene. It can also lower blood pressure (another risk of CVD) and increase immune system activity by increasing immunoglobulin levels.