Be heartened

Vegetarian Times, Feb, 1998 by Ronni Sandroff

By now we all know the drill: Eat a low-fat diet, get regular exercise, don't smoke, minimize cholesterol/weight/stress levels to prevent heart disease. Countless Americans try to heed this advice, yet heart disease remains the nation's number one health enemy, the leading cause of death for men and women, accounting for more than 40 percent of all fatalities. "Heart disease is far easier to prevent than to treat once it occurs," says Kenneth Bock, M.D., a Rhinebeck, N.Y., alternative practitioner and the author of The Road to Immunity (Pocket Books, 1997). But despite all the public health information that's out there, a quarter of a million people will die each year within one hour of their first heart attack symptom. "The recommendations are just not workable for many individuals," says Bock. "It's clear that new approaches are needed."

The heartening news is that there's a growing body of research on effective natural defenses against heart disease. These modalities go far beyond just reducing our intake of cholesterol and fats. In fact, the overall message is that heart health is less about what we deny ourselves than what we take in. Studies show that a balanced diet (which includes good fats), nutritional supplements, love and intimacy may be much greater factors than cholesterol when it comes to a healthy ticker.

There's little controversy about the immediate cause of heart problems: They occur when blood flow to the heart is disrupted. A disruption in a coronary artery can result in a heart attack. A number of mechanisms can interrupt blood flow (clots, arterial spasm), but the most common is arteriosclerosis, or arteries that impede blood flow because they are hardened, narrowed and/or blocked by the build-up of fatty plaque.

Because cholesterol is a major ingredient in plaque, heart disease prevention efforts have emphasized reducing cholesterol intake, hence the blitzkrieg of low-fat (though often highsugar) foods. Yet many doctors feel the clinical evidence proving dietary cholesterol to be a cause of heart disease is open to debate. Autopsy studies show that most people with arteriosclerosis have no abnormality in either total cholesterol or ratios of "bad" cholesterol, LDL, to "good," HDL, notes Kilmer S. McCully, M.D., in his pioneering book The Homocysteine Revolution (Keats Publishing, 1997). Furthermore, he adds, while there has been a significant decrease in heart attacks and strokes in the past few decades, there has been no significant changes in blood levels of LDL cholesterol during this period.

Today, innovative research shows that arteriosclerosis may have a variety of causes and that no one dietary regime is right for everyone. "While it is clear that cholesterol is involved in many cases of heart disease, there are a number of other risk factors," says Bock. "But they tend to be underpublicized because they can be modified by [diet], and so much consumer health education is sponsored by the companies that make cholesterol-lowering drugs."

THE HOMOCYSTEINE FACTOR

In The Homocysteine Revolution, McCully writes about the danger of elevated levels of this amino acid (over 14 micromoles per liter), which can injure the cells and tissues of arteries, setting in motion a complex process that leads to hardened, narrowed arteries and the formation of blood clots. He maintains that up to 15 percent of all heart disease may be related to high homocysteine levels. It's not clear if it's a causal relationship or just a correlation, but toxic homocysteine levels are most common in men; postmenopausal women; the elderly; people who eat a I& of meat, smoke, don't exercise, drink large amounts of alcohol and coffee and have high blood pressure and cholesterol--groups known to have higher risk for heart disease. High homocysteine levels can be caused by B-vitamin deficiencies but are easily corrected by boosting dietary levels (or taking supplements) of folic acid, [B.sub.6] and [B.sub.12] very vitamins lost in the manufacturing of processed foods.

Folic acid is the number one deficiency in American nutrition surveys. "It's particularly important for meat eaters to make sure they get sufficient amounts of B vitamins," says Neal Barnard, M.D., author of Eat Right, Live Longer (Harmony Books, 1996), and president of the Physicians Committee for Responsible Medicine. "Vegetarians usually get plenty of folic acid and [B.sub.6], but vegans may be vulnerable to [B.sub.12] deficiency and should consider supplementing if they consume no animal products at all."

McCully applauds the Food and Drug Administration's (FDA) decision to man date the addition of folic acid to so-called enriched foods beginning in 1998. He estimates that this act alone may save 50,000 American lives each year. While he thinks that most of us get adequate [B.sub.12], he's campaigning to get the FDA to insist that [B.sub.6] also be added to enriched foods.

THE DANGER OF TOO MUCH IRON

There's no debate over the danger of too much iron in the blood. "Excess iron has been implicated in vascular disease and can accelerate the production of free radicals that damage cells," says Bock. He recommends that everyone-except menstruating women--avoid nutritional supplements with iron. For patients with high iron levels, he sometimes uses chelation therapy (a controversial blood-cleansing technique) to reduce blood levels of iron. "Another method is to donate blood, which decreases iron stores simply by decreasing blood volume," he says.