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Why You Should Eat More Walnuts

We know from earlier studies that walnuts are beneficial for heart health. New research from Yale now indicates that eating walnuts can prompt beneficial improvements in diets. Investigators recruited 112 people at high risk of diabetes (based on their weight, blood sugar or blood pressure levels). Half the participants added about two ounces of walnuts per day to their diets for six months and then stopped eating walnuts for six months. Half of all the participants received nutrition counseling, including the instructions to cut calories from other sources to offset the walnuts added to their diets. The other participants had no nutrition counseling. During the study the researchers checked all the participants’ cholesterol levels, blood vessel function, blood pressure, blood sugar, body fat and BMI. They reported slight improvements in blood vessel function and total and LDL cholesterol occurred in the walnut group, but the big change was that these participants also began to make healthier food choices than they had previously. As a result of these changes, the overall quality of their diets improved, suggesting that eating walnuts made a psychological as well as physiological difference. 

Too Many Pounds = Heart Trouble

If you're seriously overweight or obese, you are at increased risk of heart failure, period. This remains true whether or not you have any other risk factors such as diabetes, high blood pressure, or high cholesterol. This news comes from a 12-year long study showing that levels of a predictive heart enzyme signal silent damage to the heart among overweight and obese individuals. Researchers from Johns Hopkins tested more than 9,500 men and women ages 53 to 75 who were free of heart disease for the enzyme, troponin T. This blood marker is considered the gold standard for diagnosing ongoing or recent heart attacks in patients who come to emergency rooms with chest pain. After testing, the investigators followed the study participants for more than 12 years. During that time, 869 of the participants developed heart failure. When the investigators looked at the participants' troponin T test results, they saw that levels of this enzyme were much lower than they are in heart attack patients. However, troponin T levels rose as body mass index (BMI) increased, the researchers reported. They found that severely obese individuals with elevated troponin levels were nine times more likely to develop heart failure than study participants of normal weight with undetectable troponin levels, and that this additional risk persisted even after accounting for other possible causes of heart damage. 

My take? This interesting study shows that you don't get a free pass for being overweight or obese, even if you're otherwise relatively risk free for heart disease. The findings suggest that obesity alone increases your risk, and the authors made the point that their results are an "alarm bell" for physicians to monitor their obese patients rigorously for emerging signs of heart disease. Bear in mind that heart disease isn't the only threat obesity poses to health - it also increases the risk of stroke, kidney and gallbladder disease, some types of cancer as well as osteoarthritis and sleep apnea.

A Bad Marriage Can Hurt Your Heart

Having an unhappy marriage can raise your risk of heart disease, particularly if you're female. Hui Liu, a sociologist at from Michigan State University, looked at five years of data from 1,200 couples - ages 57 to 85 - in order to discern how happy or unhappy marriage affected heart health. She found that bad marriages have a bigger impact on heart health than good ones - they have a negative effect while good marriages don't necessarily have beneficial effects. Participating couples were asked to respond to survey questions about the quality of their marriages and their heart health - whether or not they had had heart attacks, strokes, high blood pressure, and whether lab tests had shown high blood levels of C-reactive protein, a marker for inflammation in the body. Lui suggested that over time, stress from a bad marriage may worsen heart health because of age-related increased frailty and declining immune function and concluded that bad marriages have greater impacts on women's heart health than on men's, possibly because "women tend to internalize negative feelings and thus are more likely to feel depressed and develop cardiovascular problems."

Bad News About Energy Drinks

New research conducted in France suggests that consuming energy drinks can lead to heart problems including angina (chest pain that follows decreased blood flow to the heart), irregular heartbeat and even sudden death. The main problem with these drinks is the caffeine they contain. Of the 212 adverse effects connected to energy drinks reported to the French food safety agency between January 1, 2009 and November 30, 2012, 95 were cardiovascular symptoms, 74 psychiatric and 57 neurological symptoms, although these problems sometimes overlapped. Of the heart problems documented in the study, cardiac arrests and sudden or unexplained deaths occurred in at least eight cases, the investigators reported, while 46 people developed heart rhythm disorders and 13 experienced angina. The most common presenting symptoms were diagnosed as “caffeine syndrome” characterized by tachycardia (fast heart rate), tremor, anxiety and headache. Study leader Milou-Daniel Drici, a professor of clinical pharmacology at the University of Nice Sophia Antipolis, advised doctors to alert patients with cardiac conditions to the danger energy drinks can pose, and to ask young patients if they consume them. Dr. Drici presented the report at the European Society of Cardiology 2014 conference on August 31 in Barcelona, Spain.

My take? This new French study expands on what we already know about the health effects of caffeine in energy drinks. Consuming more than 250 mg of caffeine can cause restlessness, nervousness, excitement, insomnia, flushed face, increased urination, gastrointestinal disturbance, muscle twitching, rambling flow of thought and speech, tachycardia (rapid heartbeat) or cardiac arrhythmia, periods of inexhaustibility (where a person seems unable to use up all their energy) and psychomotor agitation (repeated activity such as pacing or handwringing). Unfortunately, the amount of caffeine in energy drinks is not listed on the label in the U.S. Prompted in part by the number of adverse effects reported, the FDA has started looking into the addition of caffeine in many products – food as well as drinks - and its effects on children and adolescents. It’s about time.

Probiotics for High Blood Pressure

Probiotics are products containing the "friendly" bacteria that normally inhabit the human intestinal tract, where these beneficial microbes help complete the digestive process. Some of these microbes actually produce vitamins, and evidence suggests that without them, the immune system doesn't function optimally, compromising resistance to infection. The latest word on probiotics is that they may also help lower blood pressure. A new analysis of nine earlier randomized controlled trials found that regularly taking probiotics led to reductions in systolic blood pressure (the top number) by an average of 3.56 millimeters of mercury and diastolic pressure by 2.38. While these changes aren’t dramatic, the Australian research team that conducted the review concluded that bigger reductions may occur in people who already have high blood pressure (some of the study participants had normal blood pressure to begin with) Greater benefits might also be possible using probiotics that provide larger quantities of helpful bacteria or multiple species, or when people take probiotics for more than two months, as was the case in the studies reviewed. Positive effects from probiotics on diastolic blood pressure were greatest in people whose blood pressure was equal to or greater than 130/85, which is considered elevated. The probiotics used in the studies were primarily strains of Lactobacillus in dairy products. The study authors concluded that more research is needed before doctors can confidently recommend probiotics for control and prevention of high blood pressure.

Sources:
Jing Sun et al, “Effect of Probiotics on Blood Pressure - A Systematic Review and Meta-Analysis of Randomized, Controlled Trials,” Hypertension, doi: 10.1161/ HYPERTENSIONAHA.114.03469

Biggest Risk Factor for Heart Disease in Women Over 30?

You might guess the answer is smoking, high blood pressure, or being overweight, and all those contributors play a role, but a new study from Australia has shown that lack of physical activity presents the most significant risk of heart disease in women over 30. The researchers used a mathematical formula to determine reductions in heart disease if specific risk factors were eliminated, and followed more than 32,000 women in three age groups to arrive at their conclusion. Predictably, in women under 30, the biggest risk turned out to be smoking, but in all the women over 30 lack of physical activity proved the strongest risk. For women in their 70s, being active would lower the risk of heart disease nearly three times as much as quitting smoking and significantly more than lowering blood pressure or reaching a healthy body weight, the study showed. Overall, it found that for all women over 30 those who are inactive were nearly 50 percent more likely to develop cardiovascular disease in their lifetimes than women who regularly get at least 150 minutes of moderately intense exercise every week.

My take? Women often don't realize that heart disease is as much of a threat to them as it is to men. True, the risk for men is higher when they're younger, but by the age of 65, the rate of heart disease in women equals that of men and is the leading cause of death in women, claiming nearly 500,000 lives per year (compared to about 40,000 for breast cancer, a disease women tend to fear more). This study’s findings emphasize the importance of daily physical activity for lowering women’s risk of heart disease. About 60 percent of American women don't get the recommended 30 minutes per day of moderate exercise. While a sedentary lifestyle may be the biggest risk, the others – smoking, high blood pressure, high cholesterol and being overweight – shouldn’t be ignored.

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Sources:
Wendy J. Brown et al, “Comparing population attributable risks for heart disease across the adult lifespan in women,” British Journal of Sports Medicine, doi:10.1136/bjsports-2013-093090

Do Bad Teeth = Heart Trouble?

The link between poor dental health and cardiovascular disease is still being examined, but results of a large study that looked at data from nearly 16,0000 people from 39 countries add to a growing body of evidence suggesting an association between oral and heart health. All had coronary heart disease and at least one other risk factor for heart problems. Nearly 70 percent were current or former smokers, and it appears the oral health of the participants also left a lot to be desired. Responses to a questionnaire showed that one quarter of the study participants experienced gum bleeding while they brushed their teeth (a sign of gum disease); 41 percent said that they had fewer than 15 teeth left and 16 percent reported having no teeth at all. The research team, from the Uppsala University in Sweden, identified links between periodontal disease (including bleeding gums), tooth loss and other risk factors for heart disease, such as large waist circumference, high blood pressure and high cholesterol levels. However, the study’s lead author acknowledged that more research is needed to determine whether practicing good dental hygiene can actually help lower the risk of heart disease.

My take? One of the first studies linking oral health and heart disease was published online in the journal Stroke on July 31, 2003. It showed that the more teeth a person has lost, the more likely he or she is to have both advanced periodontal infections and plaques in the carotid arteries that supply the brain with blood. Conceivably, oral health may contribute to heart disease through processes involving inflammation. A secondary contributor to a link may be inadequate nutritional intake. If you lack teeth, you can't optimally process your food and may not get adequate amounts of heart-healthy nutrients and fiber. Research suggests that people with poor oral health should have cardiac exams even if they have no symptoms of heart disease, and the new study supports this recommendation.

Want To Age Gracefully?
It's not about the lines on the face - it's about the wisdom behind them. Don’t lament the passing of the years, celebrate all you have achieved, learned and earned, for your benefit and the benefit of others. Begin today - start your 14-day free trial of Dr. Weil on Healthy Aging now, and save 30% when you join!

Sources:
Olga Vedin et al, “Periodontal disease in patients with chronic coronary heart disease: Prevalence and association with cardiovascular risk factors,” European Journal of Preventive Cardiology, April 10, 2014, doi: 10.1177/2047487314530660

Are Grapes Good For Your Heart?

Want to promote heart health? Look to the grapevine!

Whether you eat the fruit, seeds or skin; drink the juice; or sip on red wine, grapes can help reduce the risk of heart disease. These bright fruits are rich in polyphenols (naturally occurring plant compounds known to have antioxidant activity and other health benefits) including resveratrol, phenolic acids, anthocyanins, and flavonoids, which help to:

  1. Slow or prevent cell damage caused by oxidation, which is an important step in deterring the development of atherosclerosis.
  2. Reduce blood clotting and abnormal heart rhythms.
  3. Lower blood pressure in patients with hypertension.

Choose the darker colored varieties of grapes for the most polyphenol benefits and opt for eating the fruit or skins over juice when able.

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Statins, Cholesterol, and Heart Health (Video)

Statins are used for doing one thing in the body: to lower LDL cholesterol. However, as Dr. Weil discusses, many doctors prescribe statins but do not go beyond medication as a form of treatment and fail to discuss the benefits of healthy eating, exercise, stress-reduction and other healthful routes. Watch as Dr. Weil talks about how statins affect cholesterol and heart health, as well as where he believes statins will be in the future in our society.

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Why Take Blood Pressure in Both Arms?

If you take your own blood pressure, it’s a good idea to check it in both arms (and ask your doctor to do so as well). A study published in the March 2014, issue of The American Journal of Medicine found that a 10- point difference or more in blood pressure readings when comparing the pressures in both arms is an independent risk factor for heart disease. The study included 3,390 people age 40 and older who were followed for an average of more than 13 years. None of them had cardiovascular disease when they enrolled, but during the 13-year follow up period, 598 had a first heart attack, stroke or other cardiovascular problems. Of those 598, 14 percent had a difference of 10 points or more in systolic blood pressure (the top number) from one arm compared to the other. This difference was associated with an increased risk for a cardiac event, the researchers concluded, even when an individual had no other apparent risk factors including age, cholesterol, body mass index and high blood pressure. The researchers noted that other studies have associated disparate readings between arms with a narrowing of an artery that supplies blood to the upper extremities.

Sources:
Ido Weinberg et al, “The Systolic Blood Pressure Difference Between Arms and Cardiovascular Disease in the Framingham Heart Study,” The American Journal of Medicine, March 2014