GREEN TEA: The flavonoids in green tea are known as polyphenols. These substances have powerful antioxidant effects that may be greater than or equal to that of vitamins C and E. As little as one cup of green tea per day will provide protection.110
GARLIC: Garlic has a long history of use in the treatment of hypertension. One pilot study showed that high doses of garlic (2,400 mg of deodorized garlic per day) significantly lowered both diastolic and systolic blood pressure. Like alpha-lipoic acid, garlic appears to increase the activity of the endothelial cells that produce nitric oxide, which is a blood vessel relaxant.
Numerous studies have also shown that regular consumption of garlic reduces cholesterol by 10 percent or more and lowers triglyceride levels by up to 13 percent. It may also inhibit platelet aggregation and blood clot formation.111
The German Commission E, which evaluates therapeutic claims for natural substances, recommends a dosage level equivalent to one to four cloves of fresh raw garlic a day. This is the amount estimated to provide 4,000 mcg of allicin, one of garlic’s most beneficial compounds. Many good garlic supplements are on the market. Look for one with the active ingredient alliin, because this substance is relatively odorless until it is converted into allicin in the body. Products containing this substance supply all the benefits of fresh garlic but are more socially acceptable. A daily dose should be 10 mg of alliin, or a total allicin potential of 4,000 mcg. (See Resources.)
HAWTHORN: In her inspiring book Herbal Rituals (St. Martin’s Press, 1998), master herbalist Judith Berger points out that hawthorn leaf, blossom, or berry (Crataegus oxyacantha) extracted into water or spirit-based preparations is a “fierce and protective ally for those seeking to prevent heart-related conditions which are passed on from generation to generation.”112 Hawthorn berry extract can calm palpitations, help restore blood vessel elasticity, ease fluid buildup in the heart, halt fatty degeneration of the heart, help dilate coronary arteries, and also reduce blood pressure. It can be used by those already on cardiac medication and may help you decrease your dosage. I take my hawthorn as a tea. You just buy a bag of organically grown hawthorn berries at a natural food store and steep them in hot water to taste. There is nothing standardized about this method, but I see myself as creating a healthy heart by drinking a little tea, not treating heart disease. Hawthorn has not been shown to have any adverse side effects.
If you prefer to take your hawthorn as a pill, look for a standardized extract, and use a product that contains 10 percent proanthocyanidins or 1.8 percent vitexin-4"-rhamnoside. The usual dose is 100–250 mg three times per day.
SOY: For years, studies have shown that soy lowers triglycerides and total cholesterol levels, including LDL (“bad”) cholesterol, while raising HDL (“good”) cholesterol.113 Soy has further been shown to reduce blood levels of C-reactive protein114 and homocysteine,115 both markers for cardiovascular problems. Some studies even document improvements in the width of the arteries.116 This may be due to soy’s antioxidant properties, which could prevent LDL cholesterol from clogging the arteries.117 The data has been so overwhelming that on October 26, 1999, the FDA approved the health claim that consuming 25 gm of soy protein per day reduces the risk of coronary artery disease.118
One study using meal replacement shakes and nutrition bars, both soy-and milk-based, showed that those using the soy-based products had a decrease of 15.2 percent in total cholesterol and 17.4 percent LDL cholesterol after six weeks, as well as a significant de-crease in triglycerides. Stats for those using milk-based meal replacements were 7.9 percent and 7.7 percent, respectively, with no drop in triglyceride levels.119
Sodium-Potassium Balance
Decreasing sodium and increasing potassium in your diet can help control high blood pressure, which is an important risk factor for heart and circulatory problems.120 For the 60 percent of individuals whose hypertension is related to sodium intake, the effect of sodium on blood pressure can be relieved by increasing intake of potassium. Dietary potassium deficiency is caused by a diet that is low in fresh fruits and vegetables and high in sodium. This is your basic fast-food diet! A diet rich in fruits, vegetables, and whole grains can supply you with 4,000–6,000 mg of potassium a day. Drugs such as diuretics, laxatives, aspirin, and others can also deplete your potassium. Prolonged exercise is associated with loss of potassium as well—up to 3,000 mg of potassium can be lost in one day by sweating. A diet high in potassium and low in sodium protects against high blood pressure, stroke, and heart disease. Potassium supplements have been shown to significantly lower both systolic and diastolic blood pressure, but these have side effects, including nausea, vomiting, diarrhea, and ulcers, when given in pill form at high doses. This won’t happen if you increase your levels through diet alone.
Most Americans have a potassium-to-sodium dietary ratio of 1:2, but researchers recommend a 5:1 ratio. One trip to a fried-chicken joint or pizza place will mess up this ratio. Because fruits and vegetables like potatoes, bananas, and apples are such rich sources of potassium, don’t get too hung up on their high glycemic indexes. Because they are whole foods, they will not raise your insulin levels high enough to really cause damage unless they are highly processed into something, such as french fries. It is the simple carbohydrates in white-flour products that really mess things up as far as both insulin and potassium-to-sodium ratios are concerned. This is yet another reason why you want to try for five servings of fruits and vegetables per day in your diet.
Because magnesium and potassium work together at the level of the cell, they are often low at the same time.
FOODS TO IMPROVE YOUR POTASSIUM-SODIUM RATIO
Potatoes 110:1 (ratio of potassium to sodium)
Carrots 75:1
Apples 90:1
Bananas 440:1
Oranges 260:1
WHAT ABOUT ASPIRIN?
In 1982 John Vane, Ph.D., won the Nobel Prize by showing that aspirin can inhibit the clumping of platelets in blood vessels. This led to the widespread recommendation to take aspirin to decrease the risk of heart attack and stroke by preventing clots from forming in arteries that have been narrowed by arteriosclerosis. Studies strongly suggest that those who have evidence of ischemia of the heart muscles (decreased oxygenation of the heart) can definitely benefit from taking aspirin.121
A recent study of 40,000 female health workers over the age of forty-five, known as the Women’s Health Study, found that women who took the equivalent of a baby aspirin every other day reduced their risk of stroke by 17 percent. There was no reduction in risk of heart attack, however. Aspirin use has its risks, though they are small at low doses. There were 127 hospitalizations for gastrointestinal bleeding among the aspirin users compared to 97 cases among the non-aspirin users.122 (Excess alcohol intake is a well-known risk factor for gastrointestinal bleeding.)
Aspirin works by decreasing cellular inflammation and subsequent platelet “stickiness.” But there are other far more effective and healthful ways to do this without any possible side effects.
Eat fruits and vegetables: Studies have shown that women who eat five to six servings of fruits and vegetables per day lower their risk of stroke by 31 percent. The strongest effect comes from the cruciferous vegetables, such as broccoli, cauliflower, Brussels sprouts, and cabbage, followed by green leafy vegetables and citrus fruit and juice.123
Eat carrots: JoAnn Manson, M.D., Dr. P.H., and her colleagues at Harvard Medical School tracked 87,000 nurses for eight years in the Nurses’ Health Study and found that women who ate just five large carrots per week lowered their risk of stroke by 68 percent compared to those who ate only one carrot per week.124
Drink tea: Both black and green tea consumption have been shown to have beneficial effects on the endothelial lining of blood vessels, which helps decrease the risk of stroke.125 The Zutphen Elderly Study in the Netherlands found that foods rich in an antioxidant known as quercetin (such as apples, tea, and onions) also decreased the risk of stroke. Black tea consumption (fiv
e or more cups per day) decreased the risk of stroke by 69 percent.126
Take tocotrienols: Tocotrienols do the same thing as aspirin without the risks of gastrointestinal bleeding. They decrease blood clotting or “stickiness” the same way aspirin does, by inhibiting the production of a potent coagulation factor known as thromboxane. As thinner, more freely flowing blood is associated with the lower risk of stroke, heart attack, and transient ischemic attack, tocotrienols have also been shown to decrease platelet aggregation by as much as 15 to 30 percent, an effect equivalent to that of baby aspirin.127 (If you’re already on aspirin, you can still take tocotrienols because they don’t enhance the effect of aspirin significantly, if at all.)
Eat fish: Eating fish or taking fish oil (or another source of omega-3 fats) has consistently been shown to decrease the risk of stroke.128
BIOIDENTICAL PROGESTERONE: GROUNDBREAKING WEAPON AGAINST HEART DISEASE
Dimera, Inc., a tiny cardiovascular research and development company in Portland, Oregon, has hit on a giant idea. With research funded in part by grants from the National Institutes of Health, Dimera recently developed the first heart drug specifically for women—a form of low-dose, slow-release natural progesterone in a transdermal cream that uses gene expression to optimize its delivery method.
Dimera has shown in research using monkeys as subjects that the lower levels of progesterone common in menopause can cause abnormal coronary artery constriction. Restricted blood flow can lead to chest pain and, eventually, heart disease. But progesterone therapy can decrease the magnitude and duration of this vasoconstriction, thus keeping the heart healthy.
Because this abnormal vasoconstriction occurs intermittently, the only way it can show up in an angiogram is if the subject is experiencing angina at the time of the test. And even then, the affected blood vessels are so small that magnetic resonance (MR) or positron emission tomography (PET) scans must be used to detect it, making diagnosis of the problem difficult at best.
A 2008 study conducted by the company reviewed the cardiovascular effects of synthetic progesterone (progestin) compared to natural progesterone and found that there is in fact a minimum level of progesterone necessary for normal cardiovascular function in women.129 Dimera believes that using natural progesterone (which does not have the unpleasant side effects that synthetic progestins cause) could keep the blood vessels healthy, thus preventing abnormal vasoconstriction. My past clinical experience also shows that natural progesterone can be helpful in treating chest pain, which is caused by prolonged vasoconstriction. More research is still needed on this subject, but small studies have already shown that as little as 20 mg of natural progesterone applied to the skin of the chest, hands, or abdomen once or twice per day can effectively treat angina. Taking progesterone orally has not proven to be as effective.
Dimera is now in the midst of clinical trials and hopes to bring its drug to market soon. (For more information, visit Dimera’s website at www.dimera.net.) In the meantime, using natural progesterone cream available over the counter (PhytoGest and Pro-Gest are good brands) might well confer at least some benefits. Your doctor can also prescribe more concentrated progesterone creams or gels (available from a formulary pharmacy) that may work even better.
GET MOVING!
It should come as no surprise that maintaining a healthful lifestyle—including staying active—will go a long way toward living a longer, healthier life. The results of a 2009 study suggest that being physically active, achieving a normal weight, and never smoking are ways to effectively prevent cardiovascular disease and to extend your total life expectancy.130 A study published in 2010 gives a good picture of the flip side: the collective effects of smoking, lack of physical activity, poor diet, and alcohol consumption are associated with a substantially increased risk for death.131 According to this research, those who partake in all four unhealthy behaviors had about three times the risk of dying from cardiovascular disease or cancer, four times the risk of dying from other causes, and an overall death risk equivalent to being twelve years older than people with none of these behaviors.
Exercise provides enormous cardiovascular benefits and has been shown repeatedly to significantly reduce the risk of heart disease, hypertension, and stroke.132 Exercise training after diagnosed coronary artery disease has also been shown to improve blood flow to the heart by improving the ability of the blood vessel lining (endothelium) to keep vessels open and also by recruiting collateral vessels in the heart muscle that help bypass vessels that have been blocked.133 A 2010 study done at Boston’s Brigham and Women’s Hospital showed that women who walk two or more hours a week, especially at a brisk pace, are significantly less likely to experience any type of stroke than women who do not walk. The data for this study came from the long-term follow-up findings for the Women’s Health Study, which looked at more than 39,000 healthy women age forty-five and up.134 The benefits of exercise to help your heart even after a heart attack are evidence of just how forgiving the heart and blood vessels are when we care for them.
Your goal should be to exercise five or six days per week for at least thirty minutes. Walking is fine, but remember that true fitness includes strength, flexibility, and endurance, so activities should promote all three. Weight training, for example, builds lean muscle mass that not only increases strength but also increases your metabolic rate. Yoga is great for flexibility. Aerobic activities increase endurance. Pilates builds lean muscle mass and increases flexibility. Exercise also decreases insulin and blood sugar levels and will give you a bit more leeway with your diet.
The Role of Lymph
One of the main reasons why exercise has such healing power is that it vastly increases the lymph circulation in your body. Lymph is the clear fluid that drains from around your body’s cells into the lymphatic system, a network of thin-walled vessels found throughout every organ and tissue in your body. Lymph vessels contain small valves to keep the lymph from flowing backward. Bean-shaped structures known as lymph nodes are found at frequent intervals along lymph vessels, with major centers occurring in the groin, neck, and armpits and alongside the aorta and the inferior vena cava in the chest and the abdomen. The function of the lymph nodes is threefold: (1) to filter out and destroy foreign substances, such as bacteria and dust; (2) to produce some of the white cells called lymphocytes that help fight tumors and other invaders; and (3) to produce antibodies that help in the body’s immune surveillance system. All lymph eventually gets emptied into a large central vessel in our chest cavities, known as the thoracic duct, which eventually empties into our hearts, so that the lymph and blood get mixed together once again after our lymph nodes have removed the waste, bacteria, and other flotsam and jetsam from it.
In addition to its role in helping keep bacteria and other invaders in check, the lymphatic system is essential to the mechanism by which fats are processed by the body. Lymph vessels that drain the small intestine collect the digested fat from the foods we eat and pass it directly into the main blood circulation, bypassing the liver. Once fats are in the blood, they may or may not get laid down in the blood vessels of the heart, forming fatty streaks that eventually lead to hardening of the arteries and the beginning of cardiovascular disease. Whether or not this happens depends upon our diet, our exercise habits, and our emotional and psychological state.
I interviewed Jerry Lemole, M.D., a leading cardiovascular surgeon from Philadelphia, many of whose patients suffer from endstage heart disease. His research on the role of the lymph system is both intriguing and motivating.
The HDL-Lymph Connection
The lymphatic system in the heart is intimately involved with the process that leads to coronary artery disease. LDL, the so-called “bad” cholesterol, is a large, fluffy fat molecule that can get into blood vessel walls through breaks in the intimal tissue that forms the blood vessel lining. This is especially apt to happen when LDL cholesterol becomes oxidized. Once LDL gets stuck here, it tends to break down and leave cholesterol depo
sits behind.
HDL cholesterol, the “good” cholesterol, is a smooth football-shaped molecule that is small enough to actually get into the tissue around the blood vessel wall and vacuum up the cholesterol deposits left behind by the LDL.
In order for HDL to do its job of vacuuming up cholesterol de-posits, it needs to get to where the cholesterol is located. It does this through lymph circulation. Dr. Lemole likens HDL molecules that pick up cholesterol in the artery walls to taxicabs in New York City. If you view Manhattan from a helicopter, you’ll see a certain number of cabs. At any given time, because traffic in New York is so often backed up in the tunnels that lead to and from the city, you’ll have many cabs unavailable to passengers in the street who need to be picked up. If you could speed up the passage of the cabs through the tunnels, there would be more cabs available on the streets.
The same is true with the cholesterol-carrying capacity of HDL. When lymph flow is sluggish, HDL molecules simply are not available to pick up excess cholesterol deposits. If you speed up the circulation time of lymph, you’ll also improve the efficiency of HDL to scavenge excess fat from your arteries.135
How to Speed Up Lymph Flow
1. DON’T SIT FOR LONG PERIODS OF TIME. Women who sit for long periods of time at sedentary jobs are more likely to get heart disease because the lymphatic flow through their thoracic cavity is limited.
2. BREATHE DEEPLY AND REGULARLY. Breathing fully in through your nose and inhaling air down into the lower lobes of your lungs followed by a brisk exhalation massages the thoracic duct and all the lymph vessels and nodes in your chest cavity, which helps HDL get to the places it needs to go to do its work.
The Wisdom of Menopause Page 75
