When cholesterol, which is a component of bile, is reabsorbed into the bloodstream, it is carried to the arteries by a lipoprotein (fat-protein complex) called LDL (short for low-density lipoprotein). If a large proportion of a person’s cholesterol is combined with LDL, it is more likely to be deposited in the artery walls. Another lipoprotein called HDL (short for high-density lipoprotein) can take cholesterol out of the arteries and back to the liver. Not surprisingly, it has been popularized as “good” cholesterol—the higher a person’s HDL cholesterol compared with their LDL cholesterol, the lower the risk. The ideal ratio is one part HDL cholesterol to three parts total cholesterol.
Once again, multivitamin and mineral programs are highly effective at achieving this ideal cholesterol balance. Dr. Michael Colgan has demonstrated that by putting people on a supplement program for six months, then taking them off for three months, and doing this repeatedly over two years, he could consistently lower blood cholesterol and increase the ratio of HDL to LDL.17 vitamin B3 (niacin) is also highly effective at increasing HDL levels, although you need to supplement 500 to 1,000 mg a day. Because niacin can produce an unfortunate blushing effect, many people take niacin inositolate or “no-flush” niacin.
Another effective way to raise HDL and lower LDL and total cholesterol is by consuming significant quantities of omega-3 oils.18 In practical terms, this means taking an EPA fish oil supplement or eating a lot of oily fish. This is what is understood to have protected the Inuit.
Another important point about cholesterol is that, like any fat, it can be damaged by oxidation. Cigarette smoking, for instance, increases the oxidation of fats. Once damaged, cholesterol becomes more difficult to clear from the arteries. Oxidation can also injure the cells that line the artery wall, causing them to get clogged up. Antioxidant nutrients are protective, while low dietary and blood levels of beta-carotene and vitamins A, C, and E have repeatedly been shown to increase the risk of heart disease. By increasing intake of antioxidants and decreasing your exposure to free radicals (see chapter 15), you can reduce your risk.
The combination of the right diet plus supplements is likely to be far quicker and more effective than the current main medical treatment—statin drugs. While these do lower the risks of both heart attack and stroke in the long term (there is usually no risk reduction in the first year) by blocking the enzyme that makes cholesterol, this enzyme also makes an important heart nutrient, coenzyme Q10, so blocking it potentially increases risk for heart failure since CoQ10 is vital for the proper functioning of the heart itself. If you are on a statin drug, make sure you supplement at least 30 mg of CoQ10.
New theory on heart disease—lipoprotein A
According to Dr. Linus Pauling and Dr. Matthias Rath, even these factors may be but a small part of the underlying cause of atherosclerosis.19 On the understanding that our ancestors lost the ability to make vitamin C when living in a tropical environment, Pauling and Rath wondered how we survived through repeated ice ages without dying from scurvy, a disease that once used to decimate ships’ crews. The first sign of scurvy is vascular bleeding, as blood vessels start to leak—nowhere else in the body is membrane under such pressure.
According to Pauling and Rath, we may have developed the ability to deposit lipoproteins along the artery wall in order to increase our chances of surviving during vitamin C-deficient times. Two groups of proteins that normally accumulate at injury sites to carry out repairs are fibrinogen and apoprotein. Apoproteins have a natural affinity with fat (lipids) and become lipoprotein A (LpA), which can repair damaged or leaky blood vessels. However, it also increases the risk of heart disease by building up deposits on artery walls. In fact, of all the factors that can be measured, a person’s level of lipoprotein A is the best indicator of risk.
Genetic research is now strongly suggesting that the development of lipoprotein A was most likely a genetic response to a threat of extinction through leaky blood vessels. Could this have been nature’s way of dealing with life-threatening scurvy? The estimated dates for the development of lipoprotein A in monkeys correlate with the period in which primates are thought to have lost the ability to produce vitamin C.
How well does the theory of vitamin C deficiency as a root cause for cardiovascular disease fit with the facts? Vitamin C deficiency raises cholesterol, triglycerides (fats in the blood), bad LDLs, apoprotein, and lipoprotein A and lowers the beneficial HDLs. Conversely, increasing vitamin C intake lowers a high cholesterol, triglyceride, LDL, or LpA level and raises HDLs.
The significance of all these beneficial effects for our ancestors could have been that during the summer, when they could take in enough vitamin C, the increased HDL production would remove excess cholesterol. Vitamin C also inhibits excessive cholesterol production and helps convert cholesterol to bile. All this would lead to a decrease in unnecessary atherosclerotic deposits. In one study, it was shown that a daily 500 mg of vitamin C can lead to a reduction in atherosclerotic deposits within two to six months. “This concept also explains why heart attacks and strokes occur today with a much higher frequency in winter than during spring and summer, the seasons with increased ascorbate intake,” said Pauling.
If vitamin C deficiency does prove to be the common cause of human cardiovascular disease, then vitamin C supplementation is destined to become the universal treatment for this disease. Pauling and Rath recommend somewhere between 3 and 10 grams a day and, for those with cardiovascular disease, the addition of the amino acid lysine at around 3 grams a day. The combination of these two nutrients appears to reverse atherosclerosis.
Homocysteine—the heart attacker
While a lack of vitamin C may weaken arteries, what actually causes the damage? One answer is a dangerous amino acid called homocysteine. If you’ve had a heart attack or stroke, there’s a more than 50 percent chance you have a high homocysteine level.
The homocysteine theory was first proposed by Dr. Kilmer McCully, a pathologist at the VA Medical Center in Providence, Rhode Island, in 1969. It wasn’t until the 1990s that the evidence for the homocysteine theory started to become very convincing.20 In 1992, a study of fourteen thousand male doctors found that those with homocysteine levels in the top 5 percent had three times the heart attack risk, compared with those in the bottom 5 percent. This increased risk was confirmed by the Massachusetts-based Framingham Heart Study in 1995, which found that having more than 11.4 units of homocysteine in the blood increased the risk.21 Another study at the University of Washington found that having high homocysteine doubles the risk of heart attack in young women.
How lipoprotein A causes heart disease.
How homocysteine causes heart disease.
The real clincher was a study carried out by the European Concerted Action Group, a consortium of doctors and researchers from nineteen medical centers in nine European countries.22 They studied 750 people under the age of sixty with atherosclerosis, compared with 800 people without such cardiovascular disease. They found that having a high level of homocysteine in the blood was as great a risk factor for cardiovascular disease as smoking or having a high blood cholesterol level.
To put this in perspective, every 12 percent increase in your homocysteine score triples your risk of a heart attack if you are a man. If you have both a high homocysteine score and a family history of heart disease, this increases your personal risk of heart attack, regardless of sex, a whopping thirteen to fourteen times! Those with a homocysteine level above 14 units have an 82 percent increased risk of total stroke, compared with those below 9.2 units. Since this study in 1998, more than a thousand studies have confirmed the incredibly strong link between homocysteine and heart disease—much stronger and more important than cholesterol, yet hardly ever tested.
While much of the spotlight on heart disease diagnosis has been on cholesterol, the fact is that your homocysteine level is roughly forty times more predictive of a heart attack than your cholesterol level. Time and time again I encounter heart attack patients w
ho don’t have high cholesterol levels, haven’t been checked for homocysteine, and are still put on cholesterol-lowering drugs such as statins. While these drugs do decrease the rate of death from heart attacks, they don’t have as great an effect on overall mortality, adding, on average, a mere eighteen months to life. Lowering your homocysteine score, on the other hand, dramatically reduces death from all causes, not just heart attacks.
So the question is: how do you lower your homocysteine level? The answer is with B vitamins, not drugs. Specifically, folic acid, B12, and B6. The ideal amount to supplement depends on your homocysteine level, but suffice it to say that anyone at any risk should be supplementing at least 400 mcg of folic acid, 12 mcg of vitamin B12, and 50 mg of B6. Much larger amounts are needed to lower very raised homocysteine scores. Since homocysteine not only damages arteries but also damages cholesterol, making it accumulate in arteries, lowering your homocysteine can be expected to lower your cholesterol too. Homocysteine is discussed in full in chapter 16, together with details on how to lower it.
Supernutrition for a healthy heart
Much is known about the causes of cardiovascular disease and how to prevent it, and no doubt more is yet to be discovered. However, few if any general practitioners are applying what is already known to prevent and reverse heart disease.
The following guidelines apply to us all as a means of eliminating risk and adding at least ten healthy years to our life span
Avoid fried food and limit your intake of meat and foods high in saturated fat. Oily fish such as mackerel, herring, salmon, and tuna are better.
Eat plenty of fresh fruit and vegetables, which are high in calcium, magnesium, and potassium, especially green, leafy vegetables and beans, which are high in folate.
Eat seeds, high in vitamin E, essential fats, and minerals.
Do not add salt when cooking, or to your plate, and restrict your consumption of foods with added salt. If you do use salt, use Solo salt.
Keep fit, not fat.
Don’t smoke.
Avoid prolonged stress.
Know your blood pressure and have your blood lipid level checked every five years.
Take a supplement of antioxidant nutrients, including at least 600 IU of vitamin E and 2 g of vitamin C, plus the omega-3 fats EPA and DHA and a multivitamin containing B6, B12, and folic acid.
If you have cardiovascular disease or high blood pressure, the following also apply
See a nutritionist and have your blood lipid levels and homocysteine measured.
If you have low HDL, take 1 gram of “no-flush” niacin a day.
If you have high cholesterol or triglycerides, take an EPA fish oil supplement giving you 1,000 mg of EPA.
If you have high lipoprotein A, take a supplement of at least 5 g of vitamin C and 3 g of lysine.
If you have high homocysteine, increase your intake of vitamins B6, B12, and folic acid (see chapter 16 for amounts).
If you have high blood pressure, take a magnesium supplement.
Do all you can to improve your diet and lifestyle.
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Boosting Your Immune System
Louis Pasteur, who discovered in the nineteenth century that microorganisms were responsible for infections, realized late in his life that strengthening the body, rather than conquering the invading organism, might prove a more effective strategy. Yet for the last hundred years, medicine has focused on drugs designed to destroy the invader—antibiotics, antiviral agents, chemotherapy. By their very nature, these drugs are poison to the body. AZT, the first prescribable anti-HIV drug, is potentially harmful and proving less effective than vitamin C.23 Although initially antibiotics fight bacterial infection, in the long term they may do more harm than good as they encourage the evolution of new drug-resistant strains of bacteria.24 Chemotherapy depletes the immune system and, even in the best situations, wins a victory at a cost.
Only recently, with the seemingly endless onslaught of new infectious agents, has attention turned within—toward strengthening our immunity. The immune system is one of the most remarkable and complex systems within the human body. When you realize that it has the ability to produce a million specific “straitjackets” (called antibodies) within a minute and to recognize and disarm a billion different invaders (called antigens), the strategy of boosting immune power makes a lot of sense. The ability to react rapidly to a new invader makes all the difference between a minor twenty-four-hour cold or stomach bug and a week in bed with flu or food poisoning. It may also be the difference between a nonmalignant lump and breast cancer or a symptom-free HIV infection and full-blown AIDS.
Immune power
How do you boost your immune power? Exercise, your state of mind, and your diet all play a part. Overtraining or vigorous exercise actually suppresses the immune system, while the Chinese art of tai chi has been shown to increase the count of T cells (one of the body’s types of immune cell) by 40 percent. Calming rather than stressful forms of exercise are probably best for immunity. This may be because corticosteroids, substances produced by the adrenal glands as a response to stress (and also taken as the drug cortisone), suppress the immune system. This too may be a key explanation for numerous studies that have found that low psychological states such as stress, depression, and grief depress the immune system. Learning how to cope with stress, deal with psychological issues, and relax is an important part of boosting the immune system. Meditation, for example, has been shown to increase T-cell counts and improve the T-helper/suppressor ratio (see this page).25
Understanding immunity
The purpose of the immune system is to identify the body’s enemies and destroy them. These enemies include defective body cells as well as foreign agents such as bacteria and viruses. The main “gates” into the body are the digestive tract, which lets in food, and the lungs, which let in air. Within the digestive tract is the “gut-associated immune system,” which is programmed to allow completely digested food particles, such as amino acids, fatty acids, and simple sugars, to pass unhindered through the gut wall into the body. Incompletely digested food can result in immune reactions and eventually allergies, especially if large food molecules pass into the bloodstream. The nasal passages help prevent unwanted agents from entering the lungs. Healthy, strong mucous membranes in the respiratory and digestive tract are the first line of defense against invaders.
The immune army
Inside the body, the immune system has an army of special cells to deal with invaders. These defenders differ in their function and territory. For example, some cells operate in the blood, keeping an eye out for invaders and calling up other troops that can destroy specific invaders. The three main types of immune cell found in the blood, collectively called white cells, are B cells, T cells, and macrophages.
B cells, or B lymphocytes, are produced in an antibody for each specific invader or antigen. When a B cell comes into contact with an antigen, it grows larger and divides into several cells that secrete specific antibodies that latch on to the invader. Antibodies cannot destroy bacteria and viruses, but they do give them a hard time. They stop bacteria producing toxins, and they prevent viruses from entering body cells. Since a virus cannot reproduce unless it enters a body cell and takes over the cell’s control center, reprogramming it to produce more viruses, antibodies are a major nuisance for viruses. Antibodies also summon other, more belligerent members of the immune army, such as T cells.
The immune army and battleground. The immune system trains specialized cells, such as B or T lymphocytes, from “stem cells” made in bone marrow. These travel around the body, especially in the lymph, protecting you from invaders, be it a virus or a food you are allergic to or even a misbehaving cancer cell.
T cells, or T lymphocytes, are derived from the thymus gland at the top of the chest. There are three kinds: T-helpers, T-suppressors, and NK (natural killers). NK cells produce toxins that can destroy the invader. T-helpers help activate B cells to product antigens, while T-supp
ressors turn off the reactions once the battle is won. Normally, there are roughly twice as many T-helpers as T-suppressors. In AIDS, the HIV virus selectively destroys T-helpers, resulting in too many T-suppressors, which depress the immune system, leaving the sufferer susceptible to other infections.
Macrophages finish off the battle by completely engulfing and digesting the invader that has been identified by B and T cells. This action is called phagocytosis. Phagocytic cells that operate in the blood are called monocytes, while those that operate in other tissues are called macrophages.
The immune battleground
At any time, there are a small number of immune cells roaming the body. Many of them have only a short life: T cells, for example, live for about four days. When an invader is identified, new troops are produced in the bone marrow and thymus and posted to forts such as lymph nodes, tonsils, appendix, spleen, and Peyer’s patches in the digestive tract that concentrate lymphocytes. Lymphatic vessels drain into these forts, bringing in invaders to be destroyed. That is why lymph nodes, for example, in the neck, armpits, and groin, become inflamed during an infection. This means they are doing their job. Since the lymphatic system doesn’t have a pump, lymphatic fluid is moved along by muscle movement, so physical exercise is important for lymphatic drainage.
Immune-boosting nutrients
Your immune strength is totally dependent on an optimal intake of vitamins and minerals. Deficiency of vitamins A, B1, B2, B6, B12, folic acid, C, and E suppresses immunity, as does deficiency of iron, zinc, magnesium, and selenium. Vitamins B1, B2, and B5 have mild immune-boosting effects compared with B6. The production of antibodies, so critical in any infection, depends upon B6, as does T-cell function. The ideal daily intake is probably 50 to 100 mg. B12 and folic acid also both appear essential for proper B-cell and T-cell function. B6, zinc, and folic acid are all needed for the rapid production of new immune cells to engage an enemy.
The New Optimum Nutrition Bible Page 22
