Lamberts
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Nutrition focus on:
Heart Health
For proFessional use only
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Nutrition focus on:
Heart Health Coronary heart disease is the number one killer among adults in the uK, killing more than one out of every four men and one out of every six women.
Heart disease develops as the coronary arteries, which provide oxygen and nutrient rich blood to the heart muscle, become clogged by the build-up of cholesterol plaques. This degenerative condition of the arteries is termed atherosclerosis. Although the causes of atherosclerosis still remain to be fully understood, cholesterol is clearly involved. It appears that cholesterol is in its most dangerous form when oxidised. superior Vena Cava
Structure of the Heart
aorta left atrium right atrium
The Homocysteine Theory Excess homocysteine, a toxic amino acid formed in the body from a dietary precursor, can also oxidise cholesterol and is thought to be involved in the development of atherosclerosis. To try and prevent this happening, homocysteine needs to be broken down. To do this several nutrients are needed, the main ones being vitamin B6, folic acid, B12 and magnesium.
inferior Vena Cava
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right Ventricle
left Ventricle
Cholesterol is transported via the blood within tiny particles called lipoproteins, of which the high-density (HDL) and low-density (LDL) lipoproteins are the most important. HDL are protective against atherosclerosis, while LDL are directly related to risk in both men and women. This is due to the fact that HDL transports cholesterol to the liver for metabolism and excretion, whereas LDL transports cholesterol into the arterial walls. Hence the HDL to LDL ratio largely determines whether cholesterol is being broken down via the liver or deposited in the arterial walls. This HDL to LDL ratio also affects other balances in the body; for instance as the HDL/LDL ratio increases, platelet aggregation (the tendency for blood to become sticky) decreases. This helps to prevent the formation of blood clots. This is important because a blood clot in a coronary artery may lead to a heart attack by reducing the blood supply to the heart.
Other Risk Factors Certain activities and environmental conditions are also known to make us more prone to arterial disease. They include smoking; high stress levels; diets high in saturated animal fat; eating sugar and other refined carbohydrates; a low fibre intake; excess alcohol; and lack of exercise. We can reduce our chances of coronary heart disease by altering our lifestyle to minimise or eliminate these risk factors, and by supplementing our diets with certain dietary nutrients.
Women are partially protected from heart disease by oestrogen until the menopause, when ovarian function ceases and their risk level reaches male proportions.
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Co-Enzyme Q10 Co-enzyme Q10 is extremely important for heart health, which is not surprising considering that the highest concentration of co-enzyme Q10 in the human body is found in the muscle cells of the heart. Indeed, it helps this organ to beat more than 100,000 times per day! Whilst our bodies can make co-enzyme Q10, as we age our ability to produce it declines at a time when our requirement may increase. This makes our dietary intake an increasingly important source. However, whilst this nutrient is found in foods, such as organ meat, cooking methods have a tendency to destroy it, making supplementation relevant for many. Co-enzyme Q10 is fat-soluble and therefore to be more efficiently absorbed should be presented in an oil base.
IS yOuR patIEnt On StatInS? A type of medication generally taken to reduce cholesterol levels, termed statins, are known to not only lower unwanted cholesterol levels but also to reduce the production of co-enzyme Q10. There are many different statistics quoted but in the main it would appear that the synthesis of co-enzyme Q10 could be lowered by as much as 40% and this would appear to occur in just a few weeks of commencing on the medication. So supplementation makes good sense among those on this medication.
Omega 3’s The beneficial ingredients of fish oil are two fatty acids, EPA and DHA. These are omega 3 fatty acids, which are being extensively studied in relation to heart health. Indeed there are literally hundreds of population studies and clinical trials that provide evidence that EPA and DHA may help prevent cardiovascular disease. The omega 3’s are also being researched because for many people their dietary intake has fallen to a point that is low enough to be affecting their health. This is why the Government recommend that we eat some oily fish, once a week, and many nutritionists think that it should be as often as twice or three times a week. Ideally everyone should eat on average 2 to 3 grams of omega 3’s a day but it seems that few people achieve this level, especially if they eat little oily fish.
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Magnesium
Vitamin K
Magnesium is an essential mineral for energy and cardiac efficiency, yet our intake of magnesium has declined sharply due to modern food processing practices and dietary habits.
Vitamin K is the umbrella term for a group of fat-soluble compounds comprising vitamin K1 and vitamin K2. Vitamin K1, also known as phylloquinone, is obtained in the diet from green leaves, broccoli, brussel sprouts and plant oils, and makes up about 90% of our vitamin K intake. Vitamin K2 (a family of menaquinones) is produced in smaller quantities by the friendly bacteria in the digestive tract.
According to government statistics the median intake for magnesium in the UK is only 223mg/day, which is staggeringly lower than the new recommended daily allowance (RDA) of 375mg. The extent of magnesium insufficiency may be even greater if we consider the arguments of some award-winning nutritional scientists, that even people who are consuming the RDA may not be getting enough to provide for a healthy middle and later life, with a reduced risk of chronic disease. Moreover population studies have shown that low magnesium status may increase the risk of heart disease, abnormal cardiac rhythms and stroke, especially with hypertensive individuals. And when it comes to dosage, in order to maintain blood and tissue levels of this essential mineral, a daily oral supplement in the order of 300 to 450mg is required.
Vitamin D Our bodies obtain vitamin D (which, strictly speaking is a steroid hormone) from two sources, our diet and from the action of sunlight on our skin which drives the natural production within the body. If we all had plenty of sun then we would have plenty of vitamin D, but in reality we do need to obtain some from our diet, which makes supplementation relevant for many.
Many experts now believe that a sub-clinical vitamin K deficiency, that is, one that is not great enough to hinder blood clotting capacity, could be wide-spread and could contribute to osteoporosis, and other age-related diseases, including cardiovascular disease. Moreover, population studies clearly show a link between higher dietary intake of vitamin K2 and lower rates of arterial calcification and cardiovascular disease. And intervention studies show evidence that vitamin K1 also plays a key role in arterial health.
In fact as many as 60 percent of the UK population is vitamin D deficient and this situation is causing such concern to some experts that they are calling for vitamin D deficiency to be classified as a major ‘lifestyle’ risk, like smoking, alcohol, obesity and being sedentary. Observational studies clearly indicate that individuals with lower serum vitamin D levels have a higher risk of cardiovascular disease incidence, including heart attack, stroke and heart failure. Whilst vitamin D supplements come in two forms: D2 (ergocalciferol) and D3 (cholecalciferol). D3 is the natural form and is thus considered to be more bioavailable than D2.
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B Vitamins
L-Carnitine
Researchers have found a correlation between high homocysteine levels and an increased incidence of heart disease. Correspondingly, they have found that a high proportion of these individuals are also low in vitamins B6, B12 and folic acid, nutrients known to keep homocysteine at safe levels.
Carnitine is an important amino acid made by the body from lysine. Its most important known metabolic function is to transport long chain fatty acids into the mitochondria of muscle cells for oxidation. Cardiac muscle is especially dependent upon this mechanism as an important source of metabolic energy.
Since the functions of the B vitamins are synergistic, a deficient intake of one or more of them may cause deficiencies in the others by hindering their utilisation. Consequently, most practitioners prefer to give a B Complex (either on its own or in combination with some of the single B vitamins) when supplementation is long-term.
Vitamin E Studies are consistently confirming that vitamin E is a powerful antioxidant for fighting heart disease. Current research suggests that a daily intake of 400iu is a sensible level. However, it is often difficult, if not impossible, to get this level from a typical diet. For example, 0.45kg (1 lb) of sunflower seeds are needed to obtain 400iu of vitamin E.
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The main source of carnitine in our diets comes from red meat and dairy foods, whilst dietary supplementation of L-Carnitine can safeguard intake of this metabolically essential substance.
Garlic Garlic has a tradition of use for cardiovascular health with evidence that it may help to maintain normal cholesterol levels in the circulation, when part of a healthy low fat diet. Current investigations have attributed garlic’s effectiveness to its effect in increasing the HDL/LDL ratio. The active ingredients in garlic are believed to be the many sulphur containing compounds, one of which is alliin, which is converted to allicin when the garlic is chewed or crushed. It is allicin that gives garlic its characteristic smell, and is believed to be the compound responsible for the health benefits of garlic.
prescribers Guide to Heart Health
Suggested Daily Dose
100 to 200mg Use co-enzyme Q10 that is in a vegetable oil base since this has greater bioavailability than co-enzyme Q10 presented as a powder.
300 to 450mg Look for magnesium in the citrate form since this is the form most easily absorbed by the body and the form that has a wealth of scientific research supporting its use.
1100mg of Pure Fish Oil, twice daily Use a fish oil that gives a guaranteed level of 700mg of omega 3’s and which quotes levels of EPA & DHA at about 360mg and 240mg respectively.
1000iu Use the natural D3 form as opposed to the D2 form, since D3 is considered to be more bioavailable.
75μg Use a vitamin K Complex that combines both K1 and K2 in their natural form since evidence points to both compounds being important.
One tablet Use a B-50 Complex which includes 400µg of folic acid, 50mg of vitamin B6 and 50µg of vitamin B12.
E
400iu Use vitamin E in its natural form of d-alpha tocopherol, as this is the form in which it occurs in foods and as research has confirmed that it possesses a higher biological activity, and is absorbed and retained more readily by the body than synthetic vitamin E.
500mg Use L-Carnitine presented in its free-form, as this means it is ready to be absorbed and used by the body.
1650mg Look for a garlic product equivalent to 1650mg of fresh garlic and where the ‘allicin potential’ is preserved and is quoted in the region of 5500µg.
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