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Cardiac Wellness Workshop

Presented by:

Beacon Hill Chiropractic and MassageDr. Michael Schmolke and Associates

Dr. Sherra SandersDr. Chris Yavis

Our vision:

Vision: "We change people’s lives through inspiration, empowerment, and excellent health care delivery in a beautiful, efficient team environment making us Calgary’s first choice for natural health care."

Objectives

Understand more about cardiovascular diseases

Raise some questions about different theories and learn of emerging concepts

Discuss the controversy & contraindications of statin drugs & other drug-lab test based approaches to CVD (Effective?)

Gain command of what YOU can do about this situation

Supplement recommendations as alternatives to Rx drugs

Latest recommendations on exercise and nutrition

Have some fun learning together

Definitions

Cardiovascular diseases A class of diseases that involve the heart or

blood vessels. It primarily refers to atherosclerosis (arterial disease). CV diseases includes aneurysm, angina, atherosclerosis, stroke, cerebrovascular diseases, CHF, CAD, MI, and peripheral vascular disease.

We know that atherosclerosis begins in the 1st

decade of life. It is treatable. It must be prevented!

Atherosclerosis Definitions

Atherosclerosis is a disease in which plaque builds up inside your arteries. Arteries are blood vessels that carry oxygen-rich

blood to your heart and other parts of your body.

Plaque is made up of fat, cholesterol, calcium, and other substances found in the blood. Over time, plaque hardens and narrows your arteries, limiting the flow of oxygen-rich blood to your organs and other parts of your body. This can lead to serious problems, including heart attack, stroke, or even death.

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Plaque Build Up of Atherosclerosis

What causes this process to start?

Fats in diet?

Cholesterol levels?

Lifestyle? (eg. Smoking, sedentary

living, stress?)

Controversy exists: some say….

It is due to fat in diet! – 1980’s US Gov, A. Keyes

Good fats – bad fats

It is due to stress and high cortisol hormone output – H. Selye, J. Wilson, R. Sapolsky

It is due to refined carbohydrate consumption

It is a consequence of missing required nutrients in foods we eat – nutritionism

It depends on who you want to believe!

DefinitionsParadigm "a philosophical and theoretical framework of

a scientific school or discipline within which theories, laws, and generalizations and the experiments performed in support of them are formulated.”

“broadly: a theory or group of ideas about how something should be done.”

“Narrow paradigms” can cause big problems Examples: Tonsils, C-section births, Antibiotics,

Vaccinations, Bed rest, pain drugs MSK

Problem with current paradigmsCurrent medical paradigm (MD’s, hospital)

Educational emphasis seems to assume that humans are different from all other animals

Diseases come from within us, due to a flaw in our design >>>> Genetics

Focus of tx. is patient symptoms, “lab tests” results

Wellness & prevention paradigm (Biology)Humans are just like animals

Diseases result from poor living style, stress, & the environment (deficiencies/toxicities) >>>> Adapting to bad environments propagates dis-ease and diseases to develop over time

A new concept in health: Adaptive Physiology

Homeostasis:The tendency of an organism to maintain internal equilibrium by adjusting its physiological processes.

Allostasis:The achievement of stability by turning on and turning off the allostaticsystems including the IMMUNE SYSTEM; the AUTONOMIC NS, and NEUROENDOCRINE SYSTEMS via the NERVOUS SYSTEM.

Biological adaptation, such as the rise of EPINEPHRINE in response to exercise, stress or perceived danger, followed by a fall of epinephrine during RELAXATION.

Leading scientists now view our well-being through the eyes of how well we adapt, and are discouraging the old ideas of “normal lab values”

Adaptive physiologyWhat is normal? Views are changing

Old view – blood pressure should be 120/80 (Sys/Dias)

New view – There may be no true normal - controversyYour blood pressure is in constant flux based on circumstance. It fluctuates based on mood, activity, diet, perceived & demands.

If routinely high, why haven’t you adapted correctly? What is the cause? Not a disease, but an unhealthy factor in life!

Old view – Normal cholesterol levels TC < 5.2 mmol

New view – TC not a clear relation to CVD prediction!Cholesterol rises in response to diet and internal repair mechanisms. The real question is what are the circumstancesthat are causing internal damage, & why are we eating poorly

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The real cause of heart disease

Old theory: high cholesterol causes heart disease – take cholesterol lowering meds, reduce fat intake

Real culprit = inflammation in arterial wall!!!

It is time for an analogy

• Your health is a genetic expression of your lifestyle

• Stresses are like rocks in our backpack We need to get rid of these

rocks

Adaptation is all about the brain!Allostatic loads (or stressors) Stressors create adaptations in the body that are

perfectly suited to allow us CHANCE to remove ourselves from the threat/situation and get back into a resting balance in our environment and physiology

The wear & tear on the body results from ongoingadaptive efforts to maintain stability in response to stress.

Deficiencies or toxicities are stressors Deficiencies include: physical inactivity, inadequate sleep, improper

nutrition, lack of socialization and loving relationships,

Toxicities include: chemicals, emotional stress, dietary imbalances, high time demands, environmental elements like EMR/pollution/ too much excitatory stimulation (TV, computers)

So what is the problem?Examples of perfect adaptations: Poor diet, emotional stress, perceived threat:

High blood pressure & increased heart rate

Decreased immune function

Lowered rate of cell repair & detoxification

Increased blood cholesterol levels

We are not correcting the situation or environment, therefore we are forced to sustain adaptations.

Sustained adaptation > dis-ease > disease

Contemporary (medical) views of proposed causes of CVD

Smoking

Genetics

High amounts of certain fats and cholesterol in the blood

High blood pressure

High amounts of sugar in the blood due to insulin resistance or diabetes

Cause or Effect? Paradigm dictates approach

New biological research understandings: causes of CVD

Smoking – single l.c. of premature death - modifiable

Chronic Inflammation - modifiable

Linked to CA, Atherosclerosis, Alzheimer’s, Diabetes, Obesity

Obesity – 42 million children world wide - modifiable

High blood pressure - modifiable

Specific type of cholesterol – modifiable

Diabetes - 80% die from CVD – modifiable (II)

Low antioxidant levels - dietary

Low essential fatty acids - dietary

Low Magnesium & Potassium - dietary

Type A personality - modifiable

Alcohol - modifiable

Physical inactivity – modifiable

If modifiable >>> Preventable

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New understandings of CVDUnhealthyResponse

inOur

Body

UnhealthyCarbohydrateRichDiet

Lack

of

Antioxidants

InadequateSleep

Lack

of

PhysicalActivity

HeartDiseases

VascularDiseases

Unhealthy

BodyComposition

UnhealthyStress

Pro-InflammatoryDiet

The role of Genetics??

Inflammation

Important to our innate immune function

Caused by stress, injury, toxins, and diet

Free radicals (ROS’s), High Meat (Grain fed) consumption, infections, high sugar consumption

Imbalance of ratio of n6 oil : n3 oil

InflammationOmega 6:omega 3 ratio is severely out of balance Prehistoric 1:1

Early 1900’s 3:1

Current 25-45:1

Should be balanced in our diet. Imbalance creates massive inflammation and diseasesCVD, Cancer, Pain and degeneration like arthritis, osteoporosis, neurodegeneration

n6 n3

PgE1 & PgE2 PgE3

Inflamed or not!

Antioxidants

Derived from our diet

Come from fresh vegetables and fruits, plants substances that we consume

Many types. Best represented by the various colors of our vegetables and fruit

They repair damage caused by free radicals in our cells. They neutralize the harm causing oxidizer molecules in cells.

Refined Carbohydrates = Sugar

Carbohydrates come from plants. They are an important part of our diet.

Refining carbohydrates makes them easy to digest. This causes radical changes to our blood sugar and rapid body responses.

1830’s - <15 lbs per year per person

1920’s – 100 lbs per year per person

Currently – 150-160 lbs per yr per capita

Sugar is the hidden parent of fats & cholesterol

The single greatest change to the standard NA diet was aspectacular increase in sugar consumption from mid 19th

century onwards (Sugar, flour, white rice)

Cholesterol Summary

Omega 6:3 Carbohydrates Antioxidants

Inflammation Free Radicals

Cholesterol

Myocardial Atherosclerosis Stroke

Infarction

Atherosclerosis ReversalPomegranate Juice; Dark Cocoa chocolate; Omega 3 Fatty Acids; L-Carnitine; Glutathione (N-Acetyl Cysteine); Resveratrol; Vitamin D3; Curcumin Longa (Tumeric derived); Soy (organic) foods; Homocysteine; whole oats; Niacin; Green tea; Berries; dark red Grapes; Red yeast extract; garlic/onions/leeks; high dietary fiber intake; low saturated fat intake; NO trans fats; avoid PUFA’s; beans/legumes; Guar gum; Guava and Mango; Green foods; Plant sterols

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Statins are dangerousMedications like Crestor and Lipitor

Very effective at lowering cholesterol, but not effective at preventing heart attacks from CVD

Usually prescribed now by MD’s before trying dietary and lifestyle strategies.

If cholesterol gets too low, big health problems

Block HMG acetyl CoA reductase therefore no Co-Q10 production and no Vitamin D production

No mitochondrial repair, immune dysfunction, inflammation, rapid cell death of muscles & organs

If on statins > must take 150-300mg CoQ10/day

Pharmagedon: Better health through drugs and lab test results??

Really??

Grundy SM, et al. (2005). Diagnosis and management of the metabolic syndrome: An American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation, 112(17): 2735-2752

“To date, there is insufficient evidence for primary use of drugs that target the underlying causes of the metabolic syndrome.”

Still at risk despite having medically supported symptom management

What about Metabolic Syndrome???

A group of health risks including large waist girth, high BP, high triglycerides, low HDL and insulin resistance

All above factors are modifiable based on diet and lifestyle

Metabolic syndrome TRIPLES the risk of CVD, stroke and/or diabetes!!

Let’s chat more about modifying our risk factors……

Food..Factors we can change

Increase in our protein intake: Modest PRO increases are associated with modest decrease in CHO intake

Helps to lower glycemic load, maintain satiety, lowers insulin

Avoid Artificial sweeteners: HFCS stimulates the liver to make triglycerides.

Juice should be diluted-Better to just eat fruit!

LET’S RAISE OUR HDL LEVELSIncrease our aerobic exercise

Stop smoking

Lose fatness(especially central adiposity) and improve our body composition

Increase our fiber and antioxidants-veggies/fruit and psyllium husk powder

Supplement with Reseveratrol- eg.PinotNoir!!

Looks like the Mediterranean diet right?

Mediterranean Diet

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GOOD FAT IS NOT THE ENEMY

Monounsaturated oils like Olive Oil are great!

Lots of healthy fats in nuts, seeds, and avocados, fish etc.

AVOID toxic fats like trans fats/hydrogenated oils- Used in deep fryers and to extend the shelf life of packaged baked foods

ELIMINATE refined or damaged oils- Back to the omega6:omega3 ratio.

HEAL THE GUT!!

New research suggesting that atherosclerosis is inflammation related to immune attack of blood vessels

MUST look to connection between gut health and immune function as prevention

E.g. Celiac disease and homocysteine levels!!

MUST maintain gut integrity and healthy flora

Field of ENTERIC NEUROSCIENCE

Limit your Stress Response

80% of disease related to poor stress response

Stimulus can be physical, nutritional, emotional or internal = Fight or Flight

Raises cortisol levels, and like adrenaline can raise blood sugar levels-if not a physical threat then convert to fat

Cortisol levels cycle with circadian rhythm

Chronic stress can relate to adrenal fatigue

Manage Stress

Regulate Circadian rhythms (light in am, dark in pm)

Work to eliminate sources of stress e.g. counseling, meditation, exercise

Detoxification and adrenal support

Balance Blood sugar levels and reduce inflammation in the body

Sleep

One of the most under regarded factors of importance in over all health

Get a minimum of 7-8 hours rest per day

Don’t work the 3rd shift. Disruptive to the circadian rhythm and metabolic cycles No stimulants (chemical or mental/visual)

Safe supplements include 5 HTP and Melatonin

Low protein before bed, moderate complex carbs/oils like a fruit and yogurt

Physical activity

Walking – the best exercise routineStimulated brain due to weight bearing (gravity) stimulation, and joint motion (proprioception) stimulation. Raises Serotonin and Dopamine levels

Goal of 1-2 hours per day. “Burst” sessions work for males, not females. True full sessions are better as they activate full burning from fat stores, verses simply energy consumption

Track it with a pedometer!Effective way to track besides time and distance. Goal is 10000 steps per day.

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Supplements that modify risk factors

Magnesium1:1 or 2:1 ratio of Mg to Calcium - very safe

Vitamin K and Probiotic supplements, & PrebioticsReduced calcification in coronary arteries

Demonstrate less CVD with healthy microbiota

B vitamins (especially B3, B5, Folic Acid aka Folate (B9))Niacin as nicotinic acid 250-1000mg/day

Increase your EPA/DHA via supplementsUp to 3000mg day is GRAS

Vitamin C, B-carotene, Selenium, Curcumin LongaMajor inflammation factor reduction with supplementing

Vitamin DDeficiency is linked to immune suppression, CVD, inflammation, & cancer

Supplements that modify risk factors

Artichoke (leaf extract)Lowers LDL cholesterol by 23%

GarlicLowers LDL, reduces platelet stickiness and fibrinogen factors and kills unhealthy bacteria in gut that can increase Intestinal permeab.

Walnutsincreased satiety, lowered CHO cravings, increases omega 3 levels

Cinnamon1 gm per day – lowered TC, LDL, blood glucose

Chromium^’d # of insulin receptors on cells, lowers insulin, glucose, TC

Alpha-Lipoic AcidImproves glucose transport and increased insulin sensitivity

If there is anything that prevents the nervous system

from working at an optimal level, it will in some way affect the body’s ability

to heal and regulate!!

Chiropractic Care

Natural, druglessHighly effectiveFor all agesPreventative and

restorativePain care and

illness preventingAffordable

compared to other options

Chiropractic Care

Chiropractic has been shown to normalize increased electrical brain activity (EEG Studies), & has a calming effect on over-stimulation, by activating the Cerebellum!!

Better adapting ability to stress and less harmful stress

responses!

Summary

CVD appears to be completely modifiable and therefore preventable

CVD appears to be primarily due to dietary imbalance of high intake of refined carbohydrates, lack of antioxidant rich foods, high prevalence of inflammation from n6:n3 imbalance, and of course key lifestyle factors like sleep, stress, exercise, alcohol and smoking. NOT GENETICS!

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ReferencesDHHS NHLBI NIH

Why Zebras don’t get Ulcers RM Sapolsky

Carbohydrate Addiction “Practitioner” R Kemp

Good Calories, Bad Calories G Taubes

Diabetes, Coronary Thrombosis, and the Saccharine Disease TL Cleave, GD Campbell

Dietary Sugars and Human Disease UK Dept Health

The Schwarzbein Principle D Schwarzbein N Deville

Multiple Risk Factor Intervention for Primary Prevention of Cardiovascular Disease Cochrane Database of Systematic Reviews L Hooper

Framingham Heart Study

Seven Countries Study A Keys

MONICA Study Lancet K Kuulasmaa

MRFIT intervention trial

Lipid Research Clinics Coronary Prevention Trial (LRC-CPPT)

Effects of a Low-Glycemic Load Diet JAMA MA Pereira et al

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