Hawthorn for Heart Health

Comes as no surprise that so man),people worry about heart healthin the US: almost 60 million

people suffer some form of cardiovas-cular trouble. The good news: manycan use hawthorn, an herb with animpressive track record in cardiac care.European, Asian and Native Am-

erican herbalists have long usedhawthorn to treat conditions rangingfrom kidney stones to digestiveupsets. However, modern medicalresearch has focused on this thornytree’s reputation as a heart tonic.

Heart AidHawthorn’s greatest strength lies in

its ability to support a failing heart.(Heart failure occurs when the heartcannot pump enough blood to keepthe body supplied with oxygen andnutrients.) In the lab, hawthornextracts help human heart musclebeat more forcefully (7 CardmvascPharmaco12000; 35 (5):700-7).The German Commission E, arbiter

of all things herbal in that herballyadvanced country, approves ofhawthorn use by people with stage II(relatively mild) heart disease. Peoplesuffering stage II feel OK when theyrest but have trouble moving around.(Blumenthal M. et al., HerbalMedwine: Expanded Commission EMonographs, Integrative MedicineCommunications 2000, p. 183).

Commission E based its findingson an impressive series of studies.The folks supplied with hawthorn inthese studies were able to exercise forlonger periods of time with lessfangue and shortness of breath (ZPhytother 1994; 15:73-81; 5thCongress of Phytotherapy, 1993).Others who took hawthorn had lessankle swelling and saw their bloodpressure readings drop (Fortschr Med1993; 111(20-21)’352-4).According to Commission E,

hawthorn is also effective at easingthe chest tightness and pressure asso-ciated with angina.

Circulation BoosterThe most common cardiovascular

problems involve blood pressurethat’s too high and arteries narrowedby atherosclerosis. Hawthorn mayhelp both conditions.

Hawthorn contains oligomericproanthocyanidans (OPCs), thepowerful antioxidants also found ingrape seeds and pine bark. Haw-thorn’s antioxidant action helps itfight atherosclerosis, in which LDL(bad) cholesterol gathers intoplaques on artery walls. LDL is

Hawthorn’s strength liesin its ability to support afailing heart. The GermanCommission E, arbiter ofall things herbal in that

herbally advanced country,approves of hawthorn use

by people with stage II(mild) heart disease.

believed to only cause problemswhen it oxidizes, or gathers on arterywalls; antioxidants fight this process.Hawthorn also promotes the conver-sion of LDL cholesterol into HDL(good) cholesterol (Rister Japanese Herbal Medicine, Avery1999, p. 6O).In addition, hawthorn keeps cho-

lesterol from accumulating in theliver by encouraging production ofcholesterol-laden bile, which passesinto the intestines (where it aids fatdigestion) and out of the body.

Hawthorn’s antioxidants relaxblood vessels, resulting in lowerblood pressure (Life Sci 2000;

67(2):121-31). This herb alsoreduces blood pressure by counter-acting angiotensin convertingenzyme (ACE), a vessel-constrictingsubstance that accumulates in somepeople and may contribute to highblood pressure (Altern Med Rev1998; 3(2)).Relaxing blood vessels may aid

stroke sufferers by helping tiny brainblood vessels survive high bloodpressure or small clots (Rister, p.292). And it has shown an ability (aspart of an herbal combination) toallay anxiety ( Fundam ClinPharmaco11997; 11 (2): 127-32).

Bountiful VarietyThe existence of nearly 300 species

in the hawthorn family partlyaccounts for this herb’s worldwideappeal. Of these many species,herbalists in this country generallyuse either crataegus laevigata (alsocalled c. oxyacantha) or c. monogTna.

Compounding occasional haw-thorn confusion: various parts of thehawthorn tree are employed by vari-ous herbalists.

If you’re not sure which hawthornproduct best meets your needs, con-sult an herbally trained health practi-tioner. You should also talk to a prac-titioner if you think you suffer heartdisease or you’re already taking aheart or blood pressure medication,since hawthorn can produce an addi-tive effect.

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(626) 577-2711

ENERGY TIMES October 2000

~ONSUMER 13ULLErlN

CoQ-IO-

NUTRIENT FOR THE YOUNG AT HEARTFrom

Enzymes are protein substances found in plants,animals, humans and all living things, and are

necessary for the building and rebuilding of tissues andcells. They are made up of at least two parts: the proteinportion and the cofactor portion. Either mineral ions,itamins or both make up tile cofactor portion of the

complete enzyme. The vitamin portion is usually calledtile coenzyme.

Molecular formulations ranging from coenzymes Q-6to Q-10 are found in animals, while only Q-1O is found inhumans. The different coenzyme numbers refer to thenumber of isoprene units in the molecular chain.

The nutrient Coenzvme Q-10 is found in every cell inthe body, thus its other name, ubiquinone (from thex~ord ubiquitous and the coenzyme quinone). Ubi-quinone is a naturally-occurring substance with amolecular structure that is similar to vitamin K. Becausethe body must have energ3" available to perform even thesimplest operation, coenzy me Q-10 is considered essentialfor the body’s cells, tissues and organs.

The richest food source of the coenzyme is beef heart,while other meats and fish, especially mackerel and sar-dines, are high in CoQ-10. Other good sources are:cereals, particularly brans; nuts, especially peanuts; darkgreen ~ egetables such as spinach and broccoli; so)beansand rapeseed; and soy and sesame oils.

Exen though the "body has the ability to produceCoQ-10, deficiencies ha~e been reported in a range ofclinical conditions. Dr. Karl Foikers was a pioneerresearcher in the synthesis of CoQ-1O, and according tohim, the substance is safe and effective. The Japanesehave used a fermentation process to produce the coen-z~ me for the mass market, enabling people to use the sup-plement every day inexpensively.

Supplementation of the coenzyme helps one guardagainst a possible deficiency. Aging is considered onereason for a deficiency, since the liver loses its ability tosy, nthesize CoQ-1O as one gets older. Besides aging, pooreating habits, stress and infection affect the body’s abilityto’provide adequate anaounts of CoQ-1O. The need forsupplemental CoQ-10 could arise from a genetic or ac-quired defect in coenzyme synthesis or from increasedtissue needs resulting from a particular condition.Because it is necessary for energy production, a deficien-cy of CoQ-10 could cause or aggravate many medicalconditions.

SUPPLEMENTAL RESULTSKnown results of using CoQ-1O as an oral supplement

are energy increase, improxement of heart function,prevention and cure of gum disease, a boost to the im-mune s)stem and possible life extension. The greatestamount of the coenzyme (and, therefore, the greatestneed for the enzyme) is contained in the heart and liver,x~ hich accounts for its positixe results in the treatment of

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cardiox ascular disease, angina pectoris, congestive heartfailure, cardiomyopathy, hyperthyroid heart fadure,mitral valve prolapse and hypertension.

As for as extending one’s life span, the following pur-poses that may be connected to the aging process areserxed by CoQ-10: increases energy and cxercisetnlerance; corrects age-related declines in the immunesystem; and defuses peroxides from within and withoutthe body. In studies done with laboratory animals, thecoenzyme extended lifespan up to 56%.

In studies of patients with periodontal disease, it wasfound that there was a deficiency of CoQ-10 in gum tis-sue. Patients with advanced periodontal disease who re-ceived the coenzyme showed a quicker post.surgical Ileal-ing time -- two to three times faster than usual.

A number of studies with laboratory animals have prov-yen the immune-enhancing effect of CoQ-1O. In olderanimals, the depression that occurs in the immune systemwas partiall~’ reversed with coenzyme Q-1O supplemen-tation, so it is possible that using it on a regular basis mayhelp to reverse age-related immunosuppression. Inhunaan studies of patients with various diseases, signifi-cant increases in the level of immunoglobulin G werefound in the patient’s serum. This increase could repre-sent a correction of the immunodeficiency or an increasein immunocompetence.

Coenzyme Q-10 has been used by millions on a dailybasis, in maintenance doses of 10 to 30 rag. a day, whiletherapeutic doses have been administered in doses of 100rag. or more. No serious adverse effects have been re-ported with long-term use, but CoQ-1O shouldn’t be usedduring pregnancy or lactation simply because its safetyduring these periods has not yet been proven. One tothree months or longer may be necessary to saturate defi-cient tissues, because the synthesis of new coenzymeQ-10-dependent enzymes is a slow process.

(Sources: Coenzyme Q-IO, by William H. Lee, R.Ph.,Ph. D., A Good Health Guide, //1987; The MiracleNutrient: Coenzyme QIO, by Emile G. Bliznakov, hiDand Gerald L. Hunt, 1987; and Nutrztion News, 1987 Vol.X, No. 8)

©2000 Fif-ty-Ninth Street Brid~e Publishin~ Corp. A Literature Education Series On Dietar~ Supplements

Red-Yeast-Rice & Cholesterol Reduction

By Gene Bruno, BS, CN

According to the American Heart Association,approximately 1 million American adults dieannually of heart attacks. An estimated halfmillion Americans suffer a stroke annually,and over thirty percent of them die as a result.Truly, cardiovascular disease is the numberone cause of death among Americans today.As a matter of fact, more Americans will dieof cardiovascular disease this year than diedin all of our wars combined. Among theprimary risk factors in cardiovascular diseaseare high serum (blood) cholesterol levels, highblood pressure, heavy, cigarette smoking,obesity and physical inactivity.

Cholesterol controlResearch indicates that for every onepercentage point that cholesterol levels arereduced, the risk for cardiovascular disease isreduced by 2 points. Consequently, a 10%reduction in cholesterol could result in a 20%reduced risk for cardiovascular disease. Sincethere is a significant benefit to be gained fromreducing cholesterol levels, the followingmethods should be incorporated into aprogram for controlling cholesterol: 1)Dietary modification (reduce intake ofcholesterol containing foods and increasecomplex carbohydrate/fiber foods); 2) aerobic exercise program (endurance typeactivities such as jogging, bicycling, hiking,brisk walking); 3) The use of specific dietarysupplements. That’s where red-yeast-ricecomes into the picture.

Red rice yeastRed-yeast-rice (monascus l~urpureus Wentyeast fermented on rice) is a traditionalbotanical used in Chinese medicine. Recentresearch indicates that red-yeast-rice canactually help to reduce serum cholesterol incombination with dietary modification. Red-yeast-rice yeast has this benefit because itnaturally contains I-IMG-CoA reductaseinhibitors.

HMG-CoA reductaseHumans and all other mammals produce theenzyme 3-hydroxy-3-methyl-glutarylcoenzyme A reductase (HMG-CoAreductase). This enzyme is involved in theproduction of thousands of molecules,including cholesterol. HMG-CoA reductaseirthibitors are substances which can interferewith the action of HMG-CoA reductase,including cholesterol production) Studiesinvolving yeast indicate that certain speciesprovide HMG-CoA reduetase inhibitors, 2 andmodulate cholesterol biosynthesis.3

The researchIn 1999, the UCLA School of Medicineconducted a 12-week, double-blind, placebo-controlled study on the cholesterol-loweringeffects of a red-yeast-rice supplement in agroup consuming a diet similar to theAmerican Heart Association Step I diet (i.e.,30% of calories from fat, <10°,4 fromsaturated fat, and <300 nag cholesterol daily).Eighty-three healthy subjects (46 men and 37women aged 34-78 y) with high cholesterollevels were treated with red-yeast-flee or

placcoo, t nclr t)iooa zats were mcasurea atweeks 8, 9, 1 I, and 12. The results were thattotal cholesterol concentrations decreasedsignificantly between baseline and 8 wk in thered-yeast-rice-treated group compared withthe placebo-treated group (from 254+/-36mg/dL to 208+/-31 mg/dL). LDL cholesteroland total triacylglyccrol were also reducedwith the supplement. The authors of thestudy concluded that "red-yeast-ricesignificantly reduces total cholesterol, LDLcholesterol, and total triacylglycerolconcentrations compared with placebo andprovides a new, novel, food-based approachto lowering cholesterol in the generalpopulation.’’4

A previous 1997 study at DongzhimenHospital (Beijing University of TraditionalChinese Medicine) found similar results overa period of eight weeks in 446 patients--324of whom were given a red-yeast ricesupplement. Specifically, total cholesteroldecreased by 22.7% and LDL cholesterol by30.9%. Furtherm9re, the subjects experiencedan 19.9% increase in HDL cholesterol (the"good cholesterol") and a 34.1% decrease inserum triglycerides. The authors of the’ studyconcluded that "this traditional Chinese ricepreparation used as a dietary supplement isextremely effective and well tolerated inreducing elevated serum cholesterol andtiglycerides.’’5

DosageIn the aforementioned UCLA study, thesubjects used 2,400 mg daily of a red-yeast-rice extract standardizex] to provide 0.4%HMG-CoA reductase inhibitors--a total of9.6 mg. This amount was given as twocapsules, twice daily. Other red-yeast-ricesupplements that arc standardized to provide agreater percentage of HMG-CoA reductas¢inhibitors would not require as many capsules.For example, some red-yeast-rice supplementsare standardized to provide 4% (not 0.4%)HMG-CoA reductase inhibitors.Consequently only 240 mg would need to betaken to provide the same 9.6 mg of HMG-CoA reductase intdbitors; but this should still

taxen as two separate ooses to emulate meprotocol used in the study.

ConclusionSince the HMG-CoA reductasc enzyme isinvolved in other metabolic processes besidescholesterol production, there are a fewsituations when red-yeast-rice productsshouldn’t be used. This includes if you arc atrisk for liver disease, have active liver diseaseor any history of liver disease; ffyou have aserious infection; if you have undergone anorgan wansplant; or if you have a seriousdisease or physical disorder or have recentlyundergone major surgvry. Even so, red-yeast-rice is a remarkably safe and effective dietarysupplement for the majority of the populationwho desires to better control their cholesterollevels.

References!. Hampton IL Dims~-Dvak D, Ri~ J, Trends Biochcm

Sol (1996) 21(4): 140-5.

2. Ibid.

3. Basson ME, et el, Mo/Ce//Blo/(1988) 8(9)’.3797-808.

4. Heb~ D, ¢t al, AmJ Clln Naw (1999) 69(’2):231-6.

5. Wang J. ~ el, Cur Therap Ra (1997) 58(12).’964-78.

Ilntelligent SupplementationTM is published byFifty-Ninth Street Bridge PubHqhhg Corp. ¯strictly as an educational literature scrim, and is [[not intended as medical advice. For diagnosis IIand treatment of any disease or medial condition, [Iconsult your physician.

IFifty-Ninth Stxeet Bridge Publishing Corp. ̄

1 I0 E. 59* Street, 33’e Horn"

NUTRI

HomocysteineBy Morton Walker, D.P.M.

A lthough there are many sus-pected causes for the high inci-dence of atherosclerosis (hard-

ening of the arteries) around theworld, the medical profession stillremains puzzled as to the specificsource - as if there’s only one, which isdoubtful.

.5A combination of hereditary and

environmental factors hold centerstage just now, as the reason for yel-lowish plaques of cholesterol, fats, andother remains of metabolism to bedeposited in the walls of large andmedium-sized arteries.

These plaques are the most signifi-cant indication that atherosclerosis ispresent. Blood vessel walls becomethickened and hardened, and they nar-row. The narrowing lessens bloodflow to organs and other areas normal-ly supplied by the affected artery.Such plaques (called atheromas ) aremajor reasons for the development ofheart disease, chest pain (angina pec-toris), heart attacks, and other disor-ders of the blood circulation.

So, how atherosclerosis developsremains unclear. Previously, manyfactors were blamed: injury to theartery, an increase of muscle in bloodvessel walls, excess saturated fats inthe diet, faulty carbohydrate process-ing, free radical attack of arterial walls,and/or genetic defects. Now a rela-tively new cause - the homocysteme the-ory - is pinpointed by Kilmer McCuUy,M.D., professor of pathology atHarvard Medical Schoi.

The Homocysteine TheoryDr. Kilmer theorizes that the initial

damage to blood vessels that eventual-ly leads to the development of athero-sclerosis is caused by the accumulationof the toxic amino acid homocysteine.When, for example, during laboratoryexperiments homocysteine is infuseddirectly into the veins of baboons, itproduces clogging of their arteries.

In humans, homocystinuma maydeve!op in which there is excessivehomocvsteine in the urine even m wellnourished people. This is a geneticdisorder characterized by a deficiencyin the enzyme needed to break downthe poisonous amino acid.

Complicating symptoms include men-tal retardation, softening of the bonesleading to skeletal abnormalities, dis-located lenses of the eyes, and bloodclots in the veins.

Homozygous homocystinuria, a dis-ease inherited from both parents, israre, but approximately one out of 70persons do show heterozygous homo-cystinuna. These people have inherit-ed the defective gene of homocystin-uria from one parent and are predis-posed to developing coronary heartdisease.

Dr. McCully blames the Westerndiet of industrialized countries forpromoting homocysteine accumula-tion and its consequences. He pointsout that not only does modern foodprocessing destroy vitamin B6 (pyroxi-dine), but animal protein has two tothree times as much methionine (a sul-fur-containing amino acid) as plantprotein by weight and is lower in B6.This is significant because homocys-teine comes from methionine.

To the detriment of Americans, westuff ourselves with fatty hamburgersfrom fast food restaurants whichassuredly sell heart disease and canceras byproducts. Vegetarians experiencea decreased risk of coronary heart dis-ease most likely because of theiravoidance of meat with its concentra-tions of methionine.

Treating ExcessiveHomocysteine

The treatment of excessive physio-logical homocysteine as manifested inthe blood and urine is a diet low inmethionine, large doses of vitamin B6,vitamin B12, and folic acid. The threenutrients and an antimethionine dietwork to break down homocysteine. Incontrast, inadequate supplies of thethree vitamins tend to promote coro-nary heart disease in the general popu-lation by fostering homocysteine accu-mulation.

To learn whether somebody is sub-jected to excessive physiologicalhomocystelne, Melvyn Werbach, M.D.,of Tarzana, California recommendsthat a patient should ask the familyphysician to have his or her clinicallaboratory measure blood plasma and

urine homocysteine levels.He advises those with elevated lev-

els to follow a nutritional programdesigned to lower those levels. Afterstaying with the program for severalweeks, a repeat study would assessthat individual’s progress.

Dr. MortonWalker, a profes-sional medicaljournalist special-izing in alterna-tive methods ofhealing, is theauthor of OliveLeaf Extract, TheNew, Naturaland Nontoxic

Way to Eliminate All InfectiousIllnesses, to be published zn September1997 by the Kensington Publishing Corp.

- tz

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., ’j

D-"~"E

healthy

Although cancer, diabetes, and osteoporosis garner plenty of headlines,heart disease remains the No. 1 killer disease in the United States. An esti-mated 954,000 people die of cardiovascular disease annually. This scourgeis blamed for 42 Fiercent of all deaths in the United States every year.

Furthermore, heart disease costs the U.S. economy $214.7 billion a year.That includes $105.9 billion in direct treatment costs, and $108.8 billion inlost productivity due to illness or death.

Fortunately, we now recognize the potent impact that diet has on car-diovascular function and overall health. The American Heart AssociaUon (ALIA)has established easy-to-follow dietary guidelines that can reduce your riskof heart disease. These include limiting your intake of sodium, cholesterol,and saturated and polyunsaturated fats.

In addition, the Food and Drug Administration (FDA) has highlighted soyfoods as a critical component of a heart-healthy diet. On October 26, 1999,the FDA began allowing food products containing soy protein to carry a labelpromoting soy’s benefits for the cardiovascular system. Foods that containat least 6.25 grams of soy protein per serving are permitted to include infor-mation on their labels about soy’s heart-protective properties. The effectiveamount of soy is believed to be 25 grams per day--approximately four serv-ings of soy foods.

The FDA stated that its approval was based on evidence that soy pro-tein~in a diet low in saturated fat and cholesterol~may help reduce therisk of heart disease. Foods eligible for these labels include soy beverages,tofu, soy-based meat alternatives, and some baked goods.

Copynght~ 2002 by IMPAKT Health

wwwJmpakt.com

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"Because soy protein can be addedto a variety of foods, it is possible forconsumers to eat foods containing soyprotein at all three meals and for snacks,"FDA officials noted.

Because of soy’s potent phyto-chemicals and nutritional attributes, ithas been causing quite a stir in scien-tific circles.

The common soybean first becamea food staple in ancient China about5,000 years ago. In the United Statestoday, health-conscious consumers arecatching on to the many health-pro-moting properties of soy. The FDA’sapproval of soy’s heart healthy bene-fits on labels is still another great rea-son to incorporate more soy into yourdaily diet.

Lowering cholesterolResearch on soy’s benefits for the

cardiovascular system dates back tothe early 1900s. For the past 20+ years,the Italian National Health Service hasprovided soy protein free of charge tophysicians who treat patients with highcholesterol.

Several studies have demonstratedthat daily consumplJon of soy can lowercholesterol levels and blood pressure,strengthen blood vessel walls, reducethe risk of blood clotting, and protectagainst oxidation of LDL ("bad") cho-lesterol. LDL that is not oxidized is lesslikely to build up along artery walls.

The American Journal of ClinicalNutrition reported in 1993 that a 12 per-cent drop in cholesterol was achievedwhen 20 to 25 grams of soy protein andfiber were included in the diet.

A meta-analysis featured in a 1995issue of the New England Journal of

Medicine examined 38 controlled clin-ical trials on soy and serum lipid (fat)concentrations in humans. Researchersfound that "consumption of soyprotein, rather than animal protein,significantly decreased serum concen-trations of total cholesterol, LDL cho-lesterol, and triglycerides, withoutsignificantiy affecting HDL [’good~] cho-lesterol concentrations."

One study focused on 1,242 menand 3,596 women who participated inan annual health checkup program inTakayama City, Japan. A food-frequencyquestionnaire was used to assess theirintake of soy products and other foods.Blood samples were drawn from fast-ing subjects to measure serum totalcholesterol.

Researchers found lower cholesterollevels in men and women whose dietswere rich in soy. This was after they fac-tored in age, smoking status, and dietin men; and age, menopausal status,body mass index, diet, and vitamin Cintake in women. They concluded,’q’hese data suggest a role for soy prod-ucts in human cholesterol homeosta-sis [i.e., balance]."

Anobher study investigated the impactof soy on 32 indMduals diagnosed withcoronary heart disease. They weredivided into three groups and put ona soy-enriched, vegetarian diet for 11 -1 7, 19-22, and 30-40 days, respec-tively. At the conclusion of the study,patients’ lipid levels had normalized,and they were able to discontinue theirhyperlipidemic medicines. The mostpronounced effect was found in thegroup who followed this diet the longest.

Soy supports cardiovascular healtheven beyond cholesterol control.

"Researchers found lower cholesterol levels inmen and women whose die were rich in soy."

Soybeans are a rich source of lecithinand vitamin E, natural antioxidantsthat protect against oxidatton of LDLcholesterol.

Other heart-healthy propertiesAlthough soy is best known for its

effect on cholesterol, it also appearsto promote healthy blood pressure. Inone laboratory study, spontaneouslyhypertensive rats (SHR) were fed eithersoy protein or casein (i.e., a phos-phoprotein of milk). After five weeks,the soy-fed rats demonstrated health-ier blood pressure, as well as lowerserum total cholesterol levels, thanthe casein rats.

Nutri’donist Patti Tveit Milligan, M.S.,I~D., from California, points out that cho-lesterol reduction is only one of theways that soy promotes heart health.Soybeans provide a wealth of lecithinand vitamin E, natural antioxidants thatshield LDL cholesterol against oxidativedamage.

Soy also contains magnesium, anessential nutrient for the arteries andheart muscle. Genistein, an importantisoflavone in soy, appears to reduceblood clotting. Although some blooddotting is necessary to prevent uncon-trolled bleeding, too much clotting canblock the flow of blood and oxygen.

Soy may also protect against themultiplication of cells that make upartery plaque. Milligan states that, whileit may take two or more servings of soyper day to lower blood cholesterol lev-els, it may take only one serving a dayto reduce blood clotting, plaque for-mation, and cholesterol oxidation.

Sources of soyMilligan recommends the follow-

ing soy foods:

¯ Fresh green (immature) soybeans:They look like large pea pods; calledEdamame in Japanese restaurants ormarkets; make a delicious snack.

Dehaous Ltwngv

¯ Tofu: Made from soy milk; many dif-ferent textures; low-fat version is alsoavailable.

¯ Tempeh: Made from whole-cookedsoybeans and often with anothergrain such as barley; great for grillingor even in a sandwich or salad.

¯ Soy rrullc A combination of ground soy-beans and water; used like dairy milk;varies in protein and calcium content.

¯ Textured vegetable protein: Madefrom soy flour;, used as a meat exten-der; is the basis of many veggieburgers.

¯ Soy flour: Basically has no starchbecause it contains no gluten; usu-ally replaces only 15 to 25 percent ofwheat flour in yeast-based products.

¯ Isolated soy protein: Made fromdefatted soy flour and is almostdevoid of carbohydrates and fat;blends well with fruit shakes, muffins,pancakes, etc.

"Keep in mind that isoflavones are ̄present in all soy-containing foods,except for soy protein concentrates andisolates that have undergone alcoholextraction," explains Milligan. "It hasbeen suggested that 50 mg daily ormore of isoflavones would be pru-dent to consume through soy foods..." ¯

It has been estimated that in Japan,the average person consumes 20 to100 mg of isoflavones per day fromsoy foods.

Heart-healthy lifestyleIn the context of a plant-based diet,

soy can help lower cholesterol levels,protect against the oxidation of LDL cho-lesterol, and support healthy bloodpressure. However, you need a com-prehensive strategy to keep your heartstrong and healthy for years to come:

"In addition to providing heart-healthy benefits,soy may als0 protect against cancer 0ste0p0r0sisand help ease menopausal sympt0ms?’

¯ Consistent physical activity strength-ens the heart muscle, reduces bloodpressure and triglyceride levels, andincreases concentrations of HDL("good") cholesterol. It’s no surprisethat sedentary individuals are twiceas likely to experience a fatal heartattack as active people of the sameage, even after other risks, such assmoking, are factored in. Regularexercise increases the heart’s capac-ity to pump blood. It makes oxygenuse more efficient. Twenty to 30 min-utes of vigorous activity, three to fivetimes a week, should be enough tosupport a healthy heart.Note: Anyone who has not exer-

cised for months or years, who is over-weight or profoundly out of shape, orwho has any chronic health problems,should get a thorough medical checkupbefore starting an exercise regimen.

Learn to manage stress. A stressed-out, "type A" person may indirectlyincrease the risk of heart diseasethrough poor diet, excessive caffeineintake, and accelerated adrenalineoutput, which raises blood pressure.

If you smoke, quit. Depending onhow many years you have smoked,and how many years you haveabstained from smoking, your riskfactor after quitting may become nomore than that of an individual whohas never smoked.

If you are overweight, make dietaryand lifestyle changes that will help youslim down. By losing excess weight,you can lower your blood pressure,your total cholesterol levels, and yourtriglyceride levels.

¯ Family history. You can’t choose anew family tree. However, knowingabout your genetic risk can motivateyou to take especially good care ofyour cardiovascular system and over-all health.

Other health benefits of soyIn addition to providing heart-healthy

benefits, soy may also protect againstcancer and osteoporosis and help easemenopausal symptoms.

While more research is needed in thearea of immune stimulation, presentlyresearchers have isolated two com-pounds from soy, genistein and daidzein,that show promise in providing pro-tection against cancer. Specific stud-ies have been done involving breastand prostate cancer.

In one study involving 60 womenwith breast cancer, researchers con-cluded, "The results from this studysupport the hypothesis that a highintake of soy foods may reduce therisk of breast cancer."

Another study with more than12,000 California Seventh-DayAdventist men showed that the moresoy milk the men drank, the lowertheir risk of developing prostate can-cer. The researchers explained, "Ourstudy suggests that men with highconsumption of soy milk are at reducedrisk of prostate cancer."

Osteoporosis has reached near epi-demic proportions in the United States.Soy is believed to help provide pro-tection from this debilitating diseasebecause it is a good source of calcium,magnesium, and boron, all nutrients thathelp strengthen bone. In addition,daidzen and genistein may work likeestrogen in protecting bone loss.

Dehoous bvmg~

There is some compelling evidencethat soy foods can provide a safe alter-native to helping ease the discomfortsof menopause. In Japan, where soyfoods are consumed dally, women areonly one-third as likely to reportmenopausal symptoms compared towomen in the United States and Canada.

One study demonstrated that womenwho incorporated soy flour into their dailydiets, experienced about 40 percentfewer menopausal symptoms.

Final commentsHeart disease afflicts more than 12.2

million people in the United States. Itis the single largest cause of death andpremature, permanent disability.

This is a complex condition, withno simple solutions. However, we candevelop an armamentarium of heartprotectors. Soy foods and supplementsare among these protectors. Soy iswidely available, affordable, easy toinclude in your daily diet, and shownto promote healthy cholesterol levelsand balanced blood pressure.

Naturally, if you have any reason tosuspect that you may suffer from car-diovascular disease, consult a qualifiedhealthcare professional without delay.

You know how to reduce your riskof heart disease: Eat a plant-based,soy-rich diet, exercise consistently, loseexcess weight, quit smoking, and learnto manage stress. By following these

guidelines, and getting regular medicalcheckups, you may avoid cardiovas-cular disease altogether.

In addition to strengthening yourheart, research shows that adding soyto your daily diet may help createstronger bones, a stronger immunesystem, and ease uncomfortablemenopausal symptoms.

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The reformation provided in this health report is not intended to diagnose, treat, cure or prevent any disease. The informatJon contained inthis pubbcatlon does not necessarily reflect the views of Wild Oats Markets, Inc., and any reference to a particular product, source or usedoes not constitute an endorsement by Wild Oats Markets, Inc. Wild Oats Markets, Inc., its agents, employees, Directors and Officers arenot responsible for, and expressly disclaims all hablhty for, damages of any kind arising out of use, reference to, or reliance on any informa-tion contained within this pubhcatlon. While the informabon contained within this pubhcation is penodically updated, no guarantee is giventhat the mformat~on provided ~n this pubhcatlon is correct, complete, and up-to-date.

Pnnted on recycled paper

By Terry Grossman, M.D.

Heart disease kills more than two out of every five North Americans,with over 2,500.men and women dying of it every day. Each year inthe United States, at least 250,000 people die of heart attacks beforethey even reach a hospital. Heart disease is responsible for an estimated42 percent of all deaths in this country (Center for Disease Control andPrevention [CDC], 1999).Although the incidence of heart-related fatalities has decreased in recentyears, cardiovascular disease is still the number-one killer disease in theUnited States. It is believed that a primary risk factor for heart diseaseis a high level of low-density lipoprotein (LDL) cholesterol. By control-ling cholesterol, you may reduce your risk of cardiovascular disease andpremature death.

Cholesterol is a natural substance required for several bodily functions,including cellular health, hormone formation, and vitamin D metabo-lism. The liver manufactures most of the cholesterol in the body. LDL U-am-ports cholesterol and fat from the liver to the cells. Elevated LDL (above130 mg/dl) may endanger health. In contrast, high density lipoprotein(HDL) cholesterol is considered the "good" cholesterol. It removes cho-lesterol from the lining of the arteries. Low HDL (below 35 mg/dl) posesa health risk.

High overall cholesterol readings (above 200 mg/dl) are considereda key contributing factor in heart disease.

According to 2001 CDC statistics, 20 million Americans have highblood cholesterol levels.

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In recent years, the role of cho-lesterol in heart health has come intoquestion. For decades, it appeared tobe as simple as excess cholesterolclogging the arteries. However, nowit appears to be more complicated.

Usually, LDL is harmless. It becomesa problem when unstable moleculescalled free radicals oxidize it. When LDLsettles on artery walls, the wall mem-branes release damaging free radi-cals. The resulting oxidized LDL drawswhite blood cells to the site. Thesewhite blood cells form a fatty sub-stance called plaque. They also trig-ger inflammation of the endothelium,the layer of cells that line the bloodvessel walls.

In addition, oxidized LDL lowers lev-els of nitric acid. This important com-pound helps relax the blood vesselsand promotes healthy blood flow.When there’s not enough nitric acid,atherosclerosis (i.e., "hardening ofthe arteries") can develop, increasingthe risk of heart attack.

The homocysteine connectionScientific studies have now specified

that elevated levels of homocysteine(a metabolite of the amino acid methio-nine) can attach to LDL cholesterol,making it more likely to stick to arterywalls (Prasad K: Homocysteine, a riskfactor for cardiovascular disease.International Journal of Angiology811]:7686, January 1999). High homo-cysteine levels appear to be linked todeficiencies of folic acid and vitaminsB6 and B12.

A meta-analysis of 35 studiesrevealed higher homocysteine levels

in individuals with atherosclerosis. In23 studies, levels of homocysteinewere 26 percent higher, on average,among patients with atheroscleroticdisease than in healthy controls(Moghandasian M, eta~. Homocysteineand coronary artery disease: clinicalevidence and genetic and metabolicbackground. Arch InterMed 157:2299-2308, 1997).

Heart-healthy ratioMedical experts agree that total

cholesterol is not as important as theratio between HDL and LDL choles-terol. HDL levels above 40 mg/dl., andLDL levels below 130 mg/dL, areconsidered healthy (Berkow R [ecfJ: TheMerck Manual of Medical Information.Whitehouse Station: Merck ResearchLaboratories, 1997). If you are con-cerned about your cholesterol lev-els, consult a qualified healthcarepractitioner for a professional diagnosisand treatment plan.

Dietary guidelinesKeeping cholesterol levels within

a healthy range requires a diet highin fiber and low in saturated andhydrogenated fats. The followingguidelines can help you reduce thefat and cholesterol in your diet (SiftonDW [ed]: PDR® Family Guide toNutrition and Health. Montvale:Medical Economics, 1995):

¯ Don’t use fat as flavoring.Instead of butter, bake garlic in theoven for one hour with olive oil.Spread it on bread, pasta, or otherfoods. You can also use herbs orlemon juice to season vegetables.

"tteart disease killsmore than two out of everyfive North Americans, w th over ?.,SO0 men andwomen dyinq of it every daf

¯ Reduce your consumption ofred meat. Meat is high in saturatedfat and methionine, the amino acidfrom which homocysteine is derived.Both are implicated in heart disease.

¯ Choose fresh produce overfatty foods. Instead of snacking oncandy bars or potato chips, opt forfruits or vegetables.

¯ Eat more high-fiber foods. Theyhave been proven to reduce cholesterollevels by promoting the body’s elimi-nation of cholesterol. Choose pasta,rice (or other whole grains), vegeta-bles, and fruits as the focus of yourmeal. Specific foods especially high infiber indude apples, lentils, dried beans,peas, barley, citn~ fruits, carrots, and oatr,.

¯ Eat mom soy. ~ key,health-promoting compounds in soy---appear to function like human hor-mones that regulate cholesterol levels.

¯ Eat more fish. In general, themore fish people eat, the less likely theyare to develop heart disease. Fish pro-vide a wealth of omega-3 fatty acids,which help reduce cholesterol levels.Omega-3s also keep blood plateletsfrom sticking together and formingpotentially deadly blood clots.

¯ Eat more nuts. Almonds, wal-nuts, peanuts, and others provideheart-friendly "good" fats and vita-min E. Support healthy blood pres-sure by choosing the unsalted variety.

Importance of exerciseAerobic exercise includes activities

such as walking, running, bicyding, in-line skating, swimming, cross-countnjskiing, and ice-skating. Consistent aer-obic activity has been shown to lowerLDL cholesterol and raise HDL cho-lesterol. Getting 20 to 30 minutes ofaerobic exercise four or five days aweek has been proven to reduce therisk of heart disease.

Strength training can also improveyour HDLLDL ratio. Lifting weightsfor half an hour twice a week isrecommended.

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Conventional treatmentPrescription drugs are often used

to treat excessively high cholesterollevels. However, increasing evidencepoints to their potential toxicity andquestionable effectiveness (NewmanTB, et al: Carcinogenicity of lipid-lowering drugs. JAMA 275111:55-60,January 3, 1996).

Physician, researcher, and authorKilmer McCully writes, "The limitedsuccess in statin drugs in reducing cho-lesterol levels and vascular diseaserisk is tempered by the unpleasant sideeffects, expense, and potential toxi-city of these drugs on muscles andoptic lens, and from demonstratedcarcinogenic effects in animals."

Recently, the safety of these drugs,known as statins, has again been ques-tioned. In August 2001, Bayer recalledits cholesterol-lowering drug Baycolafter more than 50 people died fromrhabdomyolysis, a condition that causesskeletal muscle to degenerate.According to the Washington, DC-based consumer advocacy group PublicCitizen, other statin drugs have causedthis condition as well.

"While cerivastatin (Baycol)accounted for slightly more than halfof the 772 reported cases of rhab-domyolsis between October 1997 andDecember 2000, 385 cases of rhab-domyolysis and 52 rhadbomyolysisdeaths were reported in associationwith other statins," the group reported."An additional 29 deaths from rhab-domyolysis in people using statins otherthan cerivastatin were reported to theFDA prior to October 1997, for a totalof 82 deaths from rhabdomyolysiscaused by stafins other than cefiva~lin."

The group has petitioned the USFood and Drug Administration seek-ing a black box waming, which isthe strongest label caution that canbe mandated by the FDA.

Fortunately, certain nutrients andherbs can help you control cholesterollevels.

"Consistent aerobic activiW has been shown tolower LDL cholesterol and raise HDL cholesterol:’

Note: Never stop taking a med-ication without consulting yourdoctor.

Recommended nutrients¯ Niacin has been shown to dra-

matically lower total cholesterol lev-els while increasing HDL. Researchindicates that niacin provides betteroverall results than prescription Iovas-tafin (lllingworth DR, et a~. Comparativeeffects of Iovastatin and niacin in pri-mary hypercholesterolemia. Arch InternMed 154:1586-1595, 1994).

In order to avoid the side effectsassociated with higher doses of niacin,many healthcare experts recommendinositol hexaniacinate, the safer form.Because of the potential for excessiveliver toxicity, "lime-release" preparationsof niacin should almost never be used.

¯ V’Ramin C can lower total cho-lesterol and raise HDL (Hallfrisch J, eraS.High plasma vitamin C associated withhigh plasma HDL and HDL2. choles-terol. Am J CJin Nutr 60:100-105, 1994).

¯ Vitamin E helps prevent the oxi-dation of LDL, and protects the arter-ies from free-radical damage.

¯ Vitamins B6, BlZ, and folicacid help keep homocysteine levelsin check, thereby protecting LDLfrom oxidation (Malinow MR:Homocysteine, vitamins and geneticinteractions in vascular disease.Can J Cardiol 15[Suppl B]:31 B-34B,April 1999).

¯ Soy can promote healthycholesterol levels. In one study,researchers concluded that soy pro-tein, in place of animal protein, low-ered total cholesterol without affectingHDL cholesterol (Anderson JW, et al:Meta-analysis of the effects of soyprotein intake on serum lipids. New

England Journal of Medicine333[5]:276-282, August 3, 1995).

¯ Quercetln, fish oils, calcium,magnesium, L-camitine, and chon-droitin sulfate (typically used forarthritis) have also shown somepromise in stabilizing run-away cho-lesterol levels.

Recommended herbs¯ Hawthorn (Crataegus pinnati.

fida) can help dissolve cholesteroldeposits, as well as widen blood ves-sels and reduce blood pressure.

¯ Garlic (Allium sativum) is one ofthe most widely studied herbs/foodsfor heart health. Scientific studieshave shown that garlic lowers cho-lesterol levels and thins the blood,thereby reducing the risk of danger-ous blood dots (lain AK, et al: Can gar-lic reduce levels of serum lipids? Acontrolled clinical study. Am J Med9416]:632-635, June 1993).

¯ Psylllum (Plantago ovata) fibersignificantly lowered total cholesteroland LDL cholesterol levels in a studyconducted at the University ofCincinnati Medical Center and theWashington University School ofMedicine (PsyUium found to be effec-tive in lowering cholesterol. NaturalFoods Merchandiser, October 1994).

¯ Gugulipid comes from themukul myrrh tree (Commiphoramukul), which is naive to the Mideastand India. It is used to lower triglyc-erides, LDL, and total cholesterollevels, and to increase HDL. Its ben-efits are comparable to prescriptiondrugs, without the side effects(Nityanand S, et ah Clinical trialswith gugulipid, a new hypolipi-daemic agent. J Assoc Phys India37:321-328, 1989).

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¯ Red yeast tree (Monascus pur-pureus) provides the same active ingre-dient (HMG-CoA reductase inhibitor)found in the most popular cholesterol-lowering drugs (Junxian W, et al:Multicenter clinical trial of the serumlipid-lowering effects of Monascus pur-pureus [red yeast] rice preparation fromtraditional Chinese medicine. CurrentTherapeutic Research 58112], 1997).

Final thoughtsSadly, poor eating habits, a seden-

tary lifestyle, and excess body fat are

prevalent in Western society. These fac-tors lead to out-of-balance choles-terol levels and a host of other ills.Fortunately, to a large extent, cho-lesterol levels, heart health, and over-all wellness are within your control.You choose what you eat. You chooseyour level of physical activity. Youchoose whether to see your doctorat regular intervals. You choose whichsupplements and herbs you take tosupport a balanced ratio of LDL andHDL If you choose good health, thenyour choices become much simpler.

Tern/Grossman, M.D., is a practicingphysician in the Denver area. As med-ical director of Frontier Medical Institute,he devotes most of his professionaltime to running a busy nutritional prac-tice with an emphasis on anti-aging ther-apies. He is also associate professor offamily practice at the University ofColorado School of Medicine. In addi-tion, Dr. Grossman is the author of TheBaby Boomer’s Guide to Living Forever.

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