Spirituality and Health Mimi Guarneri MD FACC

Tree of Health and Disease

CARDIOLOGY

ENDOCRINOLOGY

NEUROLOGY GASTROENTEROLOGY

PULMONOLOGY

IMMUNOLOGY

ONCOLOGY PSYCHIATRY

Functional Imbalances

Systemic Inflammation

Oxidative Stress

PRE-DISEASE

SUB-OPTIMAL HEALTH

glucophage DIABETES II

singular

celebrex

paxil

nexium aricept

Chemotherapeutic

agents

ASTHMA

ARTHRITIS

GERD

(HEARTBURN)

ALZHEIMER’S

STROKE

DEPRESSION &

ANXIETY

VARIOUS

CANCERS

Lipitor

Prinavil

HEART DISEASE &

HYPERTENSION

Bypass surgery

Clinical Diagnostics

EMOTIONAL & MENTAL

BALANCE AND

STRESS RESILIENCE

MACRO & MICRO

NUTRITION

SLEEP &

RESTORATION PHYSICAL ACTIVITY &

STRUCTURAL BALANCE

ENVIRONMENTAL

PROTECTION

SPIRITUAL &

SOCIAL BALANCE

‘ENERGY SYSTEM’

BALANCE

OVERFED & UNDER-NOURISHED

-- ANGER & HOSTILITY

-- CHRONIC STRESS

-- NEGATIVE MENTAL PATTERNS

LACK OF PHYSICAL ACTIVITY

TOXIC OVERLOAD

CHRONIC SLEEP

DEPRIVATION

BLOCKAGES, CONGESTION

OR DEPLETION OF ‘ENERGY’

PATHWAYS & CENTERS

-- LACK OF LOVE & CONNECTION

-- LACK OF LIFE PURPOSE

Functional Assessment Biomarkers

Genetic Predispositions

( gate-keepers )

EMERGING RISK FACTORS Apo B/ApoA1

Inflammation

Fibrinogen

Methylation

Insulin Resistance

Lp(a)

Low HDL 2B

Small Dense LDL

Increased PAI1

Vitamin D Deficiency

Adverse Childhood Events

Increased Factor VII

Increased Factor X

Sedentary Lifestyle

Central Obesity

Toxins

Depression

Anger and Hostility

Response to Stress

Caregiver Role

Social Isolation

Social Support

Purpose in Life

Personalized

Genes ?

Vegan Diet ?

Daily Exercise ?

Bible Study ?

Connection to

Community ?

Love ?

Physiology /

Biochemistry

Genetics

Environment

Lifestyle

What Really

Determines

Health or

Disease for

Most of Us?

Rainbow the cloned cat

and her mother-Think “Epigenetics”

Take Control Tree of Life

EMOTIONAL & MENTAL

BALANCE AND

STRESS RESILIENCE

SLEEP &

RESTORATION PHYSICAL ACTIVITY &

STRUCTURAL BALANCE

ENVIRONMENTAL

PROTECTION

SPIRITUAL &

SOCIAL BALANCE

‘ENERGY SYSTEM’

BALANCE

MACRO & MICRO

NUTRITION,

AIR, WATER

ORGANS and SYSTEMS

Land Use, Air Quality and Respiratory

Health

Between 1960 and 1990 the percent of workers working outside their counties increased 200%

Vehicle miles traveled increased 250% from 1960 to

1997

Average American driver spends 443 hrs each year behind the wheel. Equivalent to 11 work weeks!

Congressional Research

Service Motor vehicle traffic

accounts for 58% of CO emissions in the US, 30% of NO, 27% of VOCs and 9% of particulate matter.

NO and VOCs contribute to smog

36,000 to 129,000 adult deaths per year in European cities are attributed to air pollution

Atlanta Olympics 1996

Atlanta Olympic

games in 1996 brought

about a reduction in

auto use by 22.5%.

Asthma admissions to

the ER and hospital

decreased by 41%

The Optimal Health Pyramid

Sleep, clean air and water, nutrition, love, touch, spirituality

Exercise, activity,

Yoga, Tai Chi, meditation

Interventions;

lifestyle, nutritional,

touch based & “system” based

Surgery

Medications

LESSON 1:

More Plants Less Meat

“Hi! I’m Coagula, the goddess of arterial plaque.”

“Consumption of fruits and

vegetables, particularly green

leafy vegetables appears

to have a protective effect

against heart disease”.

Arch Inter Med 2001; 134:

1106-14.

“Intake of fruits and vegetables

protect the development of

stroke in man”.

J Am Med Assoc 1995; 279:

1113-17.

“Among individuals aged 70 to 90 years, adherence to a

Mediterranean diet and healthful lifestyle is associated with a

more than 50% lower rate of all-causes and cause-specific

mortality”.

J Am Med Assoc 2004; 292: 1423.

LYON Heart STUDY deLongeril et al, Am.J Clin.Nutr1995;61

-80

-70

-60

-50

-40

-30

-20

-10

0

CVE's Death Late Cancer

5 Yr.RCT 605 CHD More fruit

More beans

More Veggies

More Fish

Less Meat

No Cream

No Butter

Canola Oil

“Compared with patients consuming the control diet,

patients consuming the intervention diet had significantly

reduced serum concentrations of hs-CRP, IL-6, IL-7,

and IL-18, as well as decreased insulin resistance.”

“A Mediterranean-style diet might be effective in

reducing the prevalence of the metabolic syndrome

and its associated cardiovascular risk.”

Esposito et al., JAMA 2004; 292:1440-1446

Not for Affirmative Use Din JN, et al. BMJ. 2004;328:30-35.

Synthesis of Eicosanoids From

Omega-6 and Omega-3 Fatty Acids

2-Series prostanoids TXA2, PGE2, PGI2

Omega-6–derived eicosanoids

Linoleic Acid C18:2 ω-6

Arachidonic Acid C20:4 ω-6

Cyclooxygenase

Lipoxygenase

Anti-inflammatory - Antithrombotic Proinflammatory - Prothrombotic

4-Series leukotrienes LTB4, LTC4, LTE4

5-Series leukotrienes LTB5, LTC5, LTE5

3-Series prostanoids TXA3, PGE3, PGI3

Omega-3–derived eicosanoids

Omega-6 Fatty Acids Omega-3 Fatty Acids

Gamma-Linoleic Acid C18:3 ω-6

H 3CC O O H

H 3CC O O H

-Linolenic Acid C18:3 ω-3

Docosahexaenoic Acid (DHA) C22:6 ω-3

Eicosapentaenoic Acid (EPA) C20:5 ω-3

H 3C C O O HH 3C C O O H

C O O HH 3 C C O O HH 3 C

H3C COOH

C O O HH 3 C C O O HH 3 C

“Substantial evidence indicates that diets using nonhydrogenated fats

as the predominant dietary fat, whole grains as the main form of

carbohydrates, an abundance of fruit and vegetables, and adequate

omega-3 fatty acids can offer significant protection against CHD”.

J Am Med Assoc 2002; 298: 2569-78.

Organic vs Non Organic

Chemical Fertilizers

450 Pesticides

Herbicides

Human waste

Irradiated

Nitrates

Genetically Modified Seeds

Antibiotic and Hormones

Natural Fertilizers

No Pesticides

Crop Rotation

No Waste Products

Minimal Nitrates

Healthy Seeds

No Hormones or Antibiotics

Pesticides in Produce (EWG)

12 Most Contaminated

Peaches

Apples

Sweet Bell Peppers

Celery

Nectarines

Strawberries

Cherries

Pears

Grapes (Imported)

Spinach

Lettuce

Potatoes

12 Least Contaminated

Onions

Avocados

Sweet Corn (Frozen)

Pineapples

Mango

Asparagus

Sweet Peas (Frozen)

Kiwi Fruit

Bananas

Cabbage

Broccoli

Papaya

www.foodnews.org

Farmed vs Wild Salmon

Hite Science 2004

Researchers found farm-raised Atlantic salmon had significantly higher levels of 13 toxins when compared with wild Pacific salmon.

Breaking it down by region, the researchers found levels of all 14 toxins were significantly elevated in both European and North American farm-raised salmon when compared with wild Pacific salmon

Hites and his colleagues also measured toxin levels in "salmon chow," a mixture of ground-up fish and oil fed to farm-raised salmon. They found a strong correlation between the toxicities of chow and salmon, suggesting toxins are passed into the salmon from their

food

“ The greatness of a nation and its moral progress

can be judged by the way its animals are treated”

Mohandas Gandhi

Industrialized Food System

Animal Feeding Operations

Animal Feeding Operations (AFOs) are agricultural operations where animals are kept and raised in confined situations. AFOs congregate animals, feed, manure and urine, dead animals, and production operations on a small land area. Feed is brought to the animals rather than the animals grazing or otherwise seeking feed in pastures, fields, or on rangeland

Livestock and the Environment

According to a 2006 report by the Livestock, Environment And Development Initiative, the livestock industry is one of the largest contributors to environmental degradation worldwide, and modern practices of raising animals for food contributes on a "massive scale" to air and water pollution, land degradation, climate change, and loss of biodiversity.

In 2006 FAO estimated that meat industry contributes 18% of all emissions of greenhouse gasses. This figure was revised in 2009 by two World Bank scientists and estimated at 51% minimum

More Plants Less Meat

According to the research of John Robbins it takes 23 gallons of water to produce a pound of lettuce, 25 gallons of water to produce a pound of wheat, 49 gallons of water to produce a pound of apples, 815 gallons of water to produce a pound of chicken, and a whopping 5,214 gallons of water to produce just one pound of beef. “you may save more water by not eating a pound of beef than you would by not showering for six entire months”

Tea (Camellia sinensis) Tea = 2nd most consumed beverage

in the world after water

> 1,000 types of tea on the market

– White (buds and young leaves)

– Green (steaming or panfiring)

– Oolong (partial fermentation)

– Black (fermenting)

High level of polyphenols

– flavonoids, tannins, catechins

Hertog MGL, Hollman PCH, van de Putte B. Content of potentially anticarcinogenic flavonoids of tea infusions, wines, and fruit

juices. J Agric Food Chem 1993;41:1242–6.

Preventive Medicine January 2003;36:64-70.

Endothelial dysfunction associated with coronary artery disease (CAD) & increased oxidative stress

66 patients with proven CAD has ultrasound testing after:

Short-term: 2 hrs after consumption of 450 mL tea or water

Long-term: 4 weeks after consumption of 900 mL tea or water daily

Short & long-term tea intake plasma flavonoids & endothelium- dependent flow-mediated dilation of the brachial artery vs. water (P<0.001)

Caffeine (200 mg) had no effect on flow-mediated dilation

Short- and long-term black tea consumption reverses endothelial vasomotor dysfunction in CAD

Duffy SJ. Circulation. 2001;104:151-156.

Those who consumed > 5 cups/d had a risk of all-cause and CVD mortality 16%-26% (compared with < 1 cup/d)

Stronger association with women (? smoking)

No association between green tea consumption and cancer mortality

Iwai et al found mortality in Japanese which included CV and Cancer

Shinichi K et al. Green Tea Consumption and Mortality Due to Cardiovascular Disease, Cancer, and All Causes in Japan: The

Ohsaki Study

JAMA 2006 296: 1255-1265Iwai N, Ohshiro H, Kurozawa Y, et al. Relationship between coffee and green tea consumption and

all-cause mortality in a cohort of a rural Japanese population. J Epidemiol. 2002;12:191-198.

Nutritional

Antiinflammatory

Inflammatory

Signal

molecules

Signal Transduction DNA

Protein

Protein

mRNA

mRNA

mRNA

p50 p65 IkB-

P

Cell membrane

Protein ROS ROS ROS

p50 p65 IkB-

Dietary

Proinflammatory

Signal (trauma, stress)

NFkB/IkB

Complex

Protein

Phosphorylation Antiinflammation

Inflammation

(PGE2)

Food

Allergen

Nutritional Supplementation in

Cardiovascular Disease

Antioxidants

Chelated Magnesium

B-Vitamins

Omega Three Fatty Acids

Soluble Fiber

Plant Sterols/Stanol

Vitamin D

Aged Garlic Extract

Anti-inflammatory Agents

Medicines from Plant Origins

THE BARK OF THIS TREE

CAN BE USED AS AN

ANALGESIC:

WHITE WILLOW

ASPIRIN

Medicines from Plant Origins

COMMON CARDIAC

MEDICATION, USED

IN TREATMENT OF

CHF

FOXGLOVE

DIGOXIN

Meta-Analysis: Predictive Value of HDL-

C

CPPT

2% CHD Risk

in Men

3% CHD Risk

in Women

Gordon DJ, et al. Circulation. 1989;79:8-15.

MRFIT

FHS

• Coronary Primary Prevention Trial (CPPT)

• Multiple Risk Factor Intervention Trial (MRFIT)

• Lipid Research Clinics Prevalence Mortality Follow-up Study (LRCS)

• Framingham Heart Study (FHS)

LRCS

FHS

LRCS

1 mg/dL

Increase

in HDL-C

Chol pick-up

Liver HL

Small VLDL

IDL Small LDLs

Large LDLs HDL3

HDL2b HDL3 Chol Pick-Up

Muscle/Fat tissue

LPL

endothelial cells

Removal By

Liver

CETP

Chol return from HDL2 to LDL

* Apo B *

* Antioxidant *

* Paraoxonase *

* LDL pattern B

LDL more susceptible to oxidative damage *

Large VLDL

Remnant

Small LDLs

Rapid entry

Oxidation

Plaque

HL

* Variable TG and PL content-

Oxidative susceptibility

I II

a II

b

IIIa

IIIb IVa

IVb

Association of PON1 with HDL

SMC

EC EC EC

Hepatocyte Plasma Membrane

HDL

PO

N

PO

N

PO

N

PO

N

PO

N

SMC SMC

HDL

PO

N

PO

N

PO

N

PO

N

PO

N

PO

N

Intravascular Space

Interstitium

OxLDL De-peroxidated

lipoprotein

PO

N

PON MØ

ECM

MØ

Sorenson et al. Arterioscler Thromb Vasc Biol 1999;19:2214-25.

Case: 1734

(3/95) 56 yo male distance runner

AP, CAD, CABS, + F Hx, no lipid drugs

TG=109 mg/dl

LDLC = 121

LDL IIIa+b = 36%

HDLC = 42

HDL2b = 19%

Lp(a) = 2

Homocyst(e)ine = 10/27

Apo E 4/3

251 A

HDL2b

LDL - GGE

HDL - GGE

36 %

IIIa+b

Diagnosis ?

Treatment ?

Case: 1734

(7/95) Rx = Niacin 1,500 mg

TG = 109 -> 119 mg/dl

LDLC = 121 -> 109

LDL IIIa+b = 36% -> 15%

HDLC = 42 -> 45

HDL2b = 19% -> 34%

Lp(a) = 2 -> 4

Conclusion ?

Minor change in lipids

Big Change in LDL & HDL subclass distribution

268 A

34% Increased

HDL2b

Reduced Small LDL

15%

Omega-3s

Cardiac Effects GISSI-Prevenzione N=11,324 pts < 3 mo after MI on 1 Gm

risk of death from any cause by 21%

sudden cardiac death by 45%

Japan EPA Lipid Intervention Study

(JELIS) N = 18,645 with

cholesterol (70%

women

Randomized to

statin or statin and

pure EPA (1.8 g/d).

At 5-years, EPA

reduced major

adverse CV events

by 19%

816

488

0

100

200

300

400

500

600

700

800

900

Baseline End of Therapy

LOVAZA 4 g/day Significantly

Reduced Triglycerides

-45%

Very High TG

Me

dia

n v

alu

es

(mg

/dL)

P<0.0001

LDL-C=low-density lipoprotein cholesterol; TG=triglyceride. Prescribing Information for LOVAZA. Data on file, GlaxoSmithKline.

The LDL-C value for

patients receiving

LOVAZA increased from

a median baseline of

89 mg/dL to a median of

109 mg/dL, a median

increase of 45%

• There was a 6.7% median increase in triglycerides with placebo

No diet is healthy without

exercise!

You lose muscle mass

Leads to Yo-Yo dieting

– increases cardio-vascular risk

2000 Lifestyle Advantage

Steven Blair showed that

modest exercise, like walking

daily decreased heart disease

deaths by 50%

in both men and women. Journal of The American Medical Assn.. 1989

2000 Lifestyle Advantage

The Nurses’ Health Study Results Relative Risk of Coronary Events

Exercise MET hrs/wk # of CV

(quintile) Median (range) Events

1 0.8 (0 - 20) 178

2 3.2 (2.1 - 4.6) 153

3 7.7 (4.7 - 10.4) 124

4 15.4 (10.5 - 21.7) 101

5 35.4 (>21.7) 89

Source: NEJM 343: 16-22

Exercise! Decreases stress

Increases longevity

Decreases risk of heart disease, cancer and stroke

Decreases blood pressure

Decreases LDL cholesterol and triglycerides

Increases HDL

Decreases weight

Energizes!

How much exercise?

General recommendations have been increasing over time.

40 minutes of aerobic exercise daily to one hour daily.

This should be combined with muscle building activity at least three times per week.

Paul D. Thompson et al, Exercise and Physical Activity in the Prevention and Treatment of Atherosclerotic Cardiovascular Disease: A Statement From the Council on Clinical Cardiology Circulation, Jun 2003; 107: 3109 - 3116.

“The chief and primary cause of …the very rapid

increase of nervousness is modern civilization,

which is distinguished from the ancient by these

five characteristics: steampower, the periodical

press, the telegraph, the sciences and the

mental activity of women.”

American Nervousness, Its Causes and

Consequences, George M. Beard, 1881

• Response

• Perception

• Initiating Event

• Effect

The Stress Response

Autonomic Nervous System

Parasympathetic Pathway—Brake

Low Effort/relaxation Acetylcholine

Sympathetic Pathway—Accelerator High Effort Adrenaline

STRESS RESPONSE

Enhanced

coagulation

Trophic

effects

High Renin

Angiotensin

High blood

pressure

Tachycardia

arrhythmia Abnormal

lipids

Insulin

resistance

Weight

increase

Sympathetic

Parasympathetic

tone

Warning signs

Loss of focus and

mental clarity

Lack of ability to relax and sleep

Loss of self esteem

Feeling tired and on edge/Anger

Anger And Cardiac Death Williams et al, Circulation 2000, vol. 101 (1) I am quick tempered.

(2) I have a fiery temper.

(3) I am a hotheaded person.

(4) I get angry when I am slowed down by others’ mistakes.

(5) I feel annoyed when I am not given recognition for doing good work.

(6) I fly off the handle.

(7) When I get angry, I say nasty things.

(8) It makes me furious when I am criticized in front of others.

(9) When I get frustrated, I feel like hitting someone.

(10) I feel infuriated when I do a good job and get a poor evaluation.

2000 Lifestyle Advantage

Those with the most anger have the highest death rates

Anger and MI

1623 heart patients tracked

“What happened the two hours before your

MI?”

Anger increased risk of MI by 230%

– Mittleman et al, Circulation, 1995, vol. 92

2000 Lifestyle Advantage

40

60

80

100

120

140

160

0 5 10 15 20 25 30 35 40 45 50 55 60

Minutes

Heart

Rate

(B

PM

)

Husband and Wife Arguing

Wife said

something

that got

under his skin

Heart rate remains elevated after

argument ends

© 2007 HeartMath LLC

Hormonal System

Cortisol DHEA

Immunity and Connection

“The microbe is nothing, the soil is everything” -

Louis Pasteur

Caregivers took an average of

24% longer than well-matched

controls to heal the same small,

standardized wound.

Kiecolt-Glaser, Marucha,

Malarkey, Mercado, & Glaser:

Lancet, 1995

STRESS SLOWS

WOUND HEALING

0

2

4

6

8

10

12

14

16

DA

YS

TO

HE

AL

VACATION EXAMS

Marucha, Kiecolt-Glaser, & Favagehi: Psychosomatic Medicine, 1998

Days to heal for each of the 11 students; no student healed as rapidly during exams, with

the average student taking 40% ( 3 days) longer

ANTIBODY RESPONSES TO INFLUENZA VACCINE:

CAREGIVERS VS. CONTROLS

Kiecolt-Glaser, Glaser, Gravenstein, Malarkey, Sheridan: Proceedings

of the National Academy of Sciences, USA, 1996

Replication with caregivers published by Vedhara et al. in Lancet, 1999

High Cortisol:Low DHEA

Accelerated aging (Kerr et al., 1991; Namiki, 1994)

Brain cell death (Kerr et al., 1991; Sapolsky, 1992)

Impaired memory and learning (Kerr et al., 1991; Sapolsky, 1992)

Decreased bone density; increased osteoporosis (Manolagas, 1979)

Reduced muscle mass (Beme, 1993)

Reduced skin growth and regeneration (Beme, 1993)

Impaired immune function (Hiemke, 1994)

Increased blood sugar (DeFeo, 1989)

Increased fat accumulation around waist / hips (Marin, 1992)

Chronic stress=excess cortisol=accelerated aging.

You see things not as they are but as you are. Your

perception is shaped according to your previous

experiences, your faith and according to where you

are in consciousness. More important than

changing the things out there, is changing the way

you see them.

Spiritual Economics

Eric Butterworth

IgA and Mother Teresa

Students watched a film

on Mother Teresa’s

activity or an emotionally

neutral film

On average salivary IgA

increased in those who

saw the Mother Teresa

film, but a few had

decreased IgA production!

Perception and projection

were the keys! The students were then asked to write a story

about a photo of a couple on a park bench

Those whose stories showed themes of distrust, manipulation or abandonment had lower IgA responses to the Mother Teresa film

Those same students had had significantly more illness over the previous year

– McClelland, DC and C. Kirshnet, Psychology and Health, 1988,2:31-52

Turning Stress Into Strength

Exercise: Preferable in Nature

Guided Imagery

Meditation and Yoga

Breath Work

Mudras and Mantras

Practice Appreciation

Don’t Make Assumptions

Get Plenty of Sleep and Avoid Excess Caffeine

Practice Effective Communication

Remember The Serenity Prayer

Love and Social Support

0 1 2 3 4 5 6 7 8 9 100

50

TM

HE

RR= 0.53, (95% CI 0.30 -0.95, p = .03)50

60

70

80

90

100

YEARS

Cu

mu

lati

ve P

rop

ort

ion

Even

t-fr

ee

Effects of Transcendental Meditation on

Mortality, MI, and Stroke:

A Randomized Controlled Trial

Schneider R, Nidich S, Kotchen J, Kotchen T, Grim C, Rainforth M, Gaylord- King C, Salerno J.

Effects of Stress Reduction on Clinical Events in African Americans with Coronary Heart Disease: A

Randomized Controlled Trial. Circulation. 2009;120:S461

Meta Analysis I

American Journal of Hypertension, 21:310-316, 2008

Decreased Anxiety

Journal of Clinical Psychology, 1989. 45(6): 957–974

Decreased Cigarette Smoking

Alcoholism Treatment Quarterly 11: 13–87, 1994

Decreased Alcohol Use

Alcoholism Treatment Quarterly 11: 13–87, 1994

Your Emotional Landscape High Arousal High Energy

Adrenaline

Low Arousal Low Energy

Relaxation

Str

ess

Zo

ne

Stre

ss Fre

e Z

on

e

Positive Emotion Negative Emotion

Quick Coherence® Technique

Heart focus

Heart breathing

Heart feeling

HRV, Mantras & Rosary

Prayer

Both practices:

– Decreased sympathetic tone

– Synchronized respiratory and c-v cycles

– Improved HRV

Luciano Bernardi et al BMJ 2001;323:1446-1449 ( 22-29 December )

Mantram Repetition

Walking or Jogging

Waiting in lines or stalled in traffic

When angry, anxious, upset or afraid

And especially when you are falling asleep

Stress Mastery

• Change your environment

• Change how you react and

perceive your environment

“It is not the strongest of the

species that survives, nor the

most intelligent, but the one most

responsive to change.”

—Charles Darwin

The Science of

Connection

What’s Love

Got to Do with It?

Community and disease risk:

Roseto, PA

Similar diets, weights,

smoking behaviors and

diabetes prevalence to

Surrounding

communities

Lower incidence of MI

than surrounding

communities before the

1970’s

Predictors of MI in Roseto, PA

50 year prevalence shift Before the 1970’s:

– Three generation households were prevalent

– High degree of religiosity and traditional values

After the 1970’s:

– Break up of multigenerational households

– Decreasing church attendance

– Increasing mobility

– MI prevalence equal to surrounding communities

Egolf, BJ et al, American J of Public

Health, 1992, 82(8): 1089-92

Connection And The Common

Cold

276 healthy volunteers given rhinovirus

containing nasal drops, all were shown to shed

virus

Questioned about 12 types of social

relationships - parental, childhood, groups etc.

Those who scored only 3 out of 12 developed

cold symptoms 4 times more frequently

– Cohen, S et al, JAMA, 1997, 277:1940-44

Depression

218 patients followed for 18 months post MI

75% of the post MI deaths are related to depression in the next 6 months

This was independent of other risk factors

– Frasure-Smith et al, JAMA 1993, vol. 91

Social Support, Depression

And Cardiac Death Rates

This effect was

negated when

people felt socially

supported – Frasure-Smith et al,

Circulation, 2000 vol. 101

2000 Lifestyle Advantage

The heart radiates an electromagnetic field that energetically affects those

in our environment, whether we are conscious of it or not. We experience

this when we are affected by each others’ moods, attitudes and feelings.

What we bring to the world

Mother and Baby

Heart-Brain Sync

© 2008 Institute of HeartMath® 111

Baby’s Heartbeat Detected in Mother’s Brainwaves

500 averages

© 2008 Institute of HeartMath®

500 Averages beginning at 2000 seconds

Seconds

Baby ECG Mom EEG

Entrainment During Sleep

From - The Energetic Heart: Bioelectromagnetic Interactions

Within and Between People, Rollin McCraty, Ph.D.

Spirituality in Medicine

90% of people believe in a higher being

94% regard their spiritual and physical health

as equally important

96% of FP believe that spiritual well-being is

a factor in health

Mueller,PS etal,Mayo Clinic Proc.2001;76:1225-35

Religion and Heart Disease

Religious attenders:

-Lower systolic and diastolic BP

-Greater compliance with medication

-Exercise more

-Eat healthier

-Quit smoking more readily

Mueller,PS etal,Mayo Clinic Proc.2001;76:1225-35

What is My Purpose in

Life?

A study of 700 older adults

Those who gave love and support to others had significantly fewer health issues

– Depner, CE and Ingersoll-Dayton, Psychology and Aging, 1988,3:348-57

MS Patients

MS patients trained to provide compassion

Over 2 years showed improvement in role

functioning, depression, self confidence and

self esteem

Schwartz and Sendor Social Science and Medicine, 1999

AA 12 Step Program

12 step program

Likelihood of relapse was twice as high for

non-helpers than helpers; 40%vs.22%

Pagano,et al J of studies on Alcohol,2004

It’s Good To Do Good

Helpers High

Half of helpers report a high feeling

43% felt stronger and more energetic

28% felt warm

22% calm and less depressed

21% greater feeling of self worth

13% fewer aches and pains

Luks Psychology Today 1988

Love Heals

"We are not held back by the love

we didn't receive in the past, but

by the love we're not extending in

the present."

Marianne Williamson

Each of us must be the change we want to see in the world

-Gandhi

© 2007 HeartMath LLC

MimiGuarneriMD.com

www.ScrippsIntegrative Medicine.org

Mimi GuarneriMD.com

http://www.scrippsintegrative/