Vitamin Information Center

TRANS FATS
Trans fatty acids are naturally found in small amounts in animal products; however,
the majority of trans fats in our diet come from the artifi cial form. Trans fats are cre-
ated when oils undergo a chemical process called hydrogenation, which solidifi es
them. This is the process that makes vegetable oil into margarine. Trans fat is also
found in cookies, crackers, french fries, baked goods, and other snack foods.
When trans fats were fi rst introduced into our food supply, they were thought
to be a healthier alternative to saturated fats. Many years later this was found to be
false. Trans fats elevate cholesterol levels, increasing the risk for heart disease and
heart attack, and are also linked to cancer, particularly breast cancer. The Institute
of Medicine has stated that there is no safe limit for trans fats in the diet and that
we should reduce consumption of these dangerous fats. Food companies have been
making efforts in this area. You will now see many packaged foods labelled “trans
fat free.”

Cardiovascular Diseases
Definition
Cardiovascular disease is the general term for several
chronic diseases concerning the heart and circulatory
system. The major cardiovascular diseases (CVD)
are coronary (or ischemic) heart disease (heart attack),
cerebrovascular disease (stroke), hypertension (high
blood pressure), heart failure and rheumatic heart disease.
According to the WHO, CVD made up almost 17
million (19%) of total global deaths of which around
80% occurred in low and middle-income countries. It is
expected that CVD will be the leading cause of death
in developing countries by 2010. Several risk factors
exist for CVD which can be categorized in unmodifiable
factors (e. g. male, gender and heredity) and modifiable
factors (e. g. cigarette smoking, high blood pressure,
high blood cholesterol levels, physical inactivity,
diabetes and obesity). It is estimated that more than
50% of the deaths and disabilities from heart disease
and stroke could be avoided with effective prevention
efforts targeted at reducing the modifiable risk factors.

During these gray, overcast days, we almost hate to tell you about yet another study touting the health benefits of the “sunshine vitamin” — but we will anyway.

A new study published in the Journal of the American College of Cardiology reveals that people who have a deficiency in vitamin D are more prone to cardiovascular disease, heart attacks and strokes.

Experts are increasingly telling us that vitamin D is essential for our health, in ways that were previously unrecognized. The body of evidence just keeps growing.

People should have between 20 and 30 nanograms per millimeter of the vitamin in their blood, most doctors believe. The Institute of Medicine recommends 200 units daily of vitamin D in children and adults up to age 50, and 400 to 600 units for older adults. That means taking daily supplements, especially in sun-starved Seattle.

Researchers involved in the new study suggest that patients with vitamin D levels below 15 ng/ml were twice as likely to experience a heart attack, stroke or other cardiovascular event within the next five years compared to those with higher levels. The risk remained unchanged even when they adjusted for traditional cardiovascular risk factors.

Half of U.S. adults and 30 percent of children and teenagers have low levels of vitamin D, which activate the rennin-angiotensin-aldosterone system — predisposing patients to hypertension and a stiffening and thickening of the heart and blood vessels, researchers said.

Vitamin D is found in fish, eggs, fortified milk and other foods. The sun also contributes significantly to the body’s production of vitamin D.

Hardly a week goes by, it seems, without a press release regarding a new vitamin D study appearing in my email box.

For example:

“Men with Low Vitamin D May Have Increased Risk of Heart Attack”
“Study Links Vitamin D to Colon Cancer Survival”
“Vitamin D Inadequacy May Exacerbate Chronic Pain”
“Low Vitamin D Levels May Worsen Osteoarthritis of the Knee”
“Low Levels of Vitamin D Associated with Depression in Older Adults”
“Study Links Vitamin D, Type 1 Diabetes”
“Vitamin D Linked to Reduced Mortality Rate in Chronic Kidney Disease”

Then, last Friday, came the uber-vitamin D press release:

“Low Vitamin D Levels Pose Large Threat to Health”

That study, published this week in the Archives of Internal Medicine, found a 26 percent increase in risk of early death from any cause among people with inadequate levels of vitamin D.

What’s going on? Why this sudden (or so it seems) interest in the “sunshine vitamin”? (The nickname comes from the fact that the vitamin is produced in the skin from sunlight.) And what are health consumers – especially here in Minnesota, where the low angle of the winter sun makes it difficult to sustain adequate vitamin D levels – to make of it all?

Old interest, new connections
Despite the current flurry of studies, research into vitamin D’s multipronged impact on human health “is not all that new,” said Kurt Kennel, M.D., an assistant professor of medicine at the Mayo Clinic in Rochester. Scientists have known since the 1970s that vitamin D’s effect on the body went beyond regulating calcium and helping to build strong bones.

Much of the past research, however, was confined to the laboratory. In recent years, thanks to better ways of assaying (or measuring) vitamin D in the body, scientists have been able to give it a more clinical face, linking it to the risk of developing different diseases.

In addition, aging baby boomers have developed a deep and personal interest in the bone-weakening disease osteoporosis.

“That put vitamin D on the map,” said Kennel.

A misnomer
To understand vitamin D’s ubiquitous role in the body, we need to stop thinking of it as a traditional vitamin.

“If we named it today, we’d call it a hormone,” said Kennel.

Like insulin, adrenaline, estrogen and other hormones, vitamin D is produced by a body organ (in this case, the skin). It’s then carried through the body by a fluid (blood) to other organs and tissues (the heart, brain, breasts, kidneys, muscles, and so on). At each of these destinations, vitamin D adeptly attaches itself to receptors on the DNA of genes in the cells’ nuclei.

As we’re now learning, the resulting effects appear to be remarkably beneficial, possibly protecting against heart disease, kidney disease, diabetes, osteoporosis, multiple sclerosis, certain types of cancers (including breast, lung and colon) and other major illnesses and conditions.

The latest study
In the newly published study – considered the most compelling evidence of vitamin D’s overall health benefits to date – a team of John Hopkins researchers analyzed vitamin D levels in more than 13,000 men and women aged 20 and older who participated in a large ongoing health survey conducted by the Centers for Disease Control and Prevention. The data was collected between 1988 and 1994.

To ensure comparable results, vitamin D levels were surveyed during the summer among participants living in northern states and during the winter among those in southern states.

All participants were tracked until Dec. 31, 2000, by which time 1,806 had died. Those whose vitamin D levels had been the lowest (less than 17.8 nanograms per milliliter of blood) had a 26 percent increased rate of death from any cause compared to those with the highest vitamin D levels (above 50 nanograms per milliliter).

Cardiovascular disease seemed to be the major factor in these deaths, although the study wasn’t able to determine with scientific certainty a cause-effect relationship between low vitamin D levels and heart attacks and strokes.

“In the past few months, several other papers have confirmed that low vitamin D levels are associated with increased risk of heart attacks and strokes,” said Erin Michos, M.D., one of the study’s lead investigators.

In fact, earlier this year, Michos and her team showed an 80 percent increased risk of peripheral artery disease among people with vitamin D deficiency.

It may not be long before vitamin D deficiency is added to the long list of risk factors for heart disease, she said.

What’s a consumer to do?
Vitamin D deficiency is, by some accounts, reaching epidemic proportions. A review article published in The New England Journal of Medicine last year reported that up to 50 percent of children and adults in the United States have insufficient levels (less than 20 nanograms per milliliter).

“Vitamin D deficiency is getting a lot more common because we’re getting more obese and sedentary, and we’re spending less time in the sun,” said Michos.

People who are over the age of 50, who have dark skin, or who wear clothing that covers most of their skin are also at increased risk. (The last two reasons, said Kennel, are partly why Minnesota’s Somali immigrants have higher-than-average rates of vitamin D deficiency.)

Both Kennel and Michos recommend that people boost their vitamin D levels by eating salmon, mackerel and other fatty fish and fortified dairy products. (Years ago, vitamin D used to be added to beer, but, alas, no longer.) You can also take cod-liver oil (yes, just as your great-grandparents did) and/or vitamin supplements.

Federal guidelines currently recommend that adults get 200 to 600 international units (IU) of vitamin D daily. Those recommendations are currently under review, said Kennel, and will most likely be upped.

The National Osteoporosis Society already recommends 800 to 1,000 IU to people aged 50 and older. And the Canadian Cancer Society, citing Canada’s northern latitude, recommends that adults living there take 1,000 IU of vitamin D daily during fall and winter.

Currently, most experts put the safe upper limit of vitamin D from supplementary sources at 2,000 IU per day. But that number, too, may be increased.

Out in the noonday sun
The best way to get vitamin D, of course, is to spend time in the sun. In a single 10-minute midday outing, your skin will produce about 10,000 IU.

Fortunately, your skin won’t let you overdose on vitamin D from the sun. But spending unprotected time in the sun increases your risk of skin cancer, which has also reached epidemic proportions in the United States.

“Unfortunately, the time of the day the dermatologist wants you to be out – the morning and the evening – is the worst time for your body to make vitamin D,” said Kennel.

If you think you’re at increased risk for vitamin D deficiency, talk with your physician about having your blood levels of the vitamin checked. You’ll then have a better idea of whether you need supplements.

And remember: Although the recent findings about vitamin D are intriguing and promising, the benefits are not yet proven.

Studies of other nutrients and hormones – vitamin E, vitamin A, and estrogen, to name a few – were also found to benefit the heart in observational studies. But when it came time for the clinical trials, not only did they fail to prevent heart disease, they actually increased the risk.

Stay tuned.

Heart disease is the leading cause of death in the United States today, and acute myocardial infarctions - heart attacks - make up a considerable number of those deaths. Over 850,000 Americans had a heart attack in 2007 alone. For years, scientists and physicians have sought ways to prevent heart attacks or to blunt their effects when they are happening.

A new international study suggests that folic acid, or vitamin B9, can do just that.

Heart attacks result from a lack of oxygen supply to the heart muscle itself, which has serious consequences because the heart is a highly active muscle that needs a lot of oxygen to work. The early period of low oxygen is called ischemia, but after a time the damage can become permanent, a condition known as an infarct.

An infarct can cause severe tissue scarring, changes in the structure and size of the heart muscle, arrhythmias or abnormal heart rhythms, long-term heart failure, blood clots and increased risk of future heart attacks. The best way to prevent these consequences is to reduce the severity of the initial heart attack.

A group of cardiologists and scientists led by David Kass from Hopkins looked at folic acid, which has long been thought to be able to help heart function. Folic acid is known to have antioxidant properties, which decrease tissue damage by soaking up toxic particles known as free radicals.

The scientists gave folic acid to rats before experimentally inducing heart attacks, to see if the vitamin could decrease the effects of ischemia. In comparison with non-treated controls, rats on folic acid had less heart damage and better recovery from heart attacks. They showed significantly less tissue damage when looked at under a microscope.

A fairly short treatment dose at a high concentration - lasting just one week before the induction of a heart attack - was sufficient to create a protective effect. Overall, the treated rats had infarcts about 90 percent smaller in size than in the untreated controls.

Drawing from these preliminary experiments on mice, researchers concluded that pre-treatment with folic acid can help lessen the severity of tissue damage caused by myocardial infarction, or heart attack.

There are several potential mechanisms for the results observed by the researchers. It is known that the heart continues to pump during a heart attack, often at an even greater rate to compensate for the oxygen decrease caused by an injured heart. This continued high-rate beating is energetically costly for a damaged heart.

Folic acid is known to work in the mitochondrion, the part of the cell that produces chemical energy. This study and others suggest that folic acid could act as a reserve of the cellular energy currency, phosphate, even when the heart muscle is damaged.

The extra phosphate levels provided by folic acid might be enough to tide over the heart until normal oxygen levels are restored, thus reducing the long-term effects of a heart attack.

Current therapy for treating patients after a heart attack involves using a range of medications, including drugs like Lipitor that decrease the buildup of cholesterol in the coronary arteries, as well as drugs like aspirin that thin the blood and reduce inflammation.

Surgery on the heart muscle or on the coronary arteries, either with angioplasty or an arterial bypass, may also be performed.

The next step is a study of the effects of folic acid on human heart attack patients. A major complication is the dose: The mice received a dose that would be very difficult for people to take orally on a regular basis.

Folic acid is found in a variety of vegetables and is a common ingredient in multivitamins. Previous studies have indicated beneficial effects of folic acid on the brain and other organs.

It has also long been known that taking folic acid during pregancy reduces the risk of spina bifida, a birth defect that causes mental retardation and paralysis.

If the results of this study, which appears in this week’s issue of the journal Circulation, are replicated in humans, they could provide an easy way to help reduce the severity of heart attacks in hundreds of thousands of patients.

A few weeks back, I received a call from a hopeful patient asking for confirmation of a nightly news story – one claiming that bacon might be good for the heart because of the nitrite and nitrate it contains.

Sounds surprising? After all, cured meats are often shunned over concerns that nitrite and nitrate, added to retain color and inhibit the growth of the bacteria that cause botulism, may form potentially carcinogenic compounds called nitrosamines.

The story stemmed from a report published online in the Proceedings of the National Academy of Sciences. Researchers at the University of Texas Health Science Center in Houston studied mice consuming either a nitrate/nitrite-deficient diet or one high in nitrate and nitrite to study effects on the heart after a simulated heart attack. (A third group of mice consumed a regular diet as a control.)

The mice receiving extra nitrate and nitrite in their drinking water had 48% less heart cell death than mice on the regular diet, while mice fed the low nitrate/nitrite diet had 59% greater injury than the controls And 77% of the animals receiving extra nitrate/nitrite survived the heart attack, compared with 58% that were nitrate/nitrite-deficient.

The researchers proposed that the benefit from the enriched water might be the stimulation of nitric oxide production in the body. Nitric oxide, produced in cells lining the surface of the blood vessels, is a gas that dilates arteries, thus aiding blood flow and reducing blood pressure. When inadequate nitric oxide is available, the risk rises for heart disease and stroke.

Nitric oxide is generated from oxygen and an amino acid, arginine, but can also be produced from dietary nitrate by other pathways. Unbeknownst to most people, the majority of the nitrate we consume – between 70% and 85% – comes from vegetables and fruits, the richest sources being spinach, lettuce, celery, cauliflower, grapes, strawberries and root vegetables. (Vegetarians may consume up to 10 times the nitrate levels that omnivores do.)

Only about 5% of the nitrate we eat comes from bacon, ham and other cured meats. The rest comes from nitrate naturally present in drinking water.

Once nitrate is absorbed by the small intestine, as much as 25% is taken up from the bloodstream by the salivary glands, where it is concentrated tenfold to twentyfold. Bacteria in the mouth then convert the nitrate to nitrite, and further enzymatic activity in blood and tissues leads to the production of nitric oxide.

Although nitrate and nitrite are not carcinogenic – in fruits and vegetables, in fact, they act as antioxidants – during digestion or cooking, nitrite can combine with naturally occurring amines in foods, forming nitrosamines. Some nitrosamines have been shown to be carcinogenic when administered to animals.

But it’s unclear, given the nitrate content of the typical human diet, if nitrosamines can be formed in the stomach in large enough doses to induce cancer. In fact, there is some compelling evidence that this is unlikely: Studies of human populations indicate that a diet rich in fruits and vegetables protects against several forms of cancer, particularly gastric cancer.

From an evolutionary standpoint, it doesn’t seem plausible that Mother Nature would have purposely allowed secretion of concentrated nitrate in the mouth if it were harmful to us. But that doesn’t mean that bacon is the new health food.

Even if cured meats might add a bit of nitrate or nitrite to our day’s intake, there is often a fair amount of fat and sodium tagging along.

What’s more, fruits and vegetables are naturally rich in vitamin C, which inhibits nitrosamine formation as well as enhances the generation of nitric oxide from nitrite.

I am sure my patient was disappointed, but I told him that we were designed to consume our nitrate in more natural ways – packaged with vitamins, minerals, antioxidants and phytochemicals in a multitude of healthful vegetables and fruits.

–

Susan Bowerman is a registered dietitian and assistant director of the UCLA Center for Human Nutrition.

BALTIMORE, March 27 (UPI) — Folate — vitamin B 9 – potentially may be used to limit the damage of a heart attack, U.S. researchers say.The study, scheduled to be published in the April 8 edition of the journal Circulation, finds the vitamin blunted the damage from heart attack in animal studies.

“We want to emphasize that it is premature for people to begin taking high doses of folic acid,” senior study investigator Dr. David Kass, of The Johns Hopkins University School of Medicine in Baltimore says in a statement. “But if human studies prove equally effective, then high-dose folate could be given to high-risk groups to guard against possible heart attack or to people while they are having one.”

“We do not know how much or how little of it is needed to be effective,” Kass cautions. A large amount could yield unpredictable side effects and studies have linked folic acid supplements to increased rates of colon and prostate cancer, Kass says.

Folate — naturally found in leafy green vegetables, beans and nuts — is sometimes used as a general term to include folic acid — the form of vitamin B9 put in supplements and added to foods, especially grain products.

Most people know to watch their cholesterol levels. Of course, this is not usually a concern until you hit about 40-50, then everybody watches their cholesterol. Everybody knows that cholesterol causes cardiovascular disease, the number one cause of death, but there is another important piece to this puzzle that may be missing.
Cholesterol is needed by your body for repair, and health. Cholesterol is important to your good health. In fact, it was found that people with cholesterol levels that are too low, may suffer from depression and increased suicides. We are told that cholesterol levels above 200 means high risk, but did you know that as much as 40% of heart attack victims have cholesterol under 200?

So what are you missing?

Cholesterol alone does not cause atherosclerosis. It is the oxidation of the LDL cholesterol that causes the problem. This may be one reason why lowering your cholesterol does lower your risk. There are literally hundreds of research articles written every year that identify oxidation as the key risk factor.

Oxidation does not stop there. It may be responsible for many other age related disorders as well. Disorders such as cataracts, macular degeneration, fibromyalgia, chronic fatigue, “age” or liver spots, aging, wrinkles and more, are all believed to be caused by free radical damage.

Free radical cause damage by stealing electrons from other molecules, causing a cascading effect, damaging other molecules as it goes. This becomes a problem when it effects DNA, or cellular reproduction. Keep in mind that your body regenerates, and renews itself, so why is it that we seem to deteriorate? When a damaged cell reproduces, it creates a replica of itself. When you are young, and at 100%, it takes a while before you notice this damage. This is why, I believe, there is a misconception that disorders such as poor digestion, intestinal irregularities, arthritis, age spots, cataracts, high cholesterol, cardiovascular disease, and so on… are an inevitable part of aging.

So what can you do about it?

Well, for starters, reducing inflammation in your body will help. Try and eat more whole foods, and less processed foods. Avoid foods that you are allergic to. Most people have undiagnosed food sensitivities. I have not met anybody that does not have at least a couple. These undiagnosed food sensitivities can add stress to your body, as well as cause inflammation. It’s best to have an ELISA blood test done to identify these foods so you can limit, or avoid them. Avoid transfatty acids and foods that are high in sugars and fats. Avoid foods that have a high glycemic load. Eat plenty of fruits and vegetables. Many people do not even get their RDA of essential vitamins and minerals. The RDA was set as a median level for healthy people. Stress, inflammation, chemicals, drugs, pollution, cigarette smoke, coffee, alcohol, sugar, disease, all increase your need for vitamins and minerals, so, like mom always said: Eat Your Veggies! Many people could benefit from supplements as well, since for some, its not possible to get enough from your food. Reduce stress levels. This is a big one. Implement some form of a stress relief program. Watching TV is not a stress relief program… sorry.

Have your oxidation levels tested.

This is a simple test, no needles, but it can tell you a lot more about your cardiovascular risk potential, than just your cholesterol numbers alone. When I do this test, I prefer to do a complete metabolic test, since it will yield a more complete picture.

After about age 30, your hydrochloric acid in your stomach decreases in strength which puts a strain on your body and causes various imbalances, not to mention most seniors can not absorb vitamin B12 due to decreased intrinsic factor.

Oxidation is a simple thing to combat, but it can have far reaching effects. There is even strong research to indicate that oxidative damage may be at the root of disorders such as fibromyalgia and chronic fatigue syndrome. Fortunately, its easy to detect and adjust for. To find out more on metabolic testing, or oxidation testing, click here. Maintaining your good health, or reaching a state of wellness does not have to be difficult. It also does not mean you need to spend $500/mo in supplements, and never enjoy a piece of chocolate cake again. If you make small changes, and use these simple, informative tests as a guide, your small changes can have a big impact on your health.
by Rick Jahn D.O.M.

Being healthy does not necessarily mean you have to spend hours a day in the gym and plan out each days meals to the last grain of rice on your plate. Obtaining a healthy body could be fun and hassle-free. In fact that is exactly the way it should be.
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www.Prevent-Heart-Disease.com There are a lot of people who are now at risk for heart disease. This is mainly because they have the genetic default that puts them at natural risk for heart disease. A lot of people who feel that they are at a genetic risk for heart disease will also live their life in a reckless way. They not only eat poorly, but they don’t exercise and they don’t take care of themselves. Just because you may be at risk for the disorder, it doesn’t mean that you are going to die from it. You only increase your chances by not paying attention to the signs and so on. You will want to think about how you can help yourself by avoiding addition risk factors of heart disease.
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