cardiac wellness workshop 2014...
TRANSCRIPT
2/24/2014
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Cardiac Wellness Workshop
Presented by:
Beacon Hill Chiropractic and MassageDr. Michael Schmolke and Associates
Dr. Sherra SandersDr. Chris Yavis
Our vision:
Vision: "We change people’s lives through inspiration, empowerment, and excellent health care delivery in a beautiful, efficient team environment making us Calgary’s first choice for natural health care."
Objectives
Understand more about cardiovascular diseases
Raise some questions about different theories and learn of emerging concepts
Discuss the controversy & contraindications of statin drugs & other drug-lab test based approaches to CVD (Effective?)
Gain command of what YOU can do about this situation
Supplement recommendations as alternatives to Rx drugs
Latest recommendations on exercise and nutrition
Have some fun learning together
Definitions
Cardiovascular diseases A class of diseases that involve the heart or
blood vessels. It primarily refers to atherosclerosis (arterial disease). CV diseases includes aneurysm, angina, atherosclerosis, stroke, cerebrovascular diseases, CHF, CAD, MI, and peripheral vascular disease.
We know that atherosclerosis begins in the 1st
decade of life. It is treatable. It must be prevented!
Atherosclerosis Definitions
Atherosclerosis is a disease in which plaque builds up inside your arteries. Arteries are blood vessels that carry oxygen-rich
blood to your heart and other parts of your body.
Plaque is made up of fat, cholesterol, calcium, and other substances found in the blood. Over time, plaque hardens and narrows your arteries, limiting the flow of oxygen-rich blood to your organs and other parts of your body. This can lead to serious problems, including heart attack, stroke, or even death.
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Plaque Build Up of Atherosclerosis
What causes this process to start?
Fats in diet?
Cholesterol levels?
Lifestyle? (eg. Smoking, sedentary
living, stress?)
Controversy exists: some say….
It is due to fat in diet! – 1980’s US Gov, A. Keyes
Good fats – bad fats
It is due to stress and high cortisol hormone output – H. Selye, J. Wilson, R. Sapolsky
It is due to refined carbohydrate consumption
It is a consequence of missing required nutrients in foods we eat – nutritionism
It depends on who you want to believe!
DefinitionsParadigm "a philosophical and theoretical framework of
a scientific school or discipline within which theories, laws, and generalizations and the experiments performed in support of them are formulated.”
“broadly: a theory or group of ideas about how something should be done.”
“Narrow paradigms” can cause big problems Examples: Tonsils, C-section births, Antibiotics,
Vaccinations, Bed rest, pain drugs MSK
Problem with current paradigmsCurrent medical paradigm (MD’s, hospital)
Educational emphasis seems to assume that humans are different from all other animals
Diseases come from within us, due to a flaw in our design >>>> Genetics
Focus of tx. is patient symptoms, “lab tests” results
Wellness & prevention paradigm (Biology)Humans are just like animals
Diseases result from poor living style, stress, & the environment (deficiencies/toxicities) >>>> Adapting to bad environments propagates dis-ease and diseases to develop over time
A new concept in health: Adaptive Physiology
Homeostasis:The tendency of an organism to maintain internal equilibrium by adjusting its physiological processes.
Allostasis:The achievement of stability by turning on and turning off the allostaticsystems including the IMMUNE SYSTEM; the AUTONOMIC NS, and NEUROENDOCRINE SYSTEMS via the NERVOUS SYSTEM.
Biological adaptation, such as the rise of EPINEPHRINE in response to exercise, stress or perceived danger, followed by a fall of epinephrine during RELAXATION.
Leading scientists now view our well-being through the eyes of how well we adapt, and are discouraging the old ideas of “normal lab values”
Adaptive physiologyWhat is normal? Views are changing
Old view – blood pressure should be 120/80 (Sys/Dias)
New view – There may be no true normal - controversyYour blood pressure is in constant flux based on circumstance. It fluctuates based on mood, activity, diet, perceived & demands.
If routinely high, why haven’t you adapted correctly? What is the cause? Not a disease, but an unhealthy factor in life!
Old view – Normal cholesterol levels TC < 5.2 mmol
New view – TC not a clear relation to CVD prediction!Cholesterol rises in response to diet and internal repair mechanisms. The real question is what are the circumstancesthat are causing internal damage, & why are we eating poorly
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The real cause of heart disease
Old theory: high cholesterol causes heart disease – take cholesterol lowering meds, reduce fat intake
Real culprit = inflammation in arterial wall!!!
It is time for an analogy
• Your health is a genetic expression of your lifestyle
• Stresses are like rocks in our backpack We need to get rid of these
rocks
Adaptation is all about the brain!Allostatic loads (or stressors) Stressors create adaptations in the body that are
perfectly suited to allow us CHANCE to remove ourselves from the threat/situation and get back into a resting balance in our environment and physiology
The wear & tear on the body results from ongoingadaptive efforts to maintain stability in response to stress.
Deficiencies or toxicities are stressors Deficiencies include: physical inactivity, inadequate sleep, improper
nutrition, lack of socialization and loving relationships,
Toxicities include: chemicals, emotional stress, dietary imbalances, high time demands, environmental elements like EMR/pollution/ too much excitatory stimulation (TV, computers)
So what is the problem?Examples of perfect adaptations: Poor diet, emotional stress, perceived threat:
High blood pressure & increased heart rate
Decreased immune function
Lowered rate of cell repair & detoxification
Increased blood cholesterol levels
We are not correcting the situation or environment, therefore we are forced to sustain adaptations.
Sustained adaptation > dis-ease > disease
Contemporary (medical) views of proposed causes of CVD
Smoking
Genetics
High amounts of certain fats and cholesterol in the blood
High blood pressure
High amounts of sugar in the blood due to insulin resistance or diabetes
Cause or Effect? Paradigm dictates approach
New biological research understandings: causes of CVD
Smoking – single l.c. of premature death - modifiable
Chronic Inflammation - modifiable
Linked to CA, Atherosclerosis, Alzheimer’s, Diabetes, Obesity
Obesity – 42 million children world wide - modifiable
High blood pressure - modifiable
Specific type of cholesterol – modifiable
Diabetes - 80% die from CVD – modifiable (II)
Low antioxidant levels - dietary
Low essential fatty acids - dietary
Low Magnesium & Potassium - dietary
Type A personality - modifiable
Alcohol - modifiable
Physical inactivity – modifiable
If modifiable >>> Preventable
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New understandings of CVDUnhealthyResponse
inOur
Body
UnhealthyCarbohydrateRichDiet
Lack
of
Antioxidants
InadequateSleep
Lack
of
PhysicalActivity
HeartDiseases
VascularDiseases
Unhealthy
BodyComposition
UnhealthyStress
Pro-InflammatoryDiet
The role of Genetics??
Inflammation
Important to our innate immune function
Caused by stress, injury, toxins, and diet
Free radicals (ROS’s), High Meat (Grain fed) consumption, infections, high sugar consumption
Imbalance of ratio of n6 oil : n3 oil
InflammationOmega 6:omega 3 ratio is severely out of balance Prehistoric 1:1
Early 1900’s 3:1
Current 25-45:1
Should be balanced in our diet. Imbalance creates massive inflammation and diseasesCVD, Cancer, Pain and degeneration like arthritis, osteoporosis, neurodegeneration
n6 n3
PgE1 & PgE2 PgE3
Inflamed or not!
Antioxidants
Derived from our diet
Come from fresh vegetables and fruits, plants substances that we consume
Many types. Best represented by the various colors of our vegetables and fruit
They repair damage caused by free radicals in our cells. They neutralize the harm causing oxidizer molecules in cells.
Refined Carbohydrates = Sugar
Carbohydrates come from plants. They are an important part of our diet.
Refining carbohydrates makes them easy to digest. This causes radical changes to our blood sugar and rapid body responses.
1830’s - <15 lbs per year per person
1920’s – 100 lbs per year per person
Currently – 150-160 lbs per yr per capita
Sugar is the hidden parent of fats & cholesterol
The single greatest change to the standard NA diet was aspectacular increase in sugar consumption from mid 19th
century onwards (Sugar, flour, white rice)
Cholesterol Summary
Omega 6:3 Carbohydrates Antioxidants
Inflammation Free Radicals
Cholesterol
Myocardial Atherosclerosis Stroke
Infarction
Atherosclerosis ReversalPomegranate Juice; Dark Cocoa chocolate; Omega 3 Fatty Acids; L-Carnitine; Glutathione (N-Acetyl Cysteine); Resveratrol; Vitamin D3; Curcumin Longa (Tumeric derived); Soy (organic) foods; Homocysteine; whole oats; Niacin; Green tea; Berries; dark red Grapes; Red yeast extract; garlic/onions/leeks; high dietary fiber intake; low saturated fat intake; NO trans fats; avoid PUFA’s; beans/legumes; Guar gum; Guava and Mango; Green foods; Plant sterols
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Statins are dangerousMedications like Crestor and Lipitor
Very effective at lowering cholesterol, but not effective at preventing heart attacks from CVD
Usually prescribed now by MD’s before trying dietary and lifestyle strategies.
If cholesterol gets too low, big health problems
Block HMG acetyl CoA reductase therefore no Co-Q10 production and no Vitamin D production
No mitochondrial repair, immune dysfunction, inflammation, rapid cell death of muscles & organs
If on statins > must take 150-300mg CoQ10/day
Pharmagedon: Better health through drugs and lab test results??
Really??
Grundy SM, et al. (2005). Diagnosis and management of the metabolic syndrome: An American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation, 112(17): 2735-2752
“To date, there is insufficient evidence for primary use of drugs that target the underlying causes of the metabolic syndrome.”
Still at risk despite having medically supported symptom management
What about Metabolic Syndrome???
A group of health risks including large waist girth, high BP, high triglycerides, low HDL and insulin resistance
All above factors are modifiable based on diet and lifestyle
Metabolic syndrome TRIPLES the risk of CVD, stroke and/or diabetes!!
Let’s chat more about modifying our risk factors……
Food..Factors we can change
Increase in our protein intake: Modest PRO increases are associated with modest decrease in CHO intake
Helps to lower glycemic load, maintain satiety, lowers insulin
Avoid Artificial sweeteners: HFCS stimulates the liver to make triglycerides.
Juice should be diluted-Better to just eat fruit!
LET’S RAISE OUR HDL LEVELSIncrease our aerobic exercise
Stop smoking
Lose fatness(especially central adiposity) and improve our body composition
Increase our fiber and antioxidants-veggies/fruit and psyllium husk powder
Supplement with Reseveratrol- eg.PinotNoir!!
Looks like the Mediterranean diet right?
Mediterranean Diet
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GOOD FAT IS NOT THE ENEMY
Monounsaturated oils like Olive Oil are great!
Lots of healthy fats in nuts, seeds, and avocados, fish etc.
AVOID toxic fats like trans fats/hydrogenated oils- Used in deep fryers and to extend the shelf life of packaged baked foods
ELIMINATE refined or damaged oils- Back to the omega6:omega3 ratio.
HEAL THE GUT!!
New research suggesting that atherosclerosis is inflammation related to immune attack of blood vessels
MUST look to connection between gut health and immune function as prevention
E.g. Celiac disease and homocysteine levels!!
MUST maintain gut integrity and healthy flora
Field of ENTERIC NEUROSCIENCE
Limit your Stress Response
80% of disease related to poor stress response
Stimulus can be physical, nutritional, emotional or internal = Fight or Flight
Raises cortisol levels, and like adrenaline can raise blood sugar levels-if not a physical threat then convert to fat
Cortisol levels cycle with circadian rhythm
Chronic stress can relate to adrenal fatigue
Manage Stress
Regulate Circadian rhythms (light in am, dark in pm)
Work to eliminate sources of stress e.g. counseling, meditation, exercise
Detoxification and adrenal support
Balance Blood sugar levels and reduce inflammation in the body
Sleep
One of the most under regarded factors of importance in over all health
Get a minimum of 7-8 hours rest per day
Don’t work the 3rd shift. Disruptive to the circadian rhythm and metabolic cycles No stimulants (chemical or mental/visual)
Safe supplements include 5 HTP and Melatonin
Low protein before bed, moderate complex carbs/oils like a fruit and yogurt
Physical activity
Walking – the best exercise routineStimulated brain due to weight bearing (gravity) stimulation, and joint motion (proprioception) stimulation. Raises Serotonin and Dopamine levels
Goal of 1-2 hours per day. “Burst” sessions work for males, not females. True full sessions are better as they activate full burning from fat stores, verses simply energy consumption
Track it with a pedometer!Effective way to track besides time and distance. Goal is 10000 steps per day.
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Supplements that modify risk factors
Magnesium1:1 or 2:1 ratio of Mg to Calcium - very safe
Vitamin K and Probiotic supplements, & PrebioticsReduced calcification in coronary arteries
Demonstrate less CVD with healthy microbiota
B vitamins (especially B3, B5, Folic Acid aka Folate (B9))Niacin as nicotinic acid 250-1000mg/day
Increase your EPA/DHA via supplementsUp to 3000mg day is GRAS
Vitamin C, B-carotene, Selenium, Curcumin LongaMajor inflammation factor reduction with supplementing
Vitamin DDeficiency is linked to immune suppression, CVD, inflammation, & cancer
Supplements that modify risk factors
Artichoke (leaf extract)Lowers LDL cholesterol by 23%
GarlicLowers LDL, reduces platelet stickiness and fibrinogen factors and kills unhealthy bacteria in gut that can increase Intestinal permeab.
Walnutsincreased satiety, lowered CHO cravings, increases omega 3 levels
Cinnamon1 gm per day – lowered TC, LDL, blood glucose
Chromium^’d # of insulin receptors on cells, lowers insulin, glucose, TC
Alpha-Lipoic AcidImproves glucose transport and increased insulin sensitivity
If there is anything that prevents the nervous system
from working at an optimal level, it will in some way affect the body’s ability
to heal and regulate!!
Chiropractic Care
Natural, druglessHighly effectiveFor all agesPreventative and
restorativePain care and
illness preventingAffordable
compared to other options
Chiropractic Care
Chiropractic has been shown to normalize increased electrical brain activity (EEG Studies), & has a calming effect on over-stimulation, by activating the Cerebellum!!
Better adapting ability to stress and less harmful stress
responses!
Summary
CVD appears to be completely modifiable and therefore preventable
CVD appears to be primarily due to dietary imbalance of high intake of refined carbohydrates, lack of antioxidant rich foods, high prevalence of inflammation from n6:n3 imbalance, and of course key lifestyle factors like sleep, stress, exercise, alcohol and smoking. NOT GENETICS!
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ReferencesDHHS NHLBI NIH
Why Zebras don’t get Ulcers RM Sapolsky
Carbohydrate Addiction “Practitioner” R Kemp
Good Calories, Bad Calories G Taubes
Diabetes, Coronary Thrombosis, and the Saccharine Disease TL Cleave, GD Campbell
Dietary Sugars and Human Disease UK Dept Health
The Schwarzbein Principle D Schwarzbein N Deville
Multiple Risk Factor Intervention for Primary Prevention of Cardiovascular Disease Cochrane Database of Systematic Reviews L Hooper
Framingham Heart Study
Seven Countries Study A Keys
MONICA Study Lancet K Kuulasmaa
MRFIT intervention trial
Lipid Research Clinics Coronary Prevention Trial (LRC-CPPT)
Effects of a Low-Glycemic Load Diet JAMA MA Pereira et al
Upcoming workshops
Dangers of sugars and processed foods
Running or walking: Fitter-farther-faster
Women’s Health
Ultimate Man workshop
Golf Workshop