A new study gives us another reason to pause before we take some of the common drugs for heartburn. The use of these drugs known as proton pump inhibitors correlates with a 20% higher risk of heart attack. These drugs were intended to be used for 6 months or less while many Americans are using them for much longer periods of time. This longer use is possibly part of the problem.
This study doesn’t necessarily show that proton pump inhibitors are to blame for the increased heart attack risk. We only know heart attacks happen more often in people taking these medications. The good news is there are other ways to deal with heartburn.
As one researcher commented, some of the same lifestyle choices that contribute to heart disease can also cause acid reflux. He mentions bad diet, excessive alcohol consumption, and smoking. So yes, it makes absolute sense to improve our diet and lifestyle instead of using a drug to mask the symptoms of heartburn.
When I am discussing acid reflux with my patients, I generally start with diet and stress as the two most common factors contributing to heartburn. Sometimes people know the foods that trigger their heartburn, such as fried or spicy foods. Other times there can be a hidden culprit like gluten or dairy.
While my patients are working on appropriate diet changes, I might treat the symptom temporarily to help them feel more comfortable while the body heals. On popular product is DGL, a chewable licorice tablet that soothes as well as promotes healing. Blends containing zinc carnosine like Endozin may also help protect and heal the lining of our digestive tracts. Depending on the severity of the symptoms, I might also employ some of the other steps of my gut healing protocol.
Fix the underlying problem driving heartburn and you often can prevent other health complications later in life. If you have been using medication for heartburn, discuss your heart disease risks with your doctor and see what steps you can take to improve both your acid reflux and your long-term health.
I remember when I was growing up many people who were trying to live a “healthy” lifestyle avoid all caffeine, even that in chocolate. Of course, our idea of what is healthy changes over the years. It used to be that fat was the culprit to avoid. Now, it is carbohydrates. Next it will be….your guess is as good as mine.
With coffee, there is actually some strong evidence that it is a healthy choice for most people. Many studies have shown coffee to be a brain protector that could help prevent Parkinson’s and Alzheimer’s disease. There are also studies indicating that coffee might decrease the risk of diabetes. And there are compounds in coffee besides caffeine that could be beneficial. For instance, chlorogenic acid is the active ingredient in the popular weight loss supplement Green Coffee Bean Extract.
For a small percentage of the population, these benefits might be outweighed by some potential health concerns. About 12% of us have a genetic variation in a caffeine-detoxifying enzyme, known as cytochrome p450 1A2, which leads to slower breakdown of caffeine. One study indicated an increased risk of heart attack among individuals with these genes who drank coffee. The risk increased with higher coffee intake. Likewise, coffee drinkers with these variations had higher risk of breast cancer in another study. The study seemed to indicate that if they didn’t drink coffee they had a slightly lower risk of breast cancer than the rest of the population.
So how do you know if you are in this 12%? Genetic testing is now a viable option since it has become inexpensive. Many people with this genetic variation can tell because caffeine will affect them longer or even cause strange symptoms. They might notice that a cup of coffee with supper or even lunch or breakfast keeps them awake at night.
For everyone else, some caffeine seems like a safe and possible protective part of the diet, but to quote one of my herbal medicine instructors, “the proper dose for this herbal medicine is 1-2 cups per day.” Over reliance on coffee to keep us energized might be masking underlying health issues to need to be addressed.
Posted in Health, Herbs
Tagged breast cancer, caffeine, cancer prevention, cardiovascular disease, coffee, dementia, detoxification, genetic medicine, heart disease, memory
Vitamin D has received a lot of interest in the last few years as an essential nutrient to possibly help prevent serious health issues. Not as much thought has been given to its helper Vitamin K, but I think this is going to change. Several of the conditions that are thought to be associated with vitamin D deficiency, such as osteoporosis, cardiovascular disease, and cancer, as also linked with vitamin K deficit.
Like vitamin D, vitamin K is a fat-soluble vitamin that occurs in several forms. The most commonly known form is vitamin K1, which is necessary for proper blood clotting. Vitamin K2 is the form that is gaining interest right now for its importance in bone and heart health. Sources of vitamin K2 are natto (fermented soybeans), tempeh, grass fed butter and beef, eggs, cheese, and possibly sauerkraut and other fermented vegetables. It is also sold as a dietary supplement under the name MK-7, which stands for menaquinone-7 the scientific name for vitamin K2.
Most of what vitamin K does in the body is help different protein handle calcium, but it is through the appropriate use of calcium that vitamin K has so many benefits.
Vitamin K helps certain proteins hold on to calcium. For instance in bone formation, a protein called osteocalcin needs vitamin K to be able to deposit calcium in the bones. This is why the combination of calcium, vitamin D, and vitamin K was superior for helping improve bone density than was calcium and vitamin D alone in a 2012 study.
Some recent studies have linked calcium intake to increased hardening of the arteries. My hypothesis is that if we don’t have adequate vitamin K2, taking calcium may be an issue for heart health. Vitamin K2 is an essential part of a protein in our artery walls that helps prevent calcium from being deposited in the arteries. Indeed, a few studies have demonstrated that higher vitamin K2 intake is associated with lower rates of cardiovascular disease. So I always tell my patients if they take calcium, make sure they also have adequate levels of vitamin D and vitamin K2 to help ensure the calcium is going to the bones where we want it and not to the arteries.
Posted in Health
Tagged bone density, bone health, calcium, cardiovascular disease, cardiovascular health, heart disease, MK-7, osteoporosis, vitamin D, vitamin K, vitamin K2
I created this recipe less because I wanted to avoid grains and more because I wanted to find another delicious way of eating more vegetables. When it comes to health, we seem to get more benefit from adding healthy foods to our diet as opposed to cutting out the bad ones. Increased vegetable consumption is one of the more important things we can do for our health, along with eating fruit, nuts, legumes, reduced-fat dairy, whole grains, and fish.
A recent Swedish study found that men who ate healthier diets reduced their risk of heart attack by 18%. When combined with 4 other healthy habits, they reduced their risk by 80% compared to men who did none of these things. These healthy habits were drinking alcohol in moderation, not smoking, exercising, and avoiding excess belly fat.
This study only included Swedish men, but clearly we can guess that these healthy choices could make a huge difference for anyone.
This recipe uses several of the foods on the list of healthful foods used in this study. Eating peppers in particular has been linked to lower rates of Parkinson’s disease.
3-4 peppers (I used poblanos, but bell peppers are fine)
1 cup cooked beans
1-2 cups reduced fat Monterey Jack or other cheese
½ – 1 cup onions, chopped
½ cup sliced black olives
1-4 jalapenos, sliced (I use Jalapenos En Excabeche that I make from this recipe)
1 cup tomato, chopped
1 avocado, chopped
Optional additinal toppings: sour cream, guacamole, seasoned meat, chopped green onions, cilantro, shredded lettuce or other greens, salsa or pico de gallo, or whatever else sounds good
Cut peppers in half and remove the cores.
Flatten with your hand onto a baking sheet.
Toss on the beans, cheese, onions, black olives, and jalapenos.
Bake at 425 degrees for 20-25 minutes until the cheese starts to brown and peppers get a little bit soft.
Sprinkle tomatoes and avocado and anything that you like on top and serve.
Note: In these pictures, I was making a double batch because they make awesome leftovers when reheated.
In response to my last blog on the connection between heart disease and depression, healthline.com send me this link to their excellent infographic on heart disease statistics. Being an Arkansan, I noted that Arkansas is one of the Deadly Dozen, the top 12 states with the highest rate of cardiovascular death. Well, my Arkansas grandfather did die of a heart attack way too young, and I do partially blame his biscuit and bacon diet.
In popular culture, the heart is often considered to be the seat of our emotions. We love and grieve with our hearts. From a biological point of view, we understand the heart as the organ that pumps blood through our bodies. But there is something more than that to the heart. I know I am not the only one who has experienced chest pain due to a stressful situation. I was too young to really worry that it was heart disease, but did still consider that possibility because of my family history. Ultimately, I made some changes in my life and the chest pains went away completely. The reason for this phenomenon is that stress changes the signals that the heart gets from the brain. While theses signals might be useful if we need to run from a bear, they can be detrimental when we are sitting at a desk.
Not only can stress affect our hearts, but depression can too. A large study examining English civil servants showed found participants that showed signs of depression were more likely to have heart attacks. Another study demonstrated that using therapy to depression helped prevent the development of heart disease. In fact, the participants who did not have heart disease at the beginning of the study and received counseling where 47% less likely to have a major cardiovascular event compared to those who didn’t get the same treatment for depression.
This connection between heart disease and depression might explain why some supplements are good for both the brain and the heart. A prime example is fish oil, which is probably one of the most popular cardiovascular health supplements. Countries that consume more fish and have higher levels of Omega-3 fatty acids have lower rates of coronary artery disease. Another major use of fish oil is to help treat mood issues and depression. Could this last benefit contributing to the cardiovascular advantages of taking fish oil? And to learn more about one possible genetic contribution to both depression and heart disease, check out my recent blog on methylfolate.
An important consideration for depression is that not everyone manifests the same symptoms. Generally the signs to look for are feeling sad, hopeless, anxious and sleeping or eating too much or too little, but some people’s depression manifests as tiredness, irritability or even angry. While there are different causes of depression from situational issues like loss of a loved one to genetic and brain chemistry variations, some of these symptoms seem to be connected to lack of fulfillment in life. It can be hard to find truly fulfilling roles and careers in our modern world and too many people end up working at a job just because that is the one available. I am not saying quit your job, but if you can, weigh these possible long term health concerns when choosing a career. And know that counseling and learning stress coping skills can be genuinely useful.
I’ve been wanting to write a blog about methylfolate for a while since the genetic variation in how we process folic acid can sometimes have a huge impact on heart, mood, and overall health. I’ve been delaying because it is not a simple topic, but here is a basic introduction to it.
Our bodies use several active forms of folic acid, one of these being methylfolate, or more scientifically 5-methyltetrahydrofolate. Methylfolate is necessary to activate B12 and make SAMe, which in turn is necessary for some detoxification processes, neurotransmitter production, and proper genetic expression. Methylfolate is also used to neutralize of homocysteine, an amino acid derivative that is possibly implicated in heart disease. B12 is also needed for this last process.
DNA photo courtesy of Svilen Milev
Between 10-20% of the population has a genetic variation in their ability to make methylfolate. Most people with this genetic variation will still have one gene that is functional and probably make adequate methylfolate. Other people have two bad copies of the genes and will be deficient in this active form of folate.
Especially with this last case, these genetic variations can lead to very serious health conditions. These can range from common mood issues like depression to serious mental health disorders like schizophrenia and bipolar disorder. I also see these genetic differences more commonly in my patients with ADD and autism. Because of the reduced ability to neutralize toxins, people with these genetic issues can have increased rates of autoimmune disease, Alzheimer’s, and Parkinson’s disease. Another variant in this gene can lead to an increase in conditions that are caused by blood clots like heart attacks and strokes. Finally, this genetic variation can cause an increase in birth defects and miscarriages.
So the solution to this genetic issue can be simple sometimes and more complex for others. Since the eventual end product of this gene is methylfolate (or more precisely 5-methyltetrahydrofolate), we can take this as a supplement and bypass the problem. The dosage can depend on the person so I start low unless there has been adequate testing. Where this gets challenge is that this genetic variation isn’t always the only one. Taking methylfolate can help us make epinephrine, an excitatory brain chemical. For some types of depression, this can be very useful, but others have trouble breaking down epinephrine due to other genetic mutations. For these people, they can build up too much of this stimulating epinephrine and experience anxiety.
For people who are really curious about these possible genetic variations, the good news is that genetic testing in now really inexpensive. For $119, you can get a full panel from 23andme.com, which is then translated by the Sterling App. This approach can help you and your doctor better understand how to balance your supplements for your genes.
Posted in Health
Tagged anxiety, cardiovascular disease, dementia, depression, detoxification, genetic variation, genetics, heart disease, heart health, methylfolate, methyltetrahydrofolate, mood support, MTHFR snp
This blog was inspired by a recent talk I presented on nutrition for a local prostate cancer support group. As well as talking about other dietary basics, I brought a jar of pure pomegranate juice for them to try, being inspired by some recent research on pomegranates for prostate cancer prevention. Compounds in pomegranate have been shown to inhibit the growth of prostate cancer in animal studies, even hormone-dependent cancer cells. Pomegranate extracts also reduced the ability of tumors to grow new blood vessels, a process that is essential to tumor’s ability to increase their food supply). In a separate study, men with recurrent prostate cancer who drank pomegranate juice had a much slower rise in prostate specific antigen (PSA), a marker of prostate cancer progression.
In addition to protecting the prostate, pomegranate can be a good ally in preventing heart disease, Alzheimer’s disease, and dental plaque. Best studied is pomegranate’s role in helping slow the development of atherosclerosis, the deposition of cholesterol plaques in the arteries. The consumption of pomegranate products reduces the oxidation of cholesterol, which may be one of the most important steps in the formation of atherosclerotic plaques. In fact, patients given pomegranate juice for 3 months demonstrated improved blood flow within the heart during a stress test compared to those given a placebo beverage. Pomegranate also protects the brain. Mice that were bred to have early onset Alzheimer’s disease performed better on maze tests and had decreased amyloid beta plaques in their brain when they were given pomegranate. Finally, oral use of pomegranate extract significantly decreased bacteria that contribute to dental plaque.
If you would like to read some of the other dietary advice I shared with the prostate cancer support group, you can access my handout here.
Posted in Health
Tagged cancer prevention, cardiovascular disease, cholesterol, cognitive support, dementia, dental health, gum health, health, heart disease, heart health, memory, mental-health, prostate cancer progression, prostate cancer support
Many of you will have heard about the concept known as the French paradox, specifically how the French consume more fat than Americans but have lower cholesterol levels. While I don’t think there is a simple answer to this paradox, it is widely agreed that a major factor is the consumption of red wine. Red wine contains resveratrol, an antioxidant that is also found in grape skins, raisins, mulberries, nuts, peanuts, and Japanese Knotweed. Japanese Knotweed is actually the richest sources of resveratrol, and most resveratrol supplements are now made from this herb instead of wine grapes. In addition to being an antioxidant, resveratrol is anti-inflammatory and can play a role in reducing cholesterol and other fats in the blood. Both of these attributes have earned resveratrol a reputation for helping protect the heart, especially since inflammation is now known to be a major risk contributor for heart disease.
Besides these effects on cardiovascular health, new research is revealing other health benefits for resveratrol. Consumption of resveratrol has been shown to support the health of the beneficial bacteria that live in the gut. It seems to feed beneficial gut flora like bifidobacterium, an organism often found in probiotic supplements. Resveratrol was also shown to reduce the populations of some harmful bacteria that can inhabit the gut. In fact, these changes in gut bacteria were correlated with reductions in cholesterol and inflammation, suggesting the changes in gut flora health may contribute to these other benefits. Additionally, resveratrol may help us fight viruses. Resveratrol may be able to send a message to cells to stop replicating viruses that have invaded them. Resveratrol also seems to have other attributes to help prevent cancer that are independent of its antioxidant properties.
I actually used to have massive amounts of Japanese Knotweed growing in my neighborhood in Seattle. Unfortunately since it was invasive there, it was being sprayed by the city and I couldn’t use it as a resveratrol source. If only we had a program to harvest the many useful invasive plants like this for medicine. Maybe we could all be healthier and our environment too.
Posted in Health
Tagged anti-inflammatory, beneficial gut bacteria, bifidobacterium, cancer prevention, cardiovascular disease, cholesterol, grape skins, heart disease, inflammation, prebiotics, probiotics, resveratrol