Cardiovascular Diseases

Cardiovascular diseases (CVDs) are the number one cause of death globally: more people die annually from CVDs than any other cause.

CVDs are a group of disorders of the heart and blood vessels. They mainly include

• Coronary heart disease - a disease of the blood vessels supplying the heart muscle
• Cerebrovascular disease - a disease of the blood vessels supplying the brain
• Peripheral arterial disease - a disease of blood vessels supplying the arms and legs
• Deep vein thrombosis and pulmonary embolism - blood clots in the leg veins. Which can dislodge and move to the heart and lungs.

Heart attacks and strokes are usually acute CVD events caused by a blockage that prevents blood from flowing to the heart or brain. The most common reason for this blockage is a build-up of fatty deposits on the inner walls of the blood vessels that supply the heart or brain. This accumulation process of fat and other substances is defined as atherosclerosis.

Atherosclerosis (or fat accumulation in the blood vessels) occurs in a stage wise manner including

• Endothelial dysfunction - the inner layer of the blood vessels fails to perform all the important functions normally
• Plaque formation - is a build-up of cholesterol, white blood cells, calcium, and other substances
• Thrombosis - Blood clot or blockage preventing the flow of blood leading to a heart attack or stroke.

The top 25 modifiable CVD risk factors are¹

• Hypertension
• Dyslipidemia
• Hyperglycemia, metabolic syndrome, insulin resistance, and diabetes mellitus
• Obesity
• Smoking
• Hyperuricemia
• Renal disease
• Elevated fibrinogen
• Elevated serum iron
• Trans fatty acids and refined carbohydrates
• Low dietary omega-3 fatty acids
• Low dietary potassium and magnesium with high sodium
• Inflammation: Increased hs CRP, MPO, interleukins
• Increased oxidative stress and decreased defense
• Increased immune dysfunction
• Lack of sleep
• Lack of exercise
• Stress, anxiety, and depression
• Homocysteinemia
• Subclinical hypothyroidism
• Hormonal imbalances in both genders
• Chronic clinical or subclinical infections
• Micronutrient deficiencies: numerous ones such as low vitamin D and K, etc.
• Heavy metals
• Environmental pollutants

Most of the risk factors listed above are due to the modern lifestyle and could be addressed through medical nutrition therapy (MNT). Reversing unhealthy lifestyle choices that accelerate aging and CVD, including physical activity, and specific diets are becoming progressively integrated into the standard of care².

A two-year Dietary Intervention Randomized Controlled (DIRECT) trial on moderately obese participants compared low fat, Mediterranean and low carbohydrate diets found that low carbohydrate diet was most effective in weight loss, thereby decreasing triglycerides and increasing HDL cholesterol levels³.

Another study conducted by Cochrane for 4-8 weeks concluded that eating whole grains decreases the total cholesterol levels by 7.7mg/dL and LDL cholesterol levels by 7.7 mg/dL⁴.

Also in a study by Dauchet et al, it was found that consumption of an additional serving of fruit a day reduces the risk of coronary heart diseases by 7%⁵.

REFERENCES:

1. Houston MC. Treatment of Cardiovascular Disease with Nutritional Supplements SM J Food Nutr Disord. 2016; 2(1): 1010.

2. Benjamin EJ, Virani SS, Callaway CW, et al.; American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee. e: A Report From the American Heart Association

3. Weight loss with a low-carbohydrate, Mediterranean, or low-fat diet,Weight loss with a low-carbohydrate, Mediterranean, or low-fat diet Engl J Med. 2008 Jul 17; 359(3):229-41.

4. Kelly SA, Summerbell CD, Brynes A, Whittaker V, Frost G, Wholegrain cereals for coronary heart disease, Cochrane Database Syst Rev. 2007 Apr 18; (2): CD005051.

5. Dauchet L, Amouyel P, Hercberg S, Dallongeville J,, Fruit and vegetable consumption and risk of coronary heart disease: a meta-analysis of cohort studies, J Nutr. 2006 Oct;136(10):2588-93