By: James O’Keefe

Here is an interesting article written by Shelley Wood on theheart.org regarding Vitamin D abstracts presented at the American College of Cardiology, (ACC). I have highlighted two major points from the article. I have also attached the story.

Two major points:

• Among 9491 individuals with Vitamin D deficiency (≤30 ng/mL) those who subsequently normalized their vitamin D level during follow up had a substantially lower risk of CV events, and all-cause mortality was reduced by 30%. This was not a randomized trial, but is pretty compelling observational data.

• Ideal vitamin D level for reducing risk of CV risk was at least 43 ng/mL.. Most of the emerging data point to an ideal target Vit D level of 40 to 60 ng/mL. Most Americans have levels in the mid 20’s which means the typical American adult will need about 2000 iu per day to get into the ideal range. This is quite variable however, and I have found that 25-OH vit D levels are very helpful in directing therapy.

Death, CVD risk declines in people who “normalize” vitamin-D levels

Atlanta, GA – Adding heft to the hypothesis that vitamin-D deficiency is linked to cardiovascular disease, a new study has found that people with low vitamin-D levels who managed to normalize their levels were significantly less likely to develop cardiovascular events over up to six years of follow-up.

The study was presented as a poster by Dr Tami L Bair (Intermountain Medical Center Heart Institute, Murray, UT) earlier this week at the American College of Cardiology (ACC) 2010 Scientific Sessions.

According to coauthor Dr Joseph B Muhlestein (Intermountain Medical Center Heart Institute), the study looked at baseline and subsequent vitamin-D levels in 9491 subjects with known vitamin-D deficiency, rechecked their vitamin D, then compared subsequent rates of death, coronary artery disease, MI, heart failure, stroke, and renal failure among those who managed to bring up their vitamin-D levels with those who remained vitamin-D deficient. A cut point of <30 ng/mL was used to define vitamin-D deficiency.

“This wasn’t a randomized trial, but all of these patients started with low vitamin D, and then the question is, if they treated their vitamin D, did it have an effect? We don’t know what they did . . . the presumption is that they were told their vitamin D was low, then started supplementation or got their swimsuit out and went into the sun a lot to treat it.”

Getting to normal

After a mean of one-year of follow-up, those who had normalized their vitamin-D levels were significantly less likely to have died, developed heart failure, or developed coronary artery disease. A composite end point, looking at all outcomes combined, showed a highly statistically significant reduction among those with normalized vitamin-D levels.

Muhlestein drew particular attention to the 30% reduced risk of death in the normalized vitamin-D group. “A 30% reduction in risk is about the same you could hope to get from taking a statin or treating your blood pressure, so we thought it was certainly promising. It doesn’t eliminate the need for a real randomized trial, although I’m trying to figure out a good way to do one.”

There are a number of vitamin-D trials under way, most notably VITAL, a National Institutes of Health (NIH) study, launched in January.

But Muhlestein is concerned that the NIH trial may come up empty-handed for two reasons. For one, the trial, he says, is not measuring baseline levels or checking whether patients actually reach the optimal vitamin-D range in the intervention arm. “I can see why they aren’t [measuring vitamin D at baseline], because if they find vitamin D is deficient is it ethical to say, ‘I want you to stay vitamin-D deficient’?”

Vitamin-D deficiency is already known to increase the risks of skeletal disease, he notes. But without knowing if participants actually normalize their levels, it will be impossible to link normalization with an effect on events.

His second concern is with the dose chosen in VITAL: 2000 international units (IU) per day. “What I’ve found is that there are lots of my patients who don’t become normalized with 2000 units, so 2000 units may not be enough to treat the really deficient patients.”

But what’s normal?

In fact, Muhlestein and colleagues conducted a second study, also presented as a poster during the ACC meeting, trying to identify the optimal level of vitamin D by categorizing over 31 000 patients into three levels of vitamin D. When those levels were then linked to rates of 10 adverse outcomes (most of them cardiovascular), the authors demonstrated decreasing risk of adverse outcomes with increasing vitamin-D levels, with a vitamin D level >43 ng/mL to be the cutoff point for optimal.

Currently, they point out, a level of 30 ng/ML is considered “normal”—that cut point may be too low, based on their analysis.

But also of note, “above 43 ng/mL there was no added benefit,” Muhlestein observed. “So if your level was 70 ng/mL, you were good, but you weren’t any better than if [your level] was 43 ng/mL.”

As for whether vitamin D can be too high, Muhlestein noted that there are problems with vitamin-D toxicities typically associated with hypercalcemia, but these tend to arise in people with levels higher than 100 ng/mL, and many people believe the level must be well over 150 ng/mL. “The only way I know of that people can get vitamin D that high is by overdosing on prescription vitamin D, which is supposed to be taken once a week. If someone were to make a mistake and take it once per day, they might get vitamin-D toxicity.”

The findings from both studies have convinced Muhlestein that vitamin-D deficiency is worth treating, but he urges physicians to make sure they check to see what a patient’s vitamin-D levels are to begin with and to adjust the dose accordingly. Individualization is essential, he noted, which is one reason he’s worried about the blanket 2000-IU approach being used in VITAL.

“Effective dose varies from patient to patient, which is one of the problems with the NIH trial. No one is going to become toxic on 2000 IU per day, but there will be lots who are at the highest risk who are not going to become normalized.”

here is a link to the Web site

Every once in a while a reader will ask us our opinions about whole body, colon cleanses, or detox cleanses. This is a great question and one that I’d like to share the answer with everyone.

Do I recommend cleanses? NO! Absolutely not.

First, know that cleansing is an ongoing process. It’s not something that should happen once or twice a year. The body does a very good job of cleansing itself when given the right tools. If you are following an anti-inflammatory diet like Forever Young, your body is cleansing itself regularly. A good diet will help your body cleanse daily. An anti-inflammatory diet full of colorful fruits and vegetables will sweep any toxins from your body and also sweep your colon. Fruits and vegetables are full of antioxidants, which help reduce inflammation-causing free radicals, thereby reducing toxins in the body that cause disease.

Should you consider a cleanse prior to starting your new anti-inflammatory diet and lifestyle? No! Consider your diet your cleanse. Following a good anti-inflammatory diet is not only perfectly safe (unlike some cleansing systems), but will cost you no extra money. A once yearly cleanse is not going to reduce your chance of disease, but following a good diet (your body’s natural daily cleanse) certainly will.

Many people are also under the assumption that so-called detox cleanses will undo all the damage caused by a poor diet and lifestyle. Not so. Only a healthy diet and lifestyle followed every day will keep your body running clean and efficiently.

By: Dr. James O’Keefe

A recent New York Times article profiled a group of New Yorkers who consider themselves “modern cavemen.” The hunter-gatherer lifestyle really can be ideal. Here is a link to a Mayo Clinic Proceedings article I co-authored with Dr. Loren Cordain, one of the leaders of the hunter-gatherer movement. The article, Cardiovascular Disease Resulting From a Diet and Lifestyle at Odds With Our Paleolithic Genome: How to Become a 21st-Century Hunter-Gatherer, can be found here.  When you eat the Forever Young way, you are essentially eating a hunter-gatherer style diet. Straight from our book, The Forever Young Diet and Lifestyle, here are the basics you need to know to live a hunter-gatherer’s lifestyle and eat the hunter-gatherer diet.

Nine Steps Toward a Hunter-Gatherer’s Diet

If you want to be in sync with your genetic heritage, here are the steps you should follow to become a hunter-gatherer.
1. Thrive on the earth’s natural bounty. Eat whole, natural, fresh foods; avoid highly processed foods.

2. Consume a diet high in fruits, vegetables, nuts and berries, and low in refined grains and sugars.

3. Increase consumption of omega-3 fatty acids from fish, fish oil, and plant sources like walnuts, canola oil, greens, soybeans, and flaxseed.

4. Avoid trans fats entirely. Eliminate fried foods, hard margarine commercial baked goods, and most packaged and processed snack foods. Also eliminate consumption of fatty meats and high-fat dairy.

5. Increase consumption of lean protein such as skinless poultry, fish, game meats, and whey protein. Eat only lean, fresh cuts of red meat and limit consumption of saturated fats, including fatty, salty processed meats like bacon, sausage and deli meats.

6. Incorporate olive oil or canola oil into your diet, Avoid corn, safflower, sunflower, and vegetable oils.

7. Choose purified water, tea, nonfat unsweetened dairy or soy milk, and red wine. Avoid soft drinks, fruit juices, high-fat dairy, and sports drinks. Even 100 percent fruit juices are still loaded with too much sugar and should be considered off-limits. However, low sodium vegetable juices are very nutritious.

8. Use your body as it was designed and programmed over the millennia and engage in daily exercise from a variety of activities that incorporate aerobic and strength training as well as stretching exercises. Outdoor activities are ideal.

9. Develop and maintain relationships that provide social support (e.g., spouse, family, friends, neighbors, community, etc.) Try to also include some activities that involve altruism and nurturing.

By: Dr. James O’Keefe

We’ve fielded a lot of questions lately about mercury and other toxins in fish oils. Mercury and other contaminants are commonly found in the fish richest in omega-3 fats, like salmon and tuna. That’s why the Environmental Protection Agency recommends limiting your fresh fish intake. At the same time, the American Heart Association and other national and international health organizations recommend we get more omega-3 fats from fish in our diets.

Both CardioTabs Omega-3 Fish Oil and CardioTabs Ocean Safe Omega-3 undergo extensive purification processes, including molecular distillation, which is the only method that removes PCBs, heavy metals (such as mercury, lead, and cadmium), DDT and other contaminants to below detectable levels for human consumption. Our omega-3 products are manufactured to the Global Organization for EPA and DHA (GOED) standards. CardioTabs is also an active member of the Council for Responsible Nutrition and participates in the Natural Products Association’s True Label Program. Our products are independently tested for purity by 3rd party laboratories. CardioTabs Ocean Safe Omega-3 is Gold Certified for purity by an independent, nationally recognized third-party laboratory.

By: Joan O’Keefe

A review published yesterday in the Journal of the American College of Cardiology states that some herbal supplements could be dangerous – particularly to those taking heart medications. We couldn’t agree more. As practicing clinicians, we would never recommend a nutritional supplement or herbal remedy that did not have serious research backing its safety and efficacy. In fact, the potential danger of mixing herbal supplements and prescription medications was one impetus behind the formation of CardioTabs.

We would never recommend and/or make a product that is not backed by substantial scientific research. We follow the research daily to make sure that our formulas reflect the latest science. In fact, we often change our formulations in response to emerging science. Safety is our top priority. Our products are all standardized to provide our customers with exact dosing and we have our products independently tested for label accuracy, heavy metal contamination, and microbiology.

We are constantly working to improve our product offerings and are proud to be a trusted resource for quality nutritional supplements and information.

Information about the JACC study can be found in the following article:

http://www.reuters.com/article

By: Joan O’Keefe, RD

Some people ask why CardioTabs sells a whey protein product. Isn’t that just for athletes, people ask. The answer is simple. Whey protein isolate is one of the absolute best things you can use to fuel your body. Not only is whey protein isolate the cleanest, purest, most complete (and nonfat!) protein source available, but it tastes really great too. Whey protein isolate will keep you feeling full for a long time. It can also help you build lean body mass.
We have formulated CardioWhey to contain only the highest quality whey protein isolate with none of the concentrates and fillers many whey products contain. We’ve also added magnesium and chromium and to CardioWhey.
I know that CardioWhey  is one of the healthiest things I can recommend to my clients. We’re all busy and whey protein is truly easy to make, especially for breakfast. It takes less than 30 seconds to make and it’s portable. There IS time for breakfast. Here are a few taste-tested recipes we’ve developed that provide the color and protein you need to start the day right.

Memory-Boost Smoothies
(Blueberries are a terrific memory-boosting food and this is a great way to get them into your diet.)

Blueberry/Apple Sauce
1 cup nonfat skim milk
½ cup unsweetened apple sauce
½ cup frozen blueberries
1 scoop CardioWhey Vanilla
Put all ingredients in blender and blend until smooth.

Berry Blend
1 cup nonfat skim milk
½ cup frozen strawberries
½ cup frozen blueberries
1 scoop CardioWhey Vanilla or Chocolate
Put all ingredients in blender and blend until smooth.

More Color & Protein

Mandarin Orange
1 cup nonfat skim milk
½ cup canned mandarin oranges (drained)
1 scoop CardioWhey Vanilla
(Try adding ½ cup frozen blueberries – tastes great together and packs even more of a nutritional punch.)
Put all ingredients in blender and blend until smooth.

Pumpkin Pie Smoothie
1 cup nonfat skim milk – we used unsweetened almond milk, yum!
¼ cup canned pumpkin (plain, not pumpkin pie mix)
½ tsp pumpkin pie spice (nutmeg, ginger and cinnamon combined)
½ banana
2 scoops CardioWhey Vanilla
Try adding a few ice cubes to this to make really cold.
Put all ingredients in blender and blend until smooth.

Note – while all recipes listed here call for skim milk, you can substitute with nonfat, unsweetened non-dairy milk. We tried skim milk and unsweetened almond milk in the recipes and loved both results.

By: Joan O’Keefe

The health of your arteries is critically important to virtually every aspect of your health. Too much salt (sodium) ages your cardiovascular system by raising your blood pressure and hardening, stiffening and thickening your arteries and the walls of your heart. You want to keep your blood vessels soft, smooth and supple like they were when you were a child and a teenager and avoid developing the rigid, inflamed and crusty pipes that can lead to a heart attack, stroke and congestive heart failure.

As an American adult, your chances of developing high blood pressure during your lifetime are 90 percent. If you continue to follow your current lifestyle, sooner or later you will probably get hypertension-the medical term for high blood pressure. Why? For starters, the average American consumes about 4000 mg of sodium daily, which is about six to ten times more salt than we were designed to eat. Add the fact that blood pressure rises in response to too much body fat, stress, and sugar and too little sleep and exercise, and you have the recipe for high blood pressure. In February 2005, the Center for Science in the Public Interest estimates that too much sodium kills 150,000 Americans each year. Excess sodium does much more that just raise your blood pressure. A study by David Calhoun, MD, reported in February 2005 Cardiology News showed that high-sodium intake reduced blood vessel wall function. In addition, salt leaches the calcium from your bones, making you prone to osteoporosis and fractures, and also appears to increase cancer risk- especially in the GI tract. A recent study found that extra salt in the diet increased the likelihood of heartburn (also known as esophageal reflux) by as much as 70 percent.

A good place to start lowering the sodium in your diet is by removing the salt shaker from the table and hiding it in an inconvenient spot. But only about 5 percent of the salt in our diet comes from the salt shakers; 75 percent comes from processed and restaurant foods. Most people do not choose to eat high-sodium products- they just eat foods that are readily available in our culture. Salt is everywhere in our modern diet, even in foods such as bread that don’t taste salty. Processed foods are loaded with salt to help preserve freshness, and the more sodium you eat, the more you will crave salt. When you eliminate highly processed, high- sodium foods from your diet, you will take a huge step toward a healthier more vigorous life.

Fresh fruits and vegetable contain virtually no sodium and thus are great for lowering your blood pressure along with your weight. We recommend at least nine servings of fresh produce daily. Unprocessed meat, poultry and fish contain only small amounts of sodium, but the more highly processed versions like deli meats, smoked, or barbecued meats, beef jerky and other commercially modified meats are usually very high in salt. The processed snack foods are generally also high in sodium. Try to get used to eating nuts that are unsalted or only lightly salted. Look for the sodium content on food labels and avoid items that have more than 400 mg per serving. Limit your daily intake to not more than 2300 mg (about one teaspoon) – the average American eats almost two times this much. One glass of regular V8 vegetable juice has over 1000 mg by itself. (low-sodium V8 or tomato juice is great) and a single dill pickle has 440 mg. A high potassium-to-sodium ratio is one of the most important parameters of a healthy diet. We are designed to take in much more potassium than sodium, but the ratio is reversed and sodium dwarfs the potassium consumption. So how do you get more potassium? You guessed it-lots of fruits, vegetables, lean protein and other Forever Young natural whole foods.

A Rainbow of Salt Varieties to Avoid
White salt: table salt
Red salt: ketchup
Yellow salt: mustard
Black salt: soy sauce
Green salt: pickles and olives

By: Joan O’Keefe

We received a great question from one of our favorite nurses today and because it’s so unusual, I want to share the answer with you.

Q: Is it safe to take fish oil or omega-3 if you’ve had your gall bladder removed?

A:

The gall bladder helps with the digestion of fats. The organ contracts when the body consumes fat. Following gall bladder removal, patients are often told to be careful of overloading on fat. This means that they should avoid consuming fried foods and other high-fat foods. If the patient is on a NO fat diet (not just fat-restricted, but NO fat), meaning he/she cannot tolerate fat at all – cannot tolerate meats, nuts, olive oil, avocado, cheese, fish, etc.- then the patient may have to avoid fish oils. However, NO fat diets are rare. Restricted and very low fat diets are more common and because omega-3 fish oil softgels contain such small amounts of fat, they should be safe. The key is to start with small doses. Take just one small omega-3 fish oil softgel per day. If you feel any pain or discomfort, stop. If you’re tolerating the fish oil, gradually add more until you reach your recommended dose. I wouldn’t recommend starting with liquid fish oils, but you should be fine with small softgels.

Posted By: Michelle Kruse

Low Vitamin D Has a Role in Heart Risk
Study Shows Low Levels of Vitamin D May Explain Racial Gap in Cardiovascular Risk

Jan. 7, 2010 — African-Americans are more likely than whites to die of heart attacks, strokes, and other cardiovascular causes. Now intriguing new research suggests that low vitamin D levels may help explain this disparity.

Darker-skinned people produce less vitamin D from the sun than those with lighter skin, and studies show that blacks are far more likely to have lower levels of the vitamin than whites.

Several recent studies also suggest that low levels of vitamin D are associated with an increased risk for heart attack and stroke.

In an effort to examine the role of vitamin D in the racial disparity in cardiovascular death, researchers analyzed data from a national health and nutrition survey that included more than 15,000 people.

Vitamin D levels were measured at the time the survey was conducted, and the participants were followed for up to 12 years.

(read more)

By: Joan O’Keefe

Your life can change today. I am so excited that you are reading this blog. I’m excited for you and for the joy that losing weight is going to bring to your life. How many times have you heard someone say dreadfully, “my diet starts tomorrow,” or “Ugh, my doctor says I have to lose weight?” Stop looking at weight loss as a chore. Get pumped up and excited because your life will soon be defined by feeling good and healthy, extra energy and zest for life. I have several clients that let excess weight define and limit them. One client spends her days miserable because she can’t do the things she’d like to do because of her weight. On a recent vacation, her family and friends golfed and walked on the beach while she sat watching. Excess weight was killing her spirit. She’s now 18 pounds down and gets a little of her life back every day. Imagine the joyous days she has ahead of her as she continues to shed 180 more pounds of extra weight.

In addition to my usual advice (pick two colors and a protein morning, noon and night – see Nutrition 101), here are some unconventional tips for weight loss. Losing weight is more than just “diet.” Follow these tips and you’ll be feeling great in no time!