Hearts on Fire Chronic Inflammation and Cardiac Disease By Vicki Kobliner MS RD, CD-N
monly imagine a joint or a wound becom- ing inflamed from an acute injury, such as a sprain or cut. Rarely do we think about our heart being inflamed, yet more and more research points to inflammation as an impor- tant underlying cause of heart disease. The difference is that this inflammation comes not from one specific injury, but from the longer term effects on the heart of a continu- ously stimulated immune system. Patients with chronic inflammatory conditions are known to be at an increased risk of heart disease, but even those without autoimmune disease or other inflammatory disorders can suffer from atherosclerosis after years of chronic stress from the environment, dietary and lifestyle challenges.
W Is Cholesterol The Culprit?
Cardiac disease is generally thought of as mostly a problem of excess fat deposi- tion in arteries and organs. The popular explanation is that as fat builds up in an ever thickening layer, plaques can rupture, and ultimately block the flow of blood through the arteries. While this may be a piece of the puzzle, this theory does not explain why al- most half of all heart attacks occur in people with normal cholesterol levels. To further confuse the issue, contrary to popular belief, dietary cholesterol does not increase blood cholesterol levels. Our bodies control cholesterol production in re- sponse to its need. The question then is: why do our bodies start to produce this excess cholesterol and what is cholesterols’ role in atherosclerosis? Far from being the enemy we have
grown to believe it is, cholesterol is a critical compound for all human beings. It is part of many hormones, is actually necessary for normal fat digestion, helps our brains work, and is required for normal Vitamin D production. The body also increases choles- terol production in response to inflamma- tion, in order to form a protective barrier, much like a Band-Aid. People with normal total cholesterol levels can still have small plaques targeted to areas of inflammation. It is only when this fatty covering ruptures, that
36 Natural Nutmeg February 2012
hen we think about inflammation, we envision swelling, redness, and possibly bruising. We com-
trouble occurs. This link between cholesterol production and inflammation may be a key to better understanding its role in cardiovas- cular disease, and may explain why even those with normal cholesterol can experi- ence a heart attack. Over 40 years ago, Ross and Glomset
developed what is known as the “response to injury” theory of atherosclerosis, postulat- ing that injury to the cells was the first step in the development of the disease. Other researchers implicated infectious agents such as viruses in the development of cardiac dis- ease as well, and there is good evidence to support these theories. These scientists relate the deposition of fat to evidence of inflam- mation, and suspect both are necessary for the disease to occur.
Once inflammation is present, LDL (the “bad” fat) accumulates around the site of injury and is a key component in plaque formation. The LDL is most dangerous when it is “oxidized”, which means it has been exposed to dangerous free radicals. Free radicals are naturally produced by the body, but are increased when inflammation is present, and can be reduced by consuming anti-inflammatory foods, spices and herbs. Once again, inflammation and heart disease are clearly linked.
Identifying Inflammation A specific blood marker, known as
C-reactive protein (CRP), can accurately identify people with increased inflammation,
and a number of studies have shown a clear correlation between elevated CRP and heart disease. While this is still not a routine part of a cardiac profile, more and more health- care practitioners are checking CRP. Triglycerides (TG) are another important marker to monitor. TG is a standard com- ponent of a lipid profile, but is often over- looked when assessing heart risk. This is unfortunate, as more and more data points to TG as an independent risk factor for a heart attack, regardless of whether other cholesterol markers are normal or elevated. TG rise in response to high carbohydrate in- take, especially the simple sugars that are so pervasive in a typical American diet. Sweets, alcohol, and refined flours are known to in- crease chronic inflammation in the body and will also raise TG, providing another link between heart disease and inflammation.
Fighting The Fire Reducing the lifestyle factors that in-
crease free radical damage is key to pro- tecting your heart. Stress, smoking, excess alcohol and poor diet are major contributors to free radical production and consequent inflammation. Addressing one and ideally all of these areas can have a powerful impact on cardiac health. Simple steps to fight the fire include stopping smoking and limiting alcohol. In terms of alcohol, complete avoid- ance does not seem warranted. Red wine and beer are both rich in antioxidant nutri- ents that are heart protective, so one drink a day can be beneficial. Excess intake of 3 or more drinks a day however, is counterpro- ductive and undesirable. Busy, overscheduled lives lead to inflam- mation as well. Stress reduction techniques such as meditation, yoga, exercise or simply slowing down to breathe deeply can help. Incorporating these techniques into your life daily can have far reaching benefits and don’t entail a major time commitment. In terms of diet, brightly colored fruits and vegetables are rich in antioxidants and quench the dangerous free radicals, as do flavorful herbs such as turmeric, ginger and cinnamon. Limit sugar and refined sweets to reduce inflammation. Many low fat foods have extra sugar added instead, so choos- ing artificially low-fat foods is counterpro-
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