As we learn more about how heart disease develops, we see that the usual suspects – cholesterol, diabetes and hypertension – aren’t the only factors at play. And, some research is suggesting that our attack on cholesterol may be especially unfounded, given the relative ineffectiveness of statins in most healthy adults (ie no history of heart attacks) and the myriad of side effects they come with. Inflammation is emerging as the root cause of heart disease.
How does inflammation cause heart disease?
For many years heart disease was seen as a kind of plumbing problem—that is, as merely a matter of plaque building up in the walls of blood vessels and clogging them. But it is more complicated than that. Blood vessels are nothing like pipes—they are active tissue that absorbs cholesterol from the blood, and this may result in damage to the vessel walls. In trying to heal this damage, inflammatory cells come into the vessel walls. They then release many chemicals that may cause further damage. Smoking, high blood pressure, poor diet, etc. may hasten this process. Inflammation may also contribute to the rupturing of plaque, which in turn triggers a blood clot, resulting in a heart attack or stroke.
How is inflammation measured?
There is an easy way to test for inflammation, since it can prompt the liver to produce a protein in the blood known as C-reactive protein (CRP). Elevated levels of CRP often accompany or signal an increased risk of heart attack and stroke. This may help explain why many people who get heart attacks have normal blood cholesterol levels and no other identifiable risk factors.
The link between elevated CRP levels and heart disease has been found in several studies, and there is some evidence that CRP may be a more important indicator of heart disease risk than high LDL (“bad”) cholesterol. In an eight-year study involving 27,939 women more than half of the women who eventually developed heart disease had high CRP levels even though their LDL levels were not considered high. This is such a key finding, as so much of our treatments which focus on “prevention” single out cholesterol, when in fact cholesterol may not even be a major player!
How to treat inflammation
As always, naturopathic medicine focuses on the whole person, and not just the symptoms. If inflammation is occurring in one area of the body (joints, heart, etc) it’s likely to be affecting other areas as well. Some believe that inflammation may be the root of many chronic diseases, including cancer, Alzheimer’s, etc.
1. Get plenty of good fats. I’m always talking about the benefits of omega-3-fatty acids, namely DHA and EPA. If there’s one supplement that most people can benefit from, it’s a good quality fish oil. Omega-3 fats can be found in cold water fatty fish such as salmon, mackerel, herring, sardines and tuna. Many people struggle to get the recommended 3+ servings a week though, and opt to take a supplement. If you do supplement, please make sure you take an omega-3 supplement, and not a 3-6-9 version. Most people get plenty of omega 6 and 9, and too much of these essential fats can lead to a pro-inflammatory response as the following diagram suggests.
When looking for a fish oil supplement, look for one that is molecularely distilled to remove impurities. Quality matters when it comes to fish oil – you get what you pay for. And, make sure you are getting enough – aim for a minimum of 1.5 grams of EPA/DHA per day. If you take medications such as aspirin and warfarin, you should consult with your health care practitioner first as high doses of fish oil can cause further thinning of the blood.
2. Get lots of greens! Make sure you are getting a minimum of 2.5 cups of green veggies/day – kale, spinach, boy choy, swiss chard, etc. Don’t skimp when it comes to these veggies! Also, have a look at Dr. Weil’s “Anti-Inflammatory” pyramid” – it’s a good place to start!
3. Choose grass-fed meat over grain fed meat. Grass fed meats contain higher amounts of omega-6 fatty acids, which can be pro-inflammatory. Grass fed beef is actually a good source of omega-3 fats! Local and free-range farmers are easily found at farmer’s markets in the area.
4. Avoid exposures to chemicals whenever possible. The link between chemical exposure and inflammation is based on the theory that these chemicals require a high antioxidant load to neutralize them. Don’t waste your antioxidants on chemicals!
5. Avoid sugar! New research implicates sugar as the real culprit in cardiovascular disease – not fat. A study published online at JAMA found that adults get 10 percent or more of their calories from added sugar. After adjusting for variables such as age, smoking, sex, BMI and physical activity, they found that compared with people whose calories were less than 10 percent from added sugar, those whose intake was 10 to 25 percent added sugar had a 30 percent increased risk of cardiovascular death. And shockingly, those whose diet was more than 25 percent added sugar almost tripled their risk.
5. See a Naturopathic Doctor. Treating inflammation is not quick fix. It requires an in-depth assessment into diet, lifestyle and risk factors.