Category Archives: Heart Disease

Chronic Daily Alcohol Consumption Linked to Atrial Fibrillation

Posted on September 16, 2016 | Comments Off on Chronic Daily Alcohol Consumption Linked to Atrial Fibrillation
Photo copyright: Steve Parker MD

Photo copyright: Steve Parker MD

Atrial Fibrillation is the most common serious heart rhythm disturbance in folks over 50. It can cause strokes, chest pain, trouble breathing, palpitations, dizziness, fainting, and other problems.

Many cases of atrial fibrillation are of unknown cause, but others are caused by blocked heart arteries, leaky or blocked heart valves, blood mineral disturbances, and overactive thyroid.

Another cause is alcohol consumption. Physicians typically think it takes relatively heavy alcohol consumption, even if just a short-term binge, to cause atrial fibrillation. A recent study suggests low doses could be problematic. From the American Heart Association Newsroom:

“Despite the common perception that moderate alcohol intake is good for the heart, new research suggests long-term alcohol consumption, even as little as one drink a day may enlarge the heart’s left upper chamber (atrium) and increase the risk of developing atrial fibrillation, according to new research in Journal of the American Heart Association, the Open Access Journal of the American Heart Association/American Stroke Association.

“Our study provides the first human evidence of why daily, long-term alcohol consumption may lead to the development of this very common heart rhythm disturbance,” said Gregory Marcus, M.D., senior study author and associate professor of medicine specializing in cardiac electrophysiology at the University of California at San Francisco. “We were somewhat surprised that a relatively small amount of alcohol was associated with a larger left atrium and subsequent atrial fibrillation.”

Source: Drinking alcohol daily may enlarge heart chamber; lead to atrial fibrillation | American Heart Association

Steve Parker, M.D.

PS: Although alcohol is an option with several of my diets, it’s not mandatory.

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Posted in Heart Disease

Review of the Science: Mediterranean Diet Reduces Cardiovascular Disease and Helps Control Diabetes

Posted on September 6, 2016 | Comments Off on Review of the Science: Mediterranean Diet Reduces Cardiovascular Disease and Helps Control Diabetes
From my pantry...

From my pantry…

Click the link below if you want to know how we think the diet works.

“The Mediterranean diet can be described as a dietary pattern characterized by the high consumption of plant-based foods, olive oil as the main source of fat, low-to-moderate consumption of fish, dairy products and poultry, low consumption of red and processed meat, and low-to-moderate consumption of wine with meals. The American Diabetes Association and the American Heart Association recommend Mediterranean diet for improving glycemic control and cardiovascular risk factors in type 2 diabetes. Prospective studies show that higher adherence to the Mediterranean diet is associated with a 20-23 % reduced risk of developing type 2 diabetes, while the results of randomized controlled trials show that Mediterranean diet reduces glycosylated hemoglobin levels by 0.30-0.47 %, and is also associated with a 28-30 % reduced risk for cardiovascular events.”

Source: Mediterranean diet for type 2 diabetes: cardiometabolic benefits. – PubMed – NCBI

FYI:  Glycosyated hemoglobin is a blood test that reflects average blood sugar levels over the preceding three months. A reduction of that value, also called hemoglobin A1c, translates to blood sugar levels lowered by 15-20 mg/dl (1 mmol/l).

Steve Parker, M.D.

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Posted in Diabetes, Diet Reviews, Heart Disease

Potatoes Don’t Cause Diabetes, Obesity, or Cardiovascular Disease

Posted on August 21, 2016 | Comments Off on Potatoes Don’t Cause Diabetes, Obesity, or Cardiovascular Disease

…at least according to researchers in Denmark who did a review of the scientific literature.

“The identified studies do not provide convincing evidence to suggest an association between intake of potatoes and risks of obesity, type 2 diabetes, or cardiovascular disease. French fries may be associated with increased risks of obesity and type 2 diabetes although confounding may be present. In this systematic review, only observational studies were identified. These findings underline the need for long-term randomized controlled trials.”

Source: Potatoes and risk of obesity, type 2 diabetes, and cardiovascular disease in apparently healthy adults: a systematic review of clinical intervention and observational studies

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Posted in Diabetes, Heart Disease, Overweight & Obesity

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A Pharmacist Asks: Should we use PCSK9 inhibitors?

Posted on August 9, 2016 | Comments Off on A Pharmacist Asks: Should we use PCSK9 inhibitors?

PCSK9 inhibitors are a new class of drug that dramatically lowers LDL cholesterol. LDL is the “bad cholesterol” implicated in blocked arteries that cause heart attacks and strokes. PCSK9 inhibitors are injected every several weeks. They are expensive.

Pharmacist Catherine writes:

“We know this drug lowers LDL cholesterol.  But what we really care about (or should care about) is whether this medication lowers the risk of having a heart attack or a stroke.  This data isn’t yet available.   From what data I could easily access, it seems that the PCSK9 inhibitors can halve your risk of having heart attack over one year.  This might sound good, but when you look at actual numbers, not so good.  Of the ~4500 people studied, about 2% in the control group had an ‘event’ (heart attack, stroke or other cardiovascular event) compared to about 1% in the treatment group.  And the difference between the groups was only about 60 people.  The study size just simply isn’t big enough, nor has it run for long enough to really tell if these medications are worth it.  A bigger study is in progress, but we won’t get the results before 2017.   Even then, we may not have the long-term risk/benefit data.  A systematic review on the medications in 2014 concluded that there is currently insufficient data to show benefit.”

Source: Should we use PCSK9 inhibitors? | Lifestyle Before Medication

I also want to know the effect of these drugs on death rates. As they say, “more studies are needed.”

Hey, guess what? The Mediterranean diet prevents heart attacks and strokes, and extends lifespan.

Steve Parker, M.D.

Steve Parker MD, Advanced Mediterranean Diet

Two diet books in one

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Posted in Coronary Heart Disease, Heart Disease, Stroke

Mediterranean diet helps your heart pump better

Posted on August 4, 2016 | Comments Off on Mediterranean diet helps your heart pump better

Your heart’s basically a hollow muscle that pumps blood – about five quarts a minute at rest, more if you’re exercising. The main pumping chamber is the left ventricle.

A recent study confirms what we’ve known for years: the Mediterranean diet helps prevent heart trouble.

From AJCN:

“A higher Mediterranean diet score is cross-sectionally associated with a higher LV [left ventricular] mass, which is balanced by a higher LV volume as well as a higher ejection fraction and stroke volume. Participants in this healthy, multiethnic sample whose dietary patterns most closely conformed to a Mediterranean-type pattern had a modestly better LV structure and function than did participants with less–Mediterranean-like dietary patterns.”

Source: Mediterranean diet score and left ventricular structure and function: the Multi-Ethnic Study of Atherosclerosis

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Posted in Heart Disease

Forty Years of Dietary Advice Was Wrong

Posted on August 1, 2016 | Comments Off on Forty Years of Dietary Advice Was Wrong

Dr. Axel Sigurdsson is a cardiologist who focuses his blogging on cardiovascular disease and lipid disorders. I bet he agrees with me that dietary saturated fat is not the malevolent force we were taught in medical school.

From his blog:

“The [PURE study] suggests that placing carbohydrates at the bottom of the food pyramid based on their effect on blood cholesterol was a mistake. In fact, the data show that replacing dietary carbohydrates with different types of fat may improve lipid profile.

In an interview on Medscape, Dr. Mahshid Dehghan, the principal author of the abstract said: “To summarize our findings, the most adverse effect on blood lipids is from carbohydrates; the most benefit is from consumption of monounsaturated fatty acids; and the effect of saturated and polyunsaturated fatty acids are mixed. I believe this is a big message that we can give because we are confusing people with a low-fat diet and all the complications of total fat consumption, and WHO and AHA all suggest 55% to 60% of energy from carbohydrates.”

Today, most experts agree that diets high in saturated fatty acids or refined carbohydrates are not be recommended for the prevention of heart disease. However, it appears that carbohydrates are likely to cause a greater metabolic damage than saturated fatty acids in the rapidly growing population of people with metabolic abnormalities associated with obesity and insulin resistance.”

Source: High Carbohydrate Intake Worse than High Fat for Blood Lipids

PS: A diet naturally high in monounsaturated fat is one you may have heard of: the Mediterranean diet. The Advanced Mediterranean Diet (2nd Ed.) contains both a low-carb Mediterranean diet and a portion-controlled traditional Mediterranean diet.

Steve Parker MD, Advanced Mediterranean Diet

Two diet books in one

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Posted in Coronary Heart Disease, Heart Disease, Low-Carb Mediterranean Diet

Bix Reports: Tea And Apples Are Good For The Heart 

Posted on July 27, 2016 | Comments Off on Bix Reports: Tea And Apples Are Good For The Heart 
Green tea

Green tea

The healthful component of tea and apples seems to be epicatechins. Bix, the Fanatic Cook, writes:

“Other good sources of epicatechins, besides apples and tea, include blackberries, broad beans, cherries, black grapes, pears, raspberries, and chocolate. Red wine also contains epicatechins….”

Source: New Study: Tea And Apples Are Good For The Heart | Fanatic Cook

Bix worries about the alcohol in wine causing cancer. Keep your consumption low to moderate and cancer shouldn’t be a problem.

TeaGuardian.com says green and white teas have the most catechins (same as epicatechins, I assume for now).

The study at hand involved Dutch men, so we don’t know if results apply to women. It’s an observational study. The men with the highest epicatechin consumption had a 38% lower risk of death from coronary heart disease compared to the lowest consumers. Perhaps because it was a relatively small study involving only Dutch men, the researcher write that “More studies are needed before conclusions can be drawn.”

Steve Parker, M.D.

PS: Have you heard that the Mediterranean diet is also good for your heart?

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Posted in green tea, Heart Disease

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Sugar (and Fructose) Restriction May Be the Key to Eliminating Metabolic Syndrome and Reducing Heart Disease

Posted on July 26, 2016 | 1 comment

Dr. Axel Sigurdsson is a cardiologist and blogger who writes about heart disease. A recent post of his considered the role of sugar, including fructose, in metabolic syndrome and coronary artery disease. He does a great job translating scientific research for consumption by the general public. For example:

“Lustig studied 43 obese children (ages 8-19) with metabolic abnormalities typical of the metabolic syndrome. All were high consumers of added sugar in their diets (e.g. soft drinks, juices, pastries, breakfast cereals, salad dressings, etc.).

The children were fed the same calories and percent of each macronutrient as their home diet; but within the carbohydrate fraction, the added sugar was removed, and replaced with starch. For example, pastries were taken out, and bagels put in; yogurt was taken out, baked potato chips were put in; chicken teriyaki was taken out, turkey hot dogs were put in. Whole fruit was allowed.After ten days, diastolic blood pressure fell, insulin resistance decreased, liver tests improved, and triglycerides, LDL cholesterol, and HDL cholesterol all improved.”

Source: Medical Practice

PS: All of my diets combat metabolic syndrome.

Steve Parker MD, Advanced Mediterranean Diet

Two diet books in one

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Posted in Heart Disease, Metabolic Syndrome

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Eat Nuts to Improve Your Blood Lipids and Reduce Risk of Cardiovascular Disease

Posted on September 9, 2015 | Comments Off on Eat Nuts to Improve Your Blood Lipids and Reduce Risk of Cardiovascular Disease
natural cashews, cashew apple

Cashews fresh off the tree. They’re actually fruits, not nuts.

Most of the diets I recommend to my patients include nuts because they are so often linked to improved cardiovascular health in scientific studies. Walnuts are associated with reduced risk of type 2 diabetes in women, and established type 2 diabetics see improved blood sugar control and lower cholesterols when adding nuts to their diets.

Nut consumption lowers total and LDL cholesterol levels, and if triglycerides are elevated, nuts lower them, too. Those changes would tend to reduce heart disease.

Conner Middelmann-Whitney has a good nutty article at Psychology Today.

Steve Parker, M.D.

Reference: Joan Sabaté, MD, DrPH; Keiji Oda, MA, MPH; Emilio Ros, MD, PhD. Nut Consumption and Blood Lipid Levels: A Pooled Analysis of 25 Intervention Trials. Archives of Internal Medicine, 2010, Vol. 170 No. 9, pp 821-827. Abstract:

Background  Epidemiological studies have consistently associated nut consumption with reduced risk for coronary heart disease. Subsequently, many dietary intervention trials investigated the effects of nut consumption on blood lipid levels. The objectives of this study were to estimate the effects of nut consumption on blood lipid levels and to examine whether different factors modify the effects.

Methods:  We pooled individual primary data from 25 nut consumption trials conducted in 7 countries among 583 men and women with normolipidemia and hypercholesterolemia who were not taking lipid-lowering medications. In a pooled analysis, we used mixed linear models to assess the effects of nut consumption and the potential interactions.

Results:  With a mean daily consumption of 67 g of nuts [about 2 ounces or 2 palms-ful], the following estimated mean reductions were achieved: total cholesterol concentration (10.9 mg/dL [5.1% change]), low-density lipoprotein cholesterol concentration (LDL-C) (10.2 mg/dL [7.4% change]), ratio of LDL-C to high-density lipoprotein cholesterol concentration (HDL-C) (0.22 [8.3% change]), and ratio of total cholesterol concentration to HDL-C (0.24 [5.6% change]) (P < .001 for all) (to convert all cholesterol concentrations to millimoles per liter, multiply by 0.0259). Triglyceride levels were reduced by 20.6 mg/dL (10.2%) in subjects with blood triglyceride levels of at least 150 mg/dL (P < .05) but not in those with lower levels (to convert triglyceride level to millimoles per liter, multiply by 0.0113). The effects of nut consumption were dose related, and different types of nuts had similar effects on blood lipid levels. The effects of nut consumption were significantly modified by LDL-C, body mass index, and diet type: the lipid-lowering effects of nut consumption were greatest among subjects with high baseline LDL-C and with low body mass index and among those consuming Western diets.

Conclusion:  Nut consumption improves blood lipid levels in a dose-related manner, particularly among subjects with higher LDL-C or with lower BMI.

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Posted in Coronary Heart Disease, Heart Disease, Nuts

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Dietary Cholesterol Unrelated to Cardiovascular Disease!

Posted on August 18, 2015 | Comments Off on Dietary Cholesterol Unrelated to Cardiovascular Disease!

…according to this article at American Journal of Clinical Nutrition.

Heart attack on a plate? Think again

Heart attack on a plate? Think again

This is quite contrary to the  party line spread by public health authorities for the last 40 years.

Enjoy your eggs! (If you can afford them.)

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Posted in Coronary Heart Disease, Heart Disease

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