Nutrition and Prevention of Cardiovascular Disease

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Heart disease is the leading cause of death for both men and women, accounting for every one in four deaths (1). EVERY 40 SECONDS someone in the US has a heart attack (2). Despite this, global sales of lipid lowering drugs is expected to reach ONE TRILLION dollars by 2020 (3)!  Despite lipid management, we continue to die of cardiovascular disease. There must be something missing. Last night I had the opportunity to attend a lecture by Dr. Daniel Chong on the topic of Nutrition and the Prevention of Cardiovascular Disease.Here are some of my learnings.

Conventional thinking states that high blood cholesterol leads to plaque buildup in the arteries, impeding blood flow and oxygen to heart cells, causing a heart attack. The standard of care is to manage cholesterol with statin medications. If elevated cholesterol levels were the underlying driver of heart disease, then heart attacks wouldn’t happen at the frequency they do. t’s interesting to note that brown bears do not acquire atherosclerosis despite their super high cholesterol levels (4).

Perhaps the process of atherosclerosis is actually the body’s attempt to repair itself, and this damage comes from nutritional deficiency. Enter Lipoprotein (a). This is a molecule found in the blood that functions to repair damaged vessels. We measure Lp(a) to evaluate for cardiovascular disease; if there are high amounts in the blood, this indicates the body is working to repair itself.

Lp(a) is found in animals that cannot make vitamin C on their own, like us humans (5). Apparently we lost the ability to synthesize vitamin C on our own 40 million years ago. Because of this, it has been hypothesized that Lp(a) acts as a surrogate to vitamin C. Vitamin C has amazing capabilities like keeping tissues in tact by laying collagen down. Therefore when one is vitamin C deficient, vessels cannot readily repair, so the body responds by increasing Lp(a) output. 

Several studies exist, supporting the theory that vitamin C deficiency underlies heart disease (6,7). With evidence supporting a diet rich in vitamin C foods as improving vascular function (8).

Here’s what you can do:

  1. Monitor blood lipid levels with a total cholesterol, LDL, HDL, Lp (a), and hs CRP and consider a carotid ultrasound and/or calcium score (these last two are imaging tests).

  2. Adhere to a plant based diet that is abundant in vitamin C rich foods: broccoli, brussels sprouts, red/green peppers, potatoes, kiwi, strawberries, papaya, etc.

  3. Get 150 minutes of moderate intensity, heart pumping exercise weekly.

  4. Take a vacation, because stress has a negative impact on health. 


    References 

  1.  https://www.cdc.gov/heartdisease/facts.htm

  2. https://www.cdc.gov/heartdisease/heart_attack.htm

  3. https://bjsm.bmj.com/content/52/14/905

  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5439871/

  5. https://www.dr-rath-foundation.org/2017/10/lipoprotein-a-is-a-surrogate-for-ascorbate/

  6. https://www.pnas.org/content/97/2/841

  7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4447075/

  8. https://www.ncbi.nlm.nih.gov/pubmed/12237172