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Wednesday, September 28, 2011

Cardiovascular Benefits of Fish Oil Canceled by High-Fat Diet

Study highlights:
• In an animal study of heart failure, fish oil supplementation was helpful to animals on a low-fat diet, but not to those on a high-fat diet.
• Researchers think that a high-fat diet may block the heart cells’ ability to absorb the omega-3 fatty acids in fish oil.
Fish oil (EPA & DHA [eicosapentaenoic acid and docosahexaenoic acid]) supplementation helped the heart when paired with a low-fat diet, but not when added to a high saturated-fat diet fed to rats with heart failure, according to a [July 2009] study in Hypertension: Journal of the American Heart Association
Dietary Supplements and Cardiovascular Health
A group of six researchers from different institutions, led by William C. Stanley, PhD, from the University of Maryland-Baltimore, hypothesized that when the heart is stressed, such as in heart failure, a high-fat diet may block the heart cells’ ability to absorb the heart- healthy omega-3 polyunsaturated fatty acids (PUFAs) found in fish oil.
The investigators found that heart size—measured by left ventricular mass (LV mass)—increased in rats fed low- and high saturated-fat diets without fish oil by 40 percent and 42 percent respectively. On a low-fat plus fish oil diet, LV mass increased just 4 percent, while the group fed high saturated-fat diet with fish oil saw a 36 percent LV mass increase.
The scientists also found that certain genes associated with heart failure did not get “switched on” in the group fed a low-fat diet supplemented with fish oil.
The researchers conclude, “This suggests that in order to maximize the benefit from fish oil supplementation, patients at risk for heart failure should not consume a high saturated fat diet.”
As part of an overall healthy diet, the American Heart Association recommends limiting saturated fat in the diet to 7 percent or less of calories and consuming fish, especially oily fish, two times per week. Author disclosures are on the manuscript. The National Institutes of Health funded the study.
“Benefits of fish oil cancelled by high-fat diet in lab study of heart failure,” reprinted with permission. © 2009 American Heart Association,  Inc. (

Thursday, September 22, 2011

Garlic and Cholesterol

From “Garlic for LDL Cholesterol,” National Center for Complementary and Alternative Medicine (NCCAM,, part of the National Institutes of Health, 2007. 
LDL (low-density lipoprotein) cholesterol is widely known as “bad cholesterol” and is believed to be a leading contributor to heart dis-ease. This 2007 study’s results cast doubt on garlic’s effectiveness in lowering LDL cholesterol levels in adults with moderately high cholesterol.
Dr. Gardner and his team conducted a randomized, placebo-controlled trial studying whether three different formulations of garlic could lower LDL cholesterol. The study participants were randomly divided into four groups to receive either raw garlic, a powdered garlic supplement, an aged extract supplement, or a placebo.
The 169 participants who completed the study had their cholesterol levels checked monthly during the 6-month trial. None of the formulations of garlic had a statistically significant effect on the LDL cholesterol levels. The authors caution that their results should not be generalized for all populations or all health effects. An accompanying editorial in the Archives of Internal Medicine points out that LDL cholesterol levels are only one factor contributing to heart dis-ease and that this trial did not investigate garlic’s effects on other risk factors, such as high blood pressure. Gardner CD, Lawson LD, Block E, et al. Effect of raw garlic vs. commercial garlic supplements on plasma lipid concentrations in adults with moderate hypercholesterolemia: a randomized clinical trial. Archives of Internal Medicine.

Tuesday, September 13, 2011

Vitamin D and Heart Disease

“Lack of vitamin D may increase heart disease risk,” reprinted with permission. © 2009 American Heart Association, Inc. ( 
The same vitamin D deficiency that can result in weak bones now has been associated with an increased risk of cardiovascular disease, Framing ham Heart Study researchers report in Circulation: Journal of the American Heart Association [2008].
“Vitamin D deficiency is associated with increased cardiovascular risk, above and beyond established cardiovascular risk factors,” said Thomas J. Wang, MD, assistant professor of medicine at Harvard Medical School in Boston, Massachusetts. “The higher risk associated with vitamin D deficiency was particularly evident among individuals with high blood pressure.”
In a study of 1,739 offspring from Framingham Heart Study participants (average age 59, all Caucasian), researchers found that those with blood levels of vitamin D below 15 nanograms per milliliter (ng/mL) had twice the risk of a cardiovascular event such as a heart attack, heart failure, or stroke in the next 5 years compared to those with higher levels of vitamin D.
When researchers adjusted for traditional cardiovascular risk factors such as high cholesterol, diabetes, and high blood pressure, the risk remained significant with a 62 percent higher risk of a cardiovascular event in participants with low levels of vitamin D compared to those with higher levels.
Researchers observed the highest rate of cardiovascular disease events in subset analyses dividing 688 participants according to high blood pressure status. After researchers adjusted for conventional cardiovascular risk factors, participants with hypertension and a vitamin D deficiency had about two times the risk of having a cardio-vascular disease event in 5 years.
Researchers also found an increase in cardiovascular risk with each level of vitamin D deficiency. “We found that people with low vitamin D levels had a higher rate of cardiovascular events over the 5-year follow-up period,” Wang said.
  “These results are intriguing and suggestive but need to be followed up with further study.”
Study participants had no prior cardiovascular disease and were tested for vitamin D status and then followed for an average of 5.4 years.
The participants attended the offspring examinations between 1996 and 2001. Researchers obtained medical history, physical examinations and laboratory assessments of vascular risk factors. They also obtained medical records related to cardiovascular disease.
Overall, 28 percent of individuals had levels of vitamin D below 15 ng/mL and 9 percent had levels below 10 ng/mL. Although levels above 30 ng/mL are considered optimal for bone metabolism, only 10 percent of the study sample had levels in this range, researchers said.
During follow-up:
• 120 participants developed a first cardiovascular event including fatal and nonfatal coronary heart disease;
• 28 participants had fatal or nonfatal cerebrovascular events such as non hemorrhagic stroke;
• 19 participants were diagnosed with heart failure; and
• 8 had occurrences of claudication, fatigue in the legs during activity.
“Low levels of vitamin D are highly prevalent in the United States, especially in areas without much sunshine,” Wang said. “Twenty to 30 percent of the population in many areas has moderate to severe vitamin D deficiency.”
Most of this is attributed to lack of sun exposure, pigmented skin that prevents penetration of the sun’s rays, and inadequate dietary intake of vitamin D enriched foods, researchers said.
“A growing body of evidence suggests that low levels of vitamin D may adversely affect the cardiovascular system,” Wang said. “Vitamin D receptors have a broad tissue distribution that includes vascular smooth muscle and endothelium, the inner lining of the body’s vessels. Our data raise the possibility that treating vitamin D deficiency via supplementation or lifestyle measures could reduce cardiovascular risk.
“What hasn’t been proven yet is that vitamin D deficiency actually causes increased risk of cardiovascular disease. This would re-quire a large randomized trial to show whether correcting the vitamin D deficiency would result in a reduction in cardiovascular risk.”
Therefore, Wang doesn’t recommend physicians check for vitamin D deficiency or that those with a known vitamin D deficiency be treated to prevent heart disease at this time.
During the past decade, researchers have studied several other vitamins that initially showed promise in reducing heart disease. But the vitamins didn’t reduce heart disease in subsequent large randomized trials.
“On the flip side, just because other vitamins haven’t succeeded doesn’t preclude the possibility of finding vitamins that might pre-vent cardiovascular disease,” Wang said. “This is always an area of great interest. Vitamins are easy to administer and in general have
few toxic effects.”
The American Heart Association recommends that healthy people get adequate nutrients by eating a variety of foods in moderation, rather than by taking supplements. Food sources of vitamin D include milk, salmon, mackerel, sardines, cod liver oil, and some fortified cereals. Vitamin or mineral supplements aren’t a substitute for a balanced, nutritious diet that limits excess calories, saturated fat, trans fat, sodium, and dietary cholesterol. This dietary approach has been shown to reduce coronary heart disease risk in healthy people and
those with coronary disease.
Co-authors are: Michael J. Pencina, PhD; Sarah L. Booth, PhD; Paul F. Jacques, DSc; Erik Ingelsson, MD, PhD; Katherine Lanier, BS; Emelia J. Benjamin, MD; Ralph B. D’Agostino, PhD; Myles Wolf, MD; and Ramachandran S. Vasan, MD.
The National Institute of Health, U.S. Department of Agriculture, and American Heart Association funded the study.
Statements and conclusions of study authors that are published in the American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect association policy or position. The American Heart Association makes no representation or warranty as to their accuracy or reliability.

Tuesday, September 6, 2011

Vitamin E 70.5

Excerpted from “Vitamin E Fact Sheet,” by the Office of Dietary Supplements (ODS,, part of the National Institutes of Health, May 4, 2009. 
Vitamin E is found naturally in some foods, added to others, and available as a dietary supplement. Vitamin E is the collective name for a group of fat-soluble compounds with distinctive antioxidant activities.
Antioxidants protect cells from the damaging effects of free radicals, which are molecules that contain an unshared electron. Free radicals damage cells and might contribute to the development of cardiovascular disease and cancer. Unshared electrons are highly energetic and react rapidly with oxygen to form reactive oxygen species (ROS). The body forms ROS endogenously when it converts food to energy, and antioxidants might protect cells from the damaging effects of ROS. The body is also exposed to free radicals from environmental exposures, such as cigarette smoke, air pollution, and ultraviolet radiation from the sun. ROS are part of signaling mechanisms among cells.
Vitamin E is a fat-soluble antioxidant that stops the production of ROS formed when fat undergoes oxidation. Scientists are investigating whether, by limiting free-radical production and possibly through other mechanisms, vitamin E might help prevent or delay the chronic diseases associated with free radicals.
In addition to its activities as an antioxidant, vitamin E is involved in immune function and, as shown primarily by in vitro studies of cells, cell signaling, regulation of gene expression, and other metabolic processes. Vitamin E inhibits the activity of protein kinase C, an enzyme involved in cell proliferation and differentiation in smooth muscle cells, platelets, and monocytes. Vitamin-E–replete endothelial cells lining the interior surface of blood vessels are better able to resist blood-cell components adhering to this surface. Vitamin E also increases the expression of two enzymes that suppress arachidonic acid metabolism, thereby increasing the release of prostacyclin from the endothelium, which, in turn, dilates blood vessels and inhibits platelet aggregation.