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Heart Disease

Episodes

alcohol

The Truth About Alcohol: Risks, Benefits, and Everything In-Between | Dr. Rhonda Patrick

Posted on June 27th 2024 (11 months)

In this episode, we’re taking a deep dive into alcohol. We’ll explore the science, misconceptions, controversies, and health effects of this widely used drug.

rhonda
Premium

Q&A #60 with Dr. Rhonda Patrick (6/1/24)

Posted on June 13th 2024 (11 months)

Dr. Rhonda Patrick discusses fish oil and Afib risk, hyperbaric oxygen therapy, supplements for kids, and curcumin's impact on testosterone.

exercise

HIIT – contraindications and considerations for older adults | Dr. Martin Gibala

Posted on October 4th 2023 (over 1 year)

In this clip, Dr. Martin Gibala weighs the risks vs. benefits of interval training across ages, highlighting its advantage over sedentary life.

Topic Pages

  • Aerobic exercise

    Aerobic exercise, physical activity that increases breathing and heart rate, promotes cardiovascular, brain, and whole-body health.

  • Berberine

    Berberine is a plant-based compound with pharmacological actions that share many features with metformin.

  • Breast milk and breastfeeding

    Breast milk is a complex, dynamic fluid containing nutritional and non-nutritional components that support infant development. Breastfeeding benefits both infants and mothers.

  • Cold exposure

    Cold exposure may be a hormetic stressor that reduces inflammation, activates antioxidant enzymes, and boosts the immune system to protect against age-related diseases.

  • Creatine and Cardioprotection

    Creatine may have benefits for reducing cardiovascular disease risk based on in-vitro and in-vivo evidence and small studies in adults humans.

  • Myocardial infarction (Heart attack)

    A heart attack is a critical and often life-altering event that strikes suddenly, but its underlying causes develop over time.

  • Polyphenols

    Polyphenols are bioactive plant compounds with a wide range of health benefits.

  • Sirtuins

    Sirtuins play a key role in healthspan and longevity by regulating a variety of metabolic processes implicated in aging.

News & Publications

  • Omega-3 supplementation combined with exercise improves body composition and cardiometabolic health more effectively than exercise alone, including a notable 10% decrease in triglyceride levels. pubmed.ncbi.nlm.nih.gov
    Exercise Heart Disease Omega-3 Weight Loss

    Taking an omega-3 supplement may do more than support heart health—it might enhance the effects of your workout. A recent study found that combining omega-3 supplementation with exercise training improved body composition and cardiometabolic health better than exercise alone.

    Researchers conducted a systematic review and meta-analysis of 21 studies comparing exercise training combined with omega-3 supplementation to exercise training alone. The studies involved 673 adults aged 30 to 70, with an average body mass index (BMI) of 24 to 37. The analysis focused on outcomes such as body fat, blood pressure, blood fats, blood sugar, inflammation, and muscle mass, while accounting for variations across the studies.

    They found that adding omega-3 supplements to an exercise routine resulted in modest improvements. Participants lost just over 1 kilogram (2.3 pounds) more body fat and lowered their triglyceride levels by 10% compared to those who exercised without supplements. They also experienced drops in blood pressure—around 4 mmHg lower for both systolic and diastolic pressures—and slightly reduced levels of tumor necrosis factor-alpha, a marker of inflammation. However, LDL cholesterol increased slightly. Notably, participants also improved their lower-body strength but observed no additional benefits in other areas such as BMI, lean body mass, or blood glucose control.

    These findings indicate that omega-3 supplements enhance certain health benefits of exercise, particularly in decreasing fat mass, lowering blood pressure, and boosting muscle strength. Although the changes were modest, they could accumulate over time, especially for adults aiming to improve their cardiometabolic health. Some evidence suggests that omega-3s exert anabolic effects, too. Learn more in this episode featuring Dr. Chris McGlory.

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  • Engaging in 30 minutes of vigorous daily exercise can offset up to five years of age-related heart health decline, but long sitting durations may undermine this benefit. journals.plos.org
    Exercise Aging Heart Disease Genetics

    Even if you work out, spending most of your day sitting may still adversely affect your health in ways that don’t become apparent until later in life. A recent study found that 35-year-olds who engaged in 30 minutes of vigorous exercise each day had cholesterol levels comparable to those of sedentary 30-year-olds, suggesting that vigorous exercise can offset up to five years of age-related decline in heart health.

    Researchers analyzed data from adults aged 28 to 49 who participated in the Colorado Adoption/Twin Study of Lifespan Behavioral Development and Cognitive Aging. They tracked the time participants spent sitting each day and how often they engaged in moderate or vigorous physical activity. To isolate the effects of behavior from shared genetics and environment, the researchers also compared identical twins with differing activity and sitting patterns. They examined two key health markers: body mass index and the ratio of total to high-density lipoprotein cholesterol—a strong predictor of heart disease risk.

    They found that people who spent more time sitting tended to have higher body mass index and worse cholesterol ratios as they aged. However, among those who sat for the same amount of time—about four hours daily—participants who exercised vigorously for at least 30 minutes daily had cholesterol profiles that resembled those of people five years younger. In some cases, vigorous activity was associated with health markers typical of people up to 10 years younger, but the protective effect weakened with longer sitting durations. In other words, exercise helped—but only to a point.

    These findings suggest that while vigorous exercise offers clear benefits, reducing sitting time is just as important for maintaining good health. “Exercise snacks” can offset the harmful effects of prolonged sitting. Learn more in this clip featuring Dr. Rhonda Patrick and Brady Holmer.

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  • Strawberry consumption boosts thinking speed and lowers systolic blood pressure by 3% in older adults. www.sciencedirect.com
    Nutrition Diet Heart Disease Memory Blood Pressure Polyphenol Cardiovascular

    Cognitive decline and cardiovascular disease often go hand in hand—and both become more common with age. Nutrition plays a key role in protecting brain and heart health, and certain fruits rich in antioxidants may offer targeted benefits. A recent study found that consuming fresh strawberries daily improved cognitive function and lowered systolic blood pressure by an average of 3% in older adults.

    Researchers provided 35 healthy adults, ages 60 to 78, a strawberry powder or a placebo each day for eight weeks. Each person tried both options in random order, with a four-week break in between. The strawberry powder, made from freeze-dried fruit, delivered the same nutrients and antioxidants as two cups of fresh strawberries. The researchers measured the participants' cognitive function using standard tests and tracked markers of heart health, including blood pressure, waist size, blood lipids, and antioxidant levels.

    The participants' thinking speed improved during the strawberry phase, while episodic memory improved modestly during the placebo phase. After eight weeks of strawberry consumption, systolic blood pressure dropped by an average of 3%, and waist size decreased slightly. Participants' blood antioxidant capacity increased with strawberries but decreased with the placebo. Triglycerides increased during the placebo period but remained stable with strawberries.

    The findings from this small study suggest that regular strawberry intake supports brain and heart health in older adults. Strawberries are rich in polyphenols. Learn more about polyphenols in our overview article.

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  • High-intensity interval training reduces arterial plaque size by 1.2% in coronary artery disease patients after six months, potentially slowing or reversing disease progression. academic.oup.com
    Exercise Heart Disease Cardiovascular

    Heart disease is the leading cause of death worldwide, and clogged arteries—caused by a buildup of fatty plaques—are a major culprit. While some plaques remain stable, others can rupture and trigger heart attacks. A recent study found that high-intensity interval training (HIIT) may help shrink fatty arterial plaquesin people with coronary artery disease who have undergone stent placement, reducing plaque size by 1.2% in just six months.

    Researchers randomly assigned 60 patients with stable coronary artery disease to a supervised HIIT program or standard preventive care twice a week. After six months, they used intravascular ultrasound to measure changes in plaque size inside the coronary arteries.

    They found that patients who did HIIT had a 1.2% reduction in plaque size, while those who followed standard preventive care saw no change. The total plaque volume in the HIIT group also dropped by about 9 cubic millimeters, but it remained the same in the standard care group. Even small reductions in plaque size can be meaningful because they reflect a slowing—or even a reversal—of coronary artery disease progression.

    These findings suggest that HIIT may help slow or even reverse the progression of coronary artery disease. It’s important to note that these patients were closely supervised to minimize risk. Learn about some of the contraindications and considerations for HIIT in this episode featuring Dr. Martin Gibala.

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  • Regular resistance training improves heart function in older women in just six months. link.springer.com
    Exercise Aging Heart Disease

    Keeping our hearts strong and healthy becomes increasingly challenging as we age, especially for older women. However, physical activity, especially resistance training, may benefit the heart. A recent study found that a 24-week resistance training program improved heart function in older women.

    Researchers assigned 73 physically independent older women (average age, 68) to either an exercise training or sedentary group. The training group participated in a supervised resistance training program three times weekly for 24 weeks, using machines and free weights. Each session included exercises targeting the whole body, with three sets of eight to 12 repetitions each. The researchers measured the participants' cardiac function before and after the program.

    They found that women in the training group experienced several improvements in heart function, including: - A 10.6% decrease in left ventricular volume versus a 1.1% increase in the sedentary group. - A 9.1% decrease in left atrial volume versus a 3.9% increase in the sedentary group. - Better heart relaxation, indicated by a 4.8% reduction in the diastolic function index.

    These findings suggest that regular resistance training improves heart structure and function in older women, potentially reducing the risk of age-related cardiac decline. Finding the time for resistance training can be difficult, however. Listen as Drs. Brad Schoenfeld and Stuart Phillips describe time-efficient ways to incorporate resistance training into a busy schedule.

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  • A daily cup of coffee could reduce your risk of heart disease and diabetes by half. academic.oup.com
    Sleep Heart Disease Diabetes Biomarkers Coffee Green Tea Caffeine Stroke Cardiovascular

    Drinking your daily cup of coffee or tea might do more than give you a boost—it could lower your risk of developing multiple serious cardiometabolic conditions simultaneously, like diabetes, heart disease, or stroke. A recent study found that moderate coffee or caffeine consumption may cut your risk of cardiometabolic multimorbidity by as much as 50%.

    Researchers analyzed data from more than 172,000 participants enrolled in the UK Biobank who had no cardiometabolic diseases at the start. Participants reported their coffee, tea, and caffeine consumption; about half provided blood samples for metabolic marker analysis.

    They found that people who drank about three cups of coffee daily (or consumed 200 to 300 milligrams of caffeine daily) were 40% to 50% less likely to develop multiple cardiometabolic diseases than those who drank little or no caffeine. They also discovered that specific blood markers, such as certain lipid components, were linked to coffee and caffeine consumption and a lower risk of cardiometabolic conditions.

    These findings suggest that moderate coffee or caffeine intake reduces the risk of developing cardiometabolic diseases but also slows their progression if they occur. Other evidence points to the many health benefits associated with coffee and caffeine, but it’s crucial to remember their effects on sleep. Learn more in this Aliquot featuring Drs. Guido Kroemer, Satchin Panda, Elissa Epel, Matthew Walker, and Rhonda Patrick

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  • Can chronic use of anti-inflammatory agents paradoxically promote chronic inflammation through compensatory host response? pubmed.ncbi.nlm.nih.gov
    Heart Disease Inflammation NSAID Cardiovascular

    NSAIDs may promote a paradoxical pro-inflammatory effect, increasing the risk of blood clots and cardiovascular events.

    Non-steroidal anti-inflammatory drugs, or NSAIDs, are among the most widely used drugs worldwide, available in both prescription and over-the-counter forms, such as aspirin, ibuprofen, naproxen, and others. Despite the drugs' anti-inflammatory effects, their chronic use is associated with a higher risk of acute clot-related cardiovascular events, such as heart attack, stroke, or deep-vein thrombosis. Authors of a 2005 article posited that NSAIDs induce a rebound effect that promotes inflammation, driving the formation of blood clots and predisposing a person to acute cardiovascular events.

    Inflammation is a protective response that involves immune cells, cell-signaling proteins, and pro-inflammatory factors. Acute inflammation occurs after minor injuries or infections and is characterized by local redness, swelling, or fever. Chronic inflammation occurs on the cellular level in response to toxins or other stressors and is often “invisible.” It plays a key role in the development of many chronic diseases, including cancer, cardiovascular disease, and diabetes. Inflammation initiates the clotting process and impairs the activity of natural anti-clotting mechanisms.

    Most NSAIDs, with the exception of aspirin, dampen inflammation via the inhibition of cyclooxygenases, a family of pro-inflammatory enzymes. However, evidence from animal studies suggests that when these enzymes are inhibited, the body responds by producing more of the enzymes. The authors posited that by turning off the body’s natural inflammatory processes, NSAIDs might drive a compensatory response – ramping up the activity of pro-inflammatory pathways.

    Lifestyle behaviors may reduce inflammation and the need for NSAIDs. For example, sauna use reduces levels of pro-inflammatory C-reactive protein and increases levels of anti-inflammatory protein interleukin (IL)-10. Similarly, cold exposure decreased the pro-inflammatory protein IL-2 and the inflammatory E2 series of prostaglandins while increasing the anti-inflammatory protein IL-10. Other lifestyle behaviors that may reduce inflammation include exercise, meditation, and dietary intake of polyphenols.

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  • Alcohol consumption increases the risk of cardiovascular diseases such as aortic aneurysms and reduces life expectancy. (2018) www.eurekalert.org
    Heart Disease Alcohol Blood Pressure Stroke Aneurysm

    From the article:

    The upper safe limit of drinking was about 5 drinks per week (100g of pure alcohol, 12.5 units or just over five pints of 4% ABV2 beer or five 175ml glasses of 13% ABV wine).

    However, drinking above this limit was linked with lower life expectancy. For example, having 10 or more drinks per week was linked with 1-2 years shorter life expectancy1. Having 18 drinks or more per week was linked with 4-5 years shorter life expectancy.

    […]

    The researchers also looked at the association between alcohol consumption and different types of cardiovascular disease. Alcohol consumption was associated with a higher risk of stroke, heart failure, fatal aortic aneurysms, fatal hypertensive disease and heart failure and there were no clear thresholds where drinking less did not have a benefit.

    View publication

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  • Hypertensive smoking women have up to 20-fold higher risk of brain aneurysm ruptures. (2013) www.sciencedaily.com
    Heart Disease Cholesterol Tobacco Blood Pressure Stroke Aneurysm

    From the article:

    • If smoking women with high systolic blood pressure values have 20 times higher rate of these brain bleeds than never-smoking men with low blood pressure values, it may very well be that these women diagnosed with unruptured intracranial aneurysms should be treated. On the other hand, never-smoking men with low blood pressure values and intracranial aneurysms may not need to be treated at all.

    In this largest SAH risk factor study ever, the study group also identified three new risk factors for SAH: previous myocardial infarction, history of stroke in mother, and elevated cholesterol levels in men. The results revise the understanding of the epidemiology of SAH and indicate that the risk factors for SAH appear to be similar to those for other cardiovascular diseases.

    • We have previously shown that lifestyle risk factors affect significantly the life expectancy of SAH survivors, and now we have shown that the same risk factors also affect dramatically the risk of SAH itself.

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  • Doses of omega‐3 fatty acid intake above the recommended 3 grams per day may be associated with additional benefits in lowering blood pressure www.ahajournals.org
    Heart Disease Omega-3 Blood Pressure Cardiovascular

    Higher omega-3 fatty acid intake may be necessary to reduce blood pressure.

    Nearly two-thirds of adults living in the United States have high blood pressure, defined as having a systolic pressure of 130 mmHg or higher or a diastolic pressure of 80 mmHg or higher. High blood pressure increases a person’s risk for heart disease and stroke and contributes to small vessel disease, a major risk factor for cardiovascular disease, dementia, and stroke. Although some evidence suggests that omega-3s reduce blood pressure, researchers have not identified the optimal dose necessary to achieve this effect. Findings of a recent meta-analysis suggests that 3 grams of omega-3 fatty acids daily reduce blood pressure.

    Observational data suggest that omega-3 fatty acids, especially fish-derived eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), are cardioprotective. For example, a prospective study involving more than 20,000 healthy males found that those who ate one to two servings of fish twice a week had a lower risk of sudden cardiac death than those who ate fish less than once a month, likely due to the omega-3s found in fish. But the findings from the five decades of study have been remarkably inconsistent, with some studies showing benefits, and others not. Some of these inconsistencies have arisen from differences in study designs, which vary markedly in terms of study population, dose, and duration.

    The authors of the analysis searched the scientific literature for randomized controlled trials investigating associations between omega-3 fatty acids and blood pressure. Then they filtered their findings based on a set of criteria designed to identify high-quality studies. Finally, they combined data from these high-quality studies and reanalyzed them so they could interpret the results on a large scale.

    They identified 71 trials, involving nearly 5,000 participants. On average, those who consumed 2 to 3 grams of combined EPA and DHA daily experienced reductions in blood pressure of approximately 2 mm Hg (and as much as 3.5 mm Hg). Participants who had high blood pressure and consumed more than 3 grams of EPA and DHA daily experienced reductions of 4.5 mm Hg for those with hypertension, compared to about 2 mm Hg for those without. Higher doses (5 grams daily) of omega-3s did not confer any additional benefit, with blood pressure decreasing by approximately 4 mm Hg for those with hypertension and less than 1 mm Hg for those without.

    These findings suggest that 3 grams of combined EPA and DHA daily is the optimal dose of omega-3 fatty acids necessary to achieve reductions in blood pressure. Learn more about the heart-health benefits of omega-3s in this episode featuring Dr. Bill Harris.

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  • 20 minutes of running/cycling per day beginning at age 70 reduces the risk of heart attacks, CHD, and heart failure by 52 percent in men www.eurekalert.org
    Exercise Heart Disease Aerobic

    Just 20 minutes of exercise daily reduces heart disease risk in older adults. The benefits of regular physical exercise on cardiovascular health are well established. However, most studies investigating the benefits of exercise have been conducted in younger adults rather than older ones, for whom cardiovascular disease risk is greatest. Findings from a recent study demonstrate that 20 minutes of exercise daily reduces the risk of cardiovascular disease in older adults.

    The authors of the study drew on data from the Progetto Veneto Anziani, a long-term cohort study of more than 3,000 older adults (65 years and older) living in northern Italy. They identified participants with cardiovascular disease based on information gleaned from medical exams or hospital records. Every five years (at 65, 70, 75, 80, and 85 years of age), the authors assessed the participants' physical activity levels based on information provided in questionnaires.

    The risk of cardiovascular-related events or premature death was lower among older adults who were physically active. Men, in particular, were half as likely to experience a cardiovascular event if they were physically active. The effects of exercise were dose-dependent, with 20 minutes of moderate- to vigorous-intensity exercise daily providing the greatest benefits, especially when performed earlier in one’s later years, between the ages of 70 and 75 years. Exercising more than 40 minutes daily provided no additional benefits.

    Although the authors of this study did not differentiate between the effects of different types of exercise, their findings demonstrate that aerobic exercise is particularly beneficial for cardiovascular health. Learn more about aerobic exercise in our overview article.

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  • Curcumin may improve exercise tolerance through antioxidant-regulating protein Nrf2. journals.physiology.org
    Exercise Heart Disease Curcumin Antioxidant NRF2

    Curcumin is the principal bioactive compound present in the yellow spice turmeric. An abundance of scientific evidence indicates that curcumin has antioxidant, anti-inflammatory, anticancer, and neuroprotective properties in humans. Findings from a 2019 study suggest that curcumin improves exercise tolerance in mice with heart failure via its activation of Nrf2.

    Heart failure, commonly referred to as the end stage of heart disease, affects more than 26 million people worldwide. Exercise intolerance is a common feature of heart failure and is typically attributed to low ejection fraction – a measure of ventricular efficiency. A critical driver of low ejection fraction is oxidative stress.

    Nrf2 is a cellular protein that regulates the expression of antioxidant and stress response proteins via participation in the Keap1-Nrf2-ARE biological pathway. Nrf2 activates the transcription of cytoprotective proteins that protect against oxidative stress due to injury and inflammation.

    The study investigators gauged the effects of curcumin in mice that had heart failure with reduced ejection fraction and in mice with healthy hearts. A subset of the mice received daily curcumin supplementation, while the others did not. The investigators measured the animals' heart function via echocardiogram, assessed their exercise performance on a treadmill, and measured the expression of Nrf2 and its target proteins in their muscles.

    They found that both groups of mice that received curcumin (including those with healthy hearts) had improved exercise capacity compared to those that did not receive the compound. They also found that Nrf2 expression and antioxidant proteins increased in the mice with heart failure that received curcumin.

    These findings suggest that impaired Nrf2 drives oxidative stress in skeletal muscle in those who have heart failure with low ejection fraction. Curcumin counters these effects by upregulating antioxidant defenses in skeletal muscle, likely mediated by Nrf2 activation. Many plant-based dietary compounds induce Nrf2 activity, including sulforaphane, a compound derived from broccoli and broccoli sprouts. Learn more about Nrf2 and sulforaphane in this episode featuring Dr. Jed Fahey.

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  • Eating walnuts lowers LDL cholesterol. www.sciencedaily.com
    Heart Disease Omega-3

    Heart disease is the leading cause of death among people living in the United States, claiming the lives of roughly 655,000 people every year. Having high levels of low-density lipoprotein (LDL), or “bad” cholesterol, increases a person’s risk of heart disease. Findings from a new study suggest that eating walnuts reduces LDL cholesterol.

    Walnuts contain a variety of bioactive compounds that exert antioxidant, anti-inflammatory, and anti-cancer properties. They are also excellent sources of alpha linolenic acid (ALA), an omega-3 fatty acid that plays important roles in human health. ALA is necessary for the production of eicosanoids, a class of signaling molecule that regulates blood clotting, blood pressure, blood lipid levels, immune function, inflammation, pain and fever, and reproduction.

    The investigation was part of the Walnuts and Healthy Aging study, an intervention study of health and cognition in approximately 700 healthy older adults (63 to 79 years old) recruited from diverse geographical locations in the United States and Spain. Over a period of two years, half of the participants in each location followed their normal diets but added one serving (a small handful) of walnuts to their diet per day. The other half followed their normal diets but did not add walnuts.

    The study investigators measured the participants' triglycerides, total cholesterol, LDL, and high-density lipoprotein (HDL) blood concentrations at the beginning and end of the intervention. They also measured intermediate-density lipoproteins (IDL) and LDL particle number. IDL is a precursor to LDL. In recent years it has emerged as an important cardiovascular risk factor independent of LDL cholesterol. LDL particle number is a measure of small LDL particles in a person’s blood. Evidence suggests small LDL particles are more atherogenic than large ones.

    The effects of adding walnuts to the diet were consistent across both geographical locations. Among those who ate walnuts, total cholesterol concentrations decreased by 4.4 percent, LDL decreased by 3.6 percent, and IDL decreased by 16.8 percent. Triglycerides and HDL cholesterol concentrations did not change. Total LDL particles decreased by 4.3 percent, and small LDL particle number decreased by 6.1 percent. Interestingly, the LDL-lowering effects of the walnut diet differed by sex, with a 7.9 percent decrease in LDL among men and a 2.6 percent decrease among women.

    These findings suggest that walnuts exert potent lipid-lowering effects in healthy older adults and align with previous research demonstrating that foods rich in omega-3 fatty acids benefit cardiovascular health.

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  • A high saturated fat diet increases heart disease marker, TMAO. news.vumc.org
    Microbiome Heart Disease Fat

    Heart disease is the number one cause of death in the United States, owing to a constellation of risk factors including a sedentary lifestyle, disrupted sleep patterns, stress, and poor diet. The average American adult consumes 29 grams of saturated fat per day (the amount in about four tablespoons of butter, four slices of pepperoni pizza, or 1.5 cups of ice cream), possibly contributing to heart disease risk through interactions with the gut microbiota. Findings of a new report link high saturated-fat diets to increased heart disease biomarkers among mice with high levels of E. coli bacteria.

    The gut microbiota, the community of bacteria, archaea, fungi, and viruses that lives in the human intestine, is highly influenced by changes in diet. Dietary fats that are not absorbed in the small intestine travel to the large intestine where microbes metabolize them. The same is true for other nutrients not absorbed by the gut, including choline, an essential nutrient found in high amounts in organ meats, egg yolks, and legumes. Choline is an important component of cellular membranes, a precursor for the production of neurotransmitters, and is incorporated into bile acids needed for the digestion of fats; however, some gut microbes convert choline into trimethylamine (TMA), which is absorbed by the intestine and converted to trimethylamine N-oxide (TMAO) in the liver. High serum levels of TMAO have been shown to increase the risk of major cardiovascular events such as heart attack and stroke by increasing the deposition of cholesterol in arterial walls (i.e., atherosclerosis).

    Clostridia and Enterobacteriaceae are the only two bacterial families common to the human gut microbiota that are known to produce TMAO, but only Enterobacteriaceae abundance is substantially increased on a high-fat diet. Oxygen content in the gastrointestinal tract decreases through the small and large intestines so that bacteria in the colon are mostly anaerobic (meaning they do not use oxygen for metabolism). This low oxygen environment is needed to promote the growth of more beneficial bacteria such as Clostridia and suppress the growth of more detrimental bacteria such as Enterobacteriaceae. In order to maintain this low oxygen environment, the mitochondria of colon cells must consume high levels of oxygen; however, a diet high in saturated fat may impair mitochondrial function, facilitating the growth of TMAO-producing bacteria and increasing heart disease risk.

    The investigators performed their experiments using two mouse strains with altered gut microbiota: mice that do not carry Enterobacteriaceae in their gut microbiota (E. negative) and germ-free mice, which are raised in a sterile environment and do not have a microbiota. They fed mice either a high-fat (60 percent of calories from fat) or low-fat (10 percent of calories from fat) diet for 10 weeks. The main source of fat in the high-fat diet was lard with casein protein, sugar, and micronutrients added. The researchers added a choline supplement to both the high-fat and low-fat diets one week before administering a single dose of a probiotic containing E. coli, a member of the Enterobacteriaceae family, to both E. negative and germ-free mice. All mice consumed their assigned diet for a total of 14 weeks. The researchers measured changes to epithelial cells in the colon including mitochondrial metabolism, inflammation, and cancer signatures.

    Both E. negative and germ-free mice that gained weight on the high-fat diet had increased inflammation and cancer signatures, suggesting some of the detrimental diet effects were independent of the microbiota. Germ-free mice on a low-fat diet had colon epithelial cells with appropriately low levels of oxygen; however, germ-free mice on a high-fat diet had colon epithelial cells with increased oxygen levels and reduced mitochondrial metabolism. Following E. Coli exposure, E. negative mice fed a high-fat diet supplemented with choline gained more weight and had higher levels of oxygen, inflammation, and signatures of cancer in their colons than E. negative mice fed a low-fat diet. These changes were associated with an increased concentration of fecal E. coli. In germ-free mice exposed to E. coli, a high-fat diet supplemented with choline significantly increased serum TMAO levels compared to all other groups.

    These results elucidate the mechanisms by which diets high in saturated fat may contribute to heart disease through interactions with choline metabolism by the gut microbiota. However, there are several important factors to consider in translating these results into relevant information for humans. Mouse diets often contain just one or two sources of fat such as lard and soybean oil, as was used in this study. Human diets contain a wider variety of fats, including various saturated and unsaturated fats. These diets also often contain high amounts of simple sugars, such as the sucrose and maltodextrin used in this study. The diet used in this study is also not representative of a standard human diet and limits the ability to distinguish between the effects of saturated fat and sugar. So, while animal studies are a vital foundation for human research, they should not be the basis for individual health recommendations. To hear Dr. Rhonda Patrick review the evidence on saturated fat and heart disease, listen to this episode of the FoundMyFitness podcast.

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  • Omega-3s reduce risk of death from cardiovascular disease. pubmed.ncbi.nlm.nih.gov
    Heart Disease Omega-3 Cardiovascular

    The American Heart Association recommends that adults consume at least eight ounces of fish and shellfish each week, especially those that are rich in omega-3 fatty acids. Previous research supports the benefits of omega-3 consumption in preventing coronary heart disease and sudden cardiac death; however, additional research is needed to support the benefits of omega-3s for other cardiovascular disorders. Investigators reviewed the molecular, clinical, and epidemiological evidence for the effects of omega-3s on cardiovascular disease.

    Omega-3 fatty acids cannot be produced by the body and must be consumed in the diet. Major food sources of omega-3s include fatty fish, which are rich in eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Plant sources of omega-3s include flax seeds, chia seeds, and walnuts, but the predominant omega-3 fat in these foods is alpha-linolenic acid, which must be converted to EPA before it can be used by the body. Omega-3s and their metabolites improve cardiovascular health through altering the composition of cell membranes and regulating gene expression, among other functions.

    The authors searched the literature for randomized controlled trials, in which researchers randomly assign participants to an intervention or a comparable control treatment, and observational studies, which observe a group of participants at a single time point. Randomized controlled trials are suitable for identifying cause-and-effect relationships, but because observational studies measure associations between behavior and health, they are not. Review papers aggregate data from previous research and compare results, a process that can be difficult because dose, sample size, and participant characteristics vary among studies.

    The analysis revealed that the dose of omega-3s utilized in the randomized controlled trials ranged from 376 milligrams to 1,800 milligrams. Some of these trials instructed participants to consume the recommended two servings of fish per week. Data from these trials showed that omega-3 consumption decreased cardiovascular disease, with risk reductions ranging from two to 32 percent among trials; however, some trials did not find a benefit of omega-3 consumption for reducing the risk of death from cardiovascular disease. In observational studies, the benefits of omega-3 consumption were strongest for coronary heart disease and sudden cardiac death, confirming previous reports. Evidence from the randomized controlled trials and observational studies was inadequate to support assertions that consumption of omega-3 fatty acids reduce the risk of heart attack, stroke, atrial fibrillation, arrhythmias, and heart failure.

    Current data support the consumption of omega-3s for reduced risk of death from cardiovascular disease. The authors concluded that future research should explore the effects of dose, source (i.e., seafood or supplements; plant or animal), and other molecular, physiological, and clinical effects.

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  • Coffee consumption is associated with a reduced risk of irregular heartbeats. jamanetwork.com
    Heart Disease Coffee

    Coffee consumption is popular worldwide and is associated with reduced risk of cancer, diabetes, and Parkinson’s disease. However, the American College of Cardiology and American Heart Association recommend avoiding caffeine to reduce the risk of cardiac arrhythmias. Findings from a recent observational report suggest coffee consumption may reduce, not increase, the risk of cardiac arrhythmias.

    Cardiac arrhythmias occur when the electrical impulses that control heart rate pulse too quickly, called tachycardia, or too slowly, called bradycardia. Coffee is the primary source of caffeine for most people. Because caffeine increases serum levels of catecholamines (e.g., adrenaline), it is plausible that coffee may increase the risk of cardiac arrhythmias. Although results from one observational study from 1980 support an increased risk of arrhythmias with increased coffee consumption, newer and more comprehensive evidence is needed.

    The authors collected data regarding habitual coffee consumption and the incidence of cardiac arrhythmias from over 380,000 participants of the United Kingdom Biobank, a long-term registry study of United Kingdom citizens. The researchers assigned participants to one of eight categories of coffee consumption: zero, less than one, one, two, three, four, five, or six or more cups daily. Participants also provided a DNA sample for the sequencing of genes related to coffee metabolism.

    Coffee consumption was associated with a reduced risk of cardiac arrhythmia. For each cup of coffee consumed daily, the risk of arrhythmia was reduced by three percent. This means an individual consuming three cups of coffee would have a nine percent risk reduction. This relationship was significant even after taking age, sex, race, metabolic health, smoking, alcohol and tea consumption, and exercise into account. Participants with genetic variants associated with slower caffeine metabolism drank less coffee, but did not have an increased risk of arrhythmia.

    Greater coffee consumption was associated with a reduced risk of cardiac arrhythmias, a result that contradicts earlier evidence. Learn how coffee consumption may induce autophagy to improve other aspects of health in this clip featuring Dr. Guido Kroemer.

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  • Exercise reverses effects of sleep deprivation on cardiovascular health. link.springer.com
    Exercise Heart Disease Cardiovascular

    Just one night of sleep deprivation can impair arterial function, and chronically poor sleep increases the risk of developing cardiovascular disease. Conversely, high intensity interval exercise can improve multiple markers of heart health. In this report, researchers tested the effects of exercise on flow mediated dilation, a measure of vascular function, in sleep-deprived participants.

    Flow mediated dilation is a measure of how wide an artery expands in response to increased blood flow. Meals high in fat normally cause dysfunction in blood vessels, impairing their ability to dilate. Previous research reports that high intensity exercise improves flow mediated dilation following a meal.

    Fifteen healthy active men (average age, 31 years) completed three nights of sleep for this study. The first night, participants slept a full eight hours and ate a high-fat test meal the next morning. The second night, participants slept a full eight hours, then performed high intensity interval training before eating. The third night, participants slept three and one half hours or less, then performed the same exercise and ate the same meal. The researchers measured flow mediated dilation at multiple time points.

    After comparing the post-meal flow mediated dilation following a full night of sleep and a full night of sleep plus exercise, the authors found that exercise improved arterial function. Impressively, the benefit of exercise remained following a night of sleep deprivation. Flow mediated dilation rates were similar between exercise conditions regardless of sleep duration the night before.

    The authors concluded that high intensity exercise improves artery function and that these benefits remain even after a night of sleep deprivation. However, they recommended that people get a full night of sleep before strenuous exercise to get the most benefit.

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  • Combining aerobic exercise and strength training may be the best strategy for improving healthspan. www.bmj.com
    Exercise Cancer Heart Disease Aerobic Strength

    Current public health guidelines recommend that adults engage in regular physical activity for optimal health. Findings from a new study suggest that a combination of both aerobic and strength activities reduces the risk of death from all causes as well as specific causes.

    According to the guidelines, adults should engage in at least 150 minutes of moderate-intensity aerobic physical activity or at least 75 minutes of vigorous-intensity aerobic physical activity each week, or an equivalent combination of both. They should also engage in muscle-strengthening activities of moderate or greater intensity on two days or more each week.

    The population-based cohort study, which involved nearly 480,000 adults, drew on data from the National Health Interview Survey, an ongoing, cross-sectional survey of people living in the United States. The study participants reported how much leisure time aerobic and strength physical activity they engaged in each week. Then the authors of the study categorized them as having insufficient activity, aerobic activity only, strength activity only, and both aerobic and strengthening activities, based on the guidelines.

    The authors found that the participants who engaged in recommended amounts of aerobic or muscle-strengthening activity had a lower risk of death from all causes, and these benefits were even greater if they engaged in both types of activities. They noted similar reductions in risk of death from cardiovascular disease, cancer, and chronic lower respiratory tract diseases.

    These findings suggest that adherence to public health guidelines for exercise reduce the risk of disease and death and provide support for interventions to improve compliance.

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  • Lean beef as part of a healthy dietary pattern may reduce cardiovascular disease risk. scienmag.com
    Heart Disease Cardiovascular

    Insulin resistance increases a person’s risk of developing type 2 diabetes and atherosclerosis. Findings from a new study suggest that lean beef as part of a healthy dietary pattern may reduce this risk in people with insulin resistance.

    The randomized, crossover, controlled trial, which involved 23 men and women (average age, 44 years) who were overweight or obese and had been diagnosed with prediabetes and/or metabolic syndrome, compared the effects of two dietary patterns on insulin sensitivity and cardiometabolic risk markers. One diet followed the USDA Healthy US-Style Eating Pattern, which is low in saturated fat and provides less than 40 grams of red meat per day. The other diet mirrored the first but provided an additional 150 grams (roughly five ounces) of lean beef per day as a replacement for carbohydrates (of nearly equal caloric content). Each participant consumed the two diets for four weeks, separated by a two-week washout period. At the end of each four-week diet period, the authors of the study assessed the participants' responses to the respective diets via measures of insulin sensitivity, lipid profiles, inflammation (measured by C-reactive protein), and blood pressure.

    The participants' responses to the diets did not differ significantly with the exception of a notable increase in larger, more buoyant low-density lipoprotein (LDL) particles when consuming the higher beef content diet. LDLs are formed in the liver and transport lipid molecules to cells. Often referred to as the “bad cholesterol,” LDLs can drive cardiovascular disease if they become oxidized within the walls of arteries. LDL particles exist in different sizes, ranging from large, “fluffy” molecules to small, dense molecules.

    Scientific evidence suggests that small LDL particles are more susceptible to oxidative modification. Conversely, more buoyant particles are associated with a reduced risk of atherosclerotic disease. Learn more about LDL particles and disease risk in this podcast featuring Dr. Ronald Krauss.

    Note: This study has industry funding sources, see press release for details.

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  • Fragmented sleep contributes to increased risk of atherosclerosis. news.berkeley.edu
    Sleep Heart Disease

    Atherosclerosis is a disease of the arteries characterized by the deposition of fatty plaques on the arteries' inner walls. Roughly half of all deaths in developed countries are attributed to atherosclerosis. A new study suggests that a pro-inflammatory pathway triggered by poor sleep contributes to the risk of developing atherosclerosis.

    The study involved more than 1,600 ethnically and racially diverse adults (average age, 68 years) enrolled in the Multi-Ethnic Study of Atherosclerosis. The authors of the study measured the participants' home sleep and activity levels over a period of a week and assessed their brain activity during one night in a sleep laboratory. They also ran blood tests to identify biomarkers associated with disease processes and determined the participants' coronary artery calcification scores, which provide reliable measures of atherosclerosis.

    They found that poor, fragmented sleep led to increased levels of proinflammatory molecules and white blood cells (neutrophils and monocytes). Together, these factors promote inflammation, a key driver in the pathogenesis of not only atherosclerosis but many other diseases as well. Poor sleep also predicted the degree of coronary artery calcification. Their findings held true even after ruling out factors related to age, ethnicity, gender, body mass index, sleep disorders, blood pressure, and smoking.

    These findings underscore the fact that sleep has far-reaching effects on many aspects of health. Learn more in this clip featuring sleep expert Dr. Matthew Walker, in which he describes how the different stages of sleep influence both mental and cardiovascular health.

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  • Magnesium intake reduces risk of coronary artery calcification. www.sciencedirect.com
    Heart Disease Magnesium

    Coronary artery atherosclerosis, a narrowing of the heart’s arteries caused by a buildup of plaque, is the principal cause of coronary artery disease and the single leading cause of death worldwide. Coronary artery calcification provides a reliable measure of atherosclerosis. A 2014 study found that magnesium intake is inversely related to coronary artery calcification.

    Magnesium is an essential mineral and a cofactor for hundreds of enzymes. It is involved in many physiological pathways, including energy production, nucleic acid and protein synthesis, ion transport, and cell signaling. Magnesium deficiency is linked with an increased risk of cardiovascular disease, osteoporosis, and metabolic disorders, including hypertension and type 2 diabetes. Dietary sources of magnesium include legumes, nuts, seeds, whole grains, and green leafy vegetables (such as spinach).

    The study drew on data from the Framingham Heart Study, a long-term, ongoing epidemiological study of cardiovascular disease risk among people living in Framingham, Massachusetts. The study participants included more than 2,600 people who underwent computed tomography (CT) scanning to determine the presence of coronary artery calcification and completed food frequency questionnaires to provide information about their dietary and supplemental magnesium intake. The men in the study were 35 years of age and older, and the women were 40 years of age and older.

    The scans revealed that more than 43 percent of the participants exhibited signs of coronary artery calcification. Men were roughly 50 percent more likely to have calcification than women. The food frequency questionnaires indicated that the participants' magnesium intake averaged approximately 338 milligrams per day. Participants with the highest magnesium intake were 58 percent less likely to have coronary artery calcification than those with the lowest intake.

    These findings highlight the importance of magnesium intake in modulating cardiovascular health and suggest that dietary and supplemental interventions could reduce risk of cardiovascular disease.

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  • Cardiac injury commonly occurs in patients with COVID-19 and markedly increases risk of death among patients with preexisting cardiovascular disease. jamanetwork.com
    Heart Disease COVID-19

    People who have cardiovascular diseases such as coronary artery disease, atherosclerosis, or heart failure often have poor outcomes during acute illness. Cardiac injury commonly occurs with COVID-19 illness, exacerbating preexisting cardiovascular disease. A recent editorial summarizes the available data regarding adverse outcomes associated with cardiovascular disease and COVID-19.

    The authors of the editorial describe the findings from two recent studies conducted at a teaching hospital in Wuhan, China. One study compared the outcomes of hospitalized COVID-19 patients who had myocardial damage versus COVID-19 patients without myocardial damage. More than half (51 percent) of those with myocardial damage died while in the hospital, but only 4.5 percent of those without myocardial damage died in the hospital. Another study had similar findings, with higher death rates (59.6 percent) among patients with preexisting cardiovascular disease and elevated troponin (a marker of cardiac injury) compared to those with normal troponin levels (8.9 percent).

    The findings from these two studies suggest that cardiac injury commonly occurs in patients with COVID-19 and markedly increases risk of death among patients with preexisting cardiovascular disease. These patients might require more aggressive care than other patients.

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  • Study shows Vitamin C may lower blood pressure by nearly 5 mm Hg in hypertensive patients. www.sciencedaily.com
    Heart Disease Vitamin C Blood Pressure

    From the article:

    Miller and his colleagues reviewed and analyzed data from 29 randomized, controlled, previously published clinical trials that reported systolic and/or diastolic blood pressure values and also compared vitamin C intake to a placebo. What they found is that taking an average of 500 milligrams of vitamin C daily – about five times the recommended daily requirement – reduced blood pressure by 3.84 millimeters of mercury in the short term. Among those diagnosed with hypertension, the drop was nearly 5 millimeters of mercury.

    A comparison to common pharmacological treatment:

    By comparison, Miller says, patients who take blood pressure medication such as ACE inhibitors or diuretics (so-called “water pills”) can expect a roughly 10 millimeter of mercury reduction in blood pressure.

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  • Meta-analysis finds that quercetin significantly lowers blood pressure. academic.oup.com
    Heart Disease Triglycerides Blood Pressure

    Cardiovascular disease is the number one cause of death worldwide, claiming the lives of more than 17 million people every year. A recent meta-analysis and systematic review suggests that quercetin may exert protective effects to reduce the risk of cardiovascular disease.

    Quercetin is a flavonol compound found in a wide variety of fruits and vegetables, including onions, apples, tea, and lettuce. Epidemiological data suggest that quercetin exerts protective effects against cardiovascular diseases, cancer, and other chronic diseases due to its anti-inflammatory actions.

    The analysis investigated the effects of quercetin intake on several risk factors for cardiovascular disease, including lipid profiles, blood pressure, and glucose levels. It was based on findings from 17 randomized controlled trials involving nearly 900 participants who took a standardized quercetin extract.

    The results of the analysis indicated that quercetin intake reduced systolic and diastolic blood pressures by approximately 3.09 mmHg and 2.86 mmHg, respectively. Quercetin intake did not appear to influence blood lipid profiles or glucose levels. However, a sub-group analysis demonstrated that longer trials of quercetin intake (8 weeks or more) had favorable effects on participants' HDL cholesterol and triglyceride levels.

    These findings suggest that quercetin may be useful in the clinical setting for the management of risk factors associated with cardiovascular disease.

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