February is American Heart Month. This week we sat with Dr. Sears to ask his thoughts on various topics pertaining to heart health. See what he had to say.
Q: What do you consider the most critical factor for heart health?
A: The reduction of unresolved inflammation will have the most significant impact on improved heart health. This type of inflammation is below the perception of pain but capable of causing continued tissue damage to the heart.
Q: Why is inflammation more critical than cholesterol when it comes to heart disease?
A: Ongoing unresolved inflammation causes constant damage to heart tissue. Cholesterol doesn’t cause inflammation, but oxidized cholesterol does. In particular, it is oxidized LDL cholesterol that is a more significant predictor of future cardiovascular risk than natural LDL regardless of its concentration.
Q: If you have a family history of heart disease, what dietary changes do you think people should make?
A: The primary dietary change is to reduce unresolved inflammation and then repair the damage to the tissue. These actions require optimization of the Resolution Response, which is the key for dietary control of inflammation. The Resolution Response is optimized by following an anti-inflammatory diet such as the Zone diet, coupled with the resolution of residual inflammation by hormones (i.e., resolvins) derived from omega-3 fatty acids, and finally the repair of damaged tissue by activation of the master switch of metabolism (i.e., AMPK). Adequate intake of polyphenols maximizes this final step of activation of AMPK.
Q: Name your top 5 foods for heart health?
A: There is no magic bullet for heart health. Each component of the diet has a role to play in the Resolution Response. First, you have to restrict dietary calories to reduce oxidative stress. But the amount of protein you need depends on your lean body mass and physical activity level. It doesn’t matter if the protein is animal or plant-based as long as you consume enough protein at each meal. Whatever the amount of protein you require, the protein consumed at any meal must be consistently balanced by carbohydrates, primarily non-starchy vegetables and limited amounts of fruit, to get the optimal hormonal responses. The best vegetable sources for heart health are the ABCs (artichoke, asparagus, broccoli, cauliflower, and spinach), and the best fruit sources are berries. These carbohydrates are also rich sources of fermentable fiber needed to maintain gut health, reducing potential inflammation coming from microbial fragments from a leaky gut. Finally, an anti-inflammatory diet's fat content should be low and consist primarily of omega-3 and monounsaturated fat and be very limited in omega-6 and saturated fats, which are pro-inflammatory.
Q: Omega-3 fatty acids have been FDA approved to lower triglycerides. What other key benefits for the heart do omega-3 fatty acids provide?
A: The key benefit of omega-3 fatty acids is to increase the levels of resolvins which reduce residual inflammation. However, you need an adequate dietary intake of omega-3 fatty acids such as EPA and DHA to generate resolvins. To obtain sufficient EPA and DHA levels you can either consume a lot of fatty fish or use omega-3 fatty acid supplements.
Q: When it comes to omega-3 fatty acids from fish oil, purity counts. Can you talk about the downsides of choosing omega-3 fatty acid sources that aren’t low in PCBs when it comes to heart disease?
A: All sources of fish contain trace amounts of toxins known as polychlorinated biphenyls (PCBs). When the omega-3 fatty acids in fish oils are concentrated, so are the PCBs. PCBs increase cardiovascular disease at incredibly low concentratations measured in parts per billion (ppb).
Removing PCBs from fish oil is a challenging task. The standard for upper limits in health products is 90 ppb. I have been concerned about PCB contamination for decades because of their adverse effect on heart health, neurological damage, cancer, and gene disruption. This concern is why we developed new manufacturing technology to remove residual PCBs in OmegaRx 2 to a far greater extent. Our current standard for the upper limit of PCBs in OmegaRx 2 is 2 ppb, which is 45 times lower than the standard for nutritional supplements. Our most recent samples had a PCB level of 0.05 ppb that is 20 times lower than our posted upper limit and 180 times lower than the standard for nutritional supplements.
Q: People often justify their intake of chocolate and red wine for heart health. Are there benefits to their consumption?
A: The reason why people mention chocolate and red wine benefit heart health is because they contain polyphenols. That said, for any polyphenol to be effective, it has to enter the bloodstream. Most polyphenols are either too water-insoluble or in the form of polymers so that they can’t enter the blood to activate AMPK. Only about 15% of the polyphenols in chocolate can enter the blood. There are about 50 different polyphenols in red wine, and virtually none of them can enter the blood. However, all polyphenols are potentially useful for gut health, but only if they are degraded to monomers and then metabolized phenolic metabolites that can enter the blood.
Furthermore, natural chocolate contains elevated levels of cadmium that must be reduced by purification. The most water-soluble polyphenols present in red wine must also be highly concentrated and refined to activate AMPK.
Q. Is there anything else you can recommend to help reduce the risk of heart disease?
A. Your most powerful dietary strategy to reduce heart disease risk is to optimize your internal Resolution Response. It is through the Resolution Response that the body heals from any injury. To optimize the Resolution Response, you need an integrated dietary approach. This dietary approach is to reduce, resolve, and repair the inflammatory damage that causes heart disease. You reduce inflammation by following the anti-inflammatory Zone diet. Then you resolve residual inflammation by adequate intake of omega-3 fatty acids. Finally, you repair the damage caused by inflammation by adequate consumption of polyphenols, especially those found in berries. Any one of the three dietary interventions is good, but all three working together is exceptionally powerful.
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