Does Iron Supplementation Promise Lower Heart Attack Risk?

Iron and HeartA new study identifies low levels of iron as a risk factor for cardiovascular disease, one of the leading causes of death worldwide and researchers look at iron supplementation as a low cost method for reducing the risk of heart disease.

Genomic data from over 48,000 people was used in this study.  Genetic variations were used as a way to determine a person’s iron level and its link to their cardiovascular disease risk (CVD).  Researchers looked at a trio of points located in the genome (the genetic material of an organism) where a single nucleotide polymorphism (SNP), an alteration in the DNA, can increase or decrease the iron status of a person. These SNPs were identified as rs1800562 and rs1799945 in the HFE gene and rs855791 in the TMPRSS6.  When these SNPs were reviewed researchers found those participants with the SNPs for higher iron status had reduced risks for coronary artery disease (CAD).

Current research has shown mixed results regarding iron and cardiovascular disease.  High iron stores have also been associated with increased risks factors for CVD, like Type 2 Diabetes.  Observational studies have also shown a protective effect of increased iron levels on CAD as wells as an increased death rate in patients with iron deficiency and heart failure.

This study used the Mendelian randomization technique, which has been proven effective in accounting for reverse causation, lifestyle factors or environmental factors.  The World Health Organization estimates approximately 2 billion people worldwide do not get enough iron from their diet, which can lead to anemia, shortness of breath, increased risk of infections, heart palpitations, and may cause tiredness.

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Choline,-An Underused, Essential Nutrient

CholineCholine is an essential vitamin-like nutrient that is useful for helping the body to maintain optimal health.  Only recently has this vital nutrient gained attention for its role in supporting healthy liver function, prenatal development, brain and heart health and athletic performance and recovery.  As a matter of fact Choline is the most recent nutrient to receive an RDI (reference daily intake) from the FDA.  Choline was classified as an essential nutrient in 1998 by the Institute of Medicine.  This important nutrient is not as readily available through our foods as originally thought and approximately 90% of all Americans are not meeting IOM’s (Institue of Medicine) recommended daily intakes of 425 mg for adult women and 550 mg for adult men.

Choline helps cleanse the liver of fats that can accumulate in this organ.  This in turn helps maintain normal liver function.  This is important since today almost 40% of the population now has NAFLD (non-alcoholic fatty liver disease).  Growing obesity levels is a key factor in the rise of this disease.  Without adequate levels of Choline fat transport out of the liver slows down and fat accumulates in the liver causing damage.  In healthy adults deprived of Choline for 42 days between 77% and 80% developed signs of liver dysfunction according to one study.  This damage did reverse itself once the participants were given a high-choline diet.

Choline, an essential building block of cells, is needed in larger quantities during pregnancy.  Pregnant women use twice the recommended levels of Choline, however only about 10% of pregnant women meet these higher levels.  Growing evidence link Choline, like folic acid, to the prevention of neural tube defects in newborns.  One study found a 2.4-fold higher risk of neural tube defects in participants with low blood levels of Choline during mid-pregnancy.  Additionally, Choline seems to lower cortisol levels and may reduce the baby’s response to stress.  It looks like Choline makes Omega-3 DHA more available to the prenatal brain supporting healthier cognitive development.  Pre-Eclampsia risks (onset of high blood pressure during pregnancy) have been reduced during the third trimester of pregnancy with Choline supplementation.

Choline has shown benefits for lowering homocysteine levels.  Homocysteine is an inflammatory marker associated with greater risks for heart disease, stroke, cancer, bone fractures and cognitive decline.  Choline converts homocysteine into the amino acid methionine thereby preventing the building up of homocysteine in the body.

Choline supports faster communication between muscle fibers and the brain which helps support additional muscle recovery after repetitive motion exercise which boosts overall workout performance.  Choline also helps in the optimization and synthesis of nitric oxide.  Nitric Oxide increases the flow of nutrients and oxygen into the muscles increases pump during exercise.  Active people are a greater risk of Choline depletion ultimately causing a reduction in performance and the breakdown of muscle cells to support adequate Choline supplies to the brain.

Food sources of Choline are not typically a part of most American diets.  Egg yolks and Beef liver are examples of Choline-rich foods.  Salmon, broccoli, peanuts, brussel sprouts and chicken also contain Choline but in smaller amounts and do not provide the amount of Choline needed in a day making supplementation a must.

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Omega-3 May Shorten Hospital Stay in Heart Surgery Patients

Strong Hearth ChalkboardA new review has found that a reduction in the time spent in the hospital and a reduction in the risk of complications was seen in open heart surgery patients supplementing Omega-3 Essential Fatty Acids daily.

19 randomized, controlled trials were reviewed.  Reductions of 1.4 days in the length of time spent in the hospital as well as a 22% reduction in the incidence of Post-Operative Atrial Fibrillation (POAF) were seen.  Dosages of 2 grams/day were best for reducing arrhythmias.  Researchers did acknowledge that the shorter recovery time could be due to the reduction in POAF.  However the researchers strongly felt the findings of this meta-analysis show promise for using Omega-3 Essential Fatty Acids as a perioperative therapy (therapy given before, during and after a surgical procedure).

Researchers concluded that it would make sense for patients exposed to extra-corporeal circulation (circulation of the blood outside the body, as through a heart lung machine) to experience stronger systemic inflammatory response syndrome since they come into contact with blood with non-endothelial surfaces.  The Omega-3 Essential Fatty Acids showed a positive impact on systemic inflammation reduction, the reductions seen in POAF, the shorter lengths of hospitals stays as well as other unknown improvements in clinical outcomes.

Larger scale, well designed, randomized, controlled trials are needed.

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Vitamin D Blunts Negative Impact of Statins in Diabetes Patients Post Exercise

Vitamin DA new study shows patients with Type 2 Diabetes who are taking statin drugs and supplementing with Vitamin D improves their cardio respiratory fitness as well as muscle mitochondria.

28 individuals participated in this randomized controlled trial.  Data from the participants upon completion of the trial showed that participants cardio respiratory fitness decreased by 8.4% after 12 weeks of simvastatin therapy. These individuals also experienced a 3.6% decrease in mitochondrial content.   Participants who were taking the simvastatin therapy but were also supplementing with Vitamin D however showed a decrease in cardio respiratory fitness of only .6% and a 12.1% improvement in mitochondrial content.  Participants who only took Vitamin D without the simvastatin therapy saw an increase in cardio respiratory fitness of 7.1% and a 16.7% increase in mitochondrial content.

Researchers believe that the statin simvastatin in inclined to cause a decline in exercise-mediated cardio respiratory fitness in adults with Type 2 Diabetes by interrupting the synthesis of CoEnzyme Q10.

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Dietary Potassium Linked with Lower Blood Pressure

HypertensionA new meta-analysis of several population studies has found that increasing dietary potassium may help with supporting healthier blood pressure levels.  Researchers looked at the link between blood pressure and dietary potassium, sodium and the ratio between potassium and sodium.

Researchers found that the higher the dietary potassium, measured from dietary recall and urinary excretion, the lower the participants blood pressure no matter how much sodium was ingested.  Other interventional studies with potassium supplementation showed a direct benefit of potassium and blood pressure reductions.  Researchers also reviewed recent animal studies that showed the body’s ability to balance sodium and potassium levels in the blood.  This is critical for nerve and muscle function as well as normal cardiovascular function.

Decreasing sodium intake has always been the way to reduce blood pressure, but new evidence suggests increasing potassium may be as important in reducing hypertension.  When potassium intake is high the kidneys excrete more water and salt which in turn increases potassium excretion concluded researchers.  Currently many modern diets consist of a lot of processed foods with added sodium unlike the diets of our early ancestors which were higher in potassium and very low in sodium.  This dietary shift has increased the risks of developing hypertension.  Hypertension affects over a billion people worldwide and it is estimated that high blood pressure is responsible for a least 51% of the deaths caused by strokes and 45% of the deaths caused by heart disease.

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L-Arginine-B Vitamin Combination Effective for Blood Pressure Improvements

High Blood PressureA new study has found a combination of the amino acid L-Arginine, Folic Acid, Vitamin B6 and Vitamin B12 may improve vascular function in addition to supporting a reduction in blood pressure.

81 people participated in this placebo-controlled clinical trial.  Study participants ranged in age from 40 to 65 years of age and were randomly assigned to receive a placebo or a combination of L-arginine and B vitamins (3 mg of B6, .4 mg of Folic acid, 2 mcg of B12 or 2400 mg of L-Arginine).  The study lasted for 6 months, 3 months with the assigned supplement combination or the placebo and 3 months with no supplementation.

Results showed a .37 increase in the reactive hyperemia index (RHI), a measure of endothelial function which shows improvements in vascular function, in the group taking the actual supplements with no significant changes seen in the group taking the placebo.  Additionally systolic blood pressure decreased significantly (6 mmHg) over the study period in the group supplementing with the actual supplement combination with no changes seen in the placebo group.

Most recently even modest changes in blood pressure (5 mmHg) were considered as being clinically significant and were associated with a 9% reduction in coronary heart disease risk and a 14% reduction in stroke risk.

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Vitamin D Linked to Cholesterol Levels and Cardiovascular Risk

heart diseaseA new study found a Vitamin D deficiency could be associated with a higher ratio of total cholesterol to HDL in addition to lower levels of HDL-cholesterol.  This higher ratio of total cholesterol to HDL has been associated with increased cardiovascular risks more than those seen with other cholesterol measures like LDL-cholesterol (often called bad cholesterol).

Data from over 13,000 individuals who participated in the Atherosclerosis Risk in Communities Study (ARIC) was analyzed.  The average age of the participants was 57 years of age and the mean Vitamin D level (25(OH)D) was 24 ng/ml.  Deficiency of this non active storage form of Vitamin D (25(OH)D) is less than 20 ng/ml however optimal levels of this form of Vitamin D is at least 30 ng/ml.

After adjustments were made for a range of potential confounding variables, individuals with a Vitamin D deficiency had a HDL Cholesterol level approximately 3 mg/dl lower than participants with optimal Vitamin D levels.  Additionally the total Cholesterol to HDL was .18 higher in the Vitamin D deficient participants.  When individuals on cholesterol lowering therapies were removed from the analysis an association between Vitamin D deficiency and higher LDL cholesterol were also observed.

Researchers believe the major implication of this study is the chance of changing cardiovascular risk factors through Vitamin D supplementation.

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