Many of us know that the ubiquitous chemical bisphenol A (BPA) found in plastics and epoxy resins is endocrine- disrupting, and is clearly antithetical to good health. In a recently-released cohort study of 3,883 adults in the United States, subjects with the highest urinary levels of this chemical had a higher risk of death over a 10 year period.

Those with the highest levels had a 49% increased risk of all-cause mortality, and a 46% increased risk of cardiovascular risk mortality.

This news is hardly unexpected given the populace of plastics in our lives. We are not just talking about the obvious plastics, but also many commonly used consumer products such as compact discs, medical devises, and dental sealants and composites. 

Endocrine-disrupters, such as BPA disrupt our hormonal balance and can lead to obesity, diabetes and metabolic syndrome. Exposure to BPA can accelerate coronary heart disease, and induce cardiac arrhythmias. 

The news is not good. We clearly need to limit the use of plastics and do a better job of recycling.  Moreover, we certainly need and deserve a government that works for the people, and who earnestly endeavors to protect us from environmental hazards.

You can read the original article from JAMA Network clicking HERE.

For years saturated fat has been vilified in the cardiology literature as well as by prestigious professional organizations such as the American Heart Association (AHA ). But many of us have questioned these motives, as we do not believe that universally restricting consumption of saturated fat is scientifically based. 

As a matter of fact, there is no true evidence that dietary fat, which generally contains significant amounts of saturated fat, has any harmful cardiovascular consequences. This is in contradistinction to what has been disseminated over the past fifty years.

Recently, a “State-of-the Art Review” published in the prestigious Journal of the American College of Cardiology provided evidence to the contrary which supports my view and the view of many others in the nutritional field. 

These are some of the highlights:

• Most recent meta-analyses of both randomized trials and observational studies found no beneficial effects of reducing saturated fat on cardiovascular disease and total mortality. Instead, protective effects were found against stroke.

• Although saturated fat increases low-density cholesterol (LDL), this is not due to increased levels of small dense LDL particles, but rather larger fluffy LDL particles, which are much less strongly related to cardiovascular risk. 

• Whole-fat dairy, unprocessed meat, eggs and dark chocolate are all saturated fat rich foods that are not associated with increased cardiac risk.

• The totality of available evidence does not support limiting these foods.

LET’S DEBUNK THE MYTH ABOUT SATURATED FAT!

Link to the Journal of the American College of Cardiology “Saturated Fats and Health: A Reassessment and Proposal for Food-based Recommendations: JACC State-of -the-Art Review”

Click here for full PDF of the Study "Fats and Health: A Reassessment and Proposal for Food-based Recommendations: JACC State-of -the-Art Review" from the Journal of the American College of Cardiology.

We've all been inundated with the grim facts and statistics about COVID-19. I've talked and blogged about this repeatedly. My wish is for all of us to take this opportunity and give thanks to what we have versus lament over what we cannot control.

THERE IS NO BETTER TIME THAN NOW!
To order, or arrange a nutritional evaluation, email our nutritionist Kristine Solomon at kristine@heartwise.com or call the office at (562) 945-3753.

In the next several weeks all 50 states will be "opening up" in one way or another. Exposure to COVID-19 and other pathogens won't  just wither away. We followed the requisite social distancing, etc. But we can't live that way forever. If you haven't already started practicing prevention, what are you waiting for ?

Working on optimizing your immune system should be number 1 on your list.  Most  patients who fare poorly are generally not healthy. They suffer from hypertension, heart disease, diabetes and obesity. It doesn't have to be that way.

I've talked about diet, exercise , hydration , sleep and stress reduction. Those are key.

I've gone one step further and created IMMUNOWISE. One capsule 3/day will help promote a healthy immune system. There are lots of supplements out there. My goal was to provide  an affordable product comprised of solid ingredients in appropriate doses that have been scientifically proven to be of benefit.

Please read the below fact sheet and feel free to contact  our clinical nutritionist Kristine Solomon at kristine@heartwise.com for any orders and/or inquiries. Office phone: (562) 945-3753.

Here's to your health; today and for always,

Howard Elkin MD

WHAT IT IS:

• A custom formulated high-quality blend of powerful immunity boosting and anti-viral ingredients.

WHY YOU NEED IT:

• Important for patients wanting to keep their immune systems on high alert to fight off infections and viruses and reduce duration of illness.

• All Natural, gluten-free, dairy-free, non-GMO

Vitamin C

Vitamin C contributes to immune defense by supporting various cellular functions of both the innate and adaptive immune system. Vitamin C accumulates in phagocytic cells, such as neutrophils, and can enhance chemotaxis, phagocytosis, generation of reactive oxygen species, and ultimately microbial killing. Supplementation with vitamin C appears to be able to both prevent and treat respiratory and systemic infections. Vitamin C has been used in hospital ICUs to treat COVID-19 infection.

Vitamin D

Activated vitamin D,1,25(OH) D, a steroid hormone, is an immune system modulator that reduces the expression of inflammatory cytokines and increases macrophage function. Vitamin D also stimulates the expression of potent antimicrobial peptides (AMPs), which exist in neutrophils, monocytes, natural killer cells, and epithelial cells of the respiratory tract. Vitamin D increases anti-pathogen peptides through defensins and has a dual effect due to suppressing superinfection. Evidence suggests vitamin D supplementation may prevent upper respiratory infections.

Zinc- Zinc contributes to immune defense by supporting various cellular functions of both the innate and adaptive immune system. There is also evidence that it suppresses viral attachment and replication. Zinc deficiency is common, especially in those populations most at risk for severe COVID-19 infections, and it is challenging to accurately diagnosis with laboratory measures. Supplementation with zinc is supported by evidence that it both prevents viral infections and reduces their severity and duration. Moreover, it has been shown to reduce the risk of lower respiratory infection, which may be of particular significance in the context of COVID-19

Quercetin- Quercetin has been shown to have antiviral effects against both RNA (e.g., influenza and coronavirus) and DNA viruses (e.g., herpesvirus). Quercetin has a pleiotropic role as an antioxidant and anti-inflammatory, modulating signaling pathways that are associated with post-transcriptional modulators affecting post-viral healing.

N-Acetylcysteine (NAC)

N-acetylcysteine promotes glutathione production, which has been shown to be protective in rodents infected with influenza. In a little-noticed six-month controlled clinical study enrolling 262 primarily elderly subjects, those receiving 600 mg NAC twice daily, as opposed to those receiving placebo, experienced significantly fewer influenza-like episodes and days of bed confinement.

There is no question that COVID-19 has turned our world upside down, and has remained the number 1 health concern for essentially all of us. However, we never doubted that certain classes of blood pressure medications would be suspect for worsening morbidity and mortality.

ACE inhibitors (eg. lisinopril, accupril, captopril, enalapril, benazepril,etc.) and ARBs or angiotensin receptor blockers ( losartan, valsartan, olmesartan, etc), are amongst the most commonly used meds for hypertension. They certainly constitute the most widely used meds in my cardiology practice. However, with the pandemic of Coronavirus COVID-19, these meds have recently come under scrutiny. 

Concern for these drugs grew out of recent observational Chinese data showing greater morbidity  and mortality among patients with hypertension who went on to develop COVID-19. However experts have come forth reporting that there was no adjustment for certain variables. The validity of the Chinese observation is clearly being questioned. The current consensus is that the data is simply not there. 

Most cardiologists, including myself do not recommend changing to other medications to control blood pressure; even in the presence of COVID-19. There is definite potential harm in doing so. Firstly, there is no simple formula in switching from one class of medications that have successfully controlled a patient’s blood pressure to a new class. Why go from a well-tolerated class and dose of a specific mediation to an unknown? This could easily lead to worsening blood pressure, or drug toxicities due to changing to an entirely different class. From my perspective, this is not a time to attempt trial and error. 

The other concern is losing the positive effects of ACEs and ARBs that are specific to this class of meds. These include preserving kidney function in those with diabetic kidney disease, and maintaining cardiac function in those with a history of congestive heart failure.

Fear of using these drugs stems from up-regulation of ACE2 receptors, possibly increasing viral entry into cells in the laboratory.  But we do not know the effect in the context of the human body.

In conclusion, we lack prospective data on the use of these commonly used Bp meds and their impact on COVID-19 patients. From the viewpoint of The Medical Advocate, I say stick with what works. 

Hypertension and cardiovascular disease remain the highest risk for mortality in those afflicted with COVID-19. Changing medications at such a vulnerable time is simply not recommended. It boils down to risks versus benefits. The potential risk of changing medications is outweighed by the benefits of remaining on these medications that clearly work .    

You can read the original article from TCTMD by clicking HERE.

Coronavirus  COVID-19 is  the hottest topic these days, and for good reason;  it's become a pandemic that has completely changes our lives.

In the span of less than a week, all of us are compelled  to practice social distancing. We can no longer hit the gym, or attend movies, concerts or sporting events. Eating out at restaurants and all social events are on hold. Children are no longer able to attend school. Many of us feel as if our lives have been turned upside down. All of that is understandable given the sudden nature of events. 

That said, we need to drop the panic mode and work together. During periods of social isolation we need to all do our part and remain positive. Uncertainty can be uncomfortable, but we can't allow that to stop us.

Below are a resources by two functional medicine practitioners. The first, a blog post written by Dr. Ben Weitz, DC of Weitz Chiropractic in Santa Monica, and a link to my latest Blog on COVID-19, Which you can READ HERE. Our aim is to give you our perspectives based on the knowledge we presently have with tools to move forward.

Coronavirus, what it is, and what to do about it. 

By Dr. Ben Weitz

If you’re watching the news reports all day while you are home from work, you can get completely panicked.  You may be thinking that the coronavirus will kill all of us, so you have to avoid contact with everyone and everything by staying in your house and dousing yourself and your pets and your house with bleach and alcohol.  In fact, you should bathe in bleach or alcohol.  You need to stockpile toilet paper and water and rice, beans, canned and frozen foods because there will be no food to eat or water to drink.  Or alternatively, you may think that the coronavirus is just a hoax from the fake news media to get President Trump out of office or it is just a mild flu that you should completely ignore. I have read up on some of the scientific reports about the coronavirus and would like to present a reasonable perspective on what the coronavirus is and how to keep yourself and your family safe without panic and fear.  Fear and anxiety will only weaken your immune system. 

First we will start with some of the basic facts.  

1. What is the Coronavirus and what is Covid-19?

• A virus is a tiny infectious organism that replicates inside of the cells of living organisms, including animals and plants and even bacteria.  

• The coronavirus that is the cause of the current pandemic is a type of virus similar to the SARS (Severe Acute Respiratory Syndrome) virus that also started in China in November 2002 and spread around the world.  These are both coronaviruses that originated from bats.  

• COVID-19 (Coronavirus disease 2019) is the disease caused by this current coronavirus.  Once the virus has infected you, it gets into your cells and starts reproducing unless your immune system can fight it off.  Because our immune system does not have antibodies to fight against this particular coronavirus it is referred to as a “Novel” virus, which is one of the reasons why it may be more dangerous than the seasonal flu.

• COVID-19 is rapidly spreading and the rate in the US is likely to accelerate over the next few weeks, partially because we have just ramped up testing.  The social isolation measures we are taking are designed to slow down the spread and it is likely that the measures we are taking will lead to a leveling off and a slowing of new cases, though this might take several weeks or months.  But no matter how long it takes, we will get over this and 6 months or a year from now, things will be much better.  

1. COVID-19 symptoms and incubation period.

• After being infected, there is an incubation period of up to 14 days, which means that you may not have symptoms and still be infectious for up to 14 days.  This long incubation period is one reason why it is more likely to spread throughout society.  

• One reason why you should not worry is that for 80% of those infected, they will have mild to moderate symptoms similar to the seasonal flu. 

• Here are the most common symptoms in order of frequency:

  • Fever 

  • Cough 

  • Sore throat 

  • Runny or stuffy nose 

  • Body aches 

  • Headache 

  • Chills 

  • Fatigue

  • Sometimes vomiting and diarrhea

1. How deadly is COVID-19?

While most (~80%) who contract the coronavirus will have mild symptoms, it appears to be more deadly than the seasonal flu by an order of at least 10 to 1.  The numbers out of China look like the fatality rate is between 3 and 4, while the rate in the US right now is between 1 and 2, but that is with many people with minor symptoms who have not gotten tested.   The more people who have had it will make the percentage who have died go down due to the math.   And we are only just rolling out our testing now, so there are many Americans who have been sick with COVID-19 and were sent home and have recovered and those numbers we don’t know now.  When the antibody tests are available, we will be able to get a sense of how many people previously had COVID-19 and recovered.

Those at biggest risk of severe symptoms like pneumonia are those with a weak or compromised immune system or who have existing heart or lung diseases.

1. How is the coronavirus spread?  

While this virus is not airborne, it is spread through respiratory droplets, often produced while coughing or sneezing, which can then land on your face or hands or a nearby surface that you might touch, followed by touching your eyes, nose or mouth or some food or drink.  Once this virus lands on a surface, such as a countertop or a door handle it can live there for a few hours and possibly as long as 9 days, according to one study.   This is still being debated by the experts. 

1. What is the best way to protect ourselves from getting Covid-19?

   1. Wash your hands for at least 20 seconds with soap and water.  The soap makes the fatty layer that surrounds the coronavirus fall apart.  Singing Happy Birthday twice is about 20 seconds.  Make sure to wash both the palm side and the back side of your hands and fingers. Wash under your fingernails and wash both thumbs. 

   2. Wash your hands multiple times per day, including after you blow your nose, cough, or sneeze. Also make sure to wash your hands after you have had close contact with others, after the bathroom, and before and after you eat.  You should also wash your hands before, during, and after preparing food, after you touch or feed your pet, and after visiting public spaces, such as stores.

   3. After washing your hands, drying them with a hand towel or paper towels is important, since you can remove germs with the friction.  

   4. If there is no soap and water, hand sanitizer or gel that contains at least 60% alcohol is your best bet.

   5. Clean and disinfect frequently touched surfaces, including doorknobs, light switches, desks, phone, keyboards, toilet seats, sinks, etc.

   6. Avoid shaking hands and instead use the elbow or forearm bump. and close contact with others except when necessary, such as going shopping, getting your hair cut, or going to your dentist or doctor.

   7. Avoid touching your face, rubbing your eyes, biting your nails, etc.

   8. If you have to cough or sneeze, do it into the crook of your elbow.

   9. Get chiropractic adjustments, which increase the likelihood that your nerves that start in your spinal cord and exit your spine in between vertebrae can flow freely.  Several scientific studies have shown increases in various measures of immune function with chiropractic adjustments.

1. What not to do.

   1. There is no need to stock up on toilet paper or water. There is not going to be a lack of water. It is a viral infection, not a natural disaster.  There is no lack of toilet paper, except that too many people are hording it.  Calm down and stop worrying about stuff like this.  

   2. There is no need to horde food. There is plenty of food. Give the grocery stores a few days to stock their shelves and you will be able to get the food you need.  While some stores might be temporarily out of rice and beans and pasta and frozen foods, there is plenty of fresh fruits and vegetables, which is what much of your diet should consist of anyway.  Even if you must be isolated, you will still be allowed to go to the grocery store.

   3. Don’t watch the news before you go to bed or you may have trouble sleeping.  Read a book instead.

   4. Don’t stop exercising, even if gyms are closed, as they are in Los Angeles. Do pushups and bodyweight exercises, use bands and dumbbells, and go out for a walk.  Walk up a hill at a rapid pace.

   5. Did I mention not to spend too much time watching or reading the news?

1. Ways to strengthen your immune system to help you fight off the coronavirus if you come into contact with it.  Since there is currently no effective treatment for COVID-19 and a vaccine is not available and it could be a year away or longer, the best way to protect yourself is by keeping your immune system strong.

   1. Make sure you get good sleep, since getting sufficient, quality sleep strengthens the immune system. 

   2. Continue to exercise regularly, since moderate levels of vigorous exercise improve immune function, including enhanced activity of macrophages, immunoglobulins, and anti-inflammatory cytokines.  If you are somebody who exercises by going to the gym like myself and your gym gets cancelled, you should find a way to exercise, such as by  

   3. Avoid sugar, processed foods, and junk food

   4. Eat foods that have immune boosting properties, like garlic, ginger, turmeric, onions, broccoli, mushrooms, citrus fruits, red peppers, and green tea.

   5. Drink plenty of clean, fresh water and don’t trust your tap water.  Your best bet is to get a water purification system, since plastic water bottles are problematic since chemicals from the plastic can leach into the water.

   6. Meditate 

   7. Listen to my Rational Wellness podcast (just kidding).

   8. There are a number of nutritional supplements and nutraceuticals that can benefit your immune system to help you fight off viruses, including the following favorites of mine:

      1. Vitamin C—take 500-1000 mg at least twice per day.  If you are sick take 100 mg every couple of hours. Reduce it if you get diarrhea.  Intravenous vitamin C may be beneficial in getting very high dosages into your system and there are several clinical studies using 12,000 to 24,000 mg/day IV vitamin C for patients with COVID-19

      2. Vitamin D is super important for your immune system and while it is best to get it from the sun, I have found that even in Southern California many patients have serum levels that are either low or less than the optimal level of 50-70 ng/mL. I have found 5000 IU per day to be a beneficial dosage for many patients, and ideally it should also contain vitamin K.

      3. N Acetyl-Cysteine is an antioxidant has been shown to help with acute respiratory diseases like COVID-19. I recommend 500-1000 mg twice per day. 

      4. Resveratrol and quercetin have both been shown to inhibit other types of coronavirus infections, so consider taking both of these. There is currently a clinical trial using quercetin in Wuhan for treatment of COVID-19.

      5. Selenium is a mineral that boosts the immune system. You can either eat 2-3 Brazil nuts or take a supplement of 200 mcg of selenium per day.

      6. Zinc has been shown to have antiviral effects, including against coronavirus. I recommend taking 15-20 mg twice per day for a month or two. If you do this for more than a few months, you should add 1-2 mg of copper.

      7. Reishi, shitaki, and other mushroom supplements contain beta glucans and are extremely potent immune strengtheners.  Check out episode 103 of my Rational Wellness podcast with mushroom expert Jeff Chilton.

      8. Probiotics are very important for immune function and there are even specific ones that are more potent for immune strengthening. 

      9. Andrographis, echinacea, elderberry, garlic, oregano, and astragalus are some of my favorite immune strengthening herbs that have activity against viruses.

Join Dr. Elkin and Mended Hearts of Whittier as they discuss what a heart healthy diet consists of in 2020.

Lipoprotein (a) or simply Lp(a) levels , are genetically determined.  When elevated they are a risk factor for both coronary disease and aortic stenosis. This is no small problem, because as many as 20% of the population is affected. As an integrative cardiologist, I measure Lp(a) levels in essentially all my patients with abnormal lipids, which include both cholesterol and triglyceride levels. In my patients who have experienced a cardiac event such as a heart attack or stroke, or have received balloon angioplasty/ stent or bypass surgery, this measurement is even more crucial.

Up until now, there have been no effective treatments. Statins may work well in lowering LDL cholesterol, but they do nothing to lower Lp(a). Exercise and diet also play no role. It’s simply genetic and lifestyle measures do nothing.

That is until now! An investigational drug targeting LPA gene expression successfully reduced levels of Lp(a) . This was a modest study comprising 286 patients, but it was double-blinded, and placebo controlled. Lp(a) lowering was dose dependent and observed as early as the first month of therapy. The study was led by investigators at UCSD and Ionis Pharmaceuticals.

The 80% reduction in Lp(a) levels would be expected to have a major impact over currently available therapies . For years I have used niacin in relatively high doses to lower Lp(a) levels. However, I have often noted varying success.

Drugs are no panacea. This drug will be expensive and not without potential side effects. However, the ability to lower Lp(a) levels in a large cohort of patients where lifestyle management is ineffective  will hopefully affect outcomes in a positive way.

You can read the original article from MedPageToday by clicking HERE.

Source Reference: Zheng B, et al "Insomnia symptoms and risk of cardiovascular diseases among 0.5 million adults: A 10-year cohort" Neurology 2019; DOI:10.1212/WNL.0000000000008581.

We are becoming increasingly aware of the importance of sleep in maintaining our overall health and wellness. Adequate sleep is essential to repair and restore our organ systems such as our muscles and immune system.  It’s vital for memory, creativity and quality of life. Sleep helps to curb inflammation while helping us maintain a healthy weight.

A recent observational study of a half million people in China linked insomnia to higher rates of heart attacks and strokes. Interestingly enough this was most apparent in younger adults who had normal blood pressure.

Three insomnia symptoms were studied: trouble falling asleep or staying asleep, awakening too early, and daytime dysfunction related to poor sleep.

The research supports our current knowledge about the contribution of impaired sleep for both cardiovascular and cerebrovascular disease.

The information gleaned from this study is extremely useful, but there are limitations to consider; insomnia symptoms were self-reported and were assessed only at baseline. Like many observational studies, association but not necessarily causation can be claimed.

You can read the original article from MedPageToday by clicking HERE.

Source Reference: Zheng B, et al "Insomnia symptoms and risk of cardiovascular diseases among 0.5 million adults: A 10-year cohort" Neurology 2019; DOI:10.1212/WNL.0000000000008581.

It is common knowledge that most of us eat more than we actually need. It has also become increasingly more apparent that fasting on one level or another brings a myriad of benefits. A recent study from Duke University demonstrated that caloric restriction helped improve all factors of metabolic syndrome in patients without obesity. (CALORIE trial)

This was a very modest restriction, a 12% reduction or 300 fewer calories a day. Following this plan for 2 years, there were significant improvements in multiple cardiovascular risk factors:

• Systolic blood pressure

• Diastolic blood pressure

• LDL or the “lousy” cholesterol

• Total cholesterol to HDL “healthy” cholesterol ratio

• Triglycerides

Other benefits include lowering of fasting insulin, fasting blood sugar and C-reactive protein (a sensitive measure of inflammation).

Considered groundbreaking, this is the first long-term caloric restriction intervention in non-obese young and middle age subjects. Furthermore, there was a very low dropout rate, which connotes that a modest restriction in calories is doable.

I find this study very exciting but not surprising. The benefits of restricted caloric intake go way beyond cardiovascular health. This strategy is being studied for extending lifespan and anti-aging in general.  

Read Original Article HERE

Dr. Elkin, known as The Medical Advocate, will be presenting to the Functional Medicine Discussion Group of Santa Monica at the Santa Monica Public Library at 6:30 pm on June 27, 2019.

As an integrative cardiologist, Dr. Elkin will address how to best stratify one’s cardiac risk using the latest in cutting edge laboratory testing. After all, it’s not merely how low the cholesterol numbers are, but one’s actual risk  of contracting a heart attack or stroke 

Emphasis will be on lifestyle, a healthy diet of the 21st century, and appropriate supplementation.

This class of antibiotics has taken quite a hit recently, and for good reason; they are associated with some serious side effects. This class which is commonly prescribed includes household names such as Cipro, Levaquin and Avelox.

We’ve known for some time that this class can lead to tendon injuries including Achilles tendon rupture. This commonly requires surgical intervention. Then there is the risk of peripheral neuropathy. 

In July of this year the FDA required manufacturers to update their labelling to warn about mental health issues, as well as reports of symptomatic low blood sugar. 

If that wasn’t bad enough, the FDA came back last week with a report linking the use of these meds to aortic dissection and/or aneurysm. This is a very serious and possibly life-threatening situation.

Now the FDA warns against using this class in those with known aortic aneurysms, hypertension, the elderly and certain genetic disorders that involve connective tissue such as Marfan’s syndrome. But unless you have chest x-rays, echocardiograms and abdominal ultrasounds on a given patient, how would you know?

This is a very potent class of antibiotics, commonly used by urologists, ENT specialists, pulmonologists and even family practitioners treating travelers’ diarrhea. 

When treated for pneumonia several years back I myself was prescribed Levaquin. With a short course of therapy, I developed a serious case of triceps tendonitis which took weeks to heal.

We all know that antibiotics are prescribed way too often in this county. We need to be ensured that the benefits clearly outweigh the risks. Furthermore, alternatives to the quinolone class should be used wherever possible.

You can read the original article from MedPageToday by clicking HERE.

WHAT A DIFFERENCE A MONTH CAN MAKE! Last month I attended Current Concepts and Controversies in Cardiology presented by Cedars-Sinai Medical Center. It was fabulous with national leaders from the cardiology community . But the focus was on pharmaceuticals, procedures and evidence based medicine . Lacking was any talk on lifestyle including diet, nutrition, supplementation, exercise , sleep or stress management .

I just returned from the annual American Academy of Anti-Aging Medicine meeting in Las Vegas . There was no emphasis on drugs

Hot topics : intermittent fasting and FMD ( Fasting Mimicking Diet ) which I have written about previously here.
Also : peptides , the power of gut health , the genome and epigenetics , the obesity epidemic with 70% of adult Americans overweight and nearly 50% obese. Then there was maintaining cognitive function as we age and how to prevent Alzheimer’s and lots o n the therapeutics on cannabis ( Can you believe it’s still Schedule 1 on level as ecstasy and heroin ?) REALLY?!!

Terrific conference .. I love focusing on what’s positive and possible !

There seems to be no end to this question. Cooking with the wrong oils could do the body harm as they are pro-inflammatory in nature. The confusion seems to be in the term vegetable oils. (eg. cottonseed, corn, grapeseed, safflower or sunflower oils).

Vegetable oils tend to be highly refined, comprised mostly from polyunsaturated fats. Such fats are prone to oxidation and free radical production. As a result, once ingested the process of inflammation begins.

We know that inflammation is the bane of our existence when it comes to aging. This can lead to heart disease, cancer and other degenerative diseases.

Why the American Heart Association (AHA) still endorses the use of these oils continues to elude me.  

What are healthy options?  Whole food sources such as nuts and seeds are a good choice, especially in the raw or unroasted state. Despite the ongoing controversy of saturated fat, such fats are generally healthier for cooking. They are more stable and less inflammatory. Also recommended  are extra virgin cold pressed olive oil for cooking at low temperatures. These are monounsaturated and moderately stable. I also favor avocado oil and macadamia not oil.

Natural oils are an excellent form of fat. Just be sure to avoid vegetable oils that are highly processed.

Read Original Article HERE

Having just attended Cedars-Sinai 's CONTROVERSIES & ADVANCES IN CARDIOVASCULAR DISEASE, I applaud the incredibly gifted presenters as well as everyone involved in making this 2 day symposium possible.

Lipids, cardiac imaging, heart failure,hypertension, coronary interventions,the latest devises , structural heart disease, gender differences as it relates to presentation, treatment and prognosis,genetic testing ,and the future of remote monitoring via smart phone or watch were among the topics discussed.

What I found most interesting was the discussion on some of the recent heart trials. Does a particular fish oil by Big Pharma really have a survival advantage in those with coronary disease ? Do these new generally unaffordable PCSK9 inhibitors make a difference in survival when compared to traditional cholesterol lowering meds like statins in those with known heart disease? How about the use of immunosupressive agents like methotrexate to combat inflammation and decrease progression in coronary disease?

Now being an integrative cardiologist practicing functional medicine, I must voice my disappointment that essentially nothing about diet, exercise and lifestyle interventions was included in these presentations.

For example,take this whole idea of inflammation.We all know it is the bane of our existence when it comes to aging. Why are we going straight to immunosupressive agents with all the attended side effects without even addressing the causes of inflammation and the potential of more natural remedies ?

Lets be real here. These trials are expensive to conduct. It's as if we are going straight to meds rather than encouraging our patients to practice prevention.

I am all for developments in medical technology, devices and drugs.But we need to see how a more functional approach can play a contributing role.

How important is salt restriction when it comes to heart health and blood pressure control? This topic comes to my attention more often than not, so here’s my take on the results of the recent PURE study.

                 Recently published in the prestigious journal THE LANCET, sodium consumption made little difference when it came to blood pressure control. That is unless we are talking about consuming more than six grams of sodium daily.    

It’s been assumed for years that any approach taken to reduce blood pressure will translate into fewer cardiovascular events such as heart attacks and strokes. However, the claim that salt plays a role in blood pressure control has never been proven. 

In this study the associations between sodium intake and cardiovascular events did not change when adjusted for age, sex and blood pressure, suggesting that sodium intake plays little role in event rate.

Interestingly, major cardiovascular outcomes decreased with increasing potassium intake. 

I don’t mean to imply that it’s ok to consume sodium to excess. Indeed there is a small population that may be truly salt-sensitive. But clearly they are in the minority. 

There are some inherent limitations of the PURE study. It is a large epidemiology study involving more than 130,000 subjects from 49 different countries. 

But one point is clear; eat your veggies! This study confirms the heart healthy benefits of eating fruits and vegetables 

Read Original Article Here https://www.medpagetoday.com/cardiology/prevention/74507?xid=nl_mpt_DHE_2018-08-10&eun=g565590d0r&pos=11&utm_source=Sailthru&utm_medium=email&utm_campaign=Daily%20Headlines%202018-08-10&utm_term=Daily%20Headlines%20-%20Active%20User%20-%20180%20days

I just completed my 3rd consecutive month of this 5 day plan pioneered by Dr. Valter Longo from USC. Although each round has had its challenges, this time around was clearly the best. Not once did I suffer any significant fatigue or brain fog. I amazed myself by maintaining my sense of propriety on day 2 when I was challenged by 2 social events where folks around me ate and all I did was sip herbal tea.

On days 3 and 4 I experienced true hunger pangs ,but they were manageable. Day 5 was clearly the highlight.I experienced new found energy and my work out at the gym did not falter one bit. I topped it all off today with my weekly ice bath!

BOTTOM LINE : Although not for everyone (and you should get the ok from your doctor), I am truly a believer in this diet.

I've reviewed the research. in 5 days what's possible is
* boosting stem cell renewal
* triggering cellular optimization through autophagy
* positively altering the biomarkers of aging

This is serious business. We all know that obesity has risen significantly over the past 15-20 years despite the high carb, low-fat craze that we witnessed in the 90's .Death from liver cancer is also on the rise. Hepatitis B and C were the former culprits but these can often be treated today. I say often because the cost is outrageous , and treatment may not be accessible to all who need it.

The major culprit today is non-alcoholic fatty liver disease.With the degree of obesity seen today, essentially related to bad dietary choices, the liver can't handle the load. Excessive carbs get converted to fat within the liver, and what's left gets dumped in the circulation as triglycerides.

This is what we see in metabolic syndrome and type 2 diabetes. Treating liver cancer is less than successful. The death rate is high. The truly sad fact is that this can often be prevented by diet, weight loss and exercise.

Read original article here: https://www.medpagetoday.com/hematologyoncology/othercancers/74072

As a cardiologist I continue to do all that I can to promote the heart health of my patients as well as myself.After all, heart disease remains the number one killer in the Western World.

But let's face it: who wants a healthy heart with a sick brain? Alzheimer's disease continues to rob us of a long and productive life. Traditional medicine has clearly been unable to put a dent in the treatment and prevention of this devastating disease. Medications by themselves will never be the magic cure or panacea simply because this disease is mutifactorial in extent and requires a multi-pronged approach to treatment.

In this article, integrative neurologist Dr. Pearlmutter talks about the importance of brain energetics. If the brain can't utilize glucose efficiently, it will eventually malfunction. Glucose is necessary for energy production and the brain ,which has to function 24/7 is an energy guzzler. But without insulin, glucose can't be transported to the brain.

But insulin can also be a problem. Insulin regulates glucose and fat metabolism as well as cell growth. Insulin resistance (which we see in metabolic syndrome and diabetes) can lead to the brain's unresponsiveness to the effects of insulin. This eventually can lead to memory deficits and a whole lot more when it comes to cognitive dysfunction.

Combating insulin resistance is where it's at. Lifestyle changes reign high here: lowering the carbs in your diet, increasing healthy fat as an energy source for the brain, along with weight loss and exercise.

Lifestyle changes remain the mainstay when it comes to preserving cognitive function. No medication can do as good a job.

Read original Article here: https://www.drperlmutter.com/energy-medicine-fundamental-in-alzheimers/?inf_contact_key=cec6d4946c2899f45696f960a9db93995f64993ca6005c5858be052662fe2872

We all know how important exercise is when it comes to heart health. I've been touting this for years ,before the American Heart Association (AHA) elevated physical inactivity as important a risk factor as smoking, high blood pressure and elevated cholesterol. We also are well aware of the perils of the air we breathe.

Well, this may come a surprise : a recent Danish study comprised of over 50.,000
subjects showed that exercise decreases the risk of first and recurrent heart attacks regardless of air quality.

Great news. Again the power of exercise reigns. But I would caution exercising in heavily polluted areas. Air pollution in itself is a cardiac risk factor.

Besides ,how can you compare the air quality of Copenhagen with that of Los Angles or New Your City ?!