New England Health Advisory

My husband’s family in Ireland is an adherent of the Irish temperance movement known as the Pioneers. So it was a surprise to find his Uncle Miah sipping an Irish whiskey after dinner at his house in County Cork. “Doctor’s orders,” he said with a sheepish shrug. Miah had suffered a heart attack a few months earlier, and his doctor suggested an after dinner dram of whiskey would be good medicine.

That’s not just Blarney. More than 60 separate studies find that drinking alcohol in moderation is good for your heart. And the good news doesn’t end there—moderate drinking is connected to lower risk of Alzheimer’s disease, diabetes and stroke, as well as weight loss. One Tuscan study even linked light to moderate red wine drinking to improved sexual function in women.

Scientists are still unraveling the reasons why drinking can be good for you—everything from the alcohol itself to its concentration of antioxidants may be the reason. Or it may even be some complex interaction of many different components. Some conflicting research says the same benefits can be had from grape juice, while other studies find that’s not the case. There is even some evidence to suggest that moderate drinking can slow declines in cognitive function brought on by old age. But on the other side of the coin, heavy drinking has been linked to a faster decline.

The Antioxidant Theory

A lot of research about alcohol’s benefits has focused on antioxidants, present in sizable amounts in certain kinds of alcohol, including whiskey, red wine and darker beers, and to a lesser amount in lagers and white wine. Antioxidants are thought to protect cells from free radicals—potentially harmful molecules your body produces when breaking down food or in reaction to environmental exposures like tobacco smoke and radiation. Scientists say free radicals can damage cells, and may play a role in heart disease and cancer, among other diseases.

Resveratrol, a particular type of antioxidant present in red wine, has been much discussed for its apparent ability to reduce inflammation in the arteries. It may have other important functions as well. New research on mice published in the July issue of the American Journal of Pathology links resveratrol to a shrinkage of abnormal blood vessels in the eye, yielding a promising breakthrough in dealing with leading causes of blindness. However, since the dose given to mice would be the equivalent of several bottles of wine, it would likely be given in pill form.

The Mediterranean Connection

While numerous studies, including a recent one done by French scientists at the Center for Cardiovascular Disease Prevention, point to better overall health among moderate drinkers, most researchers admit that the drinking may be a signifier of an overall healthier lifestyle, rather than a cause itself.

Much fuss was made, several years back, of the inclusion of wine in the so-called Mediterranean Diet, but it was important to note that the diet is low in saturated fat and high in whole grains and fruits and vegetables—all things that we know lead to better overall health.

The French study, published in the European Journal of Clinical Nutrition, questioned nearly 150,000 Parisians about their drinking habits, then subjected them to a battery of tests.

Moderate drinkers of both sexes were found to have low body mass index, heart rate, good blood sugar levels, lower “bad” cholesterol and higher “good” cholesterol. Men also showed lower stress and depression scores. Further, moderate and low drinkers displayed better health status than did the never-drinkers. Researchers concluded that “moderate alcohol consumption may represent a marker of higher social level, superior health status and lower cardiovascular risk.”

Moderation is Key

The key to realizing better health through drinking alcohol, as in so many things in life, is moderation. A study published in the New England Journal of Medicine linked drinking as little as the equivalent of a half glass of wine, three to four days a week, to a sizable reduction in risk for heart attack. Drinking more didn’t improve health further, and it didn’t matter what type of alcohol (wine, beer, whiskey, etc.) was consumed.

Currently, the U.S. government defines moderate drinking as one 12-ounce beer, a five-ounce glass of wine or 1.5 ounces of liquor per day for a woman and up two drinks per day for a man. Each of these servings has about the same amount of alcohol and the same number of calories. The National Institutes of Alcohol Abuse and Alcoholism recently released new guidelines expected to be adopted by the U.S. government, defining low-risk drinking as no more than seven drinks a week for women and fourteen for men, with no more than three drinks in any one single day for women and four for men.

Dangers of Heavy Drinking

For all the beneficial effects scientists have determined can be gained through moderate alcohol consumption, this is one area where you can definitely have too much of a good thing.

Many studies link excessive alcohol consumption to cancer—particularly breast, liver and colon cancer—and stroke, among other health problems. And for those who cannot restrict their consumption to moderate drinking, the dangers of excessive drinking far outweigh the possible benefits. Excessive drinking is also implicated in unintentional injury from car accidents, falls and drowning.

Experts advise enjoying your drinks with food—never on an empty stomach—and drinking slowly to avoid intoxication. Of course, you should never drink alcohol if you’ll be driving, and double check that any medication you are taking is safe to be consumed with alcohol.

Odds are prescribing a drink a day won’t be the first thing your doctor thinks of to combat heart disease. But if you’re like Uncle Miah, it might be worth exploring with your physician. If you already enjoy a few drinks a week, relax. And as they say in Ireland when posing a toast, Slainte, which means good health!

Yours in health,

Jeanne O’Brien Coffey
Contributing Editor
New England Health Advisory

Do you have a healthy heart?

I ask myself that question all the time because heart attacks have killed the last three generations of men in my family. All died in their mid-50s when you would have thought life was just beginning.

But it’s just not my family, it’s many families. According to the Centers for Disease Control and Prevention, cardiovascular disease kills 950,000 Americans every year. Millions more live disabled lifestyles caused by heart conditions—tired, out of breath and fearful of the slightest chest pain.

The question is, what can we do to avoid this fate?

You often hear that you should eat well and get plenty of exercise. But what does that really mean?

What foods should you stay away from and what should you eat? What type of exercise is best for heart health?

Our contributor Dr. Al Sears concisely answers these questions in his book “The Doctor’s Heart Cure.”  He discusses how dietary cholesterol is not our enemy—it’s the starches we eat that hurt us. Dr. Sears also discusses how long, low-intensity “cardio” exercise actually breaks down the reserve strength of our hearts. Instead, Dr. Sears advocates resistance training and interval training.

Please click here to empower yourself against the lightning fast and deadly strike of a heart attack or stroke.

Yours for health and wellness,

Andrew Palmer
Publisher
New England Health Advisory

P.S. Personally, I’m willing to do whatever it takes to prevent a heart attack, so I live see my grandkids. How about you?

Please click here to put an end to your worry … for good!

By Inger Pols

A friend of mine called me recently and said she’d read an article about a really important test to assess your wellness and she was concerned because she had gone through her records and found that her doctor had never given her that test. She was wondering whether she should demand the test or change doctors.

When she told me the article was about homocysteine, I knew she had read that high levels of homocysteine in the blood are reliable risk factors for heart attack, stroke, diabetes, cancer, neurological conditions such as Alzheimer’s and Parkinson’s, thyroid concerns, infertility, depression, digestive disorders and chronic pain.

And I also understood why she had not been tested; most doctors do not test for homocysteine levels for several reasons … and I’ll get to them.

But first a little info on what homocysteine is and why it matters.

What is Homocysteine?

Homocysteine is an intermediary amino acid. Amino acids are the building blocks of protein, which control virtually all cellular processes. There are 20 essential amino acids that the body needs to function: 10 of which the body can make, and 10 of which must come from our diets.

Homocysteine is not one of those essential 20. It is made from another amino acid called methionine, which is one of the essential amino acids we must get from food. We get it mainly through protein-rich foods like fish, eggs and sunflower seeds.

Now, the next five paragraphs are going to get a little science-heavy, so those not inclined to textbook reading can jump ahead to the next section.

During what’s called the methionine cycle, methionine is converted to a substance known as S-adenosylmethionine (SAMe). SAMe performs an important function in its ability to donate methyl groups as needed during chemical processes throughout the body. When SAMe donates its methyl group, homocysteine is synthesized. Scientists would say the SAMe has been methylated, which means it has lost a methyl group. This is important because the methylation process regulates gene expression, protein function and RNA metabolism.

All homocysteine in the body is created during this methionine cycle and most of it ends up bound to plasma and stored. But it can be released into the bloodstream when changes occur in the body’s biochemistry that are not ideal. So high levels of homocysteine are linked to a variety of specific health problems.

Once homocysteine is released into the bloodstream, one of two things can happen to metabolize it. First, it can be remethylated back into methionine. This process requires folic acid (folate), vitamin B12, vitamin B2, zinc, magnesium and TMG (or trimethylglycine) from choline. Most of the body’s homocysteine goes this route, known as the remethylation pathway, which creates more SAMe to support further healthy methylation.

The other possible option for the homocysteine is that it can be used to create cysteine, which is then converted into glutathione, a powerful antioxidant. When the body is under oxidative stress, this conversion process, known as the transsulfuration pathway because it produces sulfate byproducts, can be accelerated. The sulfate products are normally flushed from the body through urination. This pathway requires B6, B2 and zinc for proper function.

Both SAMe and glutathione benefit the body in important ways (glutathione is an anti-aging, antioxidant, detoxifying agent and SAMe has been shown to effectively treat depression, osteoarthritis and liver disease and it affects our cells’ ability to grow and function properly), so we want our bodies to be able to convert homocysteine efficiently. When the conversion process goes awry, homocysteine levels in the blood will increase.

The Dangers of High Homocysteine Levels

High homocysteine levels have been shown to increase free radical oxidation in the body, and the damage that goes along with them. This can accelerate aging. High homocysteine levels can also damage artery walls in one of several ways: They can contribute to atherosclerosis, or thickening of the artery walls; they can increase the likelihood of your blood clotting, potentially leading to a stroke; and they can lower the nitric oxide in your blood. Nitric oxide plays a critical role in healthy and flexible artery wall maintenance.

High homocysteine levels also affect your immune system, since weakened conversion processes to glutathione means less glutathione will be present and less antioxidant protection will be available to the body.  And high homocysteine levels promote higher levels of two chemicals the body uses to promote inflammation, arachidoic acid and prostaglandin E2 (PGE2). As we learned in the cholesterol article, inflammation is a necessary and healthy part of our normal body function. But chronic inflammation can cause permanent damage to systems and tissues such as nerves, joints, and arteries and can also result in chronic pain.

Because of the concern about inflammation and its effect on antioxidation, some argue homocysteine is a marker for a higher risk of most every chronic condition, including cancer. At a minimum, when homocysteine levels are high, we know that something is wrong inside the body and some important process is not functioning as it should. If homocysteine is such an important indicator, why aren’t we hearing more about it?

There are a number of reasons. First, the test is relatively expensive and is rarely covered by insurance. As a result, it’s not readily available. Another reason is that there are currently no patented drugs for lowering homocysteine levels, so pharmaceutical companies have no interest in contributing to the marketing, which is how most medical conditions gain attention today. Another reason not to test is that some doctors don’t know what to tell their patients if the test comes back high; without a drug to prescribe, the only answer is to change your diet and/or lifestyle, something not every physician is comfortable tackling in a brief office visit.

If your doctor does decide to test you, which typically only occurs with cardiologists working with high-risk heart patients, you’ll want to see a score of below 8.9 units. (lower is better). In between 9 and 19.9 units, your risk of dying a premature death from a chronic condition or degenerative disease will increase from significant to extremely high.  If the reading is over 20 units, you risk a heart attack or stroke at any moment.

The Prescription: Change Your Diet

So, as I told my friend, for most people who appear reasonably healthy, there’s no need for the test.  But whether you are tested or not, if you would like to improve your homocysteine levels, the prescription is clear: Change your diet. Eat mainly healthy fats and oils like omega 3s and avoid bad fats like trans fats. Increase your consumption of vegetables: Try to get half of your calories from vegetables, especially dark leafy green ones! Make sure your protein sources are high quality ones like organic eggs, wild fish, legumes and small amounts of nuts and seeds.

Look to ensure that your diet is rich in folate, vitamins B12, B6, B2, zinc and magnesium. (If you eat as above, it should be. If not, supplement with a whole food supplement.) A greens superfood powder or pill may also be helpful if you find your diet lacking. And work to reduce stress, a known pro-inflammatory.

A special note to vegetarians and vegans: while generally it is stated that high homocysteine levels result from a diet too heavy in meat and too light in vegetables, studies have shown that many vegans and vegetarians have high homocysteine levels. One study showed vegans to have 50% higher homocysteine levels and vegetarians to have 30% higher homocysteine levels than their omnivore counterparts. This is because their bodies lack the B12 required for the conversion processes. (B12 is typically found in animal protein.)

Vegetarians were found to have 37% less (and vegans 59% less) B12 than the omnivore group, enough to constitute clinical deficiency in 78% of the vegans and 26% of the vegetarians. The study also showed that people eating vegan and vegetarian diets lacked the essential amino acid methionine because the levels in plants are lower than those found in meat. Vegetarians—and especially vegans—need to consider adding B12 to their diets through injections, sublingual (under tongue) or spray B12 supplements.

Homocysteine may not yet be fully understood, but its importance is definitely being recognized. If you are a high risk for heart concerns, you may want to push for a homocysteine test. But because the prescription will be to change your diet, you may want to consider making some of those changes, whether you are tested or not.

To your health!

Inger Pols
Editor of New England Health Advisory

By Al Sears. M.D.

With a simple test I can tell you if you’re likely to have a heart attack or stroke.

I can also give you a remedy to help make sure you never do – no matter how high your risk is…

The test checks for levels of homocysteine. It’s your number one indicator of heart disease.

The big drug makers play down the importance of this critical factor. They haven’t figured out a way to make any money from it, so they try to convince you that it doesn’t matter.

Turns out knowing your homocysteine level is even more useful than we thought. Homocysteine can foretell a host of other diseases as well.

And here’s the good news: It’s easy to keep your level low.

Homocysteine is a naturally occurring amino acid. But too much of it irritates the lining of your blood vessels and prevents them from dilating. This increases your risk of heart attack and stroke.

One study found that levels of homocysteine were dramatically higher in men who died from heart attacks. They discovered that men with high levels were four times more likely to suffer a fatal heart attack than those with lower levels.1

In Norway, doctors studied men with heart disease for six years. Again, they found that those with high levels of homocysteine suffered the highest number of heart attacks. The higher their levels, the lower their chances of surviving.2

But their most startling discovery is that homocysteine levels are your strongest predictor of death. More so than any other measured factor, including cholesterol.

High levels of homocysteine can also alert you to other problems and potential diseases including:

• Kidney disease
• Acute Lymphoblastic leukemia
• Rheumatoid arthritis
• Depression
• HIV/AIDS
• Psoriasis
• Hypothroidism
• Gout
• Systemic Lupus Erythematosus, (SLE)
• Cancer

As you can see, many of these conditions don’t have a direct link to heart disease or stroke. Yet my own experience backs up the evidence.

The connection between high homocysteine and an underactive thyroid is also critical. Many times doctors fail to recognize thyroid problems. The result can leave patients with fatigue, migraines and depression.

The irony is that you can easily manage your homocysteine. A simple blood test will tell you if you have high homocysteine levels. I like to keep my patients’ levels at 7 or below.

I have not had a single case of elevated homocysteine that couldn’t be corrected with the right combination of natural supplements.

Here’s what I use with my patients. (Amounts are daily.) You can find these at your local health-food store:
•    Vitamin B12 – 500 mcg
•    Folic acid (B9) – 800 mcg
•    Vitamin B6 – 25 mg
•    Riboflavin (B2) – 25 mg
•    TMG (Trimethylglycine) – 500 mg

To your good health,

Al Sears, M.D.
Bibliography:

1.    Wald NJ, et al. Homocysteine and ischemic heart disease: results of a prospective study with implications regarding prevention. Arch Intern Med. 1998; 158:862-7.
2.    Nygard O, et al. Plasma homocysteine levels and mortality in patients with coronary artery disease. New England Journal of  Medicine, 1997, 337:230-6.

If you ate chocolate on Valentine’s Day or Easter, I have some news for you. You don’t have to feel guilty.

In fact, I have evidence that you may have cut your risk from dying of a stroke nearly in half.

Two studies give us great news about chocolate.

The first study found that people who ate one serving of chocolate per week were 22% less likely to have a stroke.1

The second study found that people who ate 50 grams of chocolate once a week were 46% less likely to die following a stroke than those who didn’t eat chocolate.2

About 80% of strokes occur when there isn’t enough blood getting to the brain.3 Your brain is starved of oxygen and nutrients and begins to die immediately.

Chocolate helps to counteract that in two ways. It’s rich in antioxidants and helps to increase circulation.

You may get a rush of pleasure when you bite into a piece of chocolate. But chocolate gives you more than instant gratification. Chocolate is filled with antioxidants called flavonoids. Flavonoids protect the body.

Flavonoids fight silent inflammation, which is the leading cause of chronic diseases such as cancer, heart disease, stroke, dementia, and many others.4

You can find flavonoids in vegetables, tea, and red wine, but cocoa has more flavonoids.5 In fact, dark chocolate contains up to four times the antioxidants found in tea.6

But that’s not all this Valentine’s Day treat can do.

The flavonol-rich cocoa in chocolate is also a vasodilator.7 It widens blood vessels so circulation is improved. This brings an increased blood flow to the brain. It helps to lower blood pressure and improve heart function. Vasodilators like the cocoa in chocolate also help to increase circulation to sexual organs so they’re ready to respond when you are.

No wonder the scientific name for cocoa translates to “food of the gods.”

When you’re looking for a good source of chocolate, keep this in mind:

•    Look for chocolate that contains 70% or more cocoa. This is the ingredient that contains health benefits.

•    Check how much sugar is added to the chocolate you choose. Keep it as low as possible. But choose sugar over artificial sweeteners or chocolate labeled “sugar free.”

•    Beware of other chemicals in the chocolate. Choose a brand that has pure ingredients and no chemical additives.

•    Make chocolate your special treat of choice once a week.

•    You can find good quality chocolate at a health-food store. More and more it’s finding its way into grocery and drug stores. Read the label to be sure of the quality and content.

To your good health,

Al Sears, M.D.

Contributor to New England Health Advisory

1.    “Can Chocolate Lower Your Risk of Stroke?” American Academy of Neurology. www.aan.com. Accessed 02 2010.
2.    Ibid.
3.    “Causes of Strokes.” http://www.mayoclinic.com/health/stroke/DS00150/DSECTION=causes.
4.    Wang, J.F., Schramm, D. D., et al. “A Dose-Response Effect from Chocolate Consumption on Plasma Epicatechin and Oxidative Damage,” Journal of Nutrition. 2000;130:2115S-2119S.
5.    Ki Won Lee, KW., Kim, YJ., et al. “Cocoa Has More Phenolic Phytochemicals and a Higher Antioxidant Capacity than Teas and Red Wine” J. Agric. Food Chem. 2003; 51(25):7292–7295.
6.    I.Arts, P.Hollman, D.Kromhout “Chocolate as a source of tea flavonoids,” The Lancet. 354; (9177): 488-488.
7.    Fisher, N., Hughes, M., et al. “Flavanol-rich cocoa induces nitric-oxide-dependent vasodilation in healthy humans,” Journal of Hypertension: 2003. 21; (12):2281-2286.