Cardiovascular Disease and Food

If you have high cholesterol also see healthy eating for high cholesterol.

To Lower LDL ‘bad’ cholesterol
– Decrease total fats in diet
– Decrease cholesterol in diet
– Increase essential fatty acids
– Increase fibre (especially oats and psyllium husk)
– Increase complex carbohydrates
– Decrease caffeine and nicotine
– Supplement nutrients: Vitamin B3, B6, B12, C; chromium; EPA & GLA; garlic; red rice yeast.

To Increase HDL ‘good’ cholesterol
– Get regular aerobic exercise
– Do not smoke
– Decrease body weight
– Supplement nutrients: essential fatty acids; niacin; EPA, fibre and L-carnitine.

Risks of CVD include high blood pressure, high cholesterol (especially high LDL levels), high triglyceride levels, and obesity, as well as some cases of diabetes. High fat consumption, low fibre intake, high cholesterol and excess sodium intake are influential nutritional risks. Non-diet risks include smoking, stress and lack of exercise. Proper diet alone can decrease cholesterol levels by 30% or more. It is clear that a diet high in saturated fats and cholesterol leads to increased blood cholesterol levels and increased atherosclerosis. It takes dedication, and sometimes a complete lifestyle change, to make these changes.

Fats
The primary dietary focus for preventing CVD is reducing fat intake. The diet should be low in fat and particularly low in:
– saturated fats (especially animal fats, including dairy)
– hydrogenated/partially hydrogenated fats (margarine and most packaged refined foods), and
– poor quality oils, especially when heated in cooking.

Fat intake should be reduced to a maximum of 20% of total calories. This is not easy because it includes all fried foods, meats,dairy products, eggs, nuts, and seeds, which also clearly reduces protein intake. Supplementing with essential fatty acids,and using good-quality cold-pressed vegetable oils (poly/monounsaturated); and avoidance of many of the less healthy fats is best, such as refined cooking oils and hydrogenated fats like margarine.

Particularly helpful oils are contained in deep sea cold water fish such as salmon, tuna, mackerel, sardines, and herring. These contain EPA (eicosapentaenoic acid) and DHA (dicosahexaenoic acid), which have a positive effect on lowering cholesterol and triglycerides. Consuming these oily fish two or three times a week has been proven be beneficial.

To prevent atherosclerosis, a diet low in cholesterol and high in fibre is recommended. Fibre reduces CVD risk by binding cholesterol and fats and passing them out of the body, therefore reducing their absorption and subsequently decreasing blood cholesterol and LDL. Increased fibre levels can also help to reduce blood pressure levels. Oats has been shown to help reduce cholestrol levels, and reduce weight in those who suffer from obesity.

In addition, a low-salt and low-sugar diet is also suggested. Excess sugar causes an increase in calories, weight, and blood fats, and is a direct risk factor in CVD. More complex carbohydrates, including whole grain and vegetable foods, are important for CVD prevention.

Dietary Suggestions to Reduce CVD Risk
– Eat more fruits and vegetables, and leave skin on.
– Eat more whole grains, legumes and beans.
– Fat intake no more than 25% of the diet.
– Reduce cholesterol intake to less than 300 mg per day.
– Reduce consumption of eggs to about three per week.
– Minimise use of whole milk and dairy products.
– Avoid red meats, eliminate all cured/processed meats, chicken can be eaten occassionally but without skin.
– Eat more deep sea cold water fish.
– Use fresh, cold-pressed oils, such as olive or flaxseed, to provide the essential fatty acids, and do not heat oils.
– Replace snacks with low fat foods such as corn thins, rice cakes, Finn crisp or ryvita.
– Add oat bran to cereals and use whole grain cereals in place of sugary ones, such as oats.
– Substitute ice-cream for fruit juice ices.
– Use low-fat cheeses such as cottage cheese or ricotta.
– Increase salads in summer and veggie soups in winter.
– Consume cookies and treats with no saturated fats and lower/no sugar content, sweeteners can include dried fruit, xylitol or stevia, or fruit-juice-sweetened sweets.
– Include garlic in your food, it has a cholesterol lowering effect, as do onions, ginger and cayenne pepper.
– Soybeans and soy products such as tofu, tempeh, miso and soy lecithin may have a positive effect on cholesterol and atherosclerosis; and are low in fat and high in protein.
– Millet and buckwheat, okra, asparagus, apples and bananas, red rice yeast, and flaxseed (linseed) oil may reduce cholesterol.
– Ground flaxseeds are a good source of soluble fibre and essential oils and may help reduce blood fat levels and fatty deposits.

Vegetarian Diet

Vegetarian diets typically lack protein, iron, calcium, zinc, vitamin B12, and possibly vitamin D, but are high in fibre, complex carbohydrates, and nutrient rich. If the vegetarian diet is composed mainly of whole grains, legumes, beans, vegetables, fruits, nuts and seeds then it will provide all the nutrients a vegetarian needs.

Protein
Vegetarians who include eggs and milk products in their diet can meet most nutrient requirements, especially protein. The protein of whole grains, legumes, seeds, nuts and vegetables can provide adequate amounts of all the amino acids, but should be combined appropriately in order to obtain a complete protein. Please see protein combining for more information. 50 g of protein should be consumed daily. Milk, cheese, butter and eggs are complete proteins so can be consumed alone.

Iron
Those who do not eat meat should pay close attention to their iron intake, especially women who are in their menstruating years. The iron in legumes, cereals, fortified cereals and whole grains is not readily absorbed. Iron absorption is enhanced by vitamin C. Requirements are 15 – 20 mg per day. Other sources are: dried beans, dried fruit, spinach, chard, beet greens, blackstrap molasses, prunes and legumes. Cooking in iron cookware increases iron intake. For further reading click on the following links iron deficiency or sources of iron.

Calcium
Vegetarians who do not consume eggs and milk products are at risk of deficiency. Calcium is especially important for children and post-menopausal women. Calcium is found in nuts, broccoli, tofu, soybeans, molasses, all dairy products, seeds especially sesame seeds, tahini is a high source of calcium. Calcium fortified soy milk can help to increase levels. Sources of calcium contains more information on calcium absorbtion and foods.

Zinc
Meat is one of the riches sources of zinc, and unfermented soy products can interfere with zinc absorption, hence vegetarians are often low in zinc. Requirements per day are 20 – 25 mg. It becomes necessary for vegetarians to consume a variety of nutrient dense foods rich in zinc such as legumes, e.g. black eyed peas, pinto beans and kidney beans. Zinc can also be found in pumpkin and sunflower seeds, mushrooms, fermented soy products, and eggs also see sources of zinc .

Vitamin B12
Vitamin B12 is mainly found in animal products, so is present in dairy products and eggs. Some plant foods contain traces of B12 but usually as a B12 analogue that cannot be absorbed by the body, so supplementation may be necessary. Tempeh, miso and brewers yeast contain small amounts of B12, and some seaweeds such as kombu, wakame, kelp, alaria, dulse and nori, and spirulina, chlorella and wild blue green algae (these also have a high amino acid profile, that is – a high protein content).

Vitamin D
This is not such a problem in South Africa because we have adequate sunshine, exposure to sunlight helps the synthesis of vitamin D in our bodies. Vitamin D may be lacking in climates where there is less sunshine. If you are vegetarian and do not like the sun then you may well be deficient as the most common food sources are contained in animal products, click on the following link sources of vitamin D for some options.

Hippocrates

A wise man should consider that health is the greatest of human blessings, and learn how by his thought to derive benefit from his illnesses.

Herbal Actions and Uses

Herb Action Uses
Astragalus
Astragalus
membranaceus
Immune stimulant, adaptogen tonic, increases vitality, cardio tonic, hypotensive, diuretic Debility, sweating – caused by debility, low immunity, chronic viral and bacterial infection esp. if debilitating (e.g. CFS), chronic autoimmune disease, high blood pressure, organ prolapse
Barberry
Berberis vulgaris
Stimulating bitter, digestive tonic, liver stimulant, spleen tonic, cholagogue/ choleretic, purgative, anti microbial  Debility, poor digestion, history of unresolved infection, dietary/alcohol abuse, excessive exposure to drugs/ toxins/chemicals, splenic enlargement, malaria, biliary, GIT infections, gall bladder problems
Burdock
Arctium lappa 
Alterative, bitter digestive tonic, cholagogue/choleretic aperient, diuretic, anti rheumatic Chronic skin conditions – eczema, psoriasis, dandruff when dry and scaly, acne, boils; chronic inflammatory conditions – arthritis, gout, cystitis, digestive disturbance
Centella/Gotu cola
Centella asiatica
Adaptogen, restorative, rejuvenative,
gentle adrenal stimulant and tonic, relaxant, bitter digestive stimulant, alterative, anti rheumatic, anti arthritic, dermatic, revitalises brain and nervous tissue, improves concentration
Debility, mental fatigue, digestive disturbance, neurological and mental disturbance, insomnia, anxiety, epilepsy, senility, rheumatic and inflammatory diseases, chronic skin diseases, eczema, psoriasis, leprosy, syphilis
Damiana
Turnera diffusa
Nerve tonic and restorative, mild stimulant, anti depressant, aphrodisiac, trophorestorative, tonic to male reproductive system, hormonal regulator Depression, debility, impotence, nervous system problems connected to sexual organs, neuralgia, puberty, nervous dispepsia, atopic, constipation 
Dandelion
Taraxacum officinale
Bitter digestive, hepatic tonic and stimulant, cholagogue/choleretic, aperient, stomachic, anti rheumatic, anti arthritic, detoxifier Liver congestion, constipation, jaundice, hepatitis, cirrhosis, gall stones, general toxic conditions, chronic skin and joint inflammation – gout, arthritis, rheumatism
Dong Quai
Angelica sinensis
Blood stimulant ‘makes better blood’,
menstruation corrective, emmenagogue, analgesic, female reproductive tonic, antispasmodic, anti inflammatory, alterative, sedative
Menstruation problems – painful, irregular, scanty periods, some pre-menstrual symptoms, infertility, blood stagnation, palour, cold, debilitated

Echinacea
Echinacea angustifolia/purpurea

Immune enhancing/stimulating, (increases T cells, macrophages, phagocytes) antiviral, antibacterial, antiallergic (long term), anti inflammatory, anti neoplastic, lymphatic alterative Infections (immune responsive high with continued use), immune system deficiency, post viral syndrome, rheumatoid arthritis, SLE, allergies intolerance’s, chronic respiratory catarrh, skin disorder, psoriasis, septic and infected conditions, i.e. boils, tonsillitis
Gentian
Gentiana lutea
Bitter tonic, tonic to stomach, digestive stimulant, sialagogue, cholagogue/ choleretic, stomachic, anti inflammatory Sluggish digestion, flatulence, stomach pain, heart burn, reflux, anorexia, loss of appetite, painful feeling of fullness,
intestinal and gastric inflammations,
liver and gall bladder diseases,  
Ginseng (Siberian)
Eleutherococcus senticosus
Stimulating adaptogen, adrenal tonic, antispasmodic, anti rheumatic, circulatory stimulant, peripheral vasodilator, amphoteric to blood sugar and pressure, hypocholersterolaemic Exhaustion, stress, debility, poor circulation, high and low blood pressure and sugar, high cholesterol, atheroscloerosis, depression
Ginseng (Korean)
Panax ginseng
Stimulating adaptogen. adrenal tonic, central nervous system stimulant, mood enhancer, immune stimulant, hepato protective, cardio protective Short term use for increased performance, functional adrenal exhaustion (Addison disease), angina, some chronic recurrent infections 
Golden seal
Hydrastis canadensis 
Stimulating bitter tonic, astringent to mucous membrane, hepatic stimulant, cholagogue/choleretic, laxative, spleen tonic, immune stimulant Mucous membrane problems in GIT, gastritis, colitis, reactive diarrhoea/ constipation, jaundice. Respiratory tract – catarrhal conditions, bronchitis. Reproductive system – vaginitis, menorrhagia, post-partum haemorrhage.
Urinary tract – cystitis, urethritis
Nettle/stinging nettle
Uritca dioica
Alterative, diuretic, anti rheumatic, nutritive tonic, astringent, galactogogue, amphoteric to blood level and sugar level  Skin diseases – eczema, psoriasis, urticaria, rheumatism, arthritis, gout, cystitis, debility, fatigue, convalescence, anaemia, high or low blood pressure or sugar, diarrhoea
Psyllium
Plantago psyllium/ ovata  
Hydrophilic bulking agent, bulking laxative with lots of water, astringent with smaller amount of water, demulcent, healing to gut wall Sluggish/irritable bowels, bowel disease, inflammatory bowel disease, chronic constipation (with fluid), diarrhoea (low fluid), gastritis, ulcers
Red clover
Trifolium pratence
Alterative, expectorant, diuretic, antispasmodic, nervine, hormonally active, anti neoplastic Skin conditions, eczema, bronchitis, coughs, pertusis, insomnia, restlessness, menopause
Sarsaparilla
Smilax spp.
Alterative, diuretic, anti rheumatic, anti pruritic, tonic to liver and lymphatics, reproductive tonic, antispasmodic Chronic inflammatory diseases, eczema, arthritis, rheumatism, rheumatoidal arthritis, debility, reproductive disorders (male and female), genital herpes
Withania/Ashwaganda
Withania somnifera
Tonic adaptogen, sedative nervine, anti inflammatory, anti anaemic (in high doses), anti tumour Debility, nervous exhaustion, convalescence, chronic inflammatory diseases, sexual disfunction
due to exhaustion, emaciation, anaemia,
cancer prevention, stress
Wormwood
Artemisia absinthium
Bitter and aromatic digestive tonic, hepatic, stomachic, calminative,
antimicrobial, ant parasitic, anthilmintic,
anti inflammatory, abortifacient
Slow digestion, flatulence, bloating, infections and infestations of GIT, low energy from poor digestion, low appetite, headache, menstrual irregularities
Yellow dock
Rumex crispus
Alterative, hepatic, bitter digestive tonic, cholagogue/choleretic, aperient or laxative (dose dependent), anti-pruritic, anti rheumatic, astringent, iron tonic Skin complaints – weeping/oozing and itchy from constipation/liver dysfunction, eczema, acne, jaundice, sluggish bowel, constipation, liver congestion, arthritic and rheumatic conditions, anaemia

Vitamin C – Ascorbic Acid

Essential role in human nutrition, controversy as to how much we need, but definitely needed, works as an antioxidant. Manufactures collagen, improves immune function, absorption and utilisation of other nutrients. Better absorbed if take with bioflavonoids. (Murray 2001)

Deficiency Signs and Symptoms
Scurvy – bleeding gums, poor wound healing, bruising, increased susceptibility to infection, hysteria and depression.

Naturopathic Dosage Range

500 mg maintenance.
1000 mg every three or four hours up to ‘bowel tolerance’ (usually about 5000mg) during infection or disease.

Main Uses
Asthma and allergies – generally low in asthma and allergy, improvement in symptoms, protective against oxidative damage, lowers histamine levels.
Cardiovascular disease – reduces risk of death from heart attack and stroke, strengthens arteries, raises HDL, inhibits platelet aggregation, prevents LDL from being oxidised (especially in smokers).
Immune system – infection rapidly depletes the normal high levels of vitamin C in white blood cells (especially lymphocytes). Enhances white blood cell function and activity, antibody responses and levels, secretion of thymic hormones. (Braun and Cohen 2005)
During stress vitamin C is excreted at an increased rate.
Cancer prevention and treatment – against most forms including lung, colon, breast, cervix, oesophagus, oral cavity and pancreas. Antioxidant, protects DNA from damage, enhanced immune function, able to deal with environmental pollution better.
Common cold – reduced severity of symptoms and duration.
Diabetes – insulin facilitates transport of vitamin C into cells so many diabetics have low level.
Fertility – increased sperm count.
Skin ulcers and wound healing – reduced incidence and increased healing time.
Pregnancy related conditions – reduced pre-eclampsia and premature rupture of membranes, capillary fragility.

Safety

Very safe in most people. If taking high dose then reduce gradually. 

Para aminobenzoic Acid (PABA)

Also a B vitamin, part of the folic acid molecule. Readily available in food and made by bacteria in intestines. Aids in metabolism/utilisation of amino acids. Nourishes hair. (Haas 1999)

Food Sources
Liver, brewers yeast, wheat germ, whole grains, eggs, molasses.

Deficiency

Uncommon, possible with antibiotic use or drugs that alter function of intestinal bacteria. Fatigue, irritability, depression, nervousness, headache, constipation, digestive system problems.

Dosage Range

50 – 100 mg

Main Uses
Used with biotin, pantothenic acid and folic acid for hair. Used in sunscreen, to prevent and treat sunburn. Combined with vitamin E to burns. Vitiligo orally or topically.

Safety
High doses irritating to liver – nausea, vomiting, anorexia, fever, skin rash, vitiligo.

 

Vitamin B12 – Cobalamin

Works closely with folic acid in the body for many processes including synthesis of DNA, red blood cells and the myelin sheath. The stomach secretes intrinsic factor (IF) to absorb the small amounts of B12 found in food.

Deficiency

Stored (even though water soluble), in liver kidney and body tissues. May take 5 – 6 years before deficiency signs show due to low diet intake, or lack of IF. Pernicious anaemia, impaired nerve function causing numbness, pins and needles or burning, depression in the elderly. Smooth, red tongue and diarrhoea. Common in vegans. (Murray 2001)

Dosage
Vegetarians 100 mcg daily

Main Uses
AIDS – deficiency often present, in vitro B12 reduces HIV replication.
Impaired mental function – senility, Alzheimer’s, where there is deficiency.
Asthma – improvement in symptoms where related to sulphite sensitivity.
Depression – increase in deficiency especially in elderly. (Braun and Cohen 2005)
Low sperm count – because reduced cellular replication, also improves sperm motility.
Multiple sclerosis – usually low, demylination of nerve fibres.
Tinnitis – stabilises neural activity.

Safety
No side effects reported.

Vitamin B6 – Pyridoxine

Necessary for more than 60 enzymes in the body. Multiplication of cells, so important during pregnancy, and for immune system, mucous membranes, skin, and red blood cells. Manufacture of amino acid neurotransmitters (serotonin, dopamine, melatonin).

Deficiency Signs and Symptoms
Depression, convulsions (especially in children), anaemia, impaired nerve function, cracking of the lips and tongue, seborrhoea or eczema.
Antagonists: hydrazine dyes (FD&C yellow), oral contraceptives, alcohol, excessive protein intake.

Naturopathic Dosage Range
50 – 100 mg

Main Uses
PMS – reduces symptoms of breast tenderness, depression, bloating and irritability.
Carpal tunnel syndrome – commonly a deficiency.
Depression – shown to be low in depressed states, essential for neurotransmitter manufacture.
Morning sickness – reduces nausea and vomiting.
Autism – as supplement, not cure, helps brain chemistry, better if used with magnesium.
Atherosclerosis – deficiency shows increased homocysteine levels, inhibits platelet aggrigation.
Diabetes – to prevent complications.
Immune enhancement – low in AIDS even though consuming enough in diet, correlated to decreased immune function. 

Safety
Some toxicity in large doses for long periods. More than 2000 mg can result in nerve toxicity.
Safest at 50 mg per day.