Unfortunately for some, this function most of us take for granted is the focus of their worry and concern: the American Heart Association estimates that 59,700,000 Americans are suffering from some type of cardiovascular disease (CVD.)

While there are some hopeful signs overall as far as actual heart attacks are concerned, unfortunately Doctors are seeing an increase in problems associated with heart weakness, such conditions as cardiomyopathy and congestive heart failure. 

There is a good deal of speculation about the reason for this.  In my opinion, one reason is that these heart weaknesses are the chronic manifestation of poor diet and lifestyle choices, as opposed to the the acute manifestation, which is an actual heart attack. They should be addressed in three ways:

by modifying lifestyle factors such as diet, exercise and stress levels by controlling blood sugar levels  by the judicious use of nutrients and herbs to protect and support heart function.

Interesting research suggests that fasting just one day a month positively affects cardiovascular health, possibly through reduced exposure to glucose.  Researchers theorize that this one day without food gives the organs time to rest and work more efficiently.

Implementing a program of this nature will not only lessen the chances of heart problems, but increase the chances of surviving an event.

A huge 2004  study of over 39,000 people  in 40 countries people made an incontrovertible connection between high blood sugar and cardiovascular disease.  About half of the subjects were men, averaging 63 years of age, and the researchers determined that only one man in three had normal glucose and insulin levels.  I in 5 had diabetes that had gone undetected, and over 1 in 4 had pre-diabetic readings.  This emphasizes the importance of controlling blood sugar.

Alarmingly, in December 2006, the Mayo Clinic published a paper pointing out that bad diets are causing more children to show sign of metabolic syndrome, which leads to the kinds of diseases previously found only in adults. Dr. Weinstock, the author of the study, is quoted as saying “Unfortunately, as the population becomes less active and more obese, we're seeing a rise in this constellation of risk factors for cardiovascular disease. That's of great concern because of the increased risk for heart attack, stroke and diabetes, and we're seeing this occur in younger and younger individuals.”

Consider the results of Dr. Dean Ornish's 1998 heart treatment regimen, published in JAMA (1998; 280: 2001-7).  To summarize:  there were 20 patients in the experimental group, and 15 in the control. 

• The experimental group ate a diet which was 10% vegetarian, did moderate aerobic exercise, added stress management, and stopped smoking. Experimental patients reduced chest pain by 91% at the end of one year, and 72% after 5 years

• The control group followed their individual Doctors' recommendations, followed the American Heart Association's Step 2 diet, and 60% of them took lipid lowering drugs. The control group reported an 186% INCREASE in angina frequency after one year, and a 36% increase after 5 years. 

In the experimental group, coronary artery blockage decreased by 3.1%, in the controls it increased by 11.86% The control group also experienced twice as many cardiac events as the experimental group.

These were, in my opinion, very low impact interventions, since no supplements or vitamins were used, and even so - look at the results!

• Generous amounts of olive oil are allowed on my diet, while saturated fats from animal sources and trans fats are eliminated .
• This change needs to be accompanied by consistent healthful exercise, such as brisk walking.
• Protein should be supplied liberally from plant sources, such as beans, nuts and soy, with poultry, eggs, fish and meat a few times a week, and red meat a few times a month.
• Remember: many of the herbs and spices have health benefits - consider cayenne, turmeric and parsley as examples. Season your food with the good ones.
• Cheese and yogurt may be consumed on a daily basis, but in small amounts.
• Fruits and vegetables should be consumed in variety on a daily basis.
• Make sure a goodly proportion of your food is raw, for the enzymes provided
• Walnuts and almonds are encouraged as snacks.  I like almond butter in celery sticks, and walnuts in my yoghurt.
• A glass of wine per day (moderation rules - see RESOURCES at right for alcohol and Dementia) is an acceptable addition,
• but your  main drink should be pure water.
•  Green tea is encouraged. One cup of coffee a day is accepted.

Consider increasing raw foods in your diet to offset the damaging effect of a diet that consists mostly of cooked foods. Enzymes are the difference between raw and cooked foods. Enzymes are powerful biochemical catalysts. They speed burning or building reactions in the body according to need, but enzymes are destroyed by temperatures as low as 105 degrees, the equivalent of light steaming.

Of particular interest is an analysis from the Erasmus University Medical School in Rotterdam (Am. J. of Clin. Nutr., Feb 99; 69(2):261-6) where subjects were graded by antioxidant intake, and it was found that those in the top third of beta-carotene intake from food (2.11 mg per day) had 55% the risk of heart attack of those in the bottom third (0.84 mg per day).  However, when intake from food and supplements was combined, the risk dipped to 49%.  If the person in question was a smoker, the protection was even greater - only 33% of the risk of heart attack as former smokers with low beta-carotene consumption! (Nutr. Sc. News; July 99: 313).

CoQ10 is naturally present in our cells, where it is essential for cellular respiration and energy production.  However, our supplies become depleted as we age, and replacing them from food is marginally practicable.  As an example, it would require two gallons of chopped spinach daily to provide 30 mgs of CoQ10. 

Not only do we have less CoQ10 in our bodies as we age, but since it is a potent antioxidant, under conditions of oxidative stress - for example, pollution, smoking - available supplies of CoQ10 are used first to answer that need, and less of it is therefore available to supply the needs of the cell.  This sequence of events, where our body contains less of the nutrient through the natural process of aging,  increasing demands for it in its antioxidant role deplete our remaining supplies, and therefore less of it is available for essential energy production in the body's cells, illustrates the vital role CoQ10 plays in heart disease. 

I remember CoQ10 being attacked in Dr. Gott's newspaper column years ago, and would like to quote Dr. Julian Whitaker's reply verbatim:

Dr. Judy, of the Southeastern Institute of Biomedical Research in Bradenton, FL, has been conducting research into CoQ10 for nearly two decades.  He reports that studies on over 4200 people show that CoQ10 reduced heart problems in those already suffering from them, improved pumping and heart contraction, and reduced heart volume in almost 90% of those tested within between 24 and 90 days of starting to supplement them with from 100 to 250 mg per day.

Research in 2005 shed more light on how CoQ10 may help.  Clay Semenkovich of the Washington University School of Medicine in St. Louis, Missouri does not accept the cholesterol/heart disease connection, but suggests that with age, the energy producing mechanisms in the mitochondria of the cells become less efficient.  This allows highly re-active oxygen species to leak into the blood stream, causing damage to the walls of the blood vessels.

Dr. Whitaker's book, Guide to Natural Healing, gives a number of other study examples and a search will turn them up in the hundreds:  this is a much researched and highly effective heart nutrient.

At this stage, I'm sure no one will be surprised to learn that 100 mg of CoQ10 is the first thing I would supplement with if I had heart problems of any kind. to include high blood pressure.  A minimum dose of CoQ10 would be 30 mg.  It appears to be even more effective if taken in conjunction with Vitamin E, but should in any event always be taken in conjunction with a form of fatty acids for maximum absorption.  There are CoQ 10 products on the market now that are combined with the lipids necessary for best absorption, and while they cost a little more they are documented to deliver more CoQ10 to the cells.

Obviously the production of energy in the heart cell is the key to cardiovascular health, hence the importance of Co-enzyme Q10.  Another nutrient of evolving interest is Pyruvate, which is critical to myocardial energy metabolism, and which the body under certain conditions converts to Co-enzyme A.  Much of the interest arises from the fact that the presence of adequate Acetyl Co-enzyme A  in the cells means that energy for the heart is converted preferentially through fatty acid oxidation, rather than carbohydrates or glucose.

Studies have concluded generally by saying that unfortunately, it is difficult to come up with a means of utilizing Pyruvate because it is not able to penetrate the cells when taken by mouth.  Some years ago, I came across a supplement called CoEnzyme A which has surmounted that problem, and which claims to be vital for production of cellular energy and proper fatty acid metabolism.  I have suggested it for a long time for Stress related problems, but now add a recommendation for its use also where heart problems are a concern. 

See RESOURCES at right for study.

Over time, as the deficiency of these nutrients continues, the deposits represent a desperate attempt at artery repair by our bodies.

A diet low in Vitamin C leads to the formation of lesions in the walls of blood vessels, causing the blood vessel to actually leak blood. This prompts a repair molecule called Lipoprotein (a) to apply Apo (a), which we can think of as a kind of repair tape, to the affected area.  As the damage continues to occur, however, the response stimulus overreacts, and the resulting overcompensation leads to atherosclerotic deposits. 

Imagine, as long ago as the 1940s, two groups of Doctors - the Canadian cardiologist Paterson, and Trimmer & Lundy in the U.S.  - had already noted that 70 to 80% of their patients had very low plasma levels of Vitamin C.

It is obvious that if the walls of our blood vessels were able to repel the threatened buildup there would be fewer deposits of the lipo protein (a) particles, and this is the role experts attribute to Proline and Lysine.

Lysine is an essential amino acid:  that is to say, the body is unable to manufacture it and we must obtain our supplies from our diet.  Those of us susceptible to fever blisters may be aware that they erupt when there is too little lysine in relation to Arginine in our diet, and therefore we know how easy it is to be deficient in L-Lysine. 

It is also known that L-Lysine is essential for calcium metabolism, and  that calcium plays a role in regulating many of the cellular, biochemical and molecular functions that are frequently abnormal in cardiovascular disease.

Proline is classified as a non-essential amino acid ( our body can manufacture it) but it appears that under high risk conditions for heart disease, the body is unable to manufacture enough.  Lysine and Proline are important to this process because they are natural anti-adhesives, not only  preventing  the deposit of further fat globules in the blood vessel wall, but releasing all types of deposits which ate already there such as low density lipoproteins.  The recommended amount is generally  500 mgs of each per day, and up to several grams per day therapeutically.

New research on the amino acid L-Arginine is also of interest here, particularly to angina sufferers.  It appears (research by the Mayo Clinic's Dr. A.  Lerman, published in Circulation) that L-Arginine acts on the lining of blood vessels to relax the muscle wall, thereby easing chest pain as well as inhibiting the build-up of plaque.  Another study in Circulation (Feb 1998;97:363-8) showed that intravenously administered Vitamin C, or 1 gm oral Vitamin C daily, led to increased arterial dilation in patients with chronic heart failure.  The method of action appeared to be  inhibiting the oxidation of nitrous oxide, leaving it available to ensure healthy dilation of the blood vessels.

Jack Challem, the well known nutrition writer, reports (Lets Live Aug 2000) that Australian researchers show that nearly ONE FIFTH of heart failures may be attributed to these drugs, which are very widely used.  In the same interesting article, Mr. Challem traces the connection between cardiomyopathy and mutation of the Coxsackie's B virus.  While this virus is relatively harmless in its causative role of sore throats and the like, it appears that in the absence of sufficient Vitamin E and/or selenium (both of which are undersupplied in diets of processed foods) it can mutate and attack the heart. 

New research implicates inflammation generally in  poor heart health: Dr. Giles & colleagues (Am J Respir Crit Care Med 2000;162:1348-1354) examined a study conducted from 1976 to 1992 on 8900 adults, and stated "What we found was that people with an elevated white count (WBC)  were 40% more likely to die from coronary heart disease after taking into account a number of traditional risk factors".  See RESOURCES at right for more info. Alarming new research shows that simply breathing the air we live in is linked to the development of heart disease through the inflammatory process.

The study showed that patients with a WBC count over 7.6 were at much higher risk of dying from Coronary Heart Disease, even after adjusting for other risk factors. The new findings support a role for inflammation as a causal factor in the pathogenesis of CHD, the authors say. "We really don't know whether reducing white count will lower the risk," Dr. Giles added in an interview. "That's where we need more studies."

A Dr. Sumi, in Japan, has recently made the discovery that an enzyme in a food called NATTO, from fermented soybeans, can block this process, and actually resolve thrombi.  It also decreases the viscosity of the blood, and of course, thicker blood means higher blood pressure and more work for the heart.  It goes without saying that this cannot be used by people with bleeding problems, and only under the care of a health professional if you are already on blood thinners.

The marker of systemic inflammation, a body wide problem which, it now apears, includes the heart, is C-reactive protein, or C-RP.  The main source of this protein is the body's fat cells, and it is currently considered by many MDs to be an even more accurate predictor of heart problems than homocysteine or cholesterol. 

Research in the UK has connected high levels of C-reactive protein specifically to abdominal fat, with the inflammatory process leading through insulin resistance to diabetes, and on to cardiovascular disease.

Two key passages from a 2003 editorial by Russell Tracy of the Vermont College of Medicine follow:

"First, the data fit well with a growing body of evidence implicating adipose tissue in general, and visceral adiposity in particular, as key regulators of inflammation, coagulation, and fibrinolysis. Adipose tissue secretes proinflammatory cytokines and fibrinolytic regulators such as plasminogen activator inhibitor. Along with many possible roles in atherogenesis and atherosclerotic progression, inflammatory mediators can activate coagulation by stimulating monocytes to express tissue factor  (as can C-RP itself ) and by causing disregulation in natural anticoagulation."

"They suggested that the role of visceral fat may be more complex than suspected, because even people who are not obviously overweight may still have disproportionately too much visceral fat, with the result of a predisposition toward insulin resistance and atherosclerotic disease, possibly through inappropriate cytokine secretion. ".  Full text here.

See also a study in RESOURCES at right

Tocotrienols may prevent arterial plaque build-up, and therefore lessen inflammation. Since C-RP is also to a certain extent manufactured in the liver, some liver support is recommended.

There is another important association is between fruits and vegetables and inflammation.  A 2001 study found that beta carotene levels were universally low where C-RP readings were high.  Examples of important carotenes are lutein and lycopene. 

 The latest edition of the PUFA newsletter (September 2003) has a number of studies on the importance of the proper balance of fatty acids in a number of conditions, but relevant to the heart, this:

I am sure that one of the main methods of operation is going to be the positive influence of Omega 3s on the anti-inflammatory cascade! Another connection will be the effect of proper balance of dietary fats on visceral adipose tissue.

Inflammation may be one of the connections to the fact that high levels of iron are a risk for heart disease:  although iron is an essential and important nutrient, excessive levels can be very dangerous for the liver and the heart, and can cause significant harm.

 The mechanism of action seems to be that high iron levels impede the action of nitric oxide, a chemical released by the endothelium which aids on keeping blood vessels relaxed. The lead study investigator, Dr. Hidehiro Matsuoka of Kurume Medical Scholl, states that consuming high amounts of iron long term may increase iron levels in the body, and suggests that people over 40 who have other risk factors for heart disease might find it useful to have their iron levels checked.

 Researchers in his study injected volunteers with high doses of iron (0.7 mgs per kg of body weight) and used ultrasound imagery to observe the functioning of the artery walls:  they found that the iron raised levels of malondialdehyde, a chemical marker for oxidation, and inhibited normal endothelial function.

As if the damage to the heart were not bad enough, a study from the American Academy of Neurology (June 2003) links hemochromatosis (fancy word for high iron) to Parkinson's disease.  See RESOURCES  for more information.

There are natural substances that can help control iron levels:  first among them is IP6, a phytate from rice that binds to iron and carries it out of the body.  The other one I recommend highly  is Lactoferrin. This is a natural protein fraction extracted from cow's milk, which affects iron in two ways:

. it can enhance iron absorption by assisting in its transport, leaving less free iron in the blood .  
. by transporting the iron to receptor cells in the intestine, it also facilitates its elimination from the body. 

Interestingly, with the debunking of the HRT/Women's heart health theory,  which was based on the possibility that  extraordinarily low rate of heart disease in young women was due to hormonal protection, another theory which makes more sense to me comes to the fore:  and that is  that the blood-letting of the menstrual cycle each month keeps IRON levels low in pre-menopausal women.  For a complete report on this,  see RESOURCES at right.

I am struck by the fact that each time I address a substance I consider essential for the heart I find myself saying to myself as I write "THIS is the most important one!"  Maybe this is why I had a lady ask me the other day whether I take all the things I write about - well, the answer to that, of course, is that I don't suffer from all the things I write about!  However, I do take a considerable number of supplements, and magnesium is high on my list of musts. One because I did at one point have a mild arrhythmia, two because of its extreme importance in our bodies and three because of the high incidence of magnesium deficiency. I would also add four many people lack the stomach acid to  absorb magnesium.

To take the second point, magnesium plays a part in all the enzyme reactions in the body, and also is essential ( with the other important electrolyte, potassium) for the "firing" of nerves and muscles.  This means that few of the body's vital processes take place efficiently in the presence of low levels of magnesium.

Third and fourth points: among older people, deficiencies of magnesium are especially common because processed foods contain low levels of the mineral, though it is abundant in whole foods.  Magnesium levels are also adversely affected by alcohol consumption, diuretics, antibiotics, diabetes, kidney problems, and HRT. (Among younger women, birth control has the same effect.  Think cramps!)  Then too, production of hydrochloric acid, necessary for absorption of magnesium, decreases with age.  Often these deficiencies go unrecognized, because magnesium levels are inefficiently measured through blood tests: most magnesium is stored in the cells. Ironic, that diuretics, often prescribed for heart patients, deplete the body not only of potassium ( a fact which is often addressed) but also the heart-important magnesium .

One of my preferred reference books is Dr. Werbach's Nutritional Influences on Illness, and I looked in the index to refresh my memory on some of the uses of magnesium:  it did not surprise me to find some 47 health conditions listed with the relevant research, since some  naturopathic health professionals consider

 all to be, in one degree or another, magnesium deficiency diseases. 

The role of magnesium in cardiac arrythmias was first acknowledged as long ago as 1945, and in 1989 the American Journal of Cardiology (63(14):43G-46G) published a study by Dr. Roden saying "the association between hypo-magnesia (Lynn:  hypo= low) and arrythmias ... has long been recognized.  More recently, acute intervention with magnesium in patients who are not hypomagnesic has demonstrated arrhythmia suppression.." 

In cases of High Blood Pressure, a 1981 study found that 50% of patients with HBP had low magnesium levels and their hypertension was reversed when their magnesium levels rose. It is also interesting that many women  who develop HBP do so after menopause, which makes the magnesium connection particularly important for them, especially if they are on HRT.  As a bonus,  Dr. Alan Gaby (NSN Vol.5 #9 p.402) says adequate levels of magnesium in post-menopausal women increase bone density levels.

Another really interesting study showed that when a patient is deficient  in magnesium, normal levels of a medication which would usually take care of the problem are of no help - more is needed to get results, unless the mineral deficiency is addressed. 

Magnesium is also important for patients with Cardiomyopathy, and Dr.  Michael Murray reports that magnesium levels "correlate directly with survival rates".  It is unfortunate that many of the conventional medical drugs used for these conditions, such as calcium channel blockers, diuretics and beta blockers,  deplete the body of  magnesium.

Mentioning Calcium Channel Blockers brings me to some excellent information in Dr. Ronald Hoffman's book, Intelligent Medicine, (Simon & Schuster 1997, p.318-319) where he points out that the method of action of this class of drugs is to block the spasm-inducing effect of calcium, thus keeping blood vessels dilated.  He points out that calcium and magnesium compete for the same receptor sites in the smooth muscle wall of the blood vessel:  magnesium is the nutrient that relaxes spasms, so its presence in greater amounts than calcium will prevent spasms in the same way calcium channel blockers do.  This is why, when my Doctor prescribed a calcium blocker, I went away and took lots of magnesium.  Dr. H. says his protocol in patients with advanced heart conditions is to recommend magnesium in reverse ratio to calcium.  i.e., twice as much magnesium as calcium.  Buy his book, do:  it is full of excellent information. I recommend magnesium bound to either aspartate or citrate as being the most effective for absorption, and also to avoid the possibility of diarrhea that sometimes accompanies high doses.  I have had a hard time up until now finding a means to get extra magnesium in meaningful amounts at an affordable price, but there are now some powdered magnesiums on the market, and I can recommend both Ionic Fizz Magnesium and Magna-Calm as an excellent strategy. I have also found a softgel Magnesium 500 mg.

The following information may be of interest to you:

Another important nutrient on the heart health front is L-Carnitine.
I have been recommending it for many years now, but we live in exciting times nutritionally, and new research is continually being published that underscores its vital part in the cardiovascular system, and for other health conditions. In fact, it is a little hard to limit an article on l-Carnitine JUST to the heart, because this substance has been positively linked to improvements in health problems as far removed as obesity and Parkinsonism.

First, however, what it is. The prefix "L" would lead one to suppose that it is an amino acid - but strictly speaking, although its structure is similar to amino acids , it is more closely related to the B vitamins. It is considered a nonessential nutrient in the sense that the body can manufacture it from other nutrients present in the body (Lysine, Methionine, B6 among others, with Vitamin C being a limiting factor), but it is highly essential in its actions! In the diet it is found mostly in muscle meats ( as the name would suggest, coming from the Latin root for meat), and while it is rare for an actual clinical deficiency to exist, sub-optimal levels can lead to many problems associated with diabetes, obesity, cardiovascular disease and possibly Alzheimer's and muscular dystrophy. It is also being studied for its role in energy with cancer patients.

The reason L-Carnitine can be involved in such a wide range of problems, and the reason for its extreme importance in the maintenance of heart health, is its influence on the destiny of the massive amounts of carbohydrates in the average American diet. Excess carbohydrates are stored as fat, and Carnitine facilitates the burning of fat for energy by making it possible for the long chain fatty acids it transports to enter the cell . After all, if the fatty acids cannot reach the mitochondria where they are transformed to cellular energy, it stands to reason they are going to be deposited in places where the body will suffer from their presence, as happens in fatty liver disease, fatty build-up in the heart, and your plain old everyday variety obesity, where fatty build-up occurs in the muscles..

My hero Dr. Whitaker compares the heart deficient in Carnitine to a car without a fuel pump! However, as you can plainly see, the heart is not the only organ that can benefit from more efficient burning of fats for energy: Carnitine has its uses in the following conditions: angina, myocardial infarction, recovery from heart surgery, hypertension and high cholesterol levels, also high triglycerides, Alzheimer's, liver disease (including alcohol induced liver problems) diabetes, diabetic neuropathy male infertility, diabetic neuropathy, Parkinson's and many other more obscure afflictions.

The average amount of Carnitine found in the daily diet is app. 50 mgs: therapeutic levels range from 500 to 1000 mgs. deficiencies may be due to a genetic error in Carnitine synthesis, or to low levels of lysine or vitamin C, high levels of homocysteine, or vegetarianism . There do not appear to be any side effects from its use even at high dosages, but it is wise to increase Vitamin C supplementation, since some studies show that high amounts of Carnitine cause loss of Vitamin C from the body.

Carnitine is also sometimes marketed as DL-Carnitine, which in my opinion should be avoided since some experts say it interferes with the body's use of natural L-Carnitine.

Athletes have known about Carnitine's ability to burn fat for energy for some time, but heart disease sufferers are just beginning to realize the benefits that come from using a substance that provides the heart with its main fuel: the heart gets two thirds of its energy from burning fat! Less pain and more endurance can be associated with supplementing with L-Carnitine, with no downside! It works synergistically with Coenzyme Q 10.

• Prime among other nutrients is Vitamin E.  Whenever Vitamin E is mentioned, i still feel a deep sorrow as I reflect on the way the two Doctors Shute, who first asserted that Vitamin E was helpful in cardiovascular disease, were treated.  Sneered at and discredited by their peers, I wish they were alive today to see how thoroughly they have been vindicated - find me a Doctor who doesn't take Vitamin E himself!  They probably would never have dreamed that these words would pass my pen (mouse), but I think the role of vitamin E in heart disease is well enough known now to need to comment from me.  I will say that in my opinion not only is Vitamin E important when you have heart disease, but taking it regularly when you are healthy can play a role in averting it.  I suggest a minimum of 400 i.u. of natural d-alpha tocopherol per day, and for maximum effect, look for a formula which contains the tocotrienols as well.
• Other nutritional substances I recommend are: a balance of Essential Fatty Acids, to protect the cells of the heart.  For serious heart problems, I suggest adding one gram of Fish Liver Oil.  Of interest here is a report by Dr. Roberto Marchioli of Milan, Italy, announcing to the American College of Cardiology in New Orleans LA in April of 1999, that a study of 12,000 patients with heart disease had found that those patients using the FLO had a 29% lower risk of dying. See RESOURCES at right for another new study.
• Avoid trans fatty acids - a diet rich in foods containing trans fatty acids increases concentrations of LDL cholesterol. However, unlike saturated fats, trans fatty acids also decrease concentrations of HDL cholesterol, which appears to significantly impair endothelial function, Dutch researchers report.
  
  "By measuring arterial vasodilation, we compared the effects of trans fatty acids with those of saturated fatty acids to determine whether the decrease in HDL cholesterol posed an additional risk of cardiovascular disease," Dr. Nicole M. de Roos, from Wageningen University, told Reuters Health.
  
  In a randomized crossover trial, Dr. de Roos and colleagues put 29 healthy subjects on two controlled diets, according to their report in the July issue of Atherosclerosis, Thrombosis and Vascular Biology . The subjects consumed each diet, for 4 weeks. Both diets contained 9.2 energy percent from either trans fatty acids (Trans-diet) or saturated fatty acids (Sat-diet).
  
  Dr. de Roos' group found that when subjects consumed trans fats instead of saturated fatty acids HDL-cholesterol levels went down by about 26% and arterial dilation was impaired by about one third. "When patients consumed a diet containing saturated fats, vasodilation was about 6.5% of baseline diameter, while it was about 4% of baseline diameter on the diet rich in trans fats," Dr. de Roos said.
  
  Given their findings, Dr. de Roos believes that "we should try to ban trans fatty acids from our diets and replace them with natural oils, before they are hydrogenated, or by tropical saturated fats that are rich in C14, C16 fatty acids, which do not lower HDL cholesterol."  By tropical, he means Palm Oil and/or Coconut Oil, which both have very interesting benefits.  See RESOURCES  at right
  
  Arterioscler Thromb Vasc Biol 2001;21:00-00.
   
• I also recommend a good trace mineral combination, necessary for the regulation of the heart rhythm (Balch) and selenium in more than trace amounts - 100 to 200 mcgs.  There is some research which implicates a deficiency of this mineral in heart problems.
• I considered putting Pycnogenol, or OPCs under herbs, since they are plant based but I will list them here. along with Resveratrol.  These are potent antioxidants, and have a beneficial effect on micro-circulation, possibly because they  strengthen as well as  protect the cell. They are also anti-inflammatory in nature - see RESOURCES at right for more information.
• An article by Dr. Anthony Cichoke (Health Products Mar 1999 p.22) cites research showing that proteolytic enzymes (those which break down protein) can:  improve circulation, help fight plaque build-up on blood vessel walls, decrease LDL and triglyceride levels, and maintain proper equilibrium between blood clotting and the break-up of blood clots.  He says that proteolytic enzymes help in 5 ways:  they are a natural inhibitor of inflammation which can occur in the blood vessels, they aid the efficiency of blood flow, they decrease pain and edema, they increase circulation and thereby improve the supply of nutrients to the tissues, they dissolve micro thrombi and inhibit clot formation.  In support of Dr. Cichoke, a recent study in the New England Journal of Medicine (Ricker et al,2000;342(12):836-843) followed over 28,000 women after menopause to find out what the most common predictor of heart disease would be.  The researchers were looking at 12 markers, and of them all, inflammation turned out to be the most accurate fore-runner of cardiovascular accidents.

Here is a list of some of the herbs that are protective of the heart - 

• Garlic - this looms above all others on the list in importance, because it has so many well-documented effects, not only on the heart and circulation, but on general well-being.  It is a giant in the health field, and one I think everyone can benefit from using!
• Hawthorn Berry - its effects on the heart are as important as garlic, but it has a more narrow application.  Be careful with Hawthorn berry if you are using Digoxin or Lanoxin:  consult an expert.
• Cayenne - for its effect on circulation.
• Ginger - for its anti-inflammatory properties, and as a digestive aid.  See RESOURCES at right for more about this amazing herb.
• Motherwort - one of my personal favorites with a record of use going back to the Middle Ages - it is particularly useful for palpitations where stress is a factor.
• Butchers Broom
• Ginkgo Biloba
• Bilberry

I hope this series has been helpful to those who are addressing heart problems, and to those who want to avoid them.  I would like to emphasize again that none of these things are going to be helpful unless you first address your diet, introducing more fresh and unprocessed foods, fruits and vegetables, fish, olive oil, garlic, walnuts, and herbs into your cooking, and make a commitment to a regular exercise program that is right for you.  Dr. Weiss's book is an excellent overall guide for regaining heart health!

There is no doubt that the pendulum is finally swinging back from the point where people simply surrendered their health into the hands of others, and moving back to the point where we will realize that much of what happens to our bodies is our own responsibility:  we need to remember that we are flesh and blood, of the animal world: the principles we never abandoned for our beloved pets and prize livestock apply just as much to us: we have to have the proper nutrition and we have to stay active, otherwise we pay the price.  My aim is to be your guide along the path - I hope to provide helpful insights in the search for Good Health!