What to eat...

"Eat food, not too much, mostly plants" - Michael Pollan

Testosterone and Heart Disease

There has been much written lately about the potential link between testosterone therapy and heart disease.

Some study's have shown an increased risk of heart problems but others have not. A group of American Endocrinologists recently called for a retraction of one of these papers that showed an increased risk. 

A European Medicines Agency (EMA) has reviewed the evidence and has concluded that testosterone does not increase the risk of heart disease in patients with confirmed hypogonadism. 

The FDA's final review is still pending. But until that time, the EMA's review is reassuring that testosterone treatment is probably safe for men symptomatic hypogonadism. 

Mediterranean Diet: May Reverse Metabolic Syndrome

Metabolic syndrome is a cluster of conditions — increased blood pressure, a high blood sugar level, excess body fat around the waist and abnormal cholesterol levels — that occur together and has been shown to greatly increase the risk of heart disease, stroke and diabetes.

A recent analysis of the PREMIMED trial showed that patients with established metabolic syndrome who adhered to a Mediterranean diet were more likely to reverse their disease. 

The PRIMIMED study placed patient on either:

-  Mediterranean diet—one supplemented with about 1 L of extra-virgin olive oil a week, and one supplemented with 30 g/day of walnuts, hazelnuts, and almonds

- diet low in fat intake from all sources.

The researchers found that more of the patients with Metabolic syndrome on the Mediterranean diet had full remission of the disease 

As may of you know, I am a big proponent of the Mediterranen Diet. The Mediterranean diet emphasizes eating fruits, vegetables, and seeds, many of which contain minerals, polyphenols, and other phytochemicals that combat oxidative stress, inflammation, and insulin resistance,

Heart Healthy Lifestyle Reduces Risk of MI 86%

Researchers from Sweden recently reported that five lifestyle factors were each independently associated with a lower risk of MI in men.

• Frequent physical activity (walking or cycling at least 40 minutes per day
• Mediterranean style diet (fruits, veggies, reduced-fat dairy, whole grains, and fish)
• Moderate alcohol consumption
• Not smoking 
• Waist less than 37.4 inches

When all five of these behaviors were adhered too, the risk of MI was reduced by 86% compared with individuals who did not adhere to any of these behaviors. 

In addition

• Diet and alcohol cut the risk by 35%
• Diet, alcohol, and not smoking cut the risk by 64%
• Diet, alcohol, not smoking and exercise cut the risk by 76%

So what does this show - that by adhering to the 5 above behaviors, we can dramatically reduce our risk of suffering an MI  

Just Run Baby

A new study published in the Journal of the American College of Cardiology states that even 5-10 minutes of running a day can lead to substantial lowering of all-cause and cardiovascular (CV) mortality.

Overall, runners gained about 3 years of life over their non-running counterparts and had a 30% lower risk of all-cause and a 45% lower risk of CV mortality. 

The investigators observed a significant reduction in risk in those that ran less than six miles per week, ran slower than six miles per hour and even among those that ran just 1-2 times per week. 

This is great news. You can get significant benefits from just a 5-15 minute run. (Now that time is not the issue, what will be your excuse for not exercising :)

High Intake of Fruit and Veggies Linked With Decreased CV Mortality

A new study by Harvard School of Public Health Researches are reporting that there is a dose-response relationship between fruit and veggie intake and decrease in Cardiovascular (CV) mortality.

With each additional portion of fruits or veggies there was a ~ 4% reduction in risk of CV death up to five servings. 

Therefore, five or more servings of fruits and veggies was associated witha 25% risk reduction. Each serving of fruit provided a 5% average reduction in risk and each addition veggie serving was associated with a 4% reduction in risk.

So - make sure you eat your fruits and veggies. Remember, these food are an integral component of of the Mediterranean Style Diet.  

Sleep apnea and the heart

Many of you who have heard me speak publicly, seen me in the office or read my blog know that I remain very concerned about the effects of sleep apnea on cardiovasacular health. I have written about this before:

Could your sleep be hurting your heart?

Women, Sleep and Heart Disease

Sleep apnea treatment helps your gold game

Do you have sleep apnea?

Two new important studies published in the June 12th edition of the New England Journal of Medicine continue to add to the growing body of evidence regarding the danger that sleep apnea poses to cardiovascular health and the importance of weightloss and continuous positive airway pressure (CPAP) treatment.

The first study reports that in obese patients with moderate to severe sleep apnea, weight loss is the most important intervention and reduces inflammation, insulin resistance, dyslipidemia, and blood pressure. Also, the addition of CPAP to weightloss led to a significant further reduction in blood pressure.

The second study also showed that CPAP is effective for lowering blood pressure in patients with moderate to severe sleep apnea. CPAP was much more effective that using just oxygen therapy at night.

Sleep apnea can:
- make it very hard to lose weight
- raise your high blood pressure
- make you legs swell
- increase your risk of developing atrial fibrillation
- make you feel very short of breath
- increase your chances of heart failure
- increase your chances of heart attack
- increase your chance of developing pulmonary hypertension
- increase your chances of stroke

The two most important interventions to treat this serious condition remain aggressive weightloss and CPAP.

If you have any of the following signs or symptoms, please consult your physician
- excessive daytime sleepiness
- waking up feeling unrefreshed after sleep
- memory and concentration problems
- heart burn at night
- swelling in the legs
- LOUD SNORING
- night time gasping or choking spells