Cardiovascular Risk Factors

Your Heart and Nutrition

Your Heart and Nutrition

Prevention is better than a cure. Learn how to cherish your heart by taking the necessary means to keep it pumping healthily and steadily through your life.

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Natural Secrets For Healing Your Heart

This eBook is devoted to exposing the secrets that cardiologists and surgeons don't want you to know, and how to take control of your own heart and heal yourself. Eight out of every ten coronary bypasses will not actually help the patient. So why risk being in the 80% that will get no benefit from a bypass? Learn to heal your own heart and keep yourself healthy with this eBook guide. Bob Livingston has poured years of research into his findings, and is now sharing the methods that he has developed from careful, methodical research that the medical industry would never allow. It would make them go bankrupt! You will learn what supernutrient doctors don't want you to know about, and how to make an all-natural, chemical and drug-free blood thinner And even more information that doctors don't want revealed to the public. You don't have to be one of the 70% of Americans diagnosed with heart disease. You can heal your heart!

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Cardiovascular disease

The risk of developing atherosclerosis and heart disease may be higher in people who have a low dietary Se intake. Endothelial dysfunction is a primary factor in the pathogenesis of atherosclerosis. Laboratory-based research has provided considerable evidence to suggest that Se may be beneficial to the endothelium and thus help to prevent atherosclerotic disease. Se supplementation of cell cultures protects the endothelium from oxidative damage and can alter platelet function, cytokine signalling and transcription of pro-atherogenic adhesion molecules (Fig. 12.4). The contribution of Se deficiency to the pathogenesis of cardiovascular disease was originally suggested from epidemiological studies that correlated low Se content of forage crops, drinking water and blood with regional mortality rates from cardiovascular disease (Schamberger et al., 1979). Other studies have failed to confirm this link. Huttunen (1997) postulated that the conflicting data from these studies can be...

Folate Deficiency and Cardiovascular Disease

According to the American Heart Association, high blood levels of the amino acid homocysteine are linked to an increased risk of coronary artery disease. There is some evidence to suggest that homocysteine traveling through the circulatory system may damage the walls of the arteries, leading to the development of fatty deposits. Folate is necessary to change the amino acid homocysteine into the amino acid methionine. If too little folate is available, blood levels of homo-cysteine will increase, so not getting enough folate in your gluten-free diet could put you at a greater risk for cardiovascular disease.

Cardiovascular Disease Great Killer of an Affluent Society

Cardiovascular disease is responsible for over 900,000 deaths a year, and remains the number one killer of Americans. In addition, over 1.5 million people had a heart attack this past year, and sixty million Americans have high blood pressure. All told, forty million Americans suffer from cardiovascular disease, and many times that number are unaware they are at severe risk of cardiovascular disease. The same process that causes ischemic strokes also causes heart attacks (called myocardial infarctions or MI in medical lingo) that is, atherosclerosis. In this case, one or more of the arteries supplying blood to the heart muscle become occluded to the point that a sudden blockage can occur by the formation of a blood clot at the site of the narrowing. Before an MI occurs, the person may experience episodes of sudden pain radiating either down the left arm or into the jaw, much like the warning attacks we see with strokes. The pain usually lasts for only a few seconds or minutes, but...

Cardiovascular Disease Introduction Atherosclerosis

Cardiovascular disease is the major cause of death in the industrialized countries of the world. Most cardiovascular disease is caused by atherosclerosis. Atherosclerosis is a disorder in which fatty plaques deposit within arteries, thickening the walls and reducing blood flow. Often the final event that abruptly closes off a narrowed vessel is the formation of a thrombus. About half of all deaths in Europe and North America are due to the two main forms of cardiovascular disease - myo-cardial infarction (heart attack) and stroke. These disorders kill nearly three times as many people each year as all types of cancer combined.

Coronary heart disease CHD

Correlation study of 24 developed countries showed that the supply of a-tocopherol was strongly related to CHD and explained the low rates of heart disease in some European countries (Bellizzi et al, 1994). For example, Spain, with low rates of CHD, has estimated intakes of 18-25mg day vitamin E, whereas in the UK, where the number of deaths from CHD is one of the highest, the intake of vitamin E is only 4.7-11.9 mg day. Biochemical evidence to support the epidemiological data suggests that the susceptibility of LDL-cholesterol to oxidative modification to an atherogenic form is key in the development of atherosclerosis. Oxidised LDL is taken up by monocytes, which are attracted to a site of injury on an arterial wall. Monocytes are transformed to macrophages and oxidised LDL appears to decrease the ability of macrophages to leave the arterial wall. The enhanced uptake of oxidised LDL may then convert macrophages into foam cells, the precursors of plaque, which block the artery....

El Coronary Heart Disease

The heart is like a pump, squeezing and forcing blood throughout the body. With its four chambers, the heart beats about 100,000 times in one day. Like all muscles in the body, the heart must have oxygen and nutrients to do its work. The heart cannot use oxygen and nutrients directly from the blood it pumps within its chambers. Instead, nutrients and oxygen are furnished by the three main blood vessels on the heart, which are referred to as coronary arteries. Coronary heart disease (CHD) is a broad term used to describe damage to the heart caused by narrowing or blockage of the coronary arteries. Coronary heart disease is the most common form of cardiovascular disease. Smoking, high blood cholesterol, and high blood pressure are three major risk factors for coronary heart disease. A risk factor is a habit, trait, or condition associated with an increased chance of developing a disease. Preventing or controlling risk factors generally reduces the probability of illness. Research shows...

Nutrition Heart Disease and Cancer

A little more than a century ago, infectious diseases including smallpox, tuberculosis, cholera, typhoid, and yellow fever were among the major killers of Americans. Today, advancements in medicine have controlled or nearly eliminated diseases like these. However, we are left to deal with seemingly more complicated killers, namely cardiovascular disease and cancer. When combined, these two diseases account for roughly 60 percent of the deaths of adults in the United States. In Canada and Australia heart disease and cancer are also very prominent medical problems as in other developed countries. As prominent as cardiovascular disease and cancer are, many health professionals are convinced that these diseases are largely preventable or their critical points can be pushed back years to decades for most people. Nutritional intake has proven to be one of the most important factors with regard to the prevention and treatment of these diseases. The influence of nutrition can be both a matter...

Nutrition And Cardiovascular Disease

Cardiovascular disease (CVD) is a general term for diseases of the heart and blood vessels, as seen in the following list CARDIOVASCULAR DISEASE (CVD) Diseases of the heart and blood vessels such as coronary artery disease, stroke, and high blood pressure. Coronary artery disease Rheumatic heart disease The two medical conditions that lead to most cases of cardiovascular disease are atherosclerosis and high blood pressure. Atherosclerosis, a condition characterized by plaque buildup along the artery walls, is the most common form of artery disease. (Arteriosclerosis is a general medical term that includes all diseases of the arteries that involve hardening and blocking of the blood vessels.) Atherosclerosis affects primarily the large and medium-size arteries. In this condition, arterial linings become thickened and irregular with deposits called plaque. Plaque contains cholesterol, fat, fibrous scar tissue, calcium, and other biological debris. Why plaque deposits are formed and what...

Protective Dietary Changes For Cardiovascular Disease Patients

Since dietary support and advice by health professionals and self-help materials are effective at reducing cardiovascular risk, at least in the short term, what actual changes to diet are effective in protecting people from cardiovascular disease Again considering systematic reviews of randomised controlled trials as the best level of evidence, we are lucky that quite a few have been published in the area of diet and cardiovascular disease. The most important studies show that dietary intervention actually makes a difference to health or mortality.

How Do Omega Fatty Acids Impact Heart Disease

Omega-3 PUFAs, such as linolenic acid and DHA (docosahexaenoic acid) and EPA (eicosapentaenoic acid) can have a favorable impact, lowering the risk of cardiovascular disease. However, since omega-3 fatty acids have not been shown to lower blood cholesterol levels in a consistent manner in research studies, the cardioprotective effects must extend beyond that mechanism. For instance, omega-3 fatty acid intake is associated with decreased risk of blood clots (thrombosis) that can lead to heart attacks or stokes

Cardiovascular risk factors

The scientific literature is heavily populated with papers reporting cardiovascular risk factors. The latest catalog published over one decade ago listed 177 of them with many of them falling in the categories of'Nutrition-Related' and 'Environmental' (Omura et al., 1996). Many of the reported risk factors are rather questionable, however. Updating this catalog today would probably add a few hundred more to the list. Besides diet, the best characterized environmental risk factors include smoking, inadequate physical activity, alcohol and, more recently, coffee drinking (which, given its popularity and widespread use, has received increased attention as a modifier of cardiovascular disease risk) (Campos and Baylin, 2007). Those common and well established behavioral risk factors are the focus of this section.

Folate homocysteine and cardiovascular disease CVD

Cardiovascular disease remains one of the main causes of mortality in the western world and approximately two-thirds of cases are attributable to traditional environmental and genetic factors. However, in the last decade it has emerged that a moderate rise in the amino acid homocysteine in plasma constitutes a risk factor for atherosclerotic vascular disease in the coronary and peripheral blood vessels (Ward, 2001). The B vitamins folate, Bj2 and B6 all play a key role in homocys-teine metabolism and deficiencies of any one of the three B vitamins can result in homocysteinaemia. However, folate appears to be the most important and has been shown to lower plasma homocysteine concentrations at doses of 0.2-10mg day in both healthy and hyper-homocysteinaemic subjects (Ward, 2001) (see Fig. 3.3).

Cholesterol and heart disease

Doctors measure your cholesterol level by taking a sample of blood and counting the milligrams of cholesterol in 1 deciliter ( ) liter) of blood. When you get your annual report from the doctor, your total cholesterol level looks something like this 225 mg dl. Translation You have 225 milligrams of cholesterol in every tenth of a liter of blood. Why does this matter Because cholesterol makes its way into blood vessels, sticks to the walls, and forms deposits that eventually block the flow of blood. The more cholesterol you have floating in your blood, the more cholesterol is likely to cross into your arteries, where it may increase your risk of heart attack or stroke. oj NG.' As a general rule, the National Cholesterol Education Program (NCEP) says that for adults, a cholesterol level higher than 250 mg dl is a high risk factor for heart disease between 200 mg dl and 250 mg dl is considered a moderate risk factor below 200 mg dl is considered a low risk factor. Cholesterol levels...

What Are the Risk Factors Associated with Heart Disease

Table 13.1 Warning Signs of a Heart Attack For many people atherosclerosis may be undetected as early warning signs of a heart attack have not been experienced. Therefore when the heart attack does occur it seems unexpected and happens suddenly and without warning. In fact about half of the people in the United States who die of heart disease can be characterized as having sudden cardiac death. This means that early detection is very important. important. Furthermore, we are greater risk of a heart attack and stroke as we get older and men seem to be at greater risk than women at least up to their postmenopausal years when the risk becomes about the same. These risk factors are often described as uncontrollable since we can't really do anything about our heredity, age, or gender.

Diabetes Heart Disease and Stroke

Many people with diabetes are not aware that they are at particularly high risk for heart disease and stroke, which can result from the poor blood flow that is a symptom of diabetes. In addition, people with type 2 diabetes have higher rates of hypertension and obesity, which are additional risk factors. Diabetics are two to four times more likely to have a heart attack than nondiabetics, and at least 65 percent of people with diabetes die from heart attack or stroke. While deaths from heart disease have been declining overall, deaths from heart disease among women with diabetes have increased, and deaths from heart disease among men with diabetes have not declined nearly as rapidly as they have among the general male population. The National Diabetes Education Program has launched a campaign to bring the problem to public attention. Patients are advised to work with medical personnel to control their glucose level, blood pressure, and cholesterol level and, of course, to avoid...

Role Of Flavonoids In Cardiovascular Disease

In addition to alcohol, evidence that dietary flavonoid intake was inversely related to mortality from coronary heart disease has been supported by recent epi-demiologic studies (Knekt et al., 1996 Hertog et al., 1993a, 1995, 1997 Rimm et al., 1996). In the Zutphen Elderly study, Hertog et al. (1993a, 1997) showed that after adjustment for age, weight, certain risk factors of coronary artery disease, and intake of antioxidant vitamins, the highest tertile of flavonoid intake, primarily from tea, onions, and apples, had a relative risk for heart disease of 0.32 compared with the lowest tertile, assigned a relative risk of 1.0. It should be noted that wine was not a significant contributor to flavonoid intake in these studies. At present it is not possible to distinguish from these epidemiologic observations whether the protective effect is related to polyphenols in general, consumption of certain foods high in these compounds, or other dietary components. Thus the evidence supporting a...

Diet and Heart Health

Heart disease is the number one killer of both men and women in America. Women tend to think cancer is the number one killer, but that is not the case. Heart disease and stroke account for 38 percent of deaths among women (Mosca et al. 2007), whereas cancer accounts for about 22 percent. Two ways to reduce your risk of heart disease are being physically fit and eating wisely. Yet, active people often believe they are exempt from the food rules about heart-healthy eating they assume that being physically fit protects them from heart disease. Wrong A friend of mine, a seemingly healthy 48-year-old marathoner, died suddenly of a massive heart attack. He'd run 2 hours 10 minutes, stopped his watch, and was later found dead in the running path. Everyone was shocked. Unfortunately, even the most health-conscious people can find themselves confused by the constant updates and changes to heart-health information. This leaves us wondering what the real answers are to questions such as the...

Heart Disease A Womans Issue

As estrogen levels drop with menopause, women no longer have the same protection that estrogen gives from heart disease and high blood pressure. HDL levels drop triglyceride levels increase. That's true whether menopause is natural or surgical. As a result, women's heart-disease risks parallel those of men seven to ten years later in life Their death rate is higher, perhaps due to increased age or more risk factors. In fact, heart disease (not breast cancer) is the top killer and disabler of American women a woman is three times more likely to get cardiovascular disease than breast cancer. About two-thirds of women who die of heart disease had no previous symptoms. The signs of heart disease for women often differ from those of men and may go unrecognized or ignored. Women often have angina first, rather than a heart attack. A woman's symptoms may be intermittent unexplained heartburn, profound fatigue, nausea, shortness of breath, and pain that comes and goes. Treadmill stress tests...

What Is Heart Disease

Heart disease describes several health problems that relate to the heart and blood vessels. Heart attacks and strokes may come to your mind first. However, high blood pressure, angina (chest pain), poor circulation, and abnormal heartbeats are among the other forms of heart disease. Heart Disease Are You at Risk What increases your risk for heart disease or high blood cholesterol levels Two risk factors aren't within your control age and genetic tendency. Yet many other risk factors are. Do any apply to you Risk factors you can't control Family history of early heart disease (father or brother with heart disease before age fifty-five mother or sister, before age sixty-five). African Americans, who are more likely to have high blood pressure, are at higher risk. So are Mexican Americans, Native Americans, Native Hawaiians, and some Asian Americans. Cigarette smoking, which is a significant risk factor for heart disease. Cigar and pipe smoking, as well as secondhand smoke, are risk...

Soy Foods and Heart Health

At one time, soy was believed to lower the bad LDL cholesterol and increase the good HDL cholesterol. This shift would offer protection against heart disease. The current research suggests that soy and substances in soy called isoflavones do not protect against heart disease. Yet, soy products can still be beneficial because of their high content of polyunsaturated fat, fiber, vitamins, and minerals (Sacks et al. 2006). Soy foods are also low in saturated fat, so when you choose soy foods for dinner, you forgo prime rib and other artery-clogging choices.

Can Vitamin E Help Prevent Heart Disease

Vitamin E provides some protection against heart disease as it circulates throughout the body aboard lipoproteins. As discussed, one of the primary factors associated with atherosclerotic development is the oxidation of fatty acids and proteins in LDL to form oxidized LDL. Vitamin E may provide some antioxidant protection for these molecules. Several large population research studies indicate that people with higher intake levels had a lower incidence of heart attacks and death related to heart disease. Supplementation of 200 International Units of vitamin E daily is recommended in addition to food sources.

How Does Olive Oil and Oleic Acid Impact Heart Disease

Much interest in MUFA, namely oleic acid, was generated when studies of heart disease in various populations around the world revealed that certain Mediterranean countries enjoyed a relatively lower incidence of heart disease despite eating a diet that would be considered rich in fat. Further evaluation revealed that these people ingested much of their fat in the form of olive oil, which has a high percentage (77 percent) of the MUFA oleic acid. This resulted in several research studies which determined that when oleic acid replaced palmitic acid in a diet, blood cholesterol levels were lowered by decreasing the amount of LDL-cholesterol in the blood. Researchers also determined that while this significantly impacted heart disease risk it didn't explain all of the cardioprotective

Cell Culture And Epidemiological Studies Of Betacarotene Cancer And Heart Disease

Over 250 epidemiological studies of cancer or heart disease risk have shown that high dietary intakes of beta-carotene rich fruits and vegetables were associated with lower risk of premature disease and death (Ziegler, 1991). Beta-carotene was linked to the prevention of cancer, heart disease, macular degeneration, and premature aging in these studies (Burri, 1997 Erdman et al., 1996). Cell culture, animal, human, and in vitro studies showed that beta-carotene was an effective antioxidant (Dixon et al., 1998 Dugas et al., 1999 Lin et al., 1998 Lowe et al., 1999). Furthermore, it was more powerful in gap-junction formation than lycopene (Bertram et al., 1991 Zhang et al., 1992), and inhibits cholesterol synthesis by the same mechanism as lycopene (Aviram and Fuhrman, 1998 Fuhrman et al., 1997).

How Does Linoleic Acid Omega PUFA Impact Heart Disease

When saturated fat is replaced in the diet with polyunsaturated fat, total and LDL-cholesterol levels are reduced, particularly in people with elevated levels. In fact, linoleic acid, an omega-6 fatty acid, is likely to be the most potent fatty acid when it comes to lowering blood cholesterol levels in this manner. By lowering total and LDL cholesterol, heart disease risk is lowered. Linoleic acid can be found in safflower, sunflower, corn, soybean, and canola oils. So replacing animal fat with plant fat (oil) could be helpful in preventing heart disease. However, one important consideration is that the level of omega-6 fatty acids should be in a healthy ratio with omega-3 fatty acids as explained below.

Do fiCarotene and Other Carotenoids Decrease the Risk of Heart Disease

Fruit and vegetables are endowed with carotenoids, many of which provide antioxidant support in the fight against heart disease. Being fat-soluble, carotenoids circulate throughout the body aboard lipoproteins and provide protection against oxidation (which promotes atherosclerosis). Several large population studies have reported that the incidence of heart disease is lower in people who eat a diet rich in these substances and have higher levels in the blood. However, which carotenoids are more

What Role Do Folate and Vitamins B and B Play in Relation to Heart Disease

Recently it was determined that higher levels of homocysteine in the blood can increase heart disease risk possibly by negatively influencing blood clotting and vasodilation. Homocysteine is naturally produced in the cells as they go about their molecule-making business. As displayed in Figure 9.3, homocysteine can be converted to the amino acid methionine via the assistance of folate and vitamins B6 and B12. Thus having adequate levels of these vitamins can help manage the level of homocysteine. Over the next few years ongoing research should shed more light on the exact role homocysteine plays in heart disease development and the best way to apply folate and vitamin B6 and B12. Folate and vitamins B6 and B12 can support a healthy heart by supporting homocysteine metabolism.

Supplements for Heart Health

Questions arise about the role of vitamin supplements to enhance heart health. Living healthfully could be so much easier if we could just take a pill that could compensate for both suboptimal eating and suboptimal genetics. Unfortunately, the vitamin and antioxidant studies that looked for reduction in heart disease saw few benefits and even potential harm from taking high doses of beta-carotene, selenium, and vitamin E. The same goes for folate and other B vitamins research results have been disappointing. Hence, the AHA highly encourages you to get your vitamins and antioxidants from fruits, vegetables, whole grains, and vegetable oils. The right foods can be powerfully health promoting See chapter 11 for more information about vitamin supplements.

How Important Are Blood Lipids in Determining the Risk of Heart Disease and Stroke

LDLs are a major player in the development of atherosclerosis. Because elevations in LDL-cholesterol are associated with increased risk of heart disease and stroke, it is often deemed the bad cholesterol. Although it may not be this simple, higher LDL-cholesterol levels means that there are more LDLs in the blood, which in turn means more LDLs that can participate in atherosclerosis. On the other hand, HDL-cholesterol seems to decreases the risk of heart disease and it is often referred to as the good cholesterol. Researchers believe that the virtuous nature of HDLs is due to their ability to gather some of the cholesterol associated with atherosclerotic plaque. This could slow the progression of atherosclerosis. In addition, HDLs carry antioxidants which can reduce LDL oxidation. Higher levels of LDL cholesterol are linked to greater risk of heart disease. LDL is called bad cholesterol because as its level increases in the blood, so does the risk of heart disease. As mentioned above,...

Cardiovascular Disease A Matter of Plumbing Problems

Diseases of the heart and cardiovascular system are many, but heart disease is the term most often used to address a condition in which atherosclerotic development in the arteries of the heart (coronary arteries) impedes blood flow within the heart itself. When blood flow through a coronary artery is inhibited, the region of the heart that it supplies suffers in fact, when the condition becomes critical, that tissue suffocates as it doesn't get enough oxygen. This type of heart disease is called coronary heart disease, coronary artery disease, or atherosclerotic heart disease. Like many medical terms, atherosclerosis has its roots in the Greek language. Athero means gruel or paste and sclerosis means hardness. The heart, which is largely made up of muscle cells, relies almost exclusively upon aerobic energy metabolism. Heart muscle cells die in a short period of time (minutes) if they are deprived of oxygen. When cells in a region of the heart die, it is medically known as an...

Can Drinking Wine Decrease the Risk of Heart Disease

A few years back it was recognized that there was a decreased incidence of heart disease in France despite the consumption of a high fat diet, a phenomenon referred to as the French Paradox. Since it was well known that this population and others such as Denmark also drink a lot of red wine, scientists began to investigate the potential benefits of red wine. The consumption of wine in these regions is chronic yet only moderate one to four glasses daily. Red wine consumption has been recognized to reduce the incidence of heart disease by perhaps helping keep blood pressure lower, reducing blood clot formation, and reducing LDL oxidation. It is also likely that substances found in red wine, such as quercetin, resveratrol, and similar molecules, provide much of the benefit. Interestingly, the prophylactic effects of alcohol are not limited only to red wine. Researchers have determined that alcohol in a variety of forms (that is, liquor, wine, and beer) consumed chronically but in smaller...

Nuts and Peanut Butter for Heart Health

Although many people try to stay away from nuts and peanut butter because they fear them as being fattening, research with more than 260,000 people indicates that eating one serving of nuts or peanut butter five times a week can reduce the risk of heart disease by 50 percent (Kris-Etherton et al. 2001). Research also indicates that eating nuts can reduce the risk of type 2 diabetes by about 25 percent (Jiang et al. 2002). Nuts are rich in monounsaturated fat (as well as folate, niacin, thiamin, magnesium, fiber, and other health-protective nutrients). Adding walnuts to oatmeal, peanut butter to a bagel, sliced almonds in a salad, and mixed nuts to dried fruit for trail mix are just a few simple ways to include these health-protective foods in your daily diet to say nothing of enjoying a good old peanut butter sandwich for lunch. FITTING FAT INTO YOuR DIET Both a sports diet and a heart-healthy diet limit fat to 20 to 35 percent of calorie intake. The American Heart Association advises...

Coronory Heart Disease

Vegetarianism and Coronary Heart C. Foods, Nutrients, Vegetarianism and Coronary Heart Disease 45 A. Coronary Heart Disease in B. Coronary Heart Disease in Vegetarian South Asians 47 Coronary heart disease (CHD) is the major cause of death in most Western countries, and is rapidly becoming a major cause of death in developing countries too. Lopez and Murray1 predicted that, by the year 2020, CHD will be the leading cause of disease worldwide. Differences in the diets consumed by different populations account for much of the observed variation in CHD mortality rates, and the effect of vegetarian diets on CHD is a topic of great interest. The role of triacylglycerol as an independent risk factor for CHD has been uncertain, because adjustment for HDL cholesterol has tended to reduce or eliminate the association. However, a recent meta-analysis of prospective studies has shown that triacylglycerol is an independent risk factor for CHD Austin et al.27 found that, after adjustment for...

Congenital Heart Disease

Congenital cardiac anomaly (CAA), also known as congenital heart disease (CHD), refers to any structural defect of the heart or major vessels that exists from birth. It is the most common cause of infant death, other than problems of prematurity, and death is likely to occur in the first year of life. CAA may result either from genetic causes or from external causes such as maternal infection or exposure to other factors that affect embryonic development. The general problems associated with CAA include increased cardiac workload, hypertension, poor oxygenation of blood, and respiratory infections. There are many types of CAA, including aortic stenosis, atrial septal defect, valvular stenosis, and pulmonary stenosis.

Can Garlic Help Prevent Heart Disease

Garlic has sulfur-containing substances including allicin and its breakdown products diallyl sulfides, which are purported to have medicinal properties. There are several reasons to believe that garlic can play a role in preventing heart disease. First, garlic-derived compounds lessens the activity of the key enzyme in cholesterol formation. However, garlic supplementation has not consistently been shown to lower blood cholesterol levels. Researchers have determined that garlic might be an inhibitor of blood clot formation, which is a principal cause of heart attacks, as well as having anti-inflammatory and antioxidant properties. Considered together there is strong reason to believe that garlic can play a contributing role in promoting a healthy cardiovascular system.

Eggs and Heart Health

So, when it comes to eggs, you should limit your intake if you have a high blood cholesterol level and a family history of heart disease. The American Heart Association recommends a limit of three eggs per week, including those used in cooking. Otherwise, if you have low blood cholesterol and no family history of heart disease, this highly nutritious protein source can likely be eaten without concern as a part of your balanced nutrition plan. For dieters who want to lose weight to help reduce their risk of heart disease, eggs may even be a positive addition to their diets. Eating two eggs with two slices of toast and some jam for breakfast has been shown to be more satiating than eating the same number of calories in the form of a bagel with cream cheese and a little yogurt. The egg breakfast maintained satiety, so the subjects felt less hungry and ate about 250 fewer calories the rest of the day (Vander Wal et al. 2005). When choosing eggs, you may want to buy brands such as...

Oatmeal for Heart Health

The type of fiber (soluble fiber) found in oats as well as in barley, lentils, split peas, and beans protects against heart disease. Find ways to include more of these foods in your diet. For example, trade a meat sandwich for a hummus wrap or some hearty lentil soup and some whole-grain bread.

Rheumatic Heart Disease

Rheumatic heart disease (RHD) involves damage to the heart and heart vessels caused by rheumatic fever. A susceptible person acquires a streptococ-cal infection, which may trigger an autoimmune reaction in the heart tissue. Rheumatic fever can cause swelling (inflammation) in the heart, joints, brain, and spinal cord. Rheumatic fever produces fatigue (tiredness) and the infection can damage or weaken heart valves. Problems with the heart may be evident early, or it may occur long after the infection. RHD is characterized by heart murmurs, abnormal pulse rate and rhythm, and congestive heart failure. Acute RHD requires aggressive treatment to prevent heart failure. Chronic RHD requires continuous observation. If poor cardiac function develops, it may be treated with a low-sodium diet and diuretics. Patients with deformed heart valves should be given prophylactic antibiotics before dental and surgical procedures.

What Other Dietary Factors Influence the Development of Heart Disease

Beyond fat and cholesterol, other dietary factors appear to impact the development of atherosclerosis. Studies investigating different diets and the incidence of heart disease have shown that diets richer in fruits and vegetables, fiber, and possibly other diet-derived factors, such as garlic,

Can Fiber Impact Heart Disease Prevention

Soluble fiber from foods such as (name of soluble fiber source or product), as part of a diet low in saturated fat and cholesterol, may reduce the risk of heart disease. A serving of name of food product supplies x grams of the necessary daily dietary intake for the benefit soluble fiber from name of soluble fiber source necessary per day to have this effect.

Can Eating More Flavonoids Lower the Risk of Heart Disease

Researchers in the United States, Finland, and around the world have determined that people who eat or drink less of flavonoids have a higher death rate from heart disease. Some of these flavonoids may act to decrease the level of total and LDL-cholesterol in the blood, while others may decrease free-radical activities, thereby protecting LDL from oxidation as well as helping to protect the walls of the arteries. So again, eat more fruits, vegetables, and whole grains and, if you like, enjoy a glass or two of red wine daily or a few times a week.

Can Coenzyme Q Ubiquinone Be Helpful in Preventing Heart Attacks

Coenzyme Q10 (CoQ10) is found in a variety of plants and animals, and better food sources include meats (especially organ meats such as heart and liver), sardines, mackerel, soybean oil, and peanuts. The research involving CoQ10 is difficult to assess for several reasons. Often the studies are short, not long term, or the CoQ10 is provided in addition to other drugs. CoQ10 acting as an antioxidant can be yet another protective factor against free-radical activity and thus heart disease development. Furthermore, some researchers believe that CoQ10 may decrease damage to heart muscle after it has been deprived of oxygen for a brief period of time. In this situation, when oxygen floods back into the deprived cells, there is an increased opportunity for free-radical production. Further still, many researchers have determined that the use of statin drugs for high cholesterol levels may compromise CoQ10 status in cells making CoQ10 supplementation along with statin drug use good practice.

Toast to Heart Health

Does moderate drinking reduce the risk for heart disease Maybe, although for heart health benefits people who don't drink aren't advised to start. Moderate drinking (red or white wine, beer, or distilled spirits) may offer heart-health benefits for some people. Moderate drinking also may raise HDL levels and keep some LDL cholesterol from forming, according to recent research. Resveratrol, a phytonutrient in the skins and seeds of grapes, may function as an antioxidant, promoting heart health it also may help keep blood platelets from sticking together. There's a fine line between how much alcohol is protective, though, and how much instead may promote heart disease, high blood pressure, and strokes. Remember, alcohol also can raise triglyceride levels. Stick to moderation. There's reason for caution. Research linking alcoholic beverages and heart health isn't conclusive. For example, we don't yet know who may benefit. Even if a minor benefit exists, moderate drinking is only one...

Lean Beef and Heart Health

Athletes commonly shun beef, believing it to be an artery clogger. Although that is true for greasy burgers and sausages, small portions of lean beef aren't so bad after all. In fact, lean beef is an excellent source of iron, zinc, and other nutrients athletes need. Despite popular belief, beef is not exceptionally high in cholesterol it has a cholesterol value similar to that in chicken and fish. Additionally, we now know that cholesterol, which was once thought to contribute to heart disease, is less of a culprit than saturated fat. However, beef tends to have more saturated fat than chicken or fish, so that's why it still has a bad name among health watchers. Saturated fat is hard at room temperature. For example, the hard fat on uncooked steak is different from chicken fat, which is softer and less saturated. But not all beef is fatty. In the past decade, the healthfulness of beef and other meats has improved because farmers have learned how to raise leaner animals and because...

Coronary Artery Disease

Coronary artery disease (CAD) refers to any of the conditions that affect the coronary arteries and reduces blood flow and nutrients to the heart. It is the leading cause of death worldwide for both men and women. Atherosclerosis is the primary cause of CAD. Controlled risk factors associated with CAD include hypertension, cigarette smoking, elevated blood lipids (e.g., cholesterol, triglyceride), a high-fat diet (especially saturated fats and trans-fatty acids), physical inactivity, obesity, diabetes, and stress. Lifestyle changes can assist in prevention of CAD. Uncontrolled risk factors include a family history of CAD, gender (higher in males), and increasing age.

Myocardial Infarction MI

Myocardial infarction (MI) is the clinical term for a heart attack. It is caused by occlusion (blockage) of the coronary artery (atherosclerosis) or a blood clot (coronary thrombosis), resulting in the partial or total blockage of one of the coronary arteries. When this occurs, the heart muscle (myocardium) does not receive enough oxygen. If the MI is mild, the heart muscle may partially repair itself. Permanent damage may occur when a portion of the heart muscle dies (called an infarction). MI is characterized by crushing chest pains that may radiate to the left arm, neck, or upper abdomen (which may feel like acute indigestion or a gallbladder attack). The affected person usually has shortness of breath, ashen color, clammy hands, and faints. Treatment within one hour of the heart attack is important and usually includes chewing aspirin and administering CPR. Many individuals die each year of their first MI.

Is Iron Status in the Body Related to Heart Disease

A few years ago research reported that a relationship may exist between heart attacks and higher levels of an iron-storing protein that can be found in our blood. The protein, ferritin, is typically found in tissue such as the liver and is a storage container for iron atoms. However, some ferritin can leak out of cells and circulate, which allows for it to be assessed. Researchers have noted that the risk of a heart attack is higher in individuals with higher ferritin levels in conjunction with a higher LDL-cholesterol level (greater than 193 milligrams per 100 milliliters of blood). Other researchers have reported that while total dietary iron intake was not associated with a greater risk of a heart attack, higher intake of heme iron was associated with a greater risk. Heme iron comes from animal sources, largely red meat. Furthermore, those men with a higher heme iron intake who took a vitamin E supplement were at a slightly lower risk for heart attack than those men without a...

Coronary Heart Disease in Vegetarian South Asians

South Asian migrants from the Indian subcontinent (Bangladesh, India, and Pakistan) have higher mortality from CHD than other ethnic groups living in the new host country.84 Reliable population-based CHD mortality data are not available from South Asia, but mortality is probably low in rural areas and high in urban areas.84 Many South Asians are vegetarians, which might suggest that this type of vegetarian diet does not reduce the risk for CHD. However, South Asians differ from other ethnic groups, both in many aspects of lifestyle and also genetically, and a case-control study of risk factors for CHD (specifically acute myocardial infarction) in Bangalore, India, did observe a 45 reduction in risk in vegetarians, which was partly explained by their lower blood glucose concentration and lower waist to hip ratio.85

Deaths from Acute Myocardial Infarction

Adjustment for known cardiovascular risk factors did not materially alter this inverse association (P for trend 0.03). Men who consumed > 200 g of fish and shellfish per week (> 4 servings per week) experienced 59 reductions in acute MI mortality (adjusted RR 0.41 95 CI 0.22 to 0.78) relative to those who ate < 50 g of seafood per week (Table 2.2). The average intake of marine n-3 fatty acids in this cohort was estimated to be 0.66 g per week (Table 2.1). Table 2.3 presents the associations between intake of marine n-3 fatty acids and categories of cardio- and cerebro-vascular disease mortality. Similar to the relationships with seafood intake, fatal MI was inversely associated with consumption of n-3 fatty acids derived from fish and shellfish. Compared with men in the lowest 20 of marine n-3 fatty acid intake (< 0.27 g per week), those who consumed higher levels showed significantly reduced risk of fatal MI (RR 0.55 95 CI 0.37 to 0.83). Adjustment for known cardiovascular...

Coronary Artery Disease CAD

Coronary artery disease (CAD) refers to any one of the conditions that affect the coronary arteries and reduces blood flow and nutrients to the heart. According to the American Heart Association, heart disease is the most common cause of cardiac arrest, and 95 percent of cardiac arrest patients die before they reach the hospital. That high mortality rate has prompted the placement of portable defibrillators in places such as schools, airplanes, police cars, and in this service plaza along the Pennsylvania Turnpike. Photograph by Keith Srakocic. AP Wide World Photos. Reproduced by permission. trans-fatty acids type of fat thought to increase the risk of heart disease Chronic stress is a risk factor for heart disease, and acute stress can trigger heart attacks. Regular yoga or other exercise may help prevent both conditions by releasing stress and strengthening the heart muscle. AP Wide World Photos. Reproduced by permission. Chronic stress is a risk factor for heart disease, and acute...

Your Healthy Heart

Heart disease is America's number one killer. Although its onset is slightly postponed for women, it's a disease that affects both genders. More than 71 million of the nation's more than 300 million people have some form of cardiovascular disease, and it accounts for about 910,000, or about 40 percent, of deaths annually in the United States (preliminary 2003 data). The truth is, many deaths from heart attacks or strokes are preventable. The higher your blood cholesterol level, the greater your risk for developing heart disease or having a heart attack. High blood pressure is also a risk factor. 1. Heart disease x x

Eat for Heart Health

By tweaking your daily food intake to include heart-healthy choices, you can make several small changes that accumulate to make a big difference in the long run. The American Heart Association (AHA) recommends a variety of diet and lifestyle choices to reduce your risk for cardiovascular disease (Lichtenstein et al. 2006)*. You should review your physical activity and calorie intake to ensure they are in balance. Doing so will help you reach or maintain a healthy weight. You should also strive to consume a diet that is rich in vegetables, fruits, and whole-grain, high- Other choices that can reduce your risk of heart disease include controlling your weight by limiting your intake of beverages and foods with added sugars, choosing and preparing foods with little or no salt, and consuming alcohol in moderation (if at all). And when you dine away from home you can make reasonably healthful choices by following AHA's recommendations for eating out.

Cardiovascular Risks

Soy protein intake has been touted for its effects on reducing blood cholesterol and improving risk factors for cardiovascular disease. The recommended daily intake to reap the benefits of soy protein was set at 25 g day by the FDA following its review of the literature. However, the average dose in numerous clinical trials to elicit an approximate 3 reduction of LDL cholesterol was 50 g day.13 This value is double the FDA recommendation and may account for a quarter to one half of a person's daily total protein intake. It also appears that soy may be more effective at lowering cholesterol in hypercholesterolemic individuals.75 It is of interest to note that soy isoflavones alone do not appear to affect blood lipid concentrations.76 Inclusion of soy proteins as a trade for other, higher-fat sources of protein may be protective via

Heart Disease

Heart disease, or coronary artery disease, is a result of improper function of the heart and blood vessels. There are many forms of heart disease. Atherosclerosis (hardening of the arteries) and hypertension (high blood pressure) are two of the most common. Fat deposits disrupt the flow of blood to the heart muscle, increasing the risk of myocardial infarction (heart attack). heart disease any disorder of the heart or its blood supply, including heart attack, atherosclerosis, and coronary artery disease heart attack loss of blood supply to part of the heart, resulting in death of heart muscle According to the National Cancer Institute, men are approximately 1.5 times as likely as women to develop colorectal cancer or heart disease. Both diseases may be prevented by eating well. The convenience and economic appeal of fast foods, such as hot dogs, can lead to poor dietary habits. Royalty-Free Corbis. Reproduced by permission. Heart disease is the number one cause of death for men....

Dietary Interventions That May Reduce Illness and Death

To date, the most effective dietary intervention for people who already have cardiovascular disease is omega-3-rich fish oil. Evidence for this comes from a high-quality systematic review of randomised controlled trials.14 Advice to increase intakes of long chain omega-3 fats for people with some cardiovascular disease (compared with no such advice) appears to reduce the risk of fatal myocardial infarction (relative risk 0.7, 95 CI 0.6 to 0.8), sudden death (relative risk 0.7, 95 CI 0.6 to 0.9), and overall death (relative risk 0.8, 95 CI 0.7 to 0.9), but not nonfatal myocardial infarction (relative risk 0.8, 95 CI 0.5 to 1.2). The effects of these cardioprotective doses of omega-3 fats appear consistent whether the advice is dietary (eating more oily fish, usually 2 to 3 large portions weekly) or supplemental (taking the equivalent of 0.5 to 1.0 g of a mixture of eicosapentanoic acid (EPA) and docosahexanoic acid (DHA) fatty acids daily). Evidence for a Mediterranean diet high in...

Deaths from Other Vascular Diseases

Seventy-four deaths from CHD other than acute MI were identified during follow-up (41 per 100,000 person-years). In contrast to the inverse relationship with acute MI mortality, neither fish and shellfish nor marine n-3 fatty acid intake was associated with mortality from other forms of CHD (Table 2.2 and Table 2.3). Adjustment for known cardiovascular disease risk factors or the ratio of serum total to HDL cholesterol did not materially change these associations. Consumption of fish and shellfish was not related to stroke mortality. Men who ate > 200 g of seafood per week had fatal stroke risk similar to those who ate < 50 g of seafood per day (Table 2.2). Similarly, there was no evidence that high intake of marine n-3 fatty acids was associated with stroke mortality (Table 2.3). Adjustment for known cardiovascular disease risk factors did not materially change the associations between seafood or marine n-3 fatty acid intake and stroke mortality. Our study was the first...

Results of Biomarker Studies

Albert and coworkers37 used the Physicians' Health Study database to test whether high blood levels of n-3 fatty acids predict the lower risk of sudden death. The study included 94 men who died from sudden cardiac arrest and 184 matched control subjects who were alive and remained free of cardiovascular disease at the time of case ascertainment. Nine specific fatty acids in blood including palmitic and stearic acids (saturated) oleic acid (monounsaturated) alpha linolenic acid (short-chain n-3 polyunsaturated) EPA, DHA and docosapentaenoic acids (DPA) (long-chain n-3 polyunsaturated) and linoleic and arachidonic fatty acids (n-6 polyunsaturated) were determined. Cases had statistically significantly lower baseline blood levels of total and individual long-chain n-3 fatty acids than control subjects. As compared with the lowest quartile, the RRs (95 CIs) of sudden death were 0.52 (0.16 to 1.72) in the second quartile, 0.19 (0.05 to 0.69) in the third quartile, and 0.10 (0.02 to 0.48)...

Dietary Interventions That May Alter Risk Factors

While dietary advice has a role to play in normalizing abnormal serum lipids in people with cardiovascular disease, aspects of diet that clearly protect against death and disease should be given greater emphasis than lipid reduction in this group. Dietary changes are likely to result in reductions of total cholesterol of about 5 ,25-27 while statin trials reduce total cholesterol by 18 to 28 therefore, lipid lowering medication is more effective than dietary advice.25 Metabolic ward studies suggest that replacing 60 of saturated fats by other fats and avoiding 60 of dietary cholesterol would reduce serum total cholesterol by 0.8 mmol L (about 13 ), but it appears difficult to maintain this in a normal lifestyle.25 Replacing saturated fats with unsaturated fats leads to improved lipid levels28 and a reduction in cardiovascular events, but it is not clear whether polyunsaturated or monounsaturated fats are more cardioprotective.29 Weight can be altered by dietary change, but this...

Systematic Review Evidence

These studies were carried out in the U.K., the U.S., and Australia in a variety of settings including general practices, workplaces, and clinics. Some participants had heart disease at baseline others had slightly or distinctly raised serum cholesterol and some had risk factors for diabetes. Duration of studies varied from 6 to 104 weeks, and data were used only for participants who did not take or had stopped taking lipid lowering medications (so that the outcomes were not biased by the effects of these medications in some groups). Outcome measures in the trials included total serum cholesterol in all studies, along with low density lipoprotein (LDL) cholesterol, high density lipoprotein (HDL) cholesterol, blood pressure, weight, and patient satisfaction in one or more studies. Participants seen by dietitians tended to be seen more frequently or for longer than those seen by doctors and took part in group sessions and or individual consultations. Self-help resources were usually...

Epidemiology Of Chd In African American And White Populations

To provide additional perspective regarding the continuing low rates of CHD in sub-Saharan African populations, it is valuable to consider both some past and present international epidemiological data. In 1979, an analysis was made of 6414 emergency visits in 3 hospitals in St. Louis, MO.21 Although African Americans were involved in half of all visits, myocardial infarction was found to be 15 times more common in the white population. Thus, roughly a generation or so ago, CHD was very uncommon in African Americans. What a tremendous contrast to the present situation. In 1998, in populations aged 35 years and over, following increases in risk factors, the mortality rate in African American men rose to be only slightly lower than that in white men, namely 321 versus 440 per 100,000 population. Moreover, the rate in African American women compared with white women was higher 264 versus 202 per 100,000.22 pathology department of the London Hospital performed one or two necropsies per...

Epidemiology Of Chd In Subsaharan African Populations

Africans were diagnosed with CHD in 1992,13 51 in 1993, and 65 in 1994.14 However, of the 65 diagnosed in 1994, only 36 were Sowetans the rest lived elsewhere. In 2000, the hospital treated 50 Sowetan CHD patients. This is still a very low annual incidence rate of approximately 5.0 per 100,000 population.15At urban Pirenyatwa Hospital, the main referral center for neighboring Zimbabwe, six African patients on average were diagnosed annually with acute myocardial infarction from 1988 to 1993.16 In 1996 in Nigeria, a comprehensive review concluded, CHD is still rare despite increased incidence in recent years.17 Clearly, CHD remains uncommon among urban Africans in South Africa and other sub-Saharan African countries.1318 Regarding a perspective on the epidemiological situation described, one important question is how does the uncommonness of CHD in Africans compare in magnitude with its high frequency in socioeconomically better placed Western populations In Soweto, sick Africans...

Fish n Fatty Acids and SCD

The hypothesis that eating fish may protect against SCD is derived from the results of a secondary prevention trial, the Diet and Reinfarction Trial (DART), which showed a significant reduction in total and cardiovascular mortality (both by about 30 ) in patients who ate at least two servings of fatty fish per week.3 The authors suggested that the protective effect of fish might be explained by a preventive action on ventricular fibrillation (VF), since no benefit was observed on the incidence of nonfatal acute myocardial infarction (AMI). This hypothesis was consistent with experimental evidence suggesting that n-3 polyunsaturated fatty acids (PUFAs), the dominant fatty acids in fish oil and fatty fish, have important effects on the occurrence of VF in the setting of myocardial ischemia and reperfusion in various animal models, both in vivo and in vitro.4,5 In the same studies, it was also apparent that saturated fatty acids are proarrhythmic as compared to unsaturated fatty acids.

What Dietitians Offer

It is vital that we do more than give lip service to the idea of evidence-based practice we must understand it and use it in everyday healthcare. This chapter will explore the evidence on who should provide dietary advice to reduce cardiovascular risk and the best evidence-based advice to help people with cardiovascular diseases alter the foods that they eat every day. It will start with a short introduction to evidence-based practice.

Antiarrhythmic Effect of Fish

2.4.7 Fish Intake and Other Cardiovascular Diseases Pedersen and coworkers44 reported results of an autopsy study in Greenland. Among 30 cases ascertained, 4 died from fatal hemorrhagic strokes. Compared with cases with no findings of cerebral pathology, hemorrhagic stroke cases had statistically significant or borderline significant high levels of total long-chain n-3 fatty acids (2.3 versus 1.5 of total adipose fatty acids, P 0.04), DHA (P 0.044), DPA (P 0.058), and EPA (P 0.085).44 Although these results were based on a small number of cases, they suggest that while long-chain n-3 fatty acids may protect against thrombogenesis, high levels may have an adverse effect, and thus may be a risk factor for hemorrhagic stroke. He and coworkers47 examined the relations between intakes of fish and marine n-3 fatty acids and risk of stroke in 43,671 U.S. male professionals. After 12 years of follow-up, 608 strokes occurred, including 377 ischemic, 106 hemorrhagic, and 125 unclassified...

Klaus KA Witte and Andrew L Clark

Relationship Between Vit And Copper

Homocysteine and Heart Disease Cardiovascular disease is the greatest cause of mortality in developed countries and diet plays an important role in contributing to the development and progression of ischemic heart disease (IHD). The influences of general nutrition and micronutrients such as vitamins and minerals on the progression of IHD are poorly understood and recent studies have done little to clarify the situation. The most common cause of micronutrient deficiency is a consequence of reduced dietary intake and the role of a particular micronutrient is often uncovered when the consequences of dietary deficiencies such as selenium deficiency (Keshan disease) in China and iodine deficiency (thyroid disease) in the U.K. manifest themselves. (Table 6.1 provides a summary of particular micronutrient deficiencies and their possible contribution to cardiovascular disease.) However, micronutrient deficiency in cardiovascular disease could also be a product of increased losses resulting...

Strengths and Weaknesses of Study

The current study has a number of strengths. Among them are (1) the prospective study design that eliminates the possibility of recall bias (2) adjustment for various known cardiovascular disease risk factors at baseline including serum total to HDL Our study also has several limitations. The principal limitation is reliance on death certificates as the sole diagnostic sources of cardiovascular disease mortality. However, we reviewed hospital records and other supporting medical documents related to all cardiovascular deaths among cohort members and found no evidence of other more probable causes of death in these individuals. Among CHD deaths, 67 of the patients had been hospitalized for the same disease prior to death, and an additional 16 of the patients had their death certificates signed by attending physicians at major medical centers. The corresponding figures for stroke death were 85 and 9 , respectively. Another important limitation was the single measure of fish consumption...

Editors

Ronald Ross Watson, Ph.D., is an internationally recognized nutritionist and immunologist. He directs several biomedical grants funded by the National Institutes of Health (NIH) relating to the causes of heart disease. Dr. Watson has studied the importance of fats in the diet for 20 years. His model studies have involved dietary deficiencies and excesses. Dr. Watson has edited 54 biomedical books, including a recent book Alcohol and Heart Disease. He contributed several chapters to this book based on research from his four grants from the National Heart, Lung, and Blood Institute to study cardiovascular disease.

Summary

The research evidence suggests that dietitians are needed to give dietary advice to those at high risk of cardiovascular disease, in lieu of or in addition to dietary advice from physicians. In what circumstances trained nurses or self-help materials can substitute for a dietitian's role is not clear (more research is needed), but they can serve as useful allies when a dietitian's time is limited. Dietary advice for people with cardiovascular disease should include advice to increase long-chain omega-3 fats first and foremost. Other useful advice is to replace saturated fats with unsaturated fats and to adopt a Mediterranean-style diet. These steps represent the most important dietary advice known to reduce illness and mortality and should be given before patients receive additional advice to alter specific risk factors in their diets.

Useful Contacts

The Cochrane Collaboration developed in response to Archie Cochrane's call for systematic, up-to-date reviews of all relevant randomised clinical trials of healthcare. Cochrane's suggestion that the methods used to prepare and maintain reviews of controlled trials in pregnancy and childbirth should be applied more widely was taken up by the Research and Development Programme initiated to support the United Kingdom's National Health Service. Funds were provided to establish a Cochrane Centre to collaborate with other organizations in the U.K. and elsewhere to facilitate systematic reviews of randomised controlled trials across all areas of healthcare. For more information about the Cochrane Collaboration see http www.cochrane.org . The sections of the Cochrane Collaboration that relate most specifically to cardiovascular disease include

Wanda JE Bemelmans

Traditional risk factors for coronary heart disease (CHD) that can be modified by changing dietary intake include hypercholesterolemia, hypertension, being overweight, and diabetes mellitus. Overall, changing dietary habits toward a more healthy diet will decrease incidence and mortality of CHD.1 Consensus more or less covers the key nutritional messages that effectively prevent CHD. These include limited intake of saturated fat, consumption of many fruits and vegetables, and increased intake of fatty fish.2 During the 1990s, secondary prevention studies showed remarkable reductions in CHD and total mortality in the intervention groups who obtained dietary guidelines comparable with current dietary guidelines.3,4 It should be stressed that the beneficial effect of the dietary therapy was not mediated entirely by effects on established cardiovascular risk factors. For example, in the Lyon Diet Heart Study, serum cholesterol levels dropped by 5 in both intervention and control groups....

Trial Evidence

A trial by Henkin et al12 randomised 70 hypercholesterolemic patients to dietary counseling by a physician only and 66 to counseling by a physician and a dietitian. The physician sessions were 30 minutes long and included reevaluation of cardiovascular risk factors, a brief physical examination, and counseling on smoking cessation, physical activity, weight control, and the Step I diet. Those receiving the additional time to discuss dietetic issues were offered 2 to 4 individual counseling sessions within 3 months (as needed), the use of food diaries, and Step II advice where appropriate. After 3 months, some participants in the physician-only group were given dietetic

What Tests Will I Need

After examining several laboratories, I would suggest the Great Smokies Diagnostic Laboratory for most of my cardiovascular testing. They offer a series of tests that measures markers for cardiovascular disease risk. Each of these tests indicates either an independent risk or a combined risk. For example, if both your LDL cholesterol and C-reactive protein are increased, you have a much greater risk of heart disease than if either one was elevated alone. All of these tests are available with the Comprehensive Cardiovascular Assessment. While the numbers do not directly relate to heart-attack risk, it can indicate the presence of a problem. Total cholesterol is a combination of LDL, HDL, and VLDL cholesterol levels. While this study is suggestive, there are many other factors involved as well, such as dietary differences in the two groups, exercise levels, and overall healthier lifestyle of the lower cholesterol group. These are esterified fatty oils. High levels of triglycerides also...

Nutrition and Disease

The Mediterranean diet offers a practical and effective strategy that is relatively easy to adopt and more likely to be successful over the long term than most heart-healthy nutrition plans. In April 2001, the American Heart Association (AHA) published a science advisory stating that some components trans-fatty acids type of fat thought to increase the risk of heart disease heart disease any disorder of the heart or its blood supply, including heart attack, atherosclerosis, and coronary artery disease of the Mediterranean diet may be beneficial when used in conjunction with the association's traditional diets for the prevention and treatment of cardiovascular disease. Because the Mediterranean diet emphasizes eating whole, natural foods, it is extremely low in trans-fatty acids, which are increasingly recognized as important contributors to heart disease. These fats are found in hard margarine and deep-fried and processed snacks and food, including fast food and commercially baked...

Atherosclerosis Hardening of the Arteries

Atherosclerosis (more generally known as arteriosclerosis), often called hardening of the arteries, is this country's number-one killer, leading to approximately one million deaths every year. The human and economic costs are staggering. Over forty million Americans suffer from cardiovascular disease alone, with associated costs for treatment estimated to be about 259 billion annually. More than 500,000 coronary bypass operations are performed every year, each costing between 50,000 and 100,000. And strokes and peripheral vascular disease affecting arteries to the legs and kidneys account for billions more in medical expenses. Those who survive the complications of atherosclerosis are frequently physically impaired, and many are no longer able to work or enjoy life. Millions of people are completely unaware that their blood vessels are 80, or even 90, percent occluded, and, of the 1.5 million heart attacks that occur each year, one-third of those are the first sign most people have of...

Antioxidantsyour Ace Against Oxygen Rebels

Free radicals are destabilized oxidized molecules which come in a variety of chemical forms. They can attack and destroy bystander molecules, setting off a chain reaction of cellular destruction which eventually assaults our DNA, causing normal cells to become cancerous. Without a way to neutralize these free radicals we would self-destruct. *80 They are believed to be important triggers of damage which leads to heart disease, and they are implicated in over one hundred other diseases. *81 They play a role in the aging process as well. Their discovery has changed the landscape of disease etiology. You will recall that fatty acids combine to make up the various kinds of lipids which circulate throughout our body. The very presence of an oxidized lipid may interfere with cell membrane structure, the genes, and the cell chemistry which utilizes fatty acids. *82 All fat is a culprit in this process, particularly polyunsaturated vegetable oil. The Omega-3 molecule, highly touted as the...

Antioxidant Properties Of Wine

It should be noted that flavonoids could also accelerate LDL oxidation if they were added to minimally oxidized LDL (Otero et al., 1997). Also, some flavonoids enhanced LDL aggregation (Rankin et al., 1993), and in cholesterol-fed rabbits, resveratrol actually promoted atherosclerotic lesions in the aorta (Wilson et al., 1996). Since atherosclerotic plaque contain high concentrations of copper and iron which may catalyze LDL oxidation (Dubick et al., 1991), the net in vivo effect of polyphenols on LDL oxidation cannot be predicted easily. Therefore, despite the in vitro inhibition of LDL oxidation and the acute rise in serum antioxidant potential following consumption of red wine or grapes in particular, the limited human data do not provide strong evidence that a major in vivo effect of wine polyphenols is inhibition of LDL oxidation. Further work is needed to define whether these results simply reflect insufficient absorption and or deposition of polyphenols into the target tissues,...

Fruits And Vegetables A Population Studies

A regular fruit and vegetable consumption may also reduce the risk of ischemic heart disease.13,14 A study of 11,000 health conscious people in the U.K. noted that a daily consumption of fresh fruit was associated with a 24 reduction in mortality from heart disease and a 32 reduction in death from cerebrovascular disease, compared with less frequent fruit consumption. Daily consumption of raw salad was associated with a 26 reduction in mortality from heart disease.15 A high intake of fruit and vegetables is often associated with a lower meat intake and hence, a reduced saturated fat intake. Fruit and vegetables are known to be rich in dietary fiber, folic acid, potassium, magnesium, vitamin C, and other micronutrients that provide protection against cardiovascular disease and cancer. Beyond all these factors, there are additional protective substances the phytochemicals. A host of cancer-preventive and cardio-protective phytochemicals have been identified in these foods (see Table...

Nutrition and the Gene

Research of the past twenty years has taught us that early nutrition may have a profound effect on development of, or protection from, later diseases, a phenomenon that goes beyond the direct effect on the disease itself. A growing body of evidence based on this research indicates that nutrition can actually control the genes for diseases. For instance, it is known that poor nutrition during infancy and adolescence seems to program the genes for early onset of major degenerative diseases such as cardiovascular disease, strokes, diabetes, and degenerative brain diseases. Further, good nutrition has the opposite effect, programming genes for a life free of major diseases. Most lay people are of the opinion that genes are set at birth, thereby programming our cells to function in a certain way. For example, if we inherit a bad gene for an early heart attack, there is nothing that we can do to change our fate it is locked in our system. To say otherwise would be to imply that through...

Strength of evidence

The relationship between dietary fats and CVD, especially coronary heart disease, has been extensively investigated, with strong and consistent associations emerging from a wide body of evidence accrued from animal experiments, as well as observational studies, clinical trials and metabolic studies conducted in diverse human populations (2). Saturated fatty acids raise total and low-density lipoprotein (LDL) cholesterol, but individual fatty acids within this group, have different effects (3-5). Myristic and palmitic acids have the greatest effect and are abundant in diets rich in dairy products and meat. Stearic acid has not been shown to elevate blood cholesterol and is rapidly converted to oleic acid in vivo. The most effective replacement for saturated fatty acids in terms of coronary heart disease outcome are polyunsaturated fatty acids, especially linoleic acid. This finding is supported by the results of several large randomized clinical trials, in which replacement of...

Diseasespecific Guidelines

Heart Disease Guidelines Coronary Heart Disease (CHD) is the major cause of death in industrialized and emerging nations and is the most common and serious form of cardiovascular disease. Elevated blood lipids and related disorders of lipoprotein metabolism are implicated in the progression of atherosclerosis and subsequent obstruction of coronary blood vessels and development of atherosclerotic heart disease. Atherosclerosis is infrequently hereditary in origin and there is an extensive body of epidemiologic, laboratory, and clinical evidence of an association between diet and the incidence of CHD. Recent clinical trials provide evidence that reducing serum cholesterol levels through diet, drugs, or both decreases the incidence of CHD. Although much attention has been focused on the effect of dietary fat and cholesterol on blood lipids, diet may influence other steps in the pathogenic sequence leading to atherosclerosis or to a cardiac event. For example, dietary factors may...

Nutrition and Health Status

There is a high prevalence of cardiovascular disease (coronary heart disease, stroke, hypertension) in this area, mainly due to the high intake of saturated fats, cholesterol, and sodium. Stomach cancer is also very common due to the high intake of salt and salt-cured foods, especially salted fish. Accidental injuries are the largest cause of death for individuals under forty-five years of age. Suicide and alcoholism are also prevalent, and obesity is on the rise.

Chronic Infection as a Cause of Atherosclerosis

The idea that chronic infections within arteries might cause atherosclerosis first arose when doctors observed that people with even high normal levels of c-reactive protein, a marker for inflammation, had much higher rates of coronary heart disease and stroke than those with The first suggestion came in 1988 when Dr. Pekka Saikku and his co-workers reported a study of Finnish men infected during an epidemic of mild pneumonia caused by the organism Chlamydia pneumonia. They found that men who tested positive for the organism were more likely to have a heart attack than those who tested negative. Later, the Helsinki Heart Study found that patients seropositive for C. pneumonia were 2.6 times more likely to have cardiovascular disease than those who were seronegative for the organism. It is interesting to note that C. pneumonia antibodies are present in about 50 percent of the adult population, often without any clinical symptoms. Exposure to the bacteria in early childhood, combined...

Nutritional Transition

Coronary heart disease disease of the coronary arteries, the blood vessels surrounding the heart Many Pacific Islander Americans now eat an Americanized diet consisting of fast foods and highly processed foodstuffs such as white flour, white sugar, canned meat and fish, butter, margarine, mayonnaise, carbonated beverages, candies, cookies, and sweetened breakfast cereals. Rice is now a staple food, having taken over yam and taro in popularity in the 1980s and 1990s. This nutritional transition has resulted in an increase in cardiovascular disease (i.e., coronary heart disease, stroke, hypertension), obesity, and type 2 diabetes. Nutrition education is needed to stimulate nutrition-related indigenous knowledge and the consumption of traditional nutrient-rich local foods as a more healthful alternative to fast foods and processed foods. There is also an urgent need for increased awareness of the health perils of obesity, especially among individuals with low socioeconomic status. Many...

Regulations Related to Functional Foods

May reduce the risk of heart disease reduces risk of heart disease May reduce the risk of heart disease osteoporosis, certain cancers, and heart disease May reduce the risk of heart disease Reduces risk of heart disease and certain Reduces risk of heart disease Reduces risk of heart disease and certain Reduces risk of heart disease May reduce the risk of heart disease Reduces risk of heart disease and neural May reduce the risk of heart disease Reduces risk of heart disease Disease-risk reduction claims, typically called health claims, do require FDA approval before they can be used on products and must reflect scientific consensus. For example, the health claim for soy protein and its relation to cardiovascular disease reads Diets low in saturated fat and cholesterol that include 25 grams of soy protein a day may reduce the risk of heart disease. claim may appear only on soy products that provide at least 6.25 grams of soy protein per serving. Other FDA-approved health claims include...

Figure Qualified Health Claims Ranked B C Or D

Qualified Claims about Cardiovascular Disease Risk Claim Statement (including disclaimer) Limited and not conclusive scientific evidence suggests that eating about 2 tablespoons (23 grams) of olive oil daily may reduce the risk of coronary heart disease due to the monounsaturated fat in olive oil. To achieve this possible benefit, olive oil is to replace a similar amount of saturated fat and not increase the total number of calories you eat in a day. One serving of this product contains_grams of olive oil. Nuts and heart disease Supportive but not conclusive research shows that eating 1.5 ounces per day of walnuts, as part of a low-saturated-fat and low-cholesterol diet and not resulting in increased caloric intake, may reduce the risk of coronary heart disease. See nutrition information for fat content. Omega-3 fatty acids and coronary heart disease Consumption of omega-3 fatty acids may reduce the risk of coronary heart disease. FDA evaluated the data and determined that, although...

Diseasespecific recommendations

Dietary intake of fats strongly influences the risk of cardiovascular diseases such as coronary heart disease and stroke, through effects on Summary of strength of evidence on lifestyle factors and risk of developing cardiovascular diseases Summary of strength of evidence on lifestyle factors and risk of developing cardiovascular diseases (for coronary heart disease) The evidence shows that intake of saturated fatty acids is directly related to cardiovascular risk. The traditional target is to restrict the intake of saturated fatty acids to less than 10 , of daily energy intake and less than 7 for high-risk groups. If populations are consuming less than 10 , they should not increase that level of intake. Within these limits, intake of foods rich in myristic and palmitic acids should be replaced by fats with a lower content of these particular fatty acids. In developing countries, however, where energy intake for some population groups may be inadequate, energy expenditure is high and...

What Causes Free Radicals

Thus far we have seen that free radicals are commonly produced during the normal energy-producing reactions within our cells that is, it is part of life. What is less appreciated is the fact that if we increase our metabolism, we also increase free-radical production. So how do we increase our metabolism One of the most common ways is by exercising. It is now known that intense exercise dramatically increases free-radical production and lipid peroxidation. This has been demonstrated in carefully conducted experiments in marathon runners and extreme athletes. There is also some evidence that extreme athletes have a higher incidence of free-radical diseases such as cancer, immune suppression, and cardiovascular disease. Along this same line, but less well-known, is the observation that low-protein diets also increase longevity and high-protein diets are linked to shortened life spans. If confirmed, this finding could diminish the popularity of the high-protein diets being advocated by...

Meat And The Pathology Of Human Disease

The fat in red meats has been identified as having a very high content of saturated fat (Table 7.2). Thus, based on fat content alone, red meat could be considered an atherogenic risk factor that contributes to coronary heart disease and ischemic strokes. A number of prospective studies have linked red meat intake to higher rates of coronary heart disease and stroke.18-22 Recent laboratory data also raise the possibility that the low polyunsaturated to saturated fat ratio in red meats (Table 7.2) increases the permeability of the cell membrane to insulin receptors and thus increases insulin resistance.23-25 This mechanism suggests that increased red meat intake (relative to other meats or no meat intake) could potentially produce a hyperinsulinemic state that would contribute to a higher risk of diabetes, and perhaps certain cancers (prostate, colon, breast). In this context, it is noteworthy that Snowdon has reported a prospective association between red meat intake and increased...

Foundations for practical nutritional information

Disorders from glycation and glycaemia, including vascular disease of retina, kidneys, nerves. Heart disease. Polyuria. A number of health and disease end-points, affecting a large proportion of the population, need to be addressed in developing healthy foods. Some, such as cardiovascular disease, colorectal cancer, osteoporosis, and constipation are associated with a combination of ageing and unhealthy dietary patterns. Others, such as obesity, are largely the result of food processors and marketers successfully providing foods that appeal to the basic human preferences for sweetness and fats, in all age groups. It would be best to design foods with a number of endpoints in mind, and evaluate them with a battery of tests to demonstrate nutritional balance. Producing foods for specific functions or using foods as medicines risks unbalanced nutrient intake. To be health-relevant and useable, food information needs to relate to practically measurable but valid markers linked to health...

Healthrelated roles of Pcarotene

(a) The alpha-tocopherol, beta-carotene (ATBC) Cancer Prevention study, was a randomised-controlled trial that tested the effects of daily doses of 50mg (50 IU) vitamin E (all-racemic a-tocopherol acetate), 20 mg of p-carotene, both or placebo in a population of more than 29 000 male smokers for 5-8 years. No reduction in lung cancer or major coronary events was observed with any of the treatments. What was more startling was the unexpected increases in risk of death from lung cancer and ischemic heart disease with p-carotene supplementation (ATBC Cancer Prevention Study Group, 1994). (b) Increases in risk of both lung cancer and cardiovascular disease mortality were also observed in the beta-Carotene and Retinol Efficacy Trial (CARET), which tested the effects of combined treatment with 30mg d p-carotene and retinyl palmitate (25000IU d) in 18000 men and women with a history of cigarette smoking or occupational exposure to asbestos (Hennekens et al, 1996). (c) The third study was the...

Diet nutrition and the prevention of chronic diseases through the life course

The four relevant factors in fetal life are (i) intrauterine growth retardation (IUGR) (ii) premature delivery of a normal growth for gestational age fetus (iii) overnutrition in utero and (iv) intergenera-tional factors. There is considerable evidence, mostly from developed countries, that IUGR is associated with an increased risk of coronary heart disease, stroke, diabetes and raised blood pressure (9-20). It may rather be the pattern of growth, i.e. restricted fetal growth followed by very rapid postnatal catch-up growth, that is important in the underlying disease pathways. On the other hand, large size at birth (macrosomia) is also associated with an increased risk of diabetes and cardiovascular disease (16,21). Among the adult population in India, an association was found between impaired glucose tolerance and high ponderal index (i.e. fatness) at birth (22). In Pima Indians, a U-shaped relationship to birth Retarded growth in infancy can be a reflected in a failure to gain...

Mineralsgems From The Earths Crust

We hear much more about vitamins than minerals, but minerals are certainly no less important to our health, and are critical for even basic survival. Science has been focusing more attention on their potential link to our protection from major chronic diseases like high blood pressure, osteoporosis, cardiovascular disease and cancer with promising results. As mentioned earlier, too much iron may play a crucial role in oxidation. Researchers in Finland studied about two thousand healthy men for three years. They tracked twenty risk factors for heart disease, and at the end of the study the risk of heart disease was twice as great for those men with high blood levels of iron. The only other risk factor more significant was smoking. *112 We have also mentioned the contributing role that a little known mineral, boron, may play in offering protection from osteoporosis. Certainly calcium is at the forefront of osteoporosis prevention. There are more than sixty minerals in the body which...

Cholesterol metabolism

Apolipoproteins, including As, E, and Cs, are present in HDL particles, apolipopro-teins A-I and A-II represent approximately 80 to 90 of the total apolipoprotein content of HDL. Two clinically defined fractions of HDL exist, i.e., HDL2 and HDL3, which have density ranges of 1.016 to 1.125 g ml and 1.125 to 1.210 g ml, respectively. Nascent HDL is produced mainly in the liver and intestine by the function of ABCA1, a cholesterol transport protein that plays a key role in cholesterol and phospholipid efflux.3233 Nascent HDL particles are short-lived in plasma, becoming mature HDL particles when they acquire cholesterol. Lecithin cholesterol acyltrans-ferase (LCAT) plays a critical role in esterifying free cholesterol from cells, particularly in the extrahepatic tissues, to cholesteryl ester. Numerous studies have shown that HDL protects against cardiovascular disease due, in part, to its participation in reverse cholesterol transport. In this process, excess cholesterol from...

Regional Diet American

It is quite clear that nutritional intake is associated with common health conditions such as obesity, hypertension (high blood pressure), cancer, diabetes (high blood sugar), and cardiovascular disease. People in the United States make daily decisions related to grocery purchases, meal choices, food preparation, and other factors influencing their consumption of food and nutrients, and, thus, likely affecting their health. However, much of the current knowledge and most published works are based on studies or other information that concern the general population. This information is important in influencing dietary patterns, but additional information is needed regarding specific regional and minority populations. Additionally, more detailed information is necessary to determine if there are any differences or similarities between these subpopulations. What follows is a general literature review related to minority groups in the United States.

Meat and micronutrients Iron in meat

Selenium acts as an antioxidant and is considered to protect against coronary heart disease and certain cancers, such as prostate. Meat contains about 10 mg selenium per 100 g, which is approximately 25 of our daily requirement. Beef and pork contain more selenium than does lamb, which may be due to the age of the animal as selenium may collect in the meat over time. Bioavailability of selenium from plant foods was thought to be greater than that from animal foods, but Raised homocysteine, an amino acid metabolite, is an independent risk factor for cardiovascular disease. It is estimated that 67 of the cases of hyperhomo-cysteinemia are attributable to inadequate plasma concentrations of one or more of the B vitamins namely folate, vitamin B6 and vitamin B12. Some enzymes that reduce homocysteine levels require vitamins B6 and B12 as cofactors. Vitamin B6 is a cofactor for two enzyme reactions which catabolise homocysteine to cys-teine via a transulphuration pathway, they are...

Beans Make You Healthy

Legumes are another excellent source of starch and fiber. Some legumes, such as black beans, have up to seven grams of fiber per serving. Eating legumes helps make significant headway toward meeting the current daily fiber recommendation of twenty to thirty-five grams. And beans and peas are loaded with nutrients, including iron and zinc. Many cultures have relied for centuries on the complete nutrition provided by beans and rice and have enjoyed low cardiovascular disease and cancer rates largely because of it.

Diabetes and Microalbuminuria

Microalbuminuria has been shown to be an important risk factor for cardiovascular disease and nephropathy in patients with type 2 diabetes (51). Meta-analysis has shown that the presence of microalbuminuria doubles the risk of cardiovascular morbidity or mortality and doubles the risk of total mortality (51). In patients with diabetes, the presence of microalbuminuria confers a tenfold higher risk of developing diabetic nephropathy annually, compared to patients without microalbuminuria (51). In a large cross-sectional analysis, when compared to patients with diabetes and normoalbuminuria, patients with diabetes and microalbuminuria had a longer duration of diabetes and higher waist-to-hip ratio, systolic and diastolic blood pressure, hemoglobin A1c (HbA1c), ankle-to-arm index, and serum creatinine (51). They were more likely to have a history of retinal laser therapy, hypertension, cerebrovas-cular disease, peripheral vascular disease, require insulin therapy, be smokers, and have...

Rationale for the Use of Soy Phytoestrogens for Neuroprotection

The purpose of this chapter is to stimulate thinking, not just about the potential benefits of the soy phytoestrogens in the brain, but also about the larger issue of the role of diet in general in determining late life health. This chapter will discuss experimental approaches taken to address whether soy phytoestrogens, or isoflavones, can have neuroprotective actions in the mammalian brain. The structural similarity between the soy isoflavones and the natural estrogen, 170-estradiol (Figure 8.1), has been the rationale for experiments by many others that have shown that soy isoflavones can have beneficial effects in models of cardiovascular disease (Anthony et al., 1996 Clarkson et al., 1997), breast cancer, and prostate cancer (both

African American Influences

The prevalence of hypertension, cardiovascular disease, and diabetes is greater among African Americans than other groups. Dietary intake has been strongly associated with both of these conditions for many years. Therefore, it seems prudent to focus on diet in an attempt to reduce the number of premature disabilities and deaths as the result of these conditions.

Guidelines for a prudent diet

The epidemiological evidence linking dietary factors with the diseases of affluence shows that in countries or regions with, for example, a high intake of saturated fat there is a higher incidence of cardiovascular disease and some forms of cancer than in regions with a lower intake of fat. It does not show that people who have been living on a high-fat diet will necessarily benefit from a relatively abrupt change to a low-fat diet. Indeed, the results of a number of intervention studies, in which large numbers of people have been persuaded to change their diets, have been disappointing. Overall, premature death from cardiovascular disease is reduced, but the total death rate remains unchanged, with an increase in suicide, accidents and violent death.

Dietary components and health

The availability of food in Europe has never been as good as in recent decades. Affluent though European countries are, sub-groups of populations experience the deficiency of minerals and micronutrients that play a vital role in health and development (Serra-Majem, 2001). A significant proportion of European infants and children are today experiencing a low dietary intake of iodine and iron (Trichopoulou and Lagiou, 1997a WHO, 1998). The iodine deficiency leads to several disorders collectively referred to as Iodine Deficiency Disorders (IDD), with goitre (hyperplasia of thyroid cells), cretinism (mental deficiency) and severe brain damage being the most common. It is estimated that IDD may affect approximately 16 of the European population. Furthermore, inadequate levels of folate have been implicated with a rise in the blood homocysteine levels, leading possibly to increased risk of cardiovascular disease (CVD). European policies address such deficiencies either by recommending the...