The Heart Attack Culprit: Cholesterol Isn't to Blame

Dr. Barry Sears,

Author of The Omega RX Zone: The Miracle of the New High-Dose Fish Oil by Dr. Barry Sears.
Zone Living

 

 

 

 Heart disease is the number-one killer of American men and women today.

"To live a longer and better life is to reduce the likelihood of developing heart disease and the average life expectancy of every American would increase by an estimated ten years."

"The underlying cause of heart disease – a decrease in blood flow to the heart and an increase in inflammation in the arteries. These both result from an increased production of “bad” eicosanoids."

"In fact, 50 percent of the people who are hospitalized with heart attacks have normal cholesterol levels, and 25 percent of people who develop premature heart disease have no traditional risk factors at all."

"...The likelihood of future heart attacks has everything to do with excess levels of “bad” eicosanoids – exactly the hormones that can be modified by my dietary recommendations.

A heart attack is simply the death of muscle cells in the heart from a lack of oxygen. This occurs when blood flow can’t reach the heart because of a blockage or clot in the arteries  

Causes of Heart Attacks

1. Clot formation: This occurs when a clot in the arteries caused by a clumping of blood platelets.

2. Plaque instability: Inflammation causes an unstable plaque to break off and block the blood flow in the artery.
3. Vasospasm: Sometimes a spasm in the artery blocks the flow to the heart.
4. Electrical chaos (sudden death):  The heart goes into electrical chaos and stops its synchronized beating on its own.

Recently has shown that elevated insulin puts one at a increased risk of heart disease. The reason is being that excess insulin causes body to overproduce “bad” eicosanoids altering the good eicosapentaenoic acid (EPA) vs bad arachidonic acid (AA) ratio of 1:6. It is noted that proper diet and or supplements (containing omega 3 and omega 6 in right balance) can restrict the excess formation of “bad” eicosanoids.

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"This unique test measures the ratio of arachidonic acid (AA) to eicosapentaenoic acid (EPA) in plasma. This ratio of the principle omega-3 and omega-6 fatty acids is a measure of the body's eicosanoid balance. Balancing the eicosanoids in the body is an excellent way for managing heart disease and other chronic and inflammatory processes.

Metametrix clinical laboratory

AA/EPA Ratio Profile - Plasma

A Measure of “Silent” Inflammation

http://www.metametrix.com/test-menu/profiles/fatty-acids/aaepa-ratio

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The Importance of TG/HDL Ratio

It indicates the type of LDL  particle and insulin level  in the body.

a) Ratio is less than 2 indicates  predominantly harmless large, fluffy LDL particles.

b) Ratio is greater than 4 indicates a lot of small, dense LDL particles that can accelerate the development of atherosclerotic plaques regardless of your total cholesterol levels.

c) A high TG/HDL ratio is a surrogate marker for elevated insulin.

How to Improve TG/HDL Ratio

Two ways:

 First: To decrease insulin levels. Excess insulin has been shown to increase triglyceride levels.

Second: To supplement diet with high-dose, ultra refined-grade fish oils.*

The fastest and most effective way is to do both simultaneously.

 

A study conducted by Gerald Reaven at Stanford:

Ppatients were put on diets consisting of the same number of calories but differing in their protein-to-carbohydrate ratio.

When the group consumed a high-carbohydrate diet, they had a much higher TG/HDL ratio than when they switched to a lower-carbohydrate diet. These changes occurred within four weeks of each dietary change.

Bruce Holub at the University of Guelph in Canada has shown that postmenopausal women can rapidly reduce TG/HDL ratio by diets with 3.5 grams of ultra refined-grade fish oil per day.

Copenhagen Male Study: The effect of this ratio on the long-term development of heart disease. The researchers tracked healthy patients who had either a low TG/HDL ratio (less than 1.7) or a high TG/HDL ratio (greater than 6). 

The patients with the low TG/HDL ratio who smoked, didn’t exercise, had hypertension, and had elevated levels of LDL cholesterol had a much lower risk of developing heart disease than those who had a far better lifestyle but a higher TG/HDL ratio.

 This indicates that lower TG/HDL ratio should be goal to reduce heart disease.Life style modification helps to lower this ratio.

1970s: Russell Ross of the University of Washington pointed out that atherosclerosis was an inflammatory disease (like Alzheimer’s disease).

In 1995, statins were found to be far more effective at preventing heart attacks than previous cholesterol-lowering drugs.

Thee statins lower cholesterol levels and also powerful anti-inflammatory agents. The researchers at the Harvard Medical School found that pro-inflammatory C-reactive proteins were highly predictive markers for an increased risk of heart disease. 

They and other researchers found that statins lowered the C-reactive proteins level. The  greatest impact was noted in patients with highest levels of C-reactive protein. Aspirin also reduces inflammation and thus reduce heart attacks. Aspirin is cheaper and more effective.

Heart Disease and Inflammation

Reduction of  inflammation reduces our death rate from heart attacks.

1970s  epidemiological studies revealed that Eskimos in Greenland had virtually no heart disease even though they consumed a high-fat diet.

Additional studies suggested that more fish consumption lead to the lower risk of dying from heart disease.

The DART study showed that eating one serving of fish per week decreased heart attacks by 29 percent in patients who had had a previous heart attack. 

It was the fish oil in the fish that conferred these protective benefits,to lesser extent, people who eat fish have healthier lifestyles in general.

GISSI trial: Patients with heart disease who took about 1 gram per day of ultra refined-grade long-chain omega-3 fatty acids had a 45 percent reduction in their risk of having a sudden fatal heart attack, a 30 percent reduction in their total risk of cardiovascular mortality, and a 20 percent reduction in overall mortality. 

Vitamin E given by itself or in combination with fish oil had no benefits.

The Lyon Diet Heart Study: Survivors of heart attacks were split into two groups. "One group was put on a diet that followed the American Heart Association recommendations (basically the USDA Food Pyramid), and the second group was put on a Mediterranean-type diet (rich in fruits, vegetables, and fish; supplemented with short-chain omega-3 fatty acids; and very low in omega-6). 

At the end of four years, the two groups had the same cholesterol levels. There was, however, a more than 70 percent reduction in both fatal and nonfatal heart attacks in the group on the Mediterranean diet compared with the control group, who were allowed to eat hefty amounts of omega-6 fatty acids.

 This study was very damaging for the cholesterol theory of heart disease."

However, there are many other studies indicating definite relationship between cholesterol and coronary artery disease. CAD is multi-factorial disease.

The group on the Mediterranean diet experienced no sudden deaths (an electrical chaos in the heart, which makes it stop beating in rhythm and is the primary cause of cardiovascular mortality).

The primary difference between the two groups was the ratio of the arachidonic acid to eicosapentaenoic acid in the blood. The AA/EPA ratio of the individuals in the active group was 6.1, compared with 9.0 in the group following the American Heart Association diet.

 Thus, a 30 percent reduction in the AA/EPA ratio resulted in a greater than 70 percent reduction in fatal and nonfatal heart attacks, despite the fact that the TG/HDL ratio didn’t change for either group.

The AA/EPA ratio is by far the most powerful predictor of future heart disease.

The group on the Mediterranean diet never reached an AA/EPA ratio of 1.5, which is similar to that found in the Japanese, who have the lowest rates of heart disease in the world. 

Also, the TG/HDL ratio was still elevated in both groups in the study, and this indicates that insulin levels hadn’t been lowered and that both groups were still eating diets too rich in carbohydrates.

"My dietary program represents a considerable improvement over the intervention diets used in both the GISSI study and the Lyon Diet Heart. Where the GISSI study provided a little less than 1 gram of pharmaceutical-grade fish oil, I recommend five times as much. (You need at least 3 to 4 grams of ultra refined long-chain omega-3 fatty acids per day to lower triglycerides and thus lower the TG/HDL ratio.) While the Lyon Diet Heart Study recommended eating more fruits, I recommend 10 to 15 servings of fruits and vegetables per day.

Compared with the Lyon Diet Heart Study, my dietary program would have lowered the TG/HDL ratio through improved insulin control (which reduces the production of “bad” eicosanoids) and would have provided greater eicosanoid control with the increased intake of ultra refined-grade fish oil. These differences would have been reflected in the blood by the reduction of the TG/HDL and AA/EPA ratios. On the basis of all the available evidence we have from prospective studies, achieving the clinical goals that define the Omega Rx Zone would bring your risk of heart disease down to almost zero."

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Excerpted from The Omega RX Zone: The Miracle of the New High-Dose Fish Oil by Dr. Barry Sears. Copyright © by Dr. Barry Sears.

*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease. As with any natural product, individual results will vary.

For more information about Dr. Barry Sears, his incredible fish oil supplements, or the popular Zone Diet, please visit www.zoneliving.com.

Dr. Barry Sears is a leader in the field of dietary control of hormonal response. A former research scientist at the Boston University School of Medicine and the Massachusetts Institute of Technology, Dr. Sears has dedicated his efforts over the past 25 years to the study of lipids and their inflammatory role in the development of chronic disease. He holds 13 U.S. patents in the areas of intravenous drug delivery systems and hormonal regulation for the treatment of cardiovascular disease.