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Health News Archive 18 - Heart (continued)
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• Turmeric Protects Animals Against Heart Damage
• FDA Announces Qualified Health Claims for Omega-3 Fatty Acids
• Fiber Slows the Progression of Cardiovascular Disease
• Fiber Is Good for Your Heart
• DHEA May Lower Risk of Heart Problems & Diabetes
• Beta-Carotene Intake Associated with Reduced Heart Disease
• Mixed Vitamin E tocopherols Better at Preventing Platelet Aggregation
• Calcium Supplements Offer Heart Protection for Postmenopausal Women

Turmeric Protects Animals Against Heart Damage

Turmeric protects against a type of heart damage known as reperfusion injury, according to a new animal study.

Reperfusion is the process where surgeons reinstitute blood flow to heart muscle after the heart muscle has been deprived of blood following a heart attack. While this process has been credited with reducing in-hospital mortality from a type of heart attack known as myocardial infarction, it also releases a flood of free radicals that damage arteries and create the potential for additional damage.

To investigate the effect of turmeric on reperfusion induced heart injuries, researchers gave one group of rats saline orally while another group received 100 mg/kg of turmeric (Curcuma longa) for one month. On the 31st day, the study authors closed the coronary artery of rats in both groups for 45 minutes, blocking blood flow. Then, the scientists reperfused the artery, reinstalling blood flow. The reperfusion resulted in a number of damaging effects, including cardiac necrosis, depression in left ventricular function, decline in antioxidant status and elevation in lipid peroxidation in the control group.

In the turmeric-treated group, the myocardial infarction produced after the reperfusion was significantly reduced. Turmeric treatment also restored the myocardial antioxidant status compared to controls. In addition, turmeric significantly inhibited the lipid peroxidation that occurred after reperfusion. Turmeric's protective effects translated into functional recovery of the heart, the researchers noted.  Microscopic study of the rats' hearts further confirmed the protective effects of turmeric.

The researchers concluded, "The cardioprotective effect of turmeric (Curcuma longa) likely results from the suppression of oxidative stress and correlates with the improved ventricular function."

Reference: Mohanty I, Singh Arya D, Dinda A, Joshi S, Talwar KK, Gupta SK. Protective effects of Curcuma longa on ischemia-reperfusion induced myocardial injuries and their mechanisms. Life Sci. 2004 Aug 20;75(14):1701-11.    

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FDA Announces Qualified Health Claims for Omega-3 Fatty Acids

The Food and Drug Administration (FDA) today announced the availability of a qualified health claim for reduced risk of coronary heart disease (CHD) on conventional foods that contain eiscosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) omega-3 fatty acids.

Typically, EPA and DHA omega-3 fatty acids are contained in oily fish, such as salmon, lake trout, tuna and herring. These fatty acids are not essential to the diet; however, scientific evidence indicates that these fatty acids may be beneficial in reducing CHD.

"Coronary heart disease is a significant health problem that causes 500,000 deaths annually in the United States," said Dr. Lester M. Crawford, Acting FDA Commissioner. "This new qualified health claim for omega-3 fatty acids should help consumers as they work to improve their health by identifying foods that contain these important compounds."

A qualified health claim on a conventional food must be supported by credible scientific evidence. Based on a systematic evaluation of the available scientific data, as outlined in FDA's "Interim Procedures for Qualified Health Claims in the Labeling of Conventional Human Food and Human Dietary Supplements", FDA is announcing a qualified health claim for EPA and DHA omega-3 fatty acids. While this research is not conclusive, the FDA intends to exercise its enforcement discretion with respect to the following qualified health claim:

"Supportive but not conclusive research shows that consumption of EPA and DHA omega-3 fatty acids may reduce the risk of coronary heart disease. One serving of [name of food] provides [x] grams of EPA and DHA omega-3 fatty acids. [See nutrition information for total fat, saturated fat and cholesterol content.]

In 2000, FDA announced a similar qualified health claim for dietary supplements containing EPA and DHA omega-3 fatty acids and the reduced risk of CHD. FDA recommends that consumers not exceed more than a total of 3 grams per day of EPA and DHA omega-3 fatty acids, with no more than 2 grams per day from a dietary supplement.

The EPA and DHA omega-3 fatty acid qualified health claim is the second qualified health claim that FDA has announced for conventional food. For additional information about QHC visit: http://www.cfsan.fda.gov/~dms/lab-qhc.html.

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Fiber Slows the Progression of Cardiovascular Disease

The December 2003 issue of the American Journal of Clinical Nutrition published findings obtained from the Los Angeles Atherosclerosis Study.  This prospective study is investigating factors involved in atherosclerosis progression on the ability of fiber to help combat atherosclerosis. Five hundred men and women between the ages of 40 and 60 with no history of cardiovascular events received baseline examinations and were followed for 3 years. Dietary information was obtained through in-person and telephone interviews at the beginning of the study and at the first follow-up at eighteen months. Intima-media thickness of the common carotid arteries (a measure of atherosclerosis) was determined by ultrasound examination at the study's onset, at eighteen months, and at the three year study end. Blood samples taken at all three examinations provided data on serum lipid levels.

The median total fiber intake in the highest fifth of the study population was found to be twice that of the lowest fifth. Intima-media thickness progression declined with an increase in fiber intake. The trend was significant for viscous (soluble) fiber found particularly in fruit and vegetables, and pectin. Controlling for the intake of fruit and vegetables, which have other antiatherogenic constituents, did not alter the findings.

Increased high density lipoprotein levels were correlated with an increase in total fiber, viscous fiber and pectin. Additionally, the ratio of total cholesterol to HDL cholesterol was inversely related to total fiber, viscous fiber and pectin intake. These findings support the hypothesis that fiber retards the progression of cardiovascular disease through its effect on lipids.

The researchers concluded that “The present study suggests that increased dietary fiber intake has significant cardiovascular benefit and that the regulation of serum lipids by dietary fiber may be partially involved in the process of slowing the progression of atherosclerosis.” 

Source: Wu H et al, “Dietary fiber and progression of atherosclerosis: the Los Angeles Atherosclerosis Study,” Am J Clin Nutr 2003; 78:1085-91.

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Fiber Is Good for Your Heart

The likelihood of developing heart disease is lower with a diet high in fiber, especially water-soluble fiber, according to a study in the September 2003 issue of The Archives of Internal Medicine, published by the American Medical Association.

The findings are based on data from nearly 10,000 subjects participating in the National Health and Nutrition Examination Survey I Epidemiologic Follow-up study. When they enrolled, the participants completed a 24-hour dietary recall questionnaire, which was used to calculate nutrient intake.

Participants were followed for an average of 19 years. During that time, over 1,800 cases of coronary heart disease occurred, as well as nearly 3,800 cases of other vascular diseases.

Dr. Jiang He of Tulane University in New Orleans, and others, estimate that individuals with the highest amount of fiber in their diet had a 12 percent lower risk of heart disease than those with the lowest intake of fiber. The reduction in risk of other vascular diseases with high fiber consumption was 11 percent.

Protection against heart disease was even stronger for high levels of soluble fiber consumption, with a reduction in risk of 15 percent.

The results "support the existing American Heart Association recommendations to increase dietary fiber intake from foods to approximately 25 to 30 grams per day," Dr. He's group concludes.

SOURCE: Archives of Internal Medicine, September 8, 2003.

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DHEA May Lower Risk of Heart Problems & Diabetes

DHEA, a popular supplement with men, can reduce artery stiffness and improve the body's sensitivity to insulin.  These effects may lower the risk of heart disease -- reports a study published July 2003 in the Journal of Clinical Endocrinology and Metabolism.

Levels of DHEA, also known as dehydroepiandrosterone, decrease with age, and this is linked to an increased risk of coronary artery disease.

Japanese researchers studied the effect of replenishing the hormone in 24 older men with high cholesterol levels. Half the men were given 25 milligrams of DHEA daily for 12 weeks, while the other half were given a placebo.

DHEA treatment produced a significant improvement in endothelial function, a measure of artery flexibility. This benefit was apparent after just 4 weeks of treatment, note Dr. Hiroaki Kawano and a team from Kumamoto University School of Medicine in Japan. No comparable benefit was noted in the patients taking placebo.

Treatment with DHEA also produced a significant drop in blood sugar levels without altering insulin levels. In other words, it improved insulin sensitivity, the researchers report in The Journal of Clinical Endocrinology and Metabolism.

"DHEA has been demonstrated to have an anti-atherosclerotic effect in animal models and there are some reports that DHEA may have a protective effect against age-related illnesses in humans," the investigators note. Their findings shed light on how DHEA supplements may produce these benefits.

SOURCE: The Journal of Clinical Endocrinology and Metabolism, July 2003.  

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Beta-Carotene Intake Associated with Reduced Heart Disease

Higher intakes of alpha- and beta-carotene may reduce the risk of coronary artery disease in women, according to a study published in the American Journal of Clinical Nutrition in June 2003.

To track the consumption of carotenoids and other nutrients in women, researchers asked 73,286 female nurses to complete a food-frequency questionnaire in 1984. The women were followed for 12 years and dietary information was updated in 1986, 1990, and 1994. During the follow-up period, there were 998 incident cases of coronary artery disease. After adjusting for other heart disease risk factors, the researchers observed that the women with the highest intake of beta-carotene and alpha-carotene experienced a modest but significantly reduced risk of coronary artery disease.

Source: Osganian SK, Stampfer MJ, Rimm E, Spiegelman D, Manson JE, Willett WC. Dietary carotenoids and risk of coronary artery disease in women. Am J Clin Nutr. 2003 Jun;77(6):1390-9.

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Mixed Vitamin E tocopherols Better at Preventing Platelet Aggregation

A study published in the March 2003 issue of the American Journal of Clinical Nutrition showed a mixture of tocopherols, rich in the gamma-tocopherol fraction of Vitamin E, to be more effective than alpha-tocopherol in inhibiting platelet aggregation. Prevention of blood clots through platelet aggregation inhibition has long been attributed to vitamin E, and alpha-tocopherol has until recently been the only form of the vitamin to be recognized.

Researchers at the University of Uppsala in Sweden randomly provided forty-six participants with a Vitamin E supplement consisting of alpha-tocopherol, mixed tocopherols or a placebo for eight weeks. Blood samples were taken at the study's onset and at the end of the eight-week period. The samples were tested for platelet aggregation in response to two different inducers - nitric oxide release, activation of endothelial constitutive nitric-oxide synthase and protein kinase C, and platelet content of superoxide dismutase and other factors.

Platelet aggregation was significantly reduced in the group receiving mixed tocopherols, but not in the groups receiving alpha-tocopherol or the placebo. Nitric oxide release and endothelial constitutive nitric-oxide activation were increased in the groups receiving alpha tocopherol, but more so in the mixed tocopherols group. Platelet superoxide dismutase was also increased in both of the tocopherol groups, while protein kinase C activation was decreased.

Although epidemiologic studies have demonstrated a lower cardiovascular event risk associated with a higher intake of vitamin E from diet, studies administering the vitamin as a supplement have provided conflicting results. The fact that alpha-tocopherol was the only vitamin E fraction used in these studies, and the evidence obtained in this study of a greater benefit from Vitamin E mixed tocopherols on platelet aggregation and factors involved with platelet aggregation may be an explanation for this puzzling dichotomy.

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Calcium Supplements Offer Heart Protection for Postmenopausal Women 

The American Journal of Medicine, April 2002, published the results of a study which demonstrated that calcium citrate supplements lower the damaging component of blood cholesterol LDL and raise HDL in postmenopausal women. 

Two hundred twenty three women who were not being treated for hyperlipidemia or osteoporosis were randomized to receive one gram calcium in the form of calcium citrate, or a placebo daily for one year. Fasting high density lipoprotein (HDL) cholesterol, low density lipoprotein (LDL) and triglyceride levels were measured at the study's onset and at two months, six months and one year.

At the study conclusion, the women who received calcium had higher HDL levels, greater HDL to LDL ratios, and a slight decline in LDL cholesterol levels compared to the placebo group.

Research team leader Dr Ian R Reid, Professor of the Department of Medicine at the University of Auckland in New Zealand, summarized, "This study showed that 1 gram of calcium (as the citrate) taken daily lowers the damaging component of blood cholesterol (LDL or low-density lipoprotein), and increases the protective cholesterol (HDL or high-density lipoprotein). As a result, calcium citrate may reduce the incidence of heart attacks and angina in postmenopausal women. Based on our data, one could predict that calcium citrate supplements may help otherwise healthy postmenopausal women reduce cholesterol, improve heart health and possibly even reduce the rate of cardiovascular related events by 20 to 30 percent. These data provide reason to encourage the more widespread use of calcium supplementation in postmenopausal women... Our results indicate that the benefits of calcium supplementation go beyond osteoporosis.”

The authors conclude that calcium leads to positive changes in lipids and write, "This suggests that a reappraisal of the indications for calcium supplementation is necessary, and that its cost effectiveness may have been underestimated." 

Source: Reid, et al, American Journal of Medicine, volume 112, issue 5, pp 343-347.

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