Food to Restore a Heart

reproduced from Aurametrix

We know that diet, exercise and low-stress life will keep the heart healthy. But sometimes things happen that are beyond our control.

Thanks to more coordinated, faster emergency response and improved treatment, heart attacks aren't as deadly as they used to be. But survivors still face a substantial risk of further cardiovascular events.

How to restore after a heart attack and prevent another one? What to do besides obvious things such as taking medications, reducing stress, calories, avoiding urban air pollution and getting rid of bad lifestyle habits like smoking?

Increase Cereal Fiber

Dietary fiber helps to lower cholesterol levels (as it inhibits cholesterol synthesis, increases the production of short-chain fatty acid and the rate of bile excretion), blood pressure, glucose absorption, improving insulin sensitivity, and increasing levels of antioxidants. A high-fiber diet, in general, was associated with a 31% reduction in dying from any cause and a 35% reduction in death from heart disease among over 4 thousand heart attack survivors from the Health Professionals Study and the Nurses’ Health Study.

More recent Harvard study went a step further analyzing the types of fiber consumed by thousands of men and women who survived a first myocardial infarction (MI). All participants of the study increased their average dietary fiber intake after MI, and the greater the increase, the lower was the risk of subsequent all cause and cardiovascular mortality. among cereal fiber, fruit fiber, and vegetable fiber,  only intake of cereal fiber was strongly inversely associated with lower all cause and cardiovascular mortality: pooled hazard ratio 0.73 (0.58 to 0.91) for all cause mortality, 0.72 (0.52 to 0.99) for cardiovascular mortality. In the general population, a 20-40% risk reduction in coronary heart disease has consistently been observed among those who consume fiber-rich whole grains regularly

An earlier study of over 31,000 California Seventh-day Adventists found a 44% reduced risk of nonfatal coronary heart disease and an 11% reduced risk of fatal coronary heart disease for those who ate whole wheat bread compared with those who ate white bread.

One minor change in diet could, indeed, save a life.  

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Don't overdo it on the protein

Low carbohydrate plant diets might be beneficial in reducing blood pressure ​and reducing cholesterol.

Yet, Dr Shanshan Li and her Harvard colleagues did not find a health benefit for heart attack survivors from a low carbohydrate diet even if it was low in fat and came from plant sources.

Greater adherence to a low carbohydrate diet high in animal sources of fat and protein was associated with higher all-cause and cardiovascular mortality post-MI.

According to the Institute of Medicine. healthy individuals should get at least 10% of their daily calories, but not more than 35%, from protein. Heart attack survivors in the Harvard and the Nurses’ Health Study ate from 15% to 20% protein (65 to 40% carbohydrates) and the lowest intake of protein seemed to be the best. It also correlated with the lowest intake of fat. Associations between the animal-based low carbohydrate diets and mortality were diminished after additionally adjusting for saturated fat.

A few older studies suggested that low carbohydrate plant-based diet may slightly decrease coronary heart disease in women and heart-healthy individuals, but there might be different dietary benefits in those survived from a heart attack.   

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Plant diets are definitely good for restoring the hearts. A study by Cleveland clinic  found that a plant-based diet in conjunction with cholesterol-reducing medication reversed heart disease in 70% of patients over a 12-year period. Vegetable oils high in linoleic acid (afflower oil, soybean oil, sunflower oil, and cottonseed oil.), though, failed to reduce heart disease and overall mortality and seemed to be actually worse for heart health than eating butter.
Nuts - eaten several times a week in small amounts - shown a consistent 30% to 50% lower risk of myocardial infarction, sudden cardiac death, or cardiovascular disease, as seen from several of the largest cohort studies, including the Adventist Study, the Iowa Women’s Health Study, the Nurses’ Health Study, and the Physicians’ Health Study.

The Stanford Coronary Risk Intervention Project followed 300 people with coronary artery disease for four years and found the best predictor of new coronary blockages was dietary fat intake. As fat intake rose, the number of coronary blockages rose. Those patients with the lowest intake of dietary fat (about 10% to 15%) had the greatest amount of improvement and plaque shrinkage.

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One day there could be probiotics for heart disease.

Research from Cleveland clinic proposes a new link between animal protein and coronary heart disease (CHD) that doesn’t involve cholesterol, but is mediated through "bad" for heart bacteria converting  trimethylamine to Trimethylamine N-oxide (TMAO) in the liver. The researchers followed roughly 4,000 adults for three years. At the end of the study period, those with the highest levels of TMAO had a 2.5-fold increased risk of heart attack, stroke and death.

Firmicutes Ruminococci are some of those bad bacteria, while Bacteroidales S24-7, an abundant family from Bacteroidetes, are inversely associated with TMA and TMAO levels.

And here is the last tip from Dr. Oz  - a sample diet he claims could reverse your heart disease in 28 days:
Breakfast

• Oatmeal with dried cranberries
• 4oz. of natural vegetable or fruit juice

Eating oatmeal is a great non-fat way to get your complex carbohydrates.
Morning Snack

• Non-fat granola bar
• Banana
• One cup of tea; green tea, without milk or sugar, is ideal

Lunch

• Stir-fried veggies with low-sodium teriyaki sauce and brown rice
• Green salad with edamame, chickpeas, beans and fat-free raspberry dressing, and one whole wheat roll

A lunch like this provides plenty of protein, from non-animal sources.
Dinner

• Tacos: black beans, brown rice, fat-free sour cream, fat-free cheese and salsa; corn tortillas

These tacos are low in fat and high in protein.
Night Snack

• Hummus with assorted dipping vegetables

REFERENCES

Li S, Flint A, Pai JK, Forman JP, Hu FB, Willett WC, Rexrode KM, Mukamal KJ, & Rimm EB (2014). Low carbohydrate diet from plant or animal sources and mortality among myocardial infarction survivors. Journal of the American Heart Association, 3 (5) PMID: 25246449

Li S, Flint A, Pai JK, Forman JP, Hu FB, Willett WC, Rexrode KM, Mukamal KJ, & Rimm EB (2014). Dietary fiber intake and mortality among survivors of myocardial infarction: prospective cohort study. BMJ (Clinical research ed.), 348 PMID: 24782515

Flight I, Clifton P. Cereal grains and legumes in the prevention of coronary heart disease and stroke: a review of the literature. Eur J Clin Nutr2006;60:1145-59.

Rimm EB, Ascherio A, Giovannucci E, Spiegelman D, Stampfer MJ, Willett WC. Vegetable, fruit, and cereal fiber intake and risk of coronary heart disease among men. JAMA1996;275:447-51.

Smith SC et al. AHA/ACC Guidelines for Secondary Prevention for Patients With Coronary and Other Atherosclerotic Vascular Disease: Circulation. Vol. 113:2363-2372.

Halton TL, Willett WC, Liu S, Manson JE, Albert CM, Rexrode K, Hu FB. Lowcarbohydrate-

diet score and the risk of coronary heart disease in women.

N Engl J Med. 2006;355:1991–2002.

Fung TT, van Dam RM, Hankinson SE, Stampfer M, Willett WC, Hu FB. Lowcarbohydrate

diets and all-cause and cause-specific mortality: two cohort

studies. Ann Intern Med. 2010;153:289–298.

Gustenhoff P et al. Effect of fish oil on heart rate variability in survivors of myocardial infarction: a double blind randomised controlled trial. Br Med J 1996;312:677-8.

Predicting catastrophic health events - noninvasively and short term

"I've just picked up a fault in the AE35 unit. It's going to go 100% failure in 72 hours". These were famous words of the almighty computer HAL in "2001: A Space Odyssey". Few of us believe too much in software forecasts - be it weather, earthquakes or computer hard disk failures. Yet, we all know that sometimes it works. And such systems are very valuable, assuming they continuously improve.

Word cloud generated from QS #15 intros

Wellness is always a common theme of the many presentations and experiments of Quantified Self enthusiasts - citizen scientists quantifying everyday life in order to improve it.  "Health" was the most frequent word among the two-word introductions of QS #15 attendees, followed by variations of sleep and happiness, and ways to measure and understand it.
Are health failures predictable?  Nobody argues they are, although most available services  - such as genomic testing - provide only long term predictions.  Biomarkers that scientists are interested in are obtained through invasive or costly interventions - like blood proteins or intracranial electroencephalograms. Technologies such as Mobile Cardiac Outpatient Telemetry™ (MCOT™) developed by CardioNet  are based on real time EKG focused on heart rhythm abnormalities that can't be detected in small 24 or 48 hour windows. These relatively rare events are correlated with symptoms and used for diagnostics.

Your husband just died, … here’s his black box
(from Gordon Bell's presentation)

Perhaps in the future every one of us will leave a black box holding all the truth about our health, helping next generations to better maintain, test and repair their bodies. Many lives have already contributed to the understanding of causes and effects such as the link between cholesterol levels, diet and heart attack. But what about the short term prediction horizon,  like the 72-hour window of HAL or 30 seconds to 15-to-45 minutes warning by seizure dogs?
Could computer luminary Gordon Bell predict his heart attack if he wore his heart monitor strap while bicycling?  A cardiologist would say "no way", but maybe sometimes it's better to keep quantifying and experiment despite of what medical establishment has to say?
Data from the Women’s Health Initiative study (129,135 postmenopausal women observed over a period of nearly eight years) show that a woman’s resting heart rate may be a good indicator of her risk for a heart attack. Hsia and others (2009) found that women whose resting heart rate is more than 76 beats per minute are significantly more likely to have a heart attack than women with resting heart rate less than 62 beats a minute. This risk factor is particularly strong for women between the ages of 50 and 64, less so for women over the age of 65. (Trial NCT00000611)

Of course, women have different kinds of heart attacks than men do. They are more likely to die from a spasms of heart and the blood vessels leading to the heart, and are more likely to complain of fatigue and sleep disturbances in the weeks and months leading up to a heart attack. Sleep disturbances and decreased physiological differences between day and night are increasing heart attack and stroke risks for males too, at least for shift workers. Exercise tests  - known for their false positive results - have better cardiovascular prognostic value for smokers with high cholesterol than healthy men.

Finger arterial pulsatile volume changes or finger blood flow - related to blood pressure - is another medium-to-long term predictor of pending cardiac events. A simple, noninvasive finger sensor test called EndoPAT  can predict major cardiac events such as a heart attack or stroke for people who are considered at low or moderate risk.

AngelMed Guardian System (inventor: Dr. Tim Fischell) is an early warning system - telling 24 hrs to a week before if heart attack is coming. Average time between the cardiac event and hospital arrival is 3 hrs, and about 5 hrs before the surgery starts. By that time 90% of muscles could be dead, so 5 or 10 minute warnings could save lives.  Unfortunately, Guardian is highly invasive - sized as an iPod, it is implanted directly into the patient's chest, monitoring electrogram  waveforms and other crucial heart-signal data 24-7.

Many portable oximeters and ECG are already in the market - and even though consumers are complaining about noise and difficulties in getting readings of diagnostic intervals, the technologies will continue to improve and self-quantifiers will be finding solutions for better health.

REFERENCES
Hsia, J., Larson, J., Ockene, J., Sarto, G., Allison, M., Hendrix, S., Robinson, J., LaCroix, A., Manson, J., & , . (2009). Resting heart rate as a low tech predictor of coronary events in women: prospective cohort study BMJ, 338 (feb03 2) DOI: 10.1136/bmj.b219


Mayo Clinic (2009). High resting heart rate could predict heart attack in women. Mayo Clinic women's healthsource, 13 (7) PMID: 19498326

Sit less, Move more

I am typing this standing in front of my computer. My tall chair is aside. 

About a year ago, I realized that I felt better when I stood while working. It turned out I was not alone in this discovery; more and more people are opting for a vertical approach to work, and the benefits are becoming increasingly evident.

We're all familiar with the age-old advice to "eat less and exercise". But this may not be enough. As shown in a recent study, exercise does not counteract the ill effects of sedentary lives, we should keep moving (or at least squatting) throughout the day too.  New York Times article about the study (The men who stare at screens) immediately got up-votes from over 100 hackers - those who spend hours staring at screens to code, along with 100+ comments from those staring at screens to read and comment on the news.  Stand up while you read this, asked NYT earlier this year. Prolonged sedentarity affects not only cardiovascular and metabolic health, blood clotting, diabetes and cancer. Countless hours of sitting could cause many other ailments reducing the quality of life such as skewed microbial ecology accompanied by strong body odor, diminishing overall quality of life.

Health promotion efforts targeting physical inactivity should emphasize both reducing sedentary activity and increasing regular physical activity for optimal health.

The lead author of the 2010 study says: "Stand up. Pace around your office. Get off the couch and grab a mop or change a light bulb the next time you watch ‘‘Dancing With the Stars.’’ A five-minute stroll is recommended every half hour.

Stand-up desks and treadmill desk were available years ago, a web site just stand was created for office workers who sit long hours each day, but either the desks are not very usable yet, lobbying your boss for a stand-up workstation is still tricky or most people just like sitting too much. Let's hope this will change.

References

Warren TY, Barry V, Hooker SP, Sui X, Church TS, & Blair SN (2010). Sedentary behaviors increase risk of cardiovascular disease mortality in men. Medicine and science in sports and exercise, 42 (5), 879-85 PMID: 19996993 DOI: 10.1249/MSS.0b013e3181c3aa7e

Dunstan DW, Barr EL, Healy GN, Salmon J, Shaw JE, Balkau B, Magliano DJ, Cameron AJ, Zimmet PZ, & Owen N (2010). Television viewing time and mortality: the Australian Diabetes, Obesity and Lifestyle Study (AusDiab). Circulation, 121 (3), 384-91 PMID: 20065160 
DOI: 10.1161/CIRCULATIONAHA.109.894824

Katzmarzyk PT, Church TS, Craig CL, & Bouchard C (2009). Sitting time and mortality from all causes, cardiovascular disease, and cancer. Medicine and science in sports and exercise, 41 (5), 998-1005 PMID: 19346988 DOI: 10.1249/MSS.0b013e3181930355

Healy GN, Dunstan DW, Salmon J, Shaw JE, Zimmet PZ, Owen N. (2008). Television time and continuous metabolic risk in physically active adults. Medicine and Science in Sports and Exercise 40, 639-645.(PMID: 18317383) 

Khaw K-T, Wareham N, Bingham S, Welch A, Luben R, et al. (2008) Combined Impact of Health Behaviours and Mortality in Men and Women: The EPIC-Norfolk Prospective Population Study. PLoS Med 5(1): e12. doi:10.1371/journal.pmed.0050012 (PMID: 18184033)

Beasley R, Raymond N, Hill S, Nowitz M, Hughes R. (2003) eThrombosis: the 21st century variant of venous thromboembolism associated with immobility. Eur Respir J.  21(2), 374-6. (PMID: 12608454 )

Aurametrix is developing next-generation systems for Personal Health Management. Better solutions for a healthier world

Additional references post-initial publication:

Gao W, Sanna M, Chen YH, Tsai MK, Wen CP. Occupational Sitting Time, Leisure Physical Activity, and All-Cause and Cardiovascular Disease Mortality. JAMA Network Open. 2024 Jan 2;7(1):e2350680-.

 

The Benefits of Exercise

Image by mikebaird via Flickr

Execise is good. It can halve your risk of developing many major illnesses (including type 2 diabetes, coronary heart disease, osteoporosis, cancers - e.g., it protects against bowel cancer; for older women, it may cut breast cancer risk). Benefits of regular exercise include increasing levels of HDL ('good' cholesterol) and reducing high blood pressure. It promotes bone density to protect against osteoporosis, improves sleep, reduces stress and risk of depression and dementia later in life.


Daily Exercise is good for you

What could make us eat healthy?

What could make us eat healthy? Better self-evaluation, self-awareness through personal health management tools, says Aurametrix.

Although the majority of Americans acknowledges importance of healthy diets, this does not always translate into behavior change. Taste, preferences acquired during childhood and adolescence, friends and family, and media have more influence on what we eat. In 1997, for example, food manufacturers spent 44.4% of their advertising budget on prepared convenience foods, confectionery and snacks, and bakery goods compared with only 2.2% on fruits, vegetables, grains and beans. Besides, busy people prefer prepackaged foods and restaurant meals, which are not the healthiest choices either.

Healthy eating index (HEI, developed by USDA) is a predictor of childhood diabetes, obesity, and mortality - it's associated with 4 of the 10 leading causes of death (coronary heart disease, certain types of cancer, stroke, and type 2 diabetes).

The quality of the American diet slightly improved since 1989 (the first year the Index was calculated), but flattened since 1996. In 1989 the average HEI score was 61.5, in 1996 and
1999-2000 it was 63.8, a 4-percent increase, but still in the “needs improvement” range. People seemed to be somewhat cutting down on fat, but were consuming even more salt. Excess salt consumption occurs throughout the world. Korean government even developed a salt sensor to help people eat healthier.

US studies of 1999-2000 showed that the two lowest mean scores were for the fruits (3.8) and milk (5.9) components of the HEI: Only 17% of the people consumed the recommended number of servings of fruit per day, and only 30% met the dietary recommendation for milk.

More recent studies on diet quality in Canada display even less optimistic results. Canadians are not eating enough servings of dark green and orange vegetables, as well as of whole fruits and whole-grain products.

Age-dependence show that people adjust their diets once they realize how much better they feel when eat healthy. What exactly is best for an individual may vary - some people can eat foods with high content of saturated fat and cholesterol diet, yet keep normal blood cholesterol.
Others may not realize what exactly they are eating that is not healthy for them.

Self-evaluation tools have been shown to be effective for developing healthy eating habits.
Aurametrix is working on tools to help you evaluate your personal health risks and benefits and make the right health choices.

Check this poll on twtpoll.com or see average age based on other votes

Stress 2009

The health of the nation has declined mostly because of stress caused by job losses, money worries or increased workload. According to recent US and UK studies, more people are losing sleep, take antidepressants and live unhealthy lifestyles.

Mental stress spirals with economy, and costs economy.

A study by Harvard Public School published in the May 8 issue of Demography analyzed U.S. data on a wide range of occupations: managerial and professional positions; sales, clerical and craft jobs; machine operator jobs; and service positions.The likelihood of reporting fair or poor health increased by 54 percent among those who lost a job through workplace closure (similar across all occupations and positions). The odds of developing a new health condition rose by 83 percent among those who had no preexisting health problems. Job loss due to lay-offs, being fired or voluntary resignation more than doubled the likelihood of reporting fair or poor health among blue collar workers, but it had no effect on the health status of white collar workers.
Losing a job can lead not just to financial hardships but to health problems as well, including high blood pressure, diabetes, heart disease, heart attack and stroke.

Americans worry and struggle as economy worsens

“Where and how we live, work, learn and play have a greater impact on how healthy we are than the health care we receive,” David R. Williams, staff director of the Robert Wood Johnson Foundation Commission to Build a Healthier America and a Harvard professor, said in a news release.

Economy keeping many up at night. According to the 2009 Sleep in America poll by the National Sleep Foundation, out today, more than a quarter (27%) of Americans are losing sleep over financial worries.Young adults use more sleep aids, women are using more antidepressants & less estrogen.

Job stress can affect a person’s health as bad as smoking or a sedentary lifestyle can.

According to UK Insurance Daily News, the percentage of respondents admitting to being under a significant amount of stress increased from 38% to 40%.

Half of those surveyed agreed that stress is affecting their personal lives and 41% revealed that money worries were at the root of the condition, while 22% blamed an increased workload.

The problems of increased stress are exacerbated by a lack of exercise. According to PruHealth, the number of people reporting that they never exercise has increased from 11% to 14%, with more than a quarter (28%) of adults blaming work commitments.

Unemployment Rate Rises as Pace of Layoffs Slows. But hopefully the worst days are behind. Job stress has severe consequences, for us all and for the economy. Scotland's mental health improvement plan was launched today indicating that an understanding of the importance of protecting a person's own mental health could be key to reducing health problems. How people deal with stress greatly affects their well-being.

Stress can affect nearly every part of your body. So plump up your pillows, get more sleep, exercise and stop worrying.