JUPITER to Earth: It's the Calcium Score Stupid!

Well, well, well!  A funny thing happened on the way to the "statin forum."  Astra-Zeneca, in a bald-faced attempt to broaden the narket for its statin product Crestor, ended up proving beyond a shadow of a doubt that heart scans and calcium scoring is the most powerful predictor of heart attacks in asymptomatic people.

A post hoc analysis of the MESA study population using JUPITER criteria revealed at 25-fold increase in risk for persons having a positive calcium score.  These two studies were fairly large so it was adequately powered to deliver results with a high degree of confidence.

For years docs like Bill Davis and Bill Blanchet have been screaming this from the hilltops and it something every Track Your Plaque practitioner knows.  If you have a positive calcium score you have coronary artery disease and your risk of a heart attack skyrockets.  Fortunately, it also gives you often decades of warning so you can actually DO something about it.  Coupled with technologies like advanced lipoprotein you can find the root causes and correct them.

So, "thank you" Atra-Zeneca.  I know you did it for the money - but what the heck - you might end up having helped save some lives in spite of it!

Now darn it, go out talk to your doc about getting that heart scan if you have any doubts about having the seeds of heart disease in your arteries.

Looking out for your health,


HeartHawk

Diabetes? You Gotta Exercise! It Works - Big Time!!!

Ever since I was diagnosed as prediabetic I have been looking for ways to stave off the inexorable march to full-blown diabetes and its many heart related complications.  As I wrote earlier, the words of one of many endocrinologists I went to keeps wringing in my ears.  "You gotta exercise.  I has been shown to work better than any else."

Well, as a numbers geek I have been tracking things in different situations.  Like many prediabetics my fasting blood sugar is pretty stable - about 83mg/dL in my case.  My problem is after eating - postprandial blood sugar.

To do yet another test I went out last Sunday and ate a large meal on an empty stomach.  This included some nasty stuff like an abundance of french fried eggplant, a rack of ribs (which I'm had plenty of sugar in the sauce), three massive french fried shrimp (oh but were they good) with tartar sauce, a few veggies, and a small side salad (with a dressing which also likely had HFCS).  Like I said, not a praticularly healthy meal but, then again, my intention was to cheat and see what the consequences were.

One and one-half hours after the meal my blood sugar was a still a nasty 135mg/dL so I fired up the old recumbent stationary bike and did my typical ride - about 44 minutes, 600 calories, and 7 miles (yeah, I know the calorie counter is reading high but it is just a reference number to help me track and compare rides).

So, 45 minutes later I take another reading - BADDA-BING! 77mg/dL, I dropped 58 points in 45 minutes.  WOW!  Like the doc says, "You gotta exercise!"  Take it from me, it seems like magic and it works.  I guess all those old-timers who take their evening "cosntitutional walk" after dinner knew what they were doing.

The bottomline here simple - after you eat - move.  Walk stairs, walk around he block, heck do jumping jacks.  It all adds up.  You don't have to drop your blood sugar a whopping 58 points to have a dramatic effect.  Every point you shave makes you a little healthier!

Looking out for your health,


HeartHawk

Kidney Stones and Lithotripsy: More Lessons Learned about Healthcare

Yes, there will be blood!

You know, the older I get the more I am inclined to believe that heart disease is just another symptom of a more systemic problem - getting old!  Since I became consumed by heart disease I have gone down the rabitt-hole of thyroid function (Hashimoto's in my case) and diabetes (currently prediabetic with Impaired Glucose Tolerance and an HbA1c of 5.9).

So now what?  KIDNEY STONES!

Ole, HeartHawk finally went in for Extracorporeal Shock Wave Lithotripsy (ESWL) for a collection of stones in my right kidney that I have known about for over two years.  A visit to the emergency room with nasty renal pain several weeks earlier prompted me to visit my urologist to reschedule the lithotripsy I postponed the previous year.

I want to take this opporunity provide a series of bullet-point observations about my personal experience with kidney stones and ESWL and use them to further illustrate even bigger observations about the shortcomings of traditional healthcare (just do what the doctor says) and the need for everyone to practice what I call "Informed Self-directed Healthcare" (ask many questions, do your research, get many opinions, don't blindly trust any single doctor) no matter what condition you are treating!

1. I discovered my kidney stones quite by accident during an ultrasound for a still undiagnosed (despite repeated scans and tubes shoved up and down both "ends") bouts with episodic and debilitating stomach pain.  The test showed a 16mm stone.

2. After an ER visit for another bout with whatever was ailing my stomach, a CAT scan confirmed the stone but put it at 8mm.  By the way the gastroenterologists finally decided that what I had was Cyclic Vomiting Syndrome which is thought to be a "migraine" of the stomach.  The pattern of attacks, symptoms (no vomiting actually) and fact that I had a history of migraines all contributed to the diagnosis - although they don't REALLY know but I haven't had an attack in over a year.

3. I saw a urologist who wanted to perform a KUB (Kidney, Ureter, Bladder x-ray) of the stones.  When I asked why - noting I have a CAT scan of the damn thing he suggested the KUB was a "better modality" for "seeing" the stones.  After the KUB this doc wanted to do a percutanous nephrolithotomy (PCNL) where they cut into you and extract the stone(s) with a scope.  This is an invasive 1-2 day surgical procedure which requires a stent in your incision to drain the kidney for 24 hours - hence the hospital stay.  This same doc then wanted to do a CAT scan before the procedure.  When I asked why he said because it provided better information about the stones than a KUB - ahhh, wait a minute - I thought you said ...! I dropped this doc like a hot rock!

4. I saw another urologist who suggested ESWL so I decided to research lithotriptors.  I chose the Storz Modulith SLX based on a combination of treatment efficiency and ability to pulverize stones.  Here is a link to one of the studies I reviewed.  You CAN dictate which machine will be used by your doc.  I actually had it written into the waiver I signed at the hospital.  Now, it does complicate scheduling because the machine needs to be available (more on that later).

5. After procrastinating for a year I ended up at the ER with renal colic (pain) that is typical of the stones I KNEW I had.  Right lower back pain that was bad but not the "child birth like" torment I had heard - but still bad enough to take the morphine they offered!  At the ER a nurse showed up to take me for a CAT scan.  I refused.  Wouldn't a much lower radiation dose KUB confirm things?  Hell, one urologist told me (at one point) it was superior - and certainly cheaper (another example of why healthcare is so expensive)!  I actually sat in the imaging room until the attending physician came in.  After a brief discussion she agreed with me!

6. I scheduled a followup with my new urologist who says the stone "cluster" now looks much smaller (possibly to small for lithoptripsy - or GONE) and wants to do a repeat KUB.  Right now I feel like an x-ray pin-cushion.  I suggest we first verify it with ultrasound (no radiation) and if we find something then do a KUB.  He agrees.  See a pattern here?  Seems like docs are handing out radiation like candy.  Why?

7. The first ultrasound tech (who was a trainee) had equivocal findings so the test was repeated on the spot by a more experienced tech who found the stones so I had the pre-procedure KUB (this would be the fourth).

8. The doc says the stone "cluster" is now only 4-5mm and is marginal but suggests going ahead with the ESWL to avoid future problems and I agree.  I go several rounds with the schedulers to get a Storz SLX-F2 lithotripter in a hospital setting as the procedure is done under general anethesia (I won't settle for receiving general anesthesia anywhere but in a full hospital).

9. I get to the hospital and everything goes smoothly until a nurse shows up to take me for - ANOTHER KUB!  Of course, I refuse (I always like the look of bewilderment on the faces of medical staffs when I do this - they are practically speechless).  I just had one a week ago!  So they call the urologist who agrees to bring the last one to the hospital.  After a little prodding of the staff it became clear the final KUB was ordered simply for the convenience of the urologist!  Let's see, I get another blast of x-rays so the doc can squeeze in another latte?  Bite me!

10. Did I mention an ESWL is done under flouroscopy (x-ray) so they can aim the lithotripter?  I was not amused when the lithotripter tech could not tell me what my radation exposure would be (mSV) but noted that my doc put on a lead flak jacket as I was dozing off.

11. The rest of the procedure went well with little pain but I am starting to get concerned about "peeing cherry Kool-Aid" (blood in the urine) for two and one-half days post procedure.  I heard it can last a week but usually subsides in two days.  The doc called and said I'd received the the max number of shocks (about 3000) so I am certain my guts got a little "tumbled!"  Still, somehow I doubt I will ever get used to red urine!

12. Of course, I also have to strain my bloody urine for three days.  What fun!  No rocks yet which may mean the stones got completely pulverized but it could also mean they're stuck!

13. Now, here is the kicker that REALLY pisses me off.  I am doing some post-op research about how long to expect blood in the urine and come across another study that suggests ESWL greatly increases the risks of diabetes and high blood pressure.  WHY IN GOD'S NAME WAS THIS NOT DISCUSSED WITH ME PRIOR TO THE PROCEDURE?  This is unconscionable!  I am prediabetic with heart disease!  Ya think this might be pertinent to my decision?  To be fair there are competing studies that found no such association but that is beside the point.  It should still be disclosed!

14. So here I sit, three days later, peeing red into a bucket, and wondering whether the "benign" procedure I just had is going to raise my blood pressure and accelerate my diabetes years down the road.  Sometimes I wonder - maybe ignorance is bliss - NAAAHHH!

Looking out for your health (and mine),


HeartHawk

Body by Track Your Plaque?!

Although there are several exercise guidelines there really is no "Track Your Plaque" exercise program, but if there was one it would probably be a lot like the one that produced the picture at left. Yup, that is skinny, old (and getting older every day) HeartHawk after just 90 days (one with my head chopped off and one with my trademark sunglasses, to remain incognito). No "P90X" discs, no personal trainer, no high tech equipment, just some basic Track Your Plaque principles and a scare followed by a commitment. Read on!

I recently saw my endocrinologist who looked at my OGTT and HbA1c and proclaimed, "You're insulin resistant and prediabetic!" Looking for him to prescribe some new wonder drug, supplement, or spartan diet recommendations I asked, "So what can I do about it?" "Exercise!" was his one word reply which he repeated often. What? As a Track Your Plaque devotee I am used to heart scans, advanced lipoprotein testing, exotic supplements and all the bleeding-edge science that comes along with it. The more I objected and insisted there must be more we can do beyond "exercise" the more he insisted, "Exercise!" Finally, as the frustration grew in both of us he loudly blurted, "Look, you GOTTA exercise!"

Now, I had always gotten SOME exercise. Heck, at 55 years old I still kept up with guys on the basketball court one-third my age - once a week - and there was the problem. How much exercise was needed? A lot more: 30 minutes, 5 times per week, at 70% of my maximum heart rate. Well, like everything else I thought I might as well go "whole hog" and see what I could do. I was going to do 45 minutes per day, a minimum of 5 days per week (averaging closer to 6 days) and I was going to throw in some resistance training every other day.

Guess what, my blood sugar is lower and I even got a little muscle definition after a life of being a "bean-pole." I may actually take my shirt off this summer! The point I am trying to make is that exercise is an ESSENTIAL part of Track Your Plaque or any health program for that matter - and you don't need expensive DVDs or equipment, just a commitment to developing a daily habit to just do it!

Now, I won't kid you. It is often boring and tiring (but not a lot after a few weeks), and it is definitely not as much fun or easy as other things you might do instead (like eating and sleeping). But, if an underweight, old enough to join AARP, sit on my butt behind a computer all day kind of guy like me can do it, so can you! Vigorous exercise lowers your cholesterol, your blood pressure, your blood sugar (to name only a few benefits), and damn, just plain makes ya look better (oh yeah, I can rebound better too - though it didn't help my shot much unfortunately)! What else can do all that?!

Looking out for your heart health,



HeartHawk

American Heart Association Exposed "Selling" Endorsements

I have been critical of the AHA in the past for their stodgy, politically correct perspective on heart disease but this takes the cake. No longer satisfied to endorse sugary, diabetes-inducing foods as heart healthy, they have expanded their coveted "Heart Check" endorsement to the Wii video game console on the premise that several of its games promote fitness. As one of my contemporaries titled it in his post on the Track Your Plaque Forum, "AHA whores for Nintendo." I could not have said it better myself!

What is stunning is that AHA has made selling their endorsement big business. Get a load of this brochure on the AHA website. Here is the AHA pitch . . .

"Shoppers want clear, simple purchase guidance from a trusted source. The American Heart Association heart-check mark increases product sales because seeing the mark on a package assures shoppers they are making a smart choice."

SMART CHOICE?!! OH REALLY?!! The AHA has figured out that they have created a trust factor among consumers (misplaced trust in my humble opinion) and want to cash in on it - big time.

• Nevermind that they are hopelessly behind the the cutting-edge of heart health science (they continue to push dietary cholesterol and saturated fat as the keys to heart health - NOT!).
  
  
• Nevermind they endorse foods like "Berry Burst Cheerios-Triple Berry" (22 grams of wheat and sugar, the top two ingredients). There is an epidemic of childhood obesity and diabetes and the AHA pushes sugar and highly-processed carbs into the veins of children as sure as if it were drugs through a needle.
  
  
• Nevermind that regardless of whether your product is heart healthy or not THE ONLY WAY YOU CAN GET THE AHA ENDORSEMENT IS TO PAY FOR IT!

The AHA now seeks to expand their misuse of this misplaced trust to other dubious product groups and are putting the hard sell out on the streets. They charged Nintendo a whopping $1.5 million for their "endorsement." Think about it, the AHA and Nintendo are teaming up to put the outrageous notion in the minds of consumers that buying a video game is heart healthy because in certain, non-representative situations, you could get some aerobic exercise.

I do not doubt that you can work up a real sweat playing several different video games - but is that the norm? Will Nintendo put a label on "Super Mario Brothers" that states "Nevermind?" This is the same sort of outrageous claim the FDA has recently outlawed for other products. If your claim is not representative of typical results you can be sued! Any hungry lawyers out there?

I am sad to have come to now hold the opinion the once proud AHA has indeed become a "whore" to the almighty dollar. They have lowered themselves to the level of "used car salesmen" and "snake oil peddlers." There is a lot of talk about boycotts these days. How about we start with the AHA and the disreputable companies that buy into their hucksterism to push their products on unsuspecting consumers!

Yeah, that means you General Mills and Nintendo. Consumers have lots of options for breakfast foods and entertainment. What do you think their reaction will be when they find out you and the AHA have been distorting the truth?!

Looking out for your heart health,


HeartHawk

Nattokinase Revisited

I had one of my regular meetings with Doc Davis of Track Your Plaque book and website fame today where he remarked about a patient he encountered that nearly died of a pulmonary embolism after going off prescription anti-thrombotic medicine in favor of nattokinase.

Doc Davis has been a critic of nattokinase and endured the slings and arrows of its promoters and those statistical "n of one" users who swear by it. (Interesting to note that Doc Davis is part Japanese and is not without experience with natto as a food his mother made him eat - childhood trauma perhaps? LOL!).

I was curious enough to take a look at the debate on his blog and do a little of my own research. As most readers of my blog know I am a "numbers" guy. Normally, the ridiculous bloviating and hyperbole I found on some sites pushing nattokinase would be enough to turn me off but just because "bad" people say "good" things about a product does not preclude it from actually being good! On the other hand, there is some pretty damning science against the concept that nattokinase works (the small problem of any protein surviving the gut) as well as common sense that suggests if it did work it may be a dangereous way to self-medicate (at least with a prescription drug like Coumadin you are under supervision by a doctor).

For better or worse I decided to go to my trusted sources at PubMed and look at some of the more recent studies to see if there is anything new that supported casual and chronic oral adminstration of nattokinase to prevent heart disease. Here is what I found in a highly summarized (and editorialized) form so as not to induce boredom (use the links for more info).

Bioproperties of potent nattokinase from Bacillus subtilis YJ1.
http://www.ncbi.nlm.nih.gov/pubmed/20334345
Yup, nattokinase is still fibrinolytic - if it gets into the blood stream.

Purification and Characterization of Nattokinase from Bacillus subtilis Natto B-12
http://www.ncbi.nlm.nih.gov/pubmed/19788184
Now if we could only get this stuff to work orally as a functional food!

Combined nattokinase with red yeast rice but not nattokinase alone has potent effects on blood lipids in human subjects with hyperlipidemia
http://www.ncbi.nlm.nih.gov/pubmed/19786378
Nattokinase does not appear to exert its effects (if any) via lipids.

Enhancement of oxidative stability of the subtilisin nattokinase by site-directed mutagenesis expressed in Escherichia coli
http://www.ncbi.nlm.nih.gov/pubmed/19631297
Hey, we are getting closer to at least limiting oxidative degradation - still no panacea.

Purification, immobilization, and characterization of nattokinase on PHB nanoparticles
http://www.ncbi.nlm.nih.gov/pubmed/19608412
Nanoparticles are all the rage these days and may have some utility with stabilizing nattokinase but still no oral in vivo data.

Nattokinase decreases plasma levels of fibrinogen, factor VII, and factor VIII in human subjects
http://www.ncbi.nlm.nih.gov/pubmed/19358933
Now we're talking - hard data with oral nattokinase in humans! Unfortunately, this was an open-label, self-controlled sudy with 45 people (15 in each arm). Can you imagine trying to get a prescription drug past the FDA with a study like this? Still, at least SOMETHING for proponents to hang their hats on.

Effects of nattokinase on blood pressure: a randomized, controlled trial
http://www.ncbi.nlm.nih.gov/pubmed/18971533
Hey, hey! More human data and this time randomized, controlled, and with almost twice as many participants as the previous study. Too bad the end point was blood pressure data - but it did show improvement.

Effect of nattokinase on restenosis after percutaneous transluminal angioplasty of the abdominal artery in rabbits
http://www.ncbi.nlm.nih.gov/pubmed/18819862
Reminds me of Judah Folkman's comment when the media overhyped his results and declared he had cured cancer, "If you are a mouse and you have cancer we can take good care of you!" Lucky rabbits!

Cerebellar hemorrhage provoked by combined use of nattokinase and aspirin in a patient with cerebral microbleeds
http://www.ncbi.nlm.nih.gov/pubmed/18310985
Oh yeah, just when you thought everything was rosy this booger shows up. Just because something is not classified as a drug by the FDA does not mean it is safe for general use. First Doc Davis relates a story about nattokinase putting a patient at risk because id did not bust a clot and now here is someone who "over-busted!"

Nattokinase-promoted tissue plasminogen activator release from human cells
http://www.ncbi.nlm.nih.gov/pubmed/19996631
More geek science. Yeah, if you get it in the blood nattokinase has numerous effects. So do a lot of chemicals!

The fibrinolytic activity of a novel protease derived from a tempeh producing fungus, Fusarium sp. BLB
http://www.ncbi.nlm.nih.gov/pubmed/17827689
Here is an even more powerful natural product. Should everyone abandon nattokinase and rush out to buy tempeh - the next wonder supplement?

Here is what (I think) we know.

1. Nattokinase exhibits lytic effects in vitro.
2. It MAY have some effect taken orally in vivo.
3. If it does work no one knows the mechanism of action for certain. Consider this, maybe it is some component or action OTHER than the lytic effect seen in vitro. Why take the risky components to enjoy the effective components?
4. There is a tiny amount of evidence for nattokinase taken orally but certainly nothing conclusive.
5. There is absolutely NO safety data on it other than small study and anecdotal experience. Remember torcetrapib the wonder HDL drug? I couldn't wait for it to hit the market so I could take it! It did everything Pfizer said it would - then downstream the data showed it killed more people than it saved. No way would nattokinase be FDA approved based on existing HARD data.

It seems what we have in nattokinase is an interesting agent - but nothing more. Since it is unregulated we are all free to experiment (and I experiment plenty). But don't kid yourself - it is nothing more than an experiment with an unknown outcome! "Natural supplement" does not equal "safe" any more than "drug" equals "effective!"

As always, I remain a fan of Informed, Self-directed, Healthcare (ISH). But, stay informed, remain a skeptic, and play safe!

Looking out for your heart health,


HeartHawk

Advanced Lipoprotein Testing and the Fallacy of "Average"

I use http://www.nutritiondata.com/ quite a bit to determined carb content of various foods now that I am tracking my blood sugar. I am prediabetic and like all good TYP'ers this is one more thing I am tracking to reduce my heart disease risk.

While at the site today I stumbled across a blog written by their so-called heart disease expert, Dr. Steve Parker, titled, "Advanced Lipoprotein Testing: Not Quite Ready for Prime Time" In it, Parker essentially said that advanced lipoprotein testing (ALT) such as that offered by NMR has, "never been shown that such testing offers any additional benefit over traditional risk factor assesement and management."

Now, I am certain that Dr. Parker is a very nice man who means well but for people like me and many others he is wrong - possibly dead wrong. It all has to do with applying common sense and the statistical fallacy of assuming what is good for the average person is good for all persons, more importantly, what is good for teh many is necessarily good for the one -YOU!

Dr. Parker starts with an argument that is perhaps the most powerful reason for using using ALT, "The Centers for Disease Control reports that half of all heart attacks occur in people with 'normal' cholesterol levels." If this is true (it is) one must come to the conclusion there must be some other factor besides standard lipid values (i.e. LDL, HDL, and Triglycerides) that can ferret out which person is likely to have a heart attack and which is not. Unfortunately, this is where Dr. Parker's deductive reasoning and intuition shut down. In fact, he contradicts himself based on an earlier blog he wrote praising ALT!

Here is the "killer" paragraph where Parker forgets all reasoning and statistical training he may have ever had.

"It's never been shown that such testing offers any additional benefit over traditional risk factor assesement and management. And all of the established clinical management guidelines utilize LDL cholesterol rather than LDL subfractions. Physicians know what to do with LDL cholesterol. We don't have evidence-based protocols that tell us what to do with these subfractions."

Let's dissect this statement to get to the truth.

1. It has never been shown that if I shoot myself out of a cannon wearing a parachute over Lake Michigan in February that I will die of exposure. What I do know is that a typical cannon with enough power to propel me from Wisconsin to Michigan (so I do not land over water) will kill me instantly and that even if shot from a lesser cannon with a parachute I will land far enough offshore that I will be unable to swim back in 36 degree water to safety. Sometimes one has to apply deductive reasoning. If I employ ALT and discover I have a dangerous lipoprotein subfraction such as Small LDL or Lipoprotein(a) (which I do) I am now in a better position to do something about it! I don't need a study to deduce this.

2. Just because "all of the established clinical management guidelines" use LDL and "Physicians know what to do with LDL cholesterol" does not mean I MUST be limited to antiquated methods applied by ignorant and behind-the-times physicians. I could go further and suggest Dr. Parker himself is ignorant. Many physicians DO know what to do with ALT and use it effectively to treat their patients using the most advanced technologies available.

3. The term "We don't have evidence-based protocols" is often shorthand for "I am too stupid or too lazy too engage in critical thinking so someone please tell me what to do." I do not need someone to do a study on taking common sense actions. I have high Lipoprotein (a) with an otherwise world-class lipid panel. My own physician (whom I fired) told me I was fine! If I had not done ALT I would not have discovered I had this independent risk factor for heart disease and would not be in a position to do something about it. I mean, c'mon, this is not rocket science!

4. The final and most crushing indictment of Dr. Parker's logic is the fallacy of extending information about statistical averages to an entire population. On average, a person with my traditional lipids (LDL, HDL, Triglycerides) would be in a low risk group - except I am among a few in this group who have high Lp(a). Yes, it might not be cost-effective to test EVERYONE for Lp(a). The cost of the test for everyone might not save enough lives to be cost-effective (this is the danger of national healthcare rules that rely on "evidence-based" medicine for the masses). BUT LET ME MAKE THIS CLEAR! I do not give a DAMN about the average guy - I care about ME! If I had followed "evidence-based" medicine and good old Dr. Parker's advice I might be dead. Instead I am proactively fighting my extraordinarily high Lp(a) - but only because I got the test and fought my insurance company to test my son (I won the battle and now my son knows 30 years before I did so he can take action even sooner).

So there it is. If you are a "good little soldier" willing to sacrifice your life for the "good of the many" and save a few bucks then great - more power to you. But, if you want to "pull out all the stops" to make certain you stay alive and your children live long lives then you will do everything possible to know your risks and take appropriate action.

No thanks Dr. Parker. I think I'll continue to track my lipoprotein sub-fractions using ALT. Just because most docs are stupid or lazy does not me I have to be. And, just because many people may not benefit from ALT does not mean ALL - specifically ME - won't benefit IMMENSELY. So, take your pick. Go with the flow or get aggressive. Practice Informed, Self-Directed Healthcare (ISH). Heck, it's your life. YOU decide!

Looking out for your heart health,


HeartHawk

Fish Oil and Omega-3 Index: A Feather in the Telomere Cap

And just when you thought it couldn't get any better another compelling reason for knowing your Omega-3 Blood Index and optimizing your fish oil dose is uncovered. A new study among patients with coronary artery disease (CAD) has discovered an association between fish oil and the rate at which telomeres shorten (January 20, 2010 issue of the Journal of the American Medical Association, Dr. Ramin Farzaneh-Far et al).

We all recall from high school biology (yeah, right) that the rate of telomere shortening is thought to determine the number of times a cell can replicate thus limiting the life of a cell. This shortening of telomeres has been shown to independently predict morbidity and mortality in patients with CAD.

According to lead researcher Dr. Farzaneh-Far, "This suggests the existence of a novel mechanism for why omega-3 fatty acids are effective in this patient population—an area that has not been well worked out previously; it suggests they could be acting through telomeres . . . It's also the first study that shows that a dietary factor may be able to slow down telomere shortening . . . This is yet another reason for cardiologists to try to convince their patients to take either a fish-oil supplement or eat regular fatty-fish meals."

The bottomline of this observational study (which, again, showed association not causation) is that participants (608) with the lowest levels of Omega-3s had the fastest rate of telomere shortening. What is also interesting is that Dr. Farzaneh-Far and his team used what he termed "a relatively new blood test" called the Omega-3 Index test. The test cut-offs were 2.3% for those with the fastest (worst) telomere shortening and 7.3% for the slowest (best) shortening.

TIME-OUT! TIME TO BLOW THE TRACK YOUR PLAQUE HORN - AGAIN!!!

I hate to be a total shill (not really) but, come on. Dr. Davis and Track Your Plaque are once again ahead of the curve in bringing the Omega-3 Index test to its Members for some months now. It seems to me TYP also did an extensive treatise on Omega-3 Index testing in its October 2009 newsletter, and, what was the optimal blood level discussed - oh yeah - 7.3%!

Now for the REAL bottom-line! Just like Vitamin D, it doesn't matter how much you take, it matters how much get's into your blood. In fact, you don't even know, in most cases, whether the preparation you may be taking even contains its stated dose! If you do not test your blood level you have no idea if you are receiving optimal treatment - period! It took me three blood tests just to get my Vitamin D level "zeroed in."

In summation, I guess I wholeheartedly agree with Dr, Farzaneh-Far's statements, "from the telomere point of view, this is the first study to show an effect of a dietary factor, that this may be able to slow down telomere shortening" and "The idea is that the omega-3 index, the percentage of fatty acids in the blood, could be measured and that low levels would predict worse outcomes. So the omega-3 index might be useful for risk stratification in the future."

Call your doctor, get the test. If your doc says, "No!" then test yourself to get a baseline reading and decide whether it might be a good idea to get OPTIMAL treatment. I am getting my blood draw today! I'll let you how how it turns out.

Looking out for your heart health,


HeartHawk

The Pizza Paradox

It seems to me that it has been a while since I waxed rhetoric about the roller coaster we all ride while fighting heart disease. One of my favorite rants amidst the rapid changes I encounter particularly with regard to diet and heart disease is what I call "The Pizza Paradox."

I love a good pizza but gave them up early on in my personal battle with heart disease because, let's face it, cheese, Italian sausage, and pepperoni are not high on the list of heart-healthy foods.

Well, with the flood of low-carb indications coming out for fighting heart disease my favorite lament is that I still can't eat pizza but now it is the crust that is going to kill me not the toppings!

Life just isn't fair!

Looking out for your heart heart health,


HeartHawk