Sunday, December 26, 2010

High Blood Pressure and Heart Disease

One of my friends has a high blood pressure, which he gets sporadically and has dizzyness as an indication.

High Blood Pressure has a good short term solution, drinking beet root juice. It works by providing a high dose of nitrates. The nitrates convert to Nitric oxide and then to nitrous oxide. Nitrous Oxide dilates the arteries and results in decreased blood pressure. Nitrates are present in large quantities in leafy vegetables including spinach. Some vegetables will have more nitrates and others less. Beetroot is one of the highest in nitrates.

The real problem is the long term one. High Blood pressure generally indicates bad and constricted arteries, which leads to heart trouble.

My friends cholesterol is a bit higher, but that in my opinion is not a problem. In my opinion its not high enough ;-). It should be 200-240 according to this graph.

His problem is triglycerides, which are very high, more than 200. As soon as these drop the cholesterol level will become normal.

Reducing triglycerides is very easy. They are directly related to carbohydrates. Reduce carbs and trigs will drop. Just for experiment you could eat a very low carb (< 50gm) high fat diet in the night and get your blood tested in the morning, you will find that the trigs have dropped, from your previous reading.

But that is not the real problem. The real problem is the calcification of arteries, which I am suspecting.

To find out how much of your arteries are calcified, you need to take a test called coronary calcium scoring.

It takes a special X ray to determine how much calcium exists in the arteries.

If indeed calcium score is high then you need to take several steps to get rid of it.
If you talk to a doctor they will say that it cannot be reduced. But it indeed can be reduced.

We have to understand first why calcification and coronary plaque happens.
There are several individual problems involved in heart disease.
1) The arteries get damaged. There may be several reasons for it. One is copper deficiency, another is microbial infection. Microbial (Chlamydophila_pneumoniae) infection will cause plaque buildup on its own.

The microbial infection is possibly one of the major causes as the anti-bodies to this bacteria are higher in most people with heart disease.

2) If you have lots of small dense LDL, they have a tendency to get oxidized and get stuck into the damaged arteries. Then macrophages (white blood cells) get stuck to it trying to remove them. This causes plaque buildup.

3) Arterial Calcification is highly correlated with Diabetes, so much so that it is listed as the highest risk factor.
Diabetes is the end stage of Insulin resistance. It is important to reduce insulin resistance to prevent arterial calcification.

4) Normally Calcification and Plaque buildup don't cause any problems if you don't get blood clots also called thrombosis. It is important to prevent clotting of blood.
We have to attack each of the above to cure the heart disease.

1) Checking for Copper deficiency is difficult.
You can see that potatoes are very good source for copper. But liver is the best. Some liver every week could be helpful.

2) To deal with bacterial infection it is important to increase your Vitamin D level to a good level from 40-80ng/ml. Use sun bathing. Use cod liver oil, or use vitamin D supplements but get this done. It is easy to get the Vitamin D test done in India. In Bangalore it costs 900/-. Be careful as some people with calcium regulation problems are not able to have a high vitamin D level. Hyperparathyroid or CKD may be suspected. Levels of upwards to 200ng/ml have been found in healthy individuals. 40ng/ml is the minimum acceptable level, but in lab ranges it may be the max level, because most city dwelling people are highly deficient. The ranges are based on people being tested which are all sick people from metros.

3) To reduce LDL Oxidation and to prevent calcification you need to reduce carbs in the diet. Reducing carbs reduces small dense LDL which prevents plaque formation.
Reducing carbs will also keep insulin low which should prevent further calcification.
We need to have energy. There is only so much protein a person can eat. If we reduce carbs, we need to increase fat.

4) The Calcification can be reduced by increasing intake of the Vitamin that is responsible for proper calcium utilization. The Vitamin K2.

It comes in two forms MK4 and MK7. The MK4 is the most effective vitamin but is very short lived. The MK7 is less effective but remains in the body for a much longer time. It can also get accumulated for later use. Vitamin K2 can also be utilized for other purpose where Vitamin K1 can also be used. Since it is difficult to get lots of K2. It is good to eat more vitamin K1.
Source of Vitamin K1 is Green Leafy vegetables.
Source of MK4 are milk, eggs and meat. Pastured Ghee is the most concentrated source of MK4.
Source of MK7 are fermented and aged cheeses like gouda, parmesan, etc.

5) Very important is to prevent clots in blood. It has been shown that higher Omega3:Omega6 ratio prevents clots in the blood. Inuits and other arctic dwellers who eat a lot of fish have a much higher omega3:omega6 ratio and had bleeding problems due to lack of clotting. They have a lot of coronary plaques and calcification but never get any heart problems because of this issue.

Our own diets are very high in Omega6. This causes the blood to clot sometimes. We need to balance the ratio to make sure that we don't have blood clots. There is a medicine called warfarin that is used to thin blood. But it works by blocking the action of vitamin K2. The K2 paper above used warfarin to induce calcification in rats.

The best option is to increase O3:O6 ratio in your body. You cannot test for it. It also takes a very long time in years to actually overturn the level, as the ratio is at the cellular level. But it must be attempted by reducing all high O6 sources in foods and increasing O3 sources. That is why I recommend to avoid refined oils which have higher than 10% O6. Try to calculate and add enough O3 to get nearer to 1:1. 1:2 would be OK but don't go below.

When increasing fat for reducing carbs this problem becomes much more acute. It is important to eat only fats that are very low in Omega6. The best oils are Ghee (<4%) and coconut oil(<2%), which are very low in Omega6. These have a lot of saturated fat, but contrary to popular belief saturated fats are very healthy. They are the most stable fats. Our body can desaturate them as it needs. They are the forms that our body creates from carbs. So fearing them is pointless. Even after eating lots of fats and meat for more than a year I have not been able to increase my dismal (<150) cholesterol.

Low O3:O6 ratio is also very closely related to heart disease.

6) Avoid wheat. It is very much related to heart disease. It affects in two ways. First it is known to reduce Vitamin D3 levels in the body. Secondly it is also known to increase insulin resistance. Which forces the body to increase insulin levels.
The data from China Study implicates Wheat. More than 60% relation between the two and with a better than 99.9% probability of the relation being true. This is a big deal.

7) Avoid Sugar. It is also very much related. The problem is mostly due to the fructose component of sugar. It affects insulin resistance directly.

8) Exercise. HIIT and weight training is known to increase insulin sensitivity. My friend used to be a very active sportsperson in his school and college days but got out of action after starting work, due to an injury. Weight training is very good for strengthening injured bones and joints, because the stress can be varied slowly, and in a very controlled way. This should help him get back to sports.
Saturated fat and K2 will also help in fixing the bone and joint problems, as both help in structural formations.

9) Fast. Occasional fasting can improve insulin resistance. It also increases the rate of tissue turn around, making a person younger (based on the life of average cells). It also increase growth hormone which also acts to make people feel younger. Higher tissue turnaround in arteries will enable faster repair of arteries. The following is just one of the first search results I got.

To recap.
1) Get a spoon of Cod liver oil every day. It will provide vitamin A, D and omega3s. You may want to get more Vitamin D3 if levels are not reached from Cod Liver oil. You may also need more omega3's from non-cod liver oil supplement if you don't get to a 1:2 O3:O6 ratio.
2) Avoid refined oils, they are the most concentrated source of omega6. Eat ghee or coconut oils as these have very low omega6 fats.
3) Reduce Carbs, wheat and sugar. Wheat should ideally be avoided completely.
4) Eat more greens and vegetables, for K1 and nitrates
5) Increase meat and healthy fat consumption, as it will help reduce carbs. Calories have to come from somewhere.
6) Eat aged cheeses, and ghee to improve K2 levels. There is benefit to supplementing it. Unfortunately due to low awareness the supplements are still too expensive.
7) Weight train to improve insulin sensitivity, and an overall sense of well being.
8) Fast occasionally. A 24 hour fast every week is ideal.

Saturday, December 4, 2010

Cancer: some more thoughts

I am trying to help a friend who might have cancer. It is a horrible disease. Hopefully even if it exists it will be in very early stages. It can be controlled when it is in early stages, with proper diet control and supplements.

As I wrote before, cancer feeds on glucose.
The trick to control is to keep the glucose in the system to bare minimum.
Also we want to keep the stress and inflammation to bare minimum. The above requirements mean a very accurate diet. Any diversion will feed the cancer.

First things first
1) Increase vitamin D3 to acceptable levels, ie 60ng/ml
Vitamin D3 and Cholesterol fight cancer cells. Supplement Vitamin D3 to atleast 5000IU, and get your serum level tested for 25OH Vitamin D levels. The best way is to get it partially from Cod Liver oil and partially from gelcaps. Testing is necessary because different people react differently to vitamin D. Some people raise their level very fast, but others don't do so. Some even might get some reaction to it, which would point to some other metabolic defect in the body like kidney problems or parathyroid problems.

Cholesterol will increase with more Coconut oil and ghee.

2) D3 increases blood serum calcium
We want to increase Vitamin K2 to help calcium to go where required, in bones. K2 is available from pastured butter and ghee, and aged cheeses. Luckily my friend likes blue cheese the richest source of vitamin K2, and can get kerrygold butter which is a very good pastured butter. Ghee can be made from the butter. Blue cheese is also very good for immunity as it replenishes gut bacteria. Gut bacteria are a very big factor in immunity.

3) Reduce Inflammation
Improve Omega3:Omega6 ratio. Get rid of all big sources of omega6, and get about 1gm of Omega3 from fish oil. You don't want to overdo omega3 as high PUFA in diet is not very good. Cod Liver oil is a good source, but you need to check the Vitamin D and Vitamin A levels in it. It will be best to get half of the omega3 from CLO and half of it from some other low Vitamin A oil like krill oil. Getting rid of all big sources of omega6 means avoiding all oils that contain higher omega6 content, basically limit yourself to ghee.

Limit carbs.
Humans all have very similar brain and neuron mass. Since brain and neurons are the only cells that need glucose, so we want to limit the glucose consumption to exactly what the brain and neurons require. Glucose requirement is around 100gm. It can be reduced by getting the brain to use more ketones. The method of providing ketones is to use coconut oil and fast. Coconut oil is very very rich in medium chain fatty acids. There is nothing as rich as Coconut oil. The MCFA get converted to ketones.

To reduce carb requirement, it is good to add one tablespoon of coconut oil to both meals of the day.

Use fasting to increase your ketone generation. The best way is to skip breakfast and do a 16 hour fast everyday.

With adequate combination of coconut oil and fasting the carb requirement can be reduced to below 50gms/day.

When counting carbs do not count fibers, because they do not convert into glucose. They are not processed by the liver or intestines enzymes, but by the gut bacteria. Gut bacteria convert them to short chain fatty acids. The SCFA's are anti-inflammatory. So it is good to add some fibers in the diet. Avoid insoluble fibers, as they damage the intestine. Good sources of soluble fibers are vegetables.

The best way to test whether you have enough ketones is to check urine with ketostix. If you have more than required ketones, then the excess will be discarded in the urine and will be detected by ketostix. Later when the body adapts to ketogenic diet, it will start storing the ketones as fat, then it will be difficult to measure ketones.

Divide your carb requirement into the two meals nearly equally to reduce too much glucose availability in the blood. It would not be a problem if sufficiently insulin sensitive.

Moderate proteins.
Proteins in excess convert to glucose. We do not want excess protein in the body. Still we need enough to prevent catabolization of muscles. We need enough for body's need. Calculate protein needs by finding out your lean body mass. The lean body mass is calculated by first finding out the body fat percentage, and then substracting the body fat weight from the body weight. A good way is to use those weighing machines with metal strip that calculate body fat percentage using the impedence method. Impedence method can be fairly accurate. Another way to calculate is to find your minimum weight at your maximum height. If you were very thin then assume 15% for men and 20% for women. If not thin enough then it will be difficult to estimate this way.

LBM is calculated in the following way.
LBM = WT(1-BF/100)

Once you have your LBM then calculate your protein requirement as 1.4gm/kg/day. The protein is best if it comes from animal sources. Fish/Meat/Eggs/Cheese are the best sources.

Fish will also provide vitamin D and Omega3s. So they will reduce the need for supplementation.

Whey powder should be added to the daily diet as it helps in producing more ketones. (Thanks Paul)

Fat requirements
To calculate fat requirements. Find your calorie requirements. Use this
calculator. Body fat % calculated above will be useful here.

Calculate your calorie consumption from Protein and Carbs calculated above using 4kcal/gm. Then add enough fat at 9kcal/gm to achieve the calorie requirement. You must also include the around 30-40gms of coconut oil that you are required to have in this requirement.

If you think you have excess fat on your body then reduce your calorie requirement by max 500kcal or 20% of your calorie requirement, whichever is lower. The reason is that with this diet the body will start using your own body fat also, reducing your caloric needs. Depending on the excess weight you can lose the weight at a rapid rate.

Other supplement requirements.
Very low carb increases requirement for electrolytes. The best electrolyte for the body is potassium. Make sure that you are getting more potassium than sodium intake from salts. Higher potassium requirement makes it necessary that you get all carbs from vegetables, because they are rich in potassium. Higher potassium from foods will reduce the need for supplementation. Avoid grains/legumes/milk as they will reduce your daily quota of carbs. Yogurt might be OK if sufficiently fermented. Fruits with higher carb content should be kept low.

Actually Potassium requirements are 4 times that of sodium. Try to mix potassium chloride in your salt. If you are falling short then supplement with potassium chloride or potassium gluconate. (Note: Need to determine daily potassium and sodium requirement, I know only the ratio).

Magnesium is also a very important requirement. Supplement about 400mg per day in two parts with meals.

Drink a lot of water 4-5 litres, as you want to get rid of the oxalates generated due to protein to glucose conversion.

Take 100-200gms of kidneys per week to provide selenium. Also add some more selenium as supplement.

Get Lugol's solution. Add it to your daily routine. Increase slowly doubling weekly, starting from 150mcg, reaching 12.5mg. If any problems are seen stop. It sometimes causes problems to people. My brother found that he had Hashimoto's due to the reaction he got from iodine supplementation.

You want to do some weight lifting or body weight exercises to prevent muscle catabolism. Consult the exercising article I wrote. This will also help in reducing any excess glycogen stores.

Extended fasting.
For dealing with cancer extended fasting is very important. Extended fasting gets the body into a state where it will try to utilize its proteins for fuel. In this case it attempts to use malfunctioning proteins over the well functioning ones.

Extended fasting has been known to help the body prepare for chemo therapy. It is also known to help kill cancers.

16hours daily fasting will prepare your body for extended fasting in addition to providing you with ketones. When you are comfortable with 16hour fasting then introduce extended fasting into your routine. It will be best to add one extended fast every week. Start with a 24 hour fast every week. Then introduce a 48 hour fast alternate weeks. Once you are comfortable with the 48 hour fast extend one of them every month to 72 hour or 3 day. Once you are comfortable with 3 day fast add one 7 day fast in 6 months. If you have to go in for chemo, plan it before the chemo.

In these fasts you are not trying to get any calories. But add salt preferably with potassium chloride, and lemon juice for vitamin C and some more nutrients. You wouldn't need any Omega3 or Vitamin D supplements. Make sure to get enough food and supplements to compensate when the fast is over.

Continue doing your exercises during the fasting. That will reduce the harmful effects of the fast.

Ultimately you are the best judge of everything. You live in your body and know best how your body is reacting to the diet plan. No doctor can understand your body better than you. If an advice does not feel good to your body it will not be good.

Caveat is that sometimes you do need about 2-3 weeks for a dietary change to become acceptable to the body. This change has everything to do with gut bacteria adaptation. So wait for 2-3 weeks before passing judgement on a dietary change.

You cannot rely on anybody to provide you with all the answers. This job rests on doctors, but unfortunately the doctors are too busy to care about their patients. You might have better luck with naturopaths and other alternative medicine practitioners, that use a holistic approach and are aware of the recent advances in biochemistry. These doctors/holistic practitioners are rare, and may require several attempts or luck to find one. It is well worth the effort to find one.