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.

1 comment:

  1. Excellent article Anand! I am curious. I know that you said that your wife has not wholeheartedly bought into Paleo eating yet but has made some changes. Has she experienced any positive changes in her through partial paleo lifestyle? Has she also lost weight like you?
    I was wondering if even some changes contribute to our improved health.