Diabetes and heart disease are intertwined from the start, sharing a complex panel of hidden phenomena that lay the foundation for both conditions. If diabetes is present, heart disease is much more likely to develop. If heart disease develops, it is far more likely that diabetes will also.
Archive | February 2015
How Insulin Causes Heart Disease
There are several stages involved in the development of heart disease. Unfortunately having too much insulin in your blood is involved in each and every stage.
Stage 1: First excessive insulin raises the level of bad cholesterol in the blood – the LDL version. At the same time it decreases the level of “good” cholesterol – the HDL variety. Then it goes on to increase the level of triglycerides in the blood – yet another risk factor for heart disease. Excessive insulin also causes your blood to clot more quickly which increases your risk of stroke. Though your kidneys are not insulin sensitive, when your insulin level is elevated it indirectly causes your kidneys to retain salt and fluid which further increases your blood pressure.
Stage 2: In this stage excessive insulin increases cellular proliferation which damages the lining of your blood vessels. This increases the blood vessels vulnerability and sets the stage for even more blood vessel damage.
Stage 3: In this third stage insulin plays a different role. There are two very different kinds of LDL cholesterol. “Pattern A” LDL cholesterol is light, floats on water and represents no particular threat to the human body. But “Pattern B” LDL is a smaller particle, much more dense form that’s intimately involved in the heart disease process. That’s because it’s this denser form that attaches itself to the blood vessel lining to form artery-clogging plaques. Excessive insulin increases this more dangerous form of LDL. It’s this kind of LDL that forms the “fatty streak” plaques that are the hallmark of early heart disease.
Stage 4: Excessive insulin promotes the conversion of specialized cells called microphages in your blood into foam cells which further promotes the formation of dangerous plaques.
Stage 5: Before the plaque becomes dangerous it must be oxidized by free radicals. Once again insulin plays a role by increasing the level of dangerous tissue-damaging free radicals in your blood. The smaller dense LDL particles that excessive insulin promotes are more subject to free radical oxidation.
Stage 6: This damage to your blood vessel lining triggers an inflammatory response which contributes to the vicious cycle. Excessive insulin boosts inflammation throughout the body including within the lining of blood vessels. Many medical researchers feel that inflammation plays a major role in heart disease and excessive insulin plays a major role in generating it. In addition, studies have shown that this increased level of inflammation can directly damage brain neurons. (The C-reactive blood test measures the level of inflammation in your body. Today more and more doctors are using the test in recognition of the key role inflammation plays in so many different diseases.)
Stage 7: As the plaque builds over the years, it eventually restricts the flow of blood causing either chest pain or other symptoms in other parts of your body. If the blood vessels feeding the brain become restricted, your brain function will inevitably be affected. In numerous studies where insulin was injected into the blood vessels of lab animals, it was found that thick artery clogging plaques accumulated just downstream from the injection sites.
Stage 8: Excessive insulin also directly stimulates the central nervous system raising blood pressure which further increases the risk of a heart attack or stroke. At this stage you may experience TIAs (transient ischemic attacks) which are small strokes that damage small areas of your brain. Damage caused by TIAs are commonly found in the brains of deceased Alzheimer’s patients. Stage 9: Excessive insulin causes the body to increase it’s excretion of magnesium which causes a magnesium deficiency which can then trigger arterial spasms that can directly cause a heart attack. If a heart attack doesn’t get you, remember that excessive insulin has already increased the blood’s tendency to clot. A blood clot can easily form at the site of the spasm and travel to other areas of the body such as the lungs where it can cause a fatal embolism.
Stage 10: You’re officially diagnosed as having heart disease and if that isn’t bad enough this diagnosis dramatically increases your risk of dementia and premature death. After reading the above it should come as no shock that studies have found that fatal heart attacks are three times more likely after a high carbohydrate meal than after a high fat/protein meal!
QUOTE FOR FRIDAY:
“Your sense of humor is one of the most powerful tools you have to make certain that your daily mood and emotional state support good health.”
~ Paul E. McGhee, Ph.D.
QUOTE FOR THURSDAY:
The most notable differences between sea salt and table salt are in their taste, texture and processing.
MAYO Clinic Katherine Zeratsky, R.D., L.D.
Sea Salt and Table Salt…Are they the same.
The most notable differences between sea salt and table salt are in their taste, texture and processing.
Sea salt is produced through evaporation of ocean water or water from saltwater lakes, usually with little processing. Depending on the water source, this leaves behind certain trace minerals and elements. The minerals add flavor and color to sea salt, which also comes in a variety of coarseness levels.
Table salt is typically mined from underground salt deposits. Table salt is more heavily processed to eliminate minerals and usually contains an additive to prevent clumping. Most table salt also has added iodine, an essential nutrient that helps maintain a healthy thyroid.
Sea salt and table salt have the same basic nutritional value, despite the fact that sea salt is often promoted as being healthier. Sea salt and table salt contain comparable amounts of sodium by weight.
Whichever type of salt you enjoy, do so in moderation. The Dietary Guidelines for Americans recommend limiting sodium to less than 2,300 milligrams a day — or 1,500 milligrams if you’re age 51 or older, or if you are black, or if you have high blood pressure, diabetes or chronic kidney disease
Sea salt has boomed in popularity in restaurants and supermarket aisles. Many gourmet chefs say they prefer it over table salt for its coarse, crunchy texture and stronger flavor. Manufacturers are using it in potato chips and other snacks because it’s “all natural,” and less processed than table salt. And some health-conscious consumers choose it because it contains minerals like magnesium.
In a survey conducted by the American Heart Association, 61 percent of respondents incorrectly agreed that sea salt is a low-sodium alternative to table salt. Table salt and most sea salts contain about 40 percent sodium by weight. Kosher salt and some sea salts may have larger crystal sizes than table salt, so they may have less sodium by volume (e.g., by teaspoon or tablespoon). A teaspoon of table salt has about 2,300 mg of sodium, but a teaspoon of sea salt or kosher salt may have less sodium because fewer crystals fit into the spoon.
Some varieties of sea salt may claim to have less sodium than table salt. You can check the Nutrition Facts label to compare how a given sea salt compares to table salt, which has about 575 mg sodium per ¼ teaspoon.
“It’s very important for people to be aware that sea salt often has as much sodium as table salt,” said Rachel K. Johnson, Ph.D., R.D., an American Heart Association spokeswoman and the Bickford Professor of Nutrition at the University of Vermont.
“One of the keys to maintaining a heart-healthy diet is to control your sodium intake,” she said. “If you’re consuming more sea salt than you otherwise would because you think it has less sodium, then you may be placing yourself at higher risk of developing high blood pressure, which raises your risk of heart disease.”
What’s the difference between the way sea salt and table salt are made?
Sea salt is obtained directly through the evaporation of seawater. It is usually not processed, or undergoes minimal processing, and therefore retains trace levels of minerals like magnesium, potassium, calcium and other nutrients.
Table salt, on the other hand, is mined from salt deposits and then processed to give it a fine texture so it’s easier to mix and use in recipes. Processing strips table salt of any minerals it may have contained, and additives are also usually added to prevent clumping or caking.
While these attributes may make sea salt more attractive from a marketing standpoint, Johnson says there are no real health advantages of most sea salts.
“The minute amounts of trace minerals found in sea salt are easily obtained from other healthy foods,” Johnson said. “Sea salt also generally contains less iodine than table salt. Iodine has been added to table salt since the 1920s to prevent the iodine-deficiency disease goiter.”
First off, sea salt is produced by evaporating water from the ocean or saltwater lakes, whereas table salt is usually mined from underground salt deposits. While the exact body of water or deposit can influence the concentration of certain minerals, it doesn’t affect sodium. However, the larger the salt crystals, the fewer that fit in a given volume—be it a pinch, teaspoon, or your entire salt cellar—which could influence how much you end up dishing out.
The next time you find yourself choosing between kosher salt, sea salt and table salt, remember that it’s probably mostly a matter of letting your taste buds decide. But whichever option you choose, keep in mind that both usually contain the same amount of sodium.
As far as health goes, salt has a notoriously bad reputation. But is sea salt any better (or at least less bad) than run-of-the-mill table salt?
The expert: Pamela Peeke, MD, MPH, FACP, nutritionist at Elements Behavioral Health and author of The Hunger Fix
The verdict: The answer isn’t as cut-and-dry as most chefs might like, but that’s because the path every salt (even if it’s the same “kind”) takes to reach your shaker varies.
Whether it’s mined from the earth or evaporated from the sea, unrefined salt is always the best option in terms of both flavor and health. However, since boxes nowadays tend to make everything look like a health food, read through the ingredients. If the only thing listed is sodium chloride, you know that the so-called healthy natural salt is just as refined as the table-side variety. (For help decoding those mystifying food labels, look no further.
References:
1.) Mayo Clinic
2.) American Heart Association
3.) FOX News
QUOTE FOR WEDNESDAY:
“The sciatic nerve, like most other nerves, performs two basic functions: first, it sends signals to your muscles from the brain; and second, it collects sensory information from the legs and passes this back to your brain.”
Orthopedics.about.com
What is Sciatica Nerve Damage?
Sciatica is pain, tingling, or numbness produced by an irritation of the nerve roots that lead to the sciatica nerve. The sciatic nerve is formed by the nerve roots coming out of the spinal cord into the lower back. It goes down through the buttock, then its branches extend down the back of the leg to the ankle and foot. When something presses on the sciatica nerve, like a herniated disc, it presses on that nerve which causes the pain from the buttock that can radiate all the way down to the foot. The intensity of the pressure on the nerve and where its pressed decides if it goes to the foot or less. Other causes of sciatica nerve damage:
The most common cause -a bulging or ruptured disc in the spine pressing against the nerve roots that lead to the sciatic nerve.
-Sciatica Nerve Damage can be a symptom of other conditions that affect
*Narrowing of the spinal canal due to spinal stenosis. This spinal canal narrowing pinches on the sciatica nerve.
*Bone spurs-they are growths that are small forming along joints caused by arthritis.
*Simply injury (like a car accident or fall) causing nerve root compression=again the same result-pinching the sciatica nerve.
*Pregnancy-not as common as a cause as the others listed.
*Rarely but also tumors could cause the problem also.
What are the symptoms?
Symptoms of sciatica include pain that begins in your back or buttock and moves down your leg and may move into your foot.
*Weakness, tingling, or numbness in the leg may also occur.
*At times a inconsistent stabbing feeling or pricking feeling in the ankle or foot
*Sitting, standing for a long time, and movements that cause the spine to flex (such asexercises using the knee to chest) which may make symptoms worse.
*Walking, lying down, and movements that extend the spine (such as press-ups) may relieve symptoms.
How is sciatica diagnosed?
Sciatica is diagnosed with a medical history and physical exam. Sometimes x-rays and other tests such as magnetic resonance imaging (MRI) are done to help find the cause of the sciatica.
What are the Complications?
Although most people recover fully from sciatica, often without any specific treatment, sciatica can potentially cause permanent nerve damage. Seek immediate medical attention if you experience:
-Loss of feeling in the affected leg -Weakness in the affected leg
-Loss of bowel or bladder function
How is it treated?
In many cases, sciatica will improve and go away with time. Initial treatment usually focuses on medicines and exercises to relieve pain. You can help relieve pain by:
*Avoiding sitting (unless it is more comfortable than standing).
*Alternating lying down with short walks. Increase your walking distance as you are able to, without pain.
* Takingacetaminophen (tylenol) or Motrin (Ibuporfen) or Advil or Aleve (Naproxen). All are nonsteroidal anti-inflammatory drugs which decrease the swelling of the inflammation around the area or injury to the back which will decrease the pain. More inflammation=more pinching on the nerve.
*Using a heating pad on a low or medium setting for 15 to 20 minutes every 2 or 3 hours. Try a warm shower in place of one session with the heating pad. You can also buy single-use heat wraps that last up to 8 hours. You can also try an ice pack for 10 to 15 minutes every 2 to 3 hours. There is not strong evidence that either heat or ice will help, but you can try them to see if they help you.
*Additional treatment for sciatica depends on what is causing the nerve irritation. If your symptoms do not improve, your doctor may suggest physical therapy, injections of medicines such as steroids, stronger medicines such as muscle relaxants or opiates.
*Physical Therapy or chiropracter therapy or some form of therapy for 6 to 8 weeks.
* If the therapy is uneffective than the last resort in most cases is surgery that ranges from:
– laser surgery
– scrapping of the vertebrae pinching the nerve with leaving the rest of the vertebrae spacing the spinal cord in place or removing the vertebrae pinching the nerve and replacing it with cement (not cement we use for sidewalks that we know of). It’s natural to want to return to your regular activities as soon as possible after surgery, but a lot depends on the type of operation you get.
In two common methods, vertebroplasty and kyphoplasty, your surgeon makes a small cut in your back, which lets you recover faster. If you get spinal fusion surgery, the cut is larger, and it will take a longer time to heal.
-small endoscopic surgery that is microsurgery removing pieces of the vertebraepinching which has a test called a discogram (injecting a dye right into the injured disc and than a ultrasound of the area is done to show the surgeon the exact route he has to follow to cure the problem. The surgeon numbs the area that he will repair with the pt wide awake; he makes a incision about 2/10 of an inch, using the cat scan as a guide for his eyes inserting a scope inserting a grabber that goes in the scope removing disc fragments that are pressing on the nerves causing the pain. It takes about 30 minutes for this procedure with only a small bandage covering the incision followed with the patient leaving the hosp–ital in less than a few hours
*Other self-care treatments that may be helpful include:
-Cold packs. Initially, you may get relief from a cold pack placed on the painful area for up 20 minutes several times a day. Use an ice pack or a package of frozen peas wrapped in a clean towel.
-Hot packs. After two to three days, apply heat to the areas that hurt. Use hot packs, a heat lamp or a heating pad on the lowest setting. If you continue to have pain, try alternating warm and cold packs.
-Stretching. Stretching exercises for your low back can help you feel better and may help relieve nerve root compression. Avoid jerking, bouncing or twisting during the stretch and try to hold the stretch at least 30 seconds.
-Over-the-counter medications. Pain relievers such as ibuprofen (Advil, Motrin, others) and naproxen (Aleve) are sometimes helpful for sciatica.
References:
National Cancer Society
Web MD
Mayo Clinic
Dr. Bruce Hensel M.D. (chief medical editor channel 4)/Dr. David Ditsworth Surgeon – does back scoping -Robert Forrest Physical Therapy in Santa Monica, California
QUOTE FOR TUESDAY:
“The dissolvable form of acetaminophen, better known as Tylenol, contained the most sodium, at 427 milligrams per dose, according to the study. If you took the maximum amount daily, you’d be getting more than 3,400mg of sodium, far more than the USDA recommended daily allowance of 2,000mg before you factor in your diet.”
Amir Khan, Everyday Health Staff Writer
HIgh sodium is not just controlled by our diet; check your medications too.
Researchers from the University of Dundee and University College London in the UK found that some common medications made to dissolve in water contain such high levels of sodium that taking the maximum dose each day would cause you to exceed the recommended daily limits, and put you at risk of heart attack and stroke.
The researchers, led by Jacob George, MD, senior clinical lecturer and honorary consultant in clinical pharmacology at the University of Dundee, tracked more than 1.2 million patients in the United Kingdom for more than seven years, and compared the patients taking the soluble forms of drugs, such as acetaminophen, ibuprofen, aspirin and others, to patients taking the traditional pill form. They found that the patients taking the soluble forms were at a 16 percent higher risk of heart attack or stroke, and at a 28 percent higher risk of developing high blood pressure, which researchers attributed to the high levels of sodium in these medications.
“These tablets all fizz when you put them in water,” Dr. George said. “The manufacturers use the salt to create that fizz, but it does much more harm than good.”
The dissolvable form of acetaminophen, better known as Tylenol, contained the most sodium, at 427 milligrams per dose, according to the study. If you took the maximum amount daily, you’d be getting more than 3,400mg of sodium, far more than the USDA recommended daily allowance of 2,000mg before you factor in your diet.
Soluble ibuprofen and aspirin contained far less sodium, with 202mg and 149mg per pill respectively, according to the study, but George said the levels are still far from acceptable.
“There’s no legal regulation anywhere in the U.S. or the UK to limit the amount of sodium per tablet,” he said. “The sodium levels in these medications should be clearly labeled on the packages.”
Diets high in sodium are linked to high blood pressure, heart attack and stroke, but many people are unaware just how much salt they get in their diet, let alone from their medication, according to the study.
Soluble acetaminophen and ibuprofen are often given by prescription and are much more common in the UK than in America, but soluble aspirin is frequently sold in U.S. drug stores under the brand Alka Seltzer, said Patrick Fratellone, MD, a New York City-based cardiologist.
“The U.S. should start looking at its soluble medications and determine whether the amount of salt in them should be allowed,” Dr. Fratellone said. “There’s no restrictions on the amount manufacturers can add.”
Merle Myerson, MD, director of the cardiovascular disease prevention and pre-exercise heart screening program at St. Luke’s and Roosevelt Hospital in New York City agreed, saying that even though salt is sometimes necessary in these medications, it’s not necessary for people to take them.
“We often tell patients that salt is hidden in foods,” Dr. Myerson said. “Processed foods and fast foods have a lot of hidden salt. Here again, we’re seeing another source of hidden salt that may contribute to a person’s risk for hypertension.”
“Salt helps make the medication more digestible and dissolve better,” she added. “But if it contains too much salt, it could add up to amounts that could be dangerous.”
These medications are typically used by people who have trouble swallowing pills, George said, but anyone who does should speak to their doctor.
“There are groups of people who legitimately need these medications, but anyone who takes them should realize the cardiovascular risk of these in the long term,” he said. “They need to speak to their physician to come to an informed decision of whether they should actually be taking them.”
Fratellone said that he recommends that patients avoid soluble medications, and added that he refuses to prescribe them.
“Patients need to avoid them,” he said. “There needs to be information on the front of the packaging telling patients how much salt in is their medicine.”
“We’re trying to get patients to reduce the amount of salt in their diet,” Fratellone added, “and manufacturers are putting it in our medication without giving us fair warning.”
Decongestants may raise your blood pressure.
People with high blood pressure should be aware that the use of decongestants may raise blood pressure or interfere with the effectiveness of some prescribed blood pressure medications. Many over-the-counter cold and flu preparations contain decongestants such as:
- Ephedrine
- Levmetamfetamine
- Naphazoline
- Oxymetazoline
- Phenylephrine
- Phenylpropanolamine
- Propylhexedrine
- Pseudoephedrine
- Synephrine
- Tetrahydrozoline
Check the sodium content.
Some OTCs are high in sodium, which can also raise blood pressure. Look at the active and inactive ingredients lists for words like “sodium” or “soda.” Note the amount of sodium in the medication. People with high blood pressure should consume less than 1,500 mg of sodium per day from all sources; one dose of some OTCs can contain more than a whole day’s allowance.
Those who prescribe medications may be unaware that they may contain substantial amounts of sodium. References such as package inserts, the Physicians’ Desk Reference, and Drug Information 1 do not always provide information about sodium, and the sodium content, when it does appear, may be given in various units of measurement or may need to be calculated.
Certain medications containing one or more drugs are high in sodium content regardless of the formulation used, whereas others vary according to the formulation (Sodium Content of Various Drug Products and Formulations.). High-sodium and low-sodium formulations of the same drug products should not be used interchangeably in patients who are following sodium-restricted diets.
The Food and Drug Administration (FDA) has proposed a rule for the labeling of the sodium content of over-the-counter drugs,4 and it will be working with pharmaceutical organizations to develop voluntary sodium labeling for prescription drugs. The FDA will recommend that makers of prescription drugs declare the sodium content if it exceeds 5 mg (0.22 mmol) per single recommended dose and that they issue a warning if the sodium content exceeds 140 mg (6.09 mmol) per maximal daily dose. Sodium contained in active ingredients, excipients, and any recommended diluent will be included. These measures will simplify the calculation of the total sodium content of any product prescribed for patients whose sodium intake is restricted. Until these initiatives have been implemented, this information should be obtained from the manufacturer.
References:
1.) American Heart Association
2.) The New England Journal of Medicine
3.) EverydayHealth.com
QUOTE FOR MONDAY:
Too much sodium can cause high blood pressure and significantly increase your risk of heart disease. It is also important for regulating blood volume and maintaining muscle and nerve function. Sodium is the major positively-charged ion (cation) outside your body cells and is mostly found in blood, plasma, and lymph fluid.
Marc Perry, CSCS, CPT is the creator of BuiltLean based in NYC.