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Simple Steps to Better Health I imagine there are very few parents who think about their small children developing heart disease. Heart disease, after all, is thought to be a condition that develops in the middle ages and in the elderly. Unfortunately, coronary artery disease has been affecting more and more relatively young individuals. I have seen countless numbers of patients who have had heart attacks and coronary artery disease developing in their thirties and even in their twenties. Individuals who are particularly at risk of this are those known to have the familial hypercholesterolemia with elevations in cholesterol developing even in early childhood. In a study published in the current issue of the prestigious journal Circulation, researchers conducted an interesting trial. Fifteen children with known familial hypercholesterolemia between the ages of nine to twenty years old were evaluated. The average total cholesterol in this group of fifteen children and young adults was 242 with LDL levels of 187 (LDL cholesterol, otherwise known as bad cholesterol, is considered abnormal when it is 130 or higher). Elevations in oxidized cholesterol lead to changes in the inner lining of the blood vessels with impairment of blood flow. In this clinical trial, half of the children were treated with daily doses of 500 mg of vitamin C along with 400 units of vitamin E daily for six weeks. The other half of the children and young adults were given placebo. All of the children were put on a diet that was rich in fruits and vegetables and low in animal fats. At the beginning of the trial and at the end of the trial, the researchers measured the dilation (expansion) of the brachial artery, an artery found in the arm. When the inner lining of the artery is damaged, the blood vessel tends to stiffen and does not stretch to accommodate increased blood flow. The researchers indicated that this is one of the early signs of atherosclerosis. At the start of the study, the amount of dilation of the brachial artery was 6% (with normal dilation of the brachial artery in children being between 8 and 12%). Although the change in diet did cause a modest lowering in the LDL cholesterol, it did nothing to improve the dilation of the brachial artery. However, those children treated with vitamin C and E had significant improvement of brachial artery dilation up to a level of about 9.5% which is clearly in the normal range. The children who were given placebo pills had no change whatsoever. Dr. Engler, the lead author of this paper, indicated that this was the first study to show that vitamins can reverse arterial damage, commonly known as hardening of the arteries. This study is reminiscent of another fascinating study that appeared JAMA in November 1997. In that study, 20 healthy individuals with normal cholesterol were enrolled in a double-blinded placebo controlled study. The participants in the study were initially given a high fat meal. The meal was similar to what you would typically eat at a fast food chain restaurant for breakfast including hash browns, egg & sausage breakfast sandwiches, etc. After ingesting the meal, those individuals had a significant decrease in brachial artery vasodilation, dropping by approximately 50% for up to four hours after consuming the meal. Individuals were then pretreated with 1000 mg of vitamin C, 800 units of vitamin E and then ingested the same high fat meal. This time, however, the restriction in blood flow did not occur. It is not uncommon for someone to have a heart attack after consuming a high fat meal. This is presumably secondary to the constriction of blood vessels that occurs from this high fat food consumption. However, it would seem that taking adequate doses of vitamins C and E may prevent this from occurring. Supplemental vitamins C and E are nutrients that everyone should be taking. Most one-a-day products, however, contain negligible doses of these important nutrients. The DV (daily value) for vitamin C is only 60 mg and 30 units for vitamin E. Despite these small numbers, most individuals in this country do not even consume the minimum DV. It appears that inadequate levels of antioxidants may be a risk factor for heart disease. Another major risk factor still not recognized by most physicians is elevated homocysteine levels. Homocysteine, an amino acid found in the blood was discovered in 1969 by a Harvard researcher studying why certain children were dying young from heart disease. For more info about homocysteine read this recent For Your Health newsletter: "It's Time You Test Your Homocysteine." For better cardiovascular function, it is recommended that everyone get into the routine of taking vitamin C and vitamin E along with adequate doses of B vitamins (which promote healthy homocysteine levels), trace minerals and other antioxidants and phytonutrients. The easiest way to get these important nutrients is from the Synergy line of vitamin supplements from Nutraceutical Sciences Institute (NSI). The most popular is Synergy Version 9 multi-vitamin. By taking three capsules twice a day, you receive 500 mg of Ester-CÆ, 400 units of mixed natural vitamin E, B-complex at effective levels along with a host of other antioxidants such as lutein, alpha lipoic acid, grapeseed extract, CoQ10, ginkgo biloba and more. The Synergy multi-vitamin has been continually improved over the past eight years, and was just recently reformulated (Version 9). The cost of this product is just under $1.00 a day. Allen S. Josephs, M.D.
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