High blood pressure.

High cholesterol.

Excess weight.

These are the risk factors for heart disease that your doctor typically talks to you about.  Yet, there is a risk factor that most doctors never discuss that can have as much impact as the ones I just listed — Depression.

Your mood plays a significant role in whether or not you get heart disease.  Study after study shows that the biological changes involved with depression– increased cortisol, elevated adrenaline, and decreased serotonin – causes changes in how well your heart functions.  It directly impacts how well your heart pumps as well as how much plaque develops in your arteries. Intense emotions and acute anxiety can literally change the shape of the heart. It’s a condition called Takotsubo cardiomyopathy and often referred to as “broken heart syndrome.”

Why is no one talking about this?

Even though we have made progress in recent years around the mind-body connection, we often don’t implement it in clinical practice. We create silos with physical health managed by physicians trained in internal and family medicine and mental health largely managed by psychiatry.  We need to be integrating and acknowledging there is no physical health without mental health, and there is no mental health without physical health.  It doesn’t make sense to only address risk factors such as blood pressure, cholesterol and weight – and then have mood as some time of afterthought.

If you follow some of my writing, you know I’m a big fan of risk calculators. Perhaps it’s time to update those that help calculate risk of cardiovascular disease and add depression/anxiety in the calculation of the risk score. That might force folks to be more explicit and proactive about managing mood as part of a primary prevention program.

Like many other aspects of heart disease, we wait until someone has a heart attack to adequately address it.  We talk about the need to reduce stress after patients experience chest pain – we should be talking about mood before they get to that point!

We have made amazing advances in the treatment of heart disease but sometime still dies of a heart attack every thirty- five seconds. Given the mental health challenges that many people have experienced during the past two years, I expect deaths from heart disease will increase unless we take proactive steps in reducing risk.  Addressing depression and other mental health conditions must be an important part of plan.

The post Heart Disease and Depression appeared first on Medika Life.

There has been much controversy regarding the association between alcohol intake and cardiovascular disease, the leading global cause of death.

According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), in 2019, 86 percent of adults in the United States reported consuming an alcoholic beverage.

Moreover, 14.5 million people in the U.S. aged 12 years or older live with alcohol use disorder (AUD). The NIAAA offers that Alcohol use disorder is marked by “an impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences.”

Approximately 95,000 Americans die annually from alcohol-related causes. This number makes alcohol the third largest preventable death cause.

It has long been recognized that the problems with alcohol relate not to the use of a bad thing but to the abuse of a good thing. — Abraham Lincoln

On the one hand, observational studies show a lower risk of cardiovascular disease with light to moderate alcohol intake than abstinence or heavy consumption. There appears to be a J- or U-shaped epidemiologic association.

On the other hand, these supposed heart benefits of alcohol may be secondary to confounding factors, including a favorable lifestyle (and behavioral and socioeconomic factors associated with modest alcohol drinking).

Today we try to get clarity by examining the pooled results of 107 studies involving nearly five million subjects. After analysis, study co-author Tim Stockwell offs this insight:

“We just need to be very skeptical of scientific evidence or scientific studies suggesting there are health benefits.”

Red wine — a traditional view

Moderate consumption of red wine has been associated with potential health benefits. Still, it’s important to note that these benefits are not a one-size-fits-all solution and may vary based on individual factors.

Red wine contains antioxidants, such as resveratrol, linked to cardiovascular health benefits. Resveratrol may improve cholesterol levels, lower blood pressure, and reduce the risk of blood clots.

Additionally, the polyphenols found in red wine have anti-inflammatory properties, which may help to reduce the risk of chronic diseases.

However, it’s important to remember that moderation might be a key to reaping the alleged health benefits of red wine. Excessive alcohol consumption increases the risk of several health issues, including liver disease, high blood pressure, and some types of cancer.

A new study raises questions about the traditional view that moderate alcohol consumption improves health and lengthens life.

Alcohol consumption, health, and longevity

In a new sweeping analysis, researchers discovered the following:

Despite a widespread belief that moderate alcohol consumption is good for you, the more you drink, the higher your risk of early death.

The review analyzed research on nearly five million individuals’ drinking and health habits. The study is one of the largest to undermine the belief that moderate drinking of wine (or other alcoholic beverages) is healthy.

The new study also discovered that drinking relatively low levels of alcohol — 25 grams daily for women (less than one ounce) and 45 grams (roughly 1.5 ounces) or more daily for men — increased the risk of death.

In the United States, a standard drink (5 ounces of wine, 12 ounces of beer, or 1.5 ounces of distilled spirits) typically has about 14 grams of alcohol.

Alcohol consumption study — context

The findings align with a British study from last year: Researchers examined the genetic and medical data of nearly 400,000 people. They concluded that even low alcohol intake was associated with increased disease risk.

In this cohort study of over 371,000 individuals, genetic evidence supported a non-linear, consistently risk-increasing link between all alcohol amounts, high blood pressure, and coronary artery disease.

The “J-curve might not exist when it comes to alcohol consumption level and disease risk. There were modest risk increases with light alcohol intake and exponentially greater risk increases at higher consumption levels.

In summary, alcohol intake at all levels appears to be associated with increased cardiovascular disease risk.

My take on alcohol consumption and health

This study shows that moderate alcohol consumption does not promote health. In general, less alcohol appears to be better regarding health.

You may have heard of the “French paradox,” suggesting that low cardiovascular disease rates (among men in France) appeared to be associated with daily wine consumption. Subsequent analyses revealed research flaws.

If you are keeping score, be careful: The alcohol industry funded much of the research examining the effects of alcohol on health. A recent report showed that the industry has directly or indirectly paid for 13,500 studies.

Moreover, historical research often failed to adjust for confounders such as lifestyle (for example, exercise, diet, and smoking), sex, age, and socioeconomic status. The current study attempted to remove such biases and discovered no significant reductions in the risk of death among moderate drinkers.

So why did previous research show a “J-shaped” curve — with lower heart attack rates among those consuming low or moderate alcohol amounts, with higher rates at the extremes — these studies were deeply flawed. The light-to-moderate drinkers were generally healthier than non-drinkers on physical activity, diet, weight, income, and dental hygiene measures.

In addition, abstainers from alcohol may avoid drinking because of health problems. Historical research did not control for such biases. Sometimes, being able to drink is a sign that you are still healthy, not the cause of it.

Let’s end with the words of researcher Professor Dr. Ulrich John:

“Our study is one of the very few that asked for details [about the] former life of the abstainers, details that may be known risk factors for early death. Our study is perhaps the only one so far that includes a standardized diagnosis of former alcohol or drug dependence, i.e., a severe health disorder that may explain short time to death.”

We might need to rethink the notion that daily drinking of moderate alcohol amounts promotes health. My takeaway is not that all should avoid alcohol; rather, it may not be the health potion many believe it to be.

What say you?

The post Are One or Two Drinks Daily Better Than Abstaining? appeared first on Medika Life.

Most importantly perhaps, the research showed higher intakes of dairy fat were not associated with an increased risk of death.

About the study

Entitled ‘Biomarkers of dairy fat intake, incident cardiovascular disease, and all-cause mortality: A cohort study, systematic review, and meta-analysis’ the study drew numerous conclusions that proved at odds with our current accepted views on dairy fat consumption and heart health.

The study is comprehensive. The results of this study in just over 4,000 Swedish adults were combined with those from 17 similar studies in other countries, creating the most comprehensive evidence to date on the relationship between this more objective measure of dairy fat consumption, risk of cardiovascular disease (CVD) and death.

In terms of methodology, the authors measured dairy fat consumption using an objective biomarker, serum pentadecanoic acid (15:0), in 4,150 Swedish 60-year-olds and collected information about CVD events and deaths during a median follow-up of 16.6 years.

Findings

There were, according to the study authors, two very significant findings. Bold highlights added by Medika.

When we accounted for known risk factors including demographics, lifestyle, and disease prevalence, the CVD risk was lowest for those with high levels of the dairy fat biomarker 15:0, while those with biomarker levels around the median had the lowest risk of all-cause mortality.

We also conducted a systematic review and meta-analysis, and the combined evidence from 18 studies also showed higher levels of 2 dairy fat biomarkers (15:0 and heptadecanoic acid 17:0) were linked with lower risk of CVD, but not with all-cause mortality.

Why this study is so important

Dairy consumption is on the rise worldwide. According to this OECD article, World per capita consumption of fresh dairy products is projected to increase by 1.0% p.a. over the coming decade, slightly faster than over the past ten years, driven by higher per-capita income growth.

According to one of the study authors, Dr. Matti Marklund of The George Institute for Global Health, Johns Hopkins Bloomberg School of Public Health, and Uppsala University, a better understanding of the impact of dairy on heart health is essential.

“Many studies have relied on people being able to remember and record the amounts and types of dairy foods they’ve eaten, which is especially difficult given that dairy is commonly used in a variety of foods.

Instead, we measured blood levels of certain fatty acids, or fat ‘building blocks’ that are found in dairy foods, which gives a more objective measure of dairy fat intake that doesn’t rely on memory or the quality of food databases,” he added.

“We found those with the highest levels actually had the lowest risk of CVD. These relationships are highly interesting, but we need further studies to better understand the full health impact of dairy fats and dairy foods.”

When is more, less

New research is continuously expanding our understanding of the factors that contribute to CVD, but it’s important to realize before we rush out and stock up on cheese and dairy that CVD risk is multifaceted and that both exercise and diet are integral parts of a healthy heart equation.

All your dietary habits need to be considered alongside a regular exercise regime to effectively manage the risk of CVD. The good news from this research would appear to be that lovers of cheeses and milk can now enjoy their intake without undue concern for their heart health, but only in conjunction with other healthy heartcare choices.

The lead author of the study, Dr. Kathy Trieu had this to add on the consumption of some dairy foods, especially fermented products, that have previously been associated with benefits for the heart.

“Increasing evidence suggests that the health impact of dairy foods may be more dependent on the type — such as cheese, yoghurt, milk, and butter — rather than the fat content, which has raised doubts if avoidance of dairy fats overall is beneficial for cardiovascular health.

Our study suggests that cutting down on dairy fat or avoiding dairy altogether might not be the best choice for heart health.

It is important to remember that although dairy foods can be rich in saturated fat, they are also rich in many other nutrients and can be a part of a healthy diet. However, other fats like those found in seafood, nuts, and non-tropical vegetable oils can have greater health benefits than dairy fats,”

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