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Heart Health – a matter of lifestyle

April 2012

  • Avni Sali

The human heart pumps around 7,500 litres of blood every single day. Beating an average 100,000 times a day, it sends oxygenated blood through a vascular system in the body that measures almost 100,000 kilometres long. For an organ the size of your fist, this is an incredible workload and taking care of the heart is clearly an important component of a complete lifestyle-based health care approach.

Cardiovascular disease, or CVD, is the leading cause of death globally; more people die from CVD (heart disease and stroke) than any other cause. According to the World Health Organisation (WHO), this amounted to 17.3 million people in 2008 and this figure is projected to rise to almost 23.6 million people per annum by 2030.

Heart health has been on the agenda for health authorities in Australia for several decades where behavioural factors such as an unhealthy diet, physical inactivity, smoking and other toxins such as alcohol are all cited to be contributors to CVD in individuals. When we view heart health from the perspective of integrative medicine we have a much more complete picture of risk factors and can approach both the treatment and prevention of this disease with a ‘total lifestyle’ approach. The good news is that the same lifestyle factors that increase the risk of CVD can be modified through lifestyle change to reduce the risk, as well as helping to reverse CVD.

In an Integrative Medicine model, risk factors for CVD include:
• Depression and/or anxiety
• Social isolation
• Stress
• Anger and/or hostility
• Inadequate exercise
• Lack of sunlight
• Poor sleep
• Hypertension
• Poor diet
• Overweight and/or obesity
• Abnormal serum lipids (cholesterols) and /or elevated levels of homocysteine
• Smoking, environmental pollutants and other toxins
Many of these risk factors are also indicated for other chronic diseases such as diabetes and cancer.

In the integrated model, risk factors such as stress, depression and social isolation are considered on par with the risk associated with smoking. In one study, depressive symptoms were associated with a significant 31% higher rate of cardiovascular events (compared to those with no depression). Work stress, anxiety and lack of social supports have all been shown to impact on heart health with a recent study indicating that chronic work stress was associated with two-fold increase in the risk of CVD. Worldwide trends towards obesity and type 2 diabetes, particularly in Western countries, are further risk factors that have a direct contribution to the development of CVD. A distinct relationship between body weight, blood pressure and CVD has been well documented, and the relative risk of developing hypertension, a risk factor for CVD, increases as body mass (weight) increases.

An integrated approach to the treatment and prevention of CVD includes mind-body medicine, nutrition, supplements and exercise. Adequate sleep and sunshine are also vital in managing CVD and in relation to health and wellbeing in general.

 Mind-body medicine is a well-researched area where very particular benefits for heart health have been associated with a sense of emotional vitality. One research report shows that there was a doubling of coronary risk associated with social deprivation over a 10-year period. Depression, social isolation and lack of quality social supports are associated with both the causes and prognosis of CVD. Stress management, anger management and counselling therapies including music therapy, have all been shown to be effective in managing risk factors for CVD. A very popular and proven technique in mind-body medicine is developing a meditation practice, which has demonstrable effects for relaxation and mood. In one study, meditation reduced the chances of dying or having a heart attack or stroke by 47%.

A poor diet or inadequate nutrition are considered to be key risk factors for CVD. Research into the Mediterranean-style diet has shown it lowers the risk of CVD. The Japanese diet, which is high in seafood, is also shown to be protective. A diet rich in seafood, fresh fruits and vegetables, nuts, wholegrain cereals and legumes, but low in salt, trans fats and chemicals (including artificial sweeteners and additives) is considered optimal. Quality sources of omega 3 and 9 such as olive oil and fish are highly recommended. Moderate alcohol consumption, especially red wine, is considered protective.

Supplements that are useful in preventing or treating CVD and its related ailments such as hypertension and high cholesterol, include fish oils, cocoa, coenzyme Q10, garlic, vitamin E (natural form), vitamin C, vitamins B6 and B12, vitamin D, folate, alpha lipoic acid, niacin, artichoke, red yeast rice, resveratol, magnesium, potassium, selenium, chromium, L-arginine, L-carnitine, psyllium fibre, cinnamon, and the herbs gymnema sylvestre, ginko biloba and hawthorn.

Low levels of vitamin D, the sunlight vitamin, have been associated with increased CVD mortality and deaths due to CVD are more common in winter. Research indicates that elevated homocysteine levels, an amino acid product of normal protein metabolism, show a relationship to increased vascular disease, especially in the elderly. The B group vitamins, including folate B6 and B12, are proving to be effective in managing homocysteine levels. Vitamins E, C and selenium have powerful antioxidant effects in the body and a synergy between the three provides maximum benefit. Magnesium deficiencies have been shown to produce coronary artery spasm, a potential cause of heart attack. Research continues into many supplements.

Exercise has a powerful effect on heart health and as little as 30 minutes walking per day is beneficial. Sessions can even be broken down into three sessions of ten minutes. Exercise helps reduce hypertension and, in addition to improving physical functioning, can assist in blood pressure management and improve mental health, physical condition and one’s ability to cope with stress.

Of course limiting exposure to environmental pollutants, including air pollution, tobacco, drugs and excess alcohol are essential components to any health care philosophy and quality sleep/rest is essential. Lack of sleep is now understood to be a significant risk factor for CVD and regular napping, e.g. siestas can reduce the risk of coronary mortality by up to 37%.

Keys to good heart health
• Adopt an integrated lifestyle approach.
• Get enough sleep – take a siesta if needed.
• Establish healthy responses to stress, anxiety and depression – practise meditation daily and seek guidance and support from health professionals, family and friends.
• Foster emotional vitality – protective against CVD in men and women.
• Manage your weight – a reduction in body weight of just 10% can normalise blood pressure.
• Consume fish daily (if possible) as part of a good diet including fruit, vegetables and nuts.
• Walk every day, preferably outdoors.
• Seek professionally prescribed supplements and herbal remedies as required.
• Embrace joy in life and create fun events to share with others.
• Consume dark chocolate daily (ideally two squares, 85% cocoa)

Good heart health means good overall health and wellbeing. Changes to your lifestyle will have an immediate and recognisable impact on many elements of your health. Integrative Medicine provides both a treatment and prevention protocol that can be annexed to other treatment options. In integrative medicine, emphasis is placed on the prevention of CVD though lifestyle change, not only the treatment of symptoms. As a worldwide community this is an important way we can arrest the trend of CVD as the number one cause of mortality.

Professor Avni Sali is Founding Director of the National Institute of Integrative Medicine (NIIM). He oversees the facilitation of the practice of Integrative Medicine at the NIIM Clinic in Hawthorn, as well as the promotion of education and research.

Sources
www.who.int/cardiovascular_disease/en/
Kotsirilos, Vitetta, Sali. 2011 A guide to evidence-based integrative and complementary medicine, Elsevier, Sydney

 

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