Functional Medicine For Heart Disease
Functional medicine can address heart disease with holistic lifestyle changes such as diet, exercise, stress, and sleep. Many forms of heart disease can be prevented or treated with healthy lifestyle choices.
What is heart disease?
Is poor heart health limiting your quality of life? Then, it's time to take extra care of your heart to get the most of your life. The heart is an important organ that works continuously throughout your life supporting your organs and the whole body. Rain or shine, day or night, it keeps pumping. Maintaining good heart health is an important thing that must be taken care of. Heart disease is the most common disease faced by the majority of the population.
Heart disease describes a range of conditions that Influence your heart. Diseases beneath the heart disease umbrella include blood vessel diseases, such as coronary artery disease; heart rhythm problems (arrhythmias); and heart defects you are born with (congenital heart defects), amongst others.
The term "heart disease" is often used interchangeably with the term "cardiovascular disease." The cardiovascular disease normally refers to conditions that involve narrowed or blocked blood vessels which may result in a heart attack, chest pain (angina) or stroke. Other heart conditions that affect your heart muscle, valves or rhythm, are also considered forms of cardiovascular disease. Many forms of heart disease can be prevented or treated with healthy lifestyle choices.
Researchers using whole-body magnetic resonance angiography have found that an alarmingly high incidence of asymptomatic atherosclerosis in people considered to be at low to intermediate risk for cardiovascular disease. Atheroma develops over time, and subclinical disease is present before clinical symptoms are evident.
Atherosclerotic plaque, blood vessels, blood pressure, and cholesterol are known risk factors for cardiovascular events, the leading cause of death in the US. However, with early detection and interventions to deal with modifiable lifestyle factors, atherosclerosis and cardiovascular disease (CVD) can be slowed or reversed.
In today’s fast-paced life, where people are subjected to unhealthy food, stress, and sedentary lifestyle habits have failed to respond to conventional treatments that produce side effects such as headache, nausea, vomiting, stomach pain, constipation, diarrhea, weakness, fatigue, and erectile dysfunction. In such a situation there arises a need for considering integrative therapies like functional medicine in the form of a holistic approach that is known to promote good health and little or no side effects.
How does Functional Medicine view heart disease?
By fixing the root cause, rather than symptoms, Functional Medicine practitioners become oriented to identifying the complexity of the disease. They may find one condition that has many diverse causes and, likewise, one cause may lead to many medical conditions. Because of this, Functional Medicine treatment targets the particular manifestations of disease in each person. Many research studies have suggested that lifestyle changes in diet, exercise, weight loss, and sleep to have positive effects on cardiovascular disease.
A 2010 study indicates that a wider adherence to recommendations for the daily consumption of vegetables, fruit, fish, and fatty acid composition may eliminate as much as 20-30 percent of the burden of CVD and result in approximately one additional year of life for a 40-year-old person. Evidence indicates that healthy eating may impact CVD-related outcomes. Fixing the gut with diet, probiotics, prebiotics, and other remedies can decrease risks for many cardiometabolic patients.
In 2017, an international panel reasoned that a healthy lifestyle, such as the Mediterranean, DASH, Nordic, or vegetarian diet, is vital for the prevention or delay of the onset of metabolic syndrome, CVD, and type 2 diabetes. Western-type diets, which can be characterized by high consumption of red meat, processed foods, refined grains, sugars, and saturated fatty acids, have been associated with a higher incidence of metabolic syndrome in women. A possible analysis conducted over the Atherosclerosis Risk in Communities study indicated an 18% higher risk of incident metabolic syndrome for people with the greatest Western dietary pattern score.
In 2018, research among Asian Indians living in the US indicated that a "Western/non-vegetarian" dietary pattern is related to a metabolomic profile that's connected to a negative cardiometabolic profile. A September 2018 study indicated that the incidence of metabolic syndrome, obesity, elevated high sensitivity C-reactive protein, and glucose intolerance increase as diet-related inflammation increases.
Besides diet, regular physical activity has been proven to decrease the risk of prevalent diseases such as metabolic syndrome, CVD, and type 2 diabetes. A 2018 study found that high-velocity circuit resistance training enhanced biological markers, health quality of life, and total CVD risk in adults with cardiometabolic syndrome and CVD risk factors.
Another research in frail, obese older adults found that lifestyle interventions related to weight loss improved cardiometabolic risk factors, but continuous improvement in insulin sensitivity was only attained when exercise has been added to weight loss.
A growing number of research studies have gathered connecting sleep quality/quantity and general health. A 2016 evaluation of 75 studies investigating associations between sleep factors and measures of abdominal adiposity, glucose homeostasis, blood lipids, blood pressure, and inflammatory markers indicates that insufficient sleep may play a part in cardiometabolic risk at a later age for children and teens.
A 2018 research in postmenopausal women indicates that sleep quality is a significant correlate of insulin resistance in this population, no matter whether they have metabolic syndrome. The study calls for additional research to find out whether enhancing sleep improves insulin resistance in people with an elevated cardiometabolic risk.
A similar study, in children and teens from Bogotá DC, Colombia, showed that boys who met the recommended length of sleep had a decreased risk of elevated blood sugar levels. Poor sleep quality was associated with reduced HDL-c and higher triglyceride levels in women, suggesting the clinical value of improving sleep hygiene to reduce metabolic risk factors in children and teens.
Functional Medicine For A Healthy Heart
Functional medicine for heart health utilizes a multi-directional approach of an individual’s health to provide better health outcomes. Numerous clinical trials have evaluated the replacement of micronutrient; deficiencies, along with a high-dose therapy of selected nutraceuticals when combined with an optimal diet, exercise, stress and weight management can result in achieving good heart health and controls high blood pressure.
It’s ultimately the food that we take is responsible for the overall functioning of the body. Correcting nutritional deficiency in your body can help in the prevention of various heart diseases like coronary heart disease, stroke, and hypertension. Functional medicine for blood pressure and heart disease includes dietary modification as its first-line treatment. Nutritional supplements such as beta carotene, selenium, vitamin C, vitamin E, cod liver oil, garlic, Co-enzyme Q10, beta-glucan, lipoic acid, whole grains, vitamins B6, potassium, magnesium, sodium, polyphenol, botanicals, and vanadium are known to promote good heart health and some of these supplements are mentioned below.
Choline and heart disease- Choline, an essential dietary nutrient for humans, is involved in a broad range of critical physiological functions. It is required for the synthesis of the neurotransmitter, acetylcholine, the methyl group donor, betaine, and phospholipids. Research has found that inadequate levels of choline may diminish the capacity to methylate homocysteine to methionine due to which the levels of plasma homocysteine increase. Increased homocysteine levels may be associated with greater risk of several chronic diseases and conditions including cardiovascular disease.
Sources of choline include - eggs, liver, and peanuts, spinach, shellfish, dairy products, beets, and wheat.
Cod liver oil
Cod liver oil/fish liver oil is rich in Omega-6 and omega-3 fatty acids which are polyunsaturated fatty acids (PUFA). They must be derived from the diet as humans cannot synthesize them in sufficient quantities. These fatty acids when consumed results in EPA and DHA production inside the body. These derivatives are known to possess promising anti-inflammatory effects where it reduces cardiometabolic risk factors, myocardial infarction, reduces blood pressure and ameliorates atherogenic effects.
Fish for heart health is considered to be good as it contains essential fatty acids like EPA and DHA which can be found in fish like Herring haddock, Atlantic salmon, trout, tuna, cod, and mackerel. Nowadays, Krill oil which is also considered good for heart health is used as an alternative to fish oil.
Garlic- Allin is an important organ sulfur compound derived from garlic. It’s a potent antioxidant and anti-bacterial compound. Research study has shown that treatment with alliin attenuated hypoxia/re-oxygenation (H/R) induced apoptosis of cardiomyocytes and thus cause a decrease in the apoptosis of cardiomyocytes in vivo showing its protective effect on the heart from the myocardial infusion. Garlic is also known to reduce the incidence of cardiovascular diseases by lowering blood pressure and increasing levels of antioxidant enzymes.
Coenzyme Q-10 - CoQ10 is a highly lipophilic molecule that has a prominent role in redox reactions within the electron transport chain. CoQ10 strengthens the heart muscle and improves a variety of heart conditions by decreasing oxidative stress. Numerous trials have suggested Coenzyme Q10 (CoQ10) be a safe therapeutic option for patients with heart failure. CoQ10 supplement is widely available over the counter.
Beta-glucan- β-glucan reduces cholesterol levels and thus reduces the risk of coronary heart disease (CHD). It forms a viscous layer in the small intestine which delays stomach emptying and allows the body to draw upon the pool of circulating cholesterol and produce new bile acids. This results in reduced levels of cholesterol circulating in the blood. It also acts as an Immune enhancer and has a cholesterol-lowering effect. β-glucan is found to be abundantly present in oats, pepper, sorghum, rye, maize, triticale, wheat, rice, seaweed, and mushrooms.
Healthful plant-based diet- It has been seen that consuming plant-based diet like whole grains, fruits/vegetables, oils (containing MUFA, PUFA), nuts/legumes, tea/coffee which are diets high in antioxidants, micronutrient content, dietary fiber, unsaturated fat, and low in saturated fat and heme iron content, can help enhance glycemic control and insulin regulation, aid in weight loss/maintenance, improve lipid profile, reduce blood pressure, improve vascular health, act against inflammation and can also foster more favorable diet- gut microbiome interactions all of which are considered to be favorable in preventing cardiovascular risk disease.
Potassium- low levels of potassium can cause vascular calcification, characterized by the buildup of calcium, plaque and other proteins in the smooth muscle cells within arteries. Thus potassium depletion can cause increased blood pressure by retention of sodium and calcium and can also cause atherosclerotic plaques. Potassium can be found in fruits and vegetables such as apricots, bananas, tomatoes, and carrots.
Magnesium- Magnesium is a potent antioxidant with anti-inflammatory properties. It has been found through various trials that magnesium has a potential therapeutic role in the prevention/treatment of atherosclerosis and could inhibit platelet dependent thrombosis by downregulating the production of free radicals caused by oxidative stress. Green leafy vegetables, legumes, seeds, nuts, and whole grains, are good sources of magnesium.
Folic acid, vitamin B6, and Vitamin B12 - Vitamin B9/Folic Acid is another essential vitamin that helps regulate the amount of homocysteine in the blood, which is associated with a possible risk for blood clots, found in the bloodstream. Nutritional deficiencies of folate, vitamin B6, and vitamin B12 can cause hyperhomocysteinemia. Hyperhomocysteinemia can cause endothelial cell damage, reduction in the flexibility of vessels, and alters the process of hemostasis. Hyperhomocysteinemia may be a risk factor for hypertension, smoking, lipid and lipoprotein metabolism, as well as the promotion of the development of inflammation.
Natural sources high in folic acid, vitamin B6, Vitamin B12, include broccoli, lentils, Brussels sprouts, and asparagus.
Vitamin- C- Vitamin C is helpful for long term health maintenance of arteries and has implications in thrombosis, lipid peroxidation, and atherogenesis. It also possesses diuretic effects and thus helps to lower blood pressure in hypertensive patients. Citrus fruits such as orange, grapefruit, guava, kiwi, lemon, and vegetables such as cauliflower, broccoli, and capsicums are rich, natural sources of vitamin C.
Studies in Functional Medicine for Heart Disease
1. First Study: A total of 420 patients with moderate to severe heart failure were enrolled in a 2-year prospective trial. These patients either received CoQ10 100 mg 3 times daily (n= 202) or a placebo (n=218) treatment along with standard therapy. The study was divided into short term (16 weeks) and long term phases (2 years).
The results reported have shown that long-term administration of CoQ10 in patients with chronic HF is safe, improves various symptoms of heart disease, and reduces major adverse cardiovascular events when compared to short -term treatment.
2. Second Study "Effect of medium-term supplementation with a moderate dose of n-3 polyunsaturated fatty acids on blood pressure in mild hypertensive patients"
A total of 32 males were recruited in the study to understand the effect of n-3 polyunsaturated fatty acids on blood pressure in mild hypertensive patients.
Out of 32 patients, 16 patients were found to be suffering from mild essential hypertension, and were found to be non-diabetic, and normolipidemic, while the other 16 males were recruited to participate in the study as normotensive controls.
The hypertensive patient groups were randomly assigned to receive either EPA or DHA ethyl esters as an active treatment, whereas the control group received olive oil (4 g/day) as a placebo treatment. The duration of the treatment lasted for a period of 4 months.
A Blood chemistry analysis along with 24-hour ambulatory BP monitoring was carried out at 2 and 4 months of treatment. After 2 months of treatment, it was found that the effect of n-3 PUFA was maximum on BP in the active group. Both systolic and diastolic BP significantly decreased during the n-3 PUFA ethyl ester supplementation and no further reduction or effect was observed at 4 months. Thus the study indicates that 4 g/day of highly purified EPA + DHA ethyl esters are able to favorably affect BP in mild hypertensive.
Functional medicine plays a significant role in treating cardiovascular diseases with holistic lifestyle modifications based on evidence. The approach in treating a patient traditionally through lifestyle modifications, rich and healthy diet, reducing stress levels through exercise, and supplementing with healthy nutrients. There are various evidence-based studies that have proved the efficacy of functional medicine in preventing heart disease. More research is ongoing to understand the correlation between functional medicine and many aspects of cardiovascular disease.
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