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Friday, November 2, 2012

Nitric Oxide Levels in Heart Health

I was employed at Parkview Hospital in Riverside, CA in 1988. Before the first day of work began, a phyiscal was required.  I was found to have a very high cholesterol level of 250.  Back then they didn't talk about HDL and LDL and triglycerides, at least not to me, so I don't know what my ratio was.  I was 22 years-old and they immediately signed me up for a nutrition class.

My usual diet prior to the class was scrambled eggs, hotdogs, white bread, milk, macaroni and cheese, and a very few fruits and vegetables.  The nutrition class was six weeks long and I had to learn how to eat fat free.  This meant fat free white bread was okay, fat free Entemann's was okay, fat free jelly beans were okay, white pasta and chicken was okay.

In the years that followed I gained 83 pounds on this fat free diet.

Back then, I didn't know that there was a lot more to preventing heart disease then just keeping the total cholesterol to 200 (which I never accomplished on the diet the hospital was teaching me to use).

But now we know there is far more to controlling heart disease than controlling cholesterol.  Unfortunately, I did not realize this until a year ago, after my husband's heart disease was well established.

As children, our bodies make an abundance of nitric oxide which is a gas in our bodies that keeps the arteries flexible so that the blood can move easily around the plaques that may exist.  

According to a conversation we had with Caldwell Esselstyn, M.D. of the Wellness Institute at the Cleveland Clinic, by the time we reach our 40's our ability to make nitric oxide is decreased by 50%.  This is why so many people do well cardiovascularly until they reach middle age, and may be why so many people wind up with a heart surprise in their middle ages.  I'm also wondering if those who suffer from a family history of heart disease might have a genetically lower amount of nitric oxide production.  I would love to see some research on that. 

As I said in my first post, I believe this discovery, made a year ago, saved my husband's life.  He had a 99% blockage in his left circumflex artery (interesting that the hardening was in the artery that has the word flex in it), but because we had switched to a low-fat plant based diet in December 2011, I really believe that artery which was completely clean except for the one portion which was blocked, was able to allow enough blood flow to his heart, despite the narrowing, because it was flexible due to the change of diet.  And I am sure that he did not have a heart attack caused by that artery because he had stopped cleaned up his diet.  The schematic given us after the angiogram shows a beautifully flexible and clean artery except for about 1/16 of an inch, where the stent now sits, and the area of his LCA that had the 1/16 inch of 1% flow was able to expand to some degree, as needed because of the new flexibility.

Our troubles began when he was hiking with the scouts in Colorado. Busy and on the road with the boys and other leaders, he was eating pulled pork, bacon, eggs, veggie burgers, not fat free, Wendy's, and whatever the outfitters were feeding him.  This is when the chest pain started, and that would have been when the nitric oxide levels were low in his body.  Could it had been that those two arteries were only 70 or 80% blocked before he went to Colorado, and the food he ate on the trip closed the arteries up the rest of the way?  I believe so, since the pain started while he was there.

How does a middle age person increase their nitric oxide levels?  Dr. Esselstyn explained that middle age adults need to eat foods high in nitrates, mostly steamed greens like kale, bok choy, beet greens, spinach, and then other foods like whole oatmeal, and other fruits and vegetables.  Chewing food well is essential because the enzymes in the saliva help the stomach to produce nitric oxide for the body.  I recently saw a study which explains that elderly people with the inability to chew well have a higher risk of heart disease  This causes me to wonder if people who "wolf" down their food also have a higher risk of heart disease, since they are not allowing the foods they eat to release their nitric oxide by not chewing thoroughly and mixing the foods they eat with the enzymes in their saliva?

When we eat foods that damage nitric oxide levels, i.e. anything with a face, a mother (animal products), oils (no matter what people say about olive oil), nuts, sweeteners (artificial and not artifical, honey, maple syrup, sucrose), we compromise nitric oxide levels, and promote hardening of the arteries.

This is a very important focus to have when helping a family member manage heart disease.  

Cholesterol management is very important, but nitric oxide promotion is also important and essential.  

Many people ask me, "why not nuts?".  I don't know the science on this, especially since so many people have told me that nuts are heart healthy.  Well, Dr. Esselstyn covers this in his book Preventing and Resversing Heart Disease, but I have found for myself, that the high levels of Omega 6's in all nuts, except walnuts, cause me problems, mostly digestively, and some inflammation.  I know that sounds funny when almonds are known to fight inflammation, but I do feel better when I eat more Omega 3's like chia seeds, and less Omega 6's.  We need both types of fats, but we needs more Omega 3's than 6's to feel healthy.

In order to feel well when I'm eating nuts, I need to eat more foods high in Omega 3's, and just a tiny amount of nuts. I have a theory that diets high in Omega 6 and not balanced out by Omega 3 damage lowers nitric oxide levels.

Just another note on nuts.  If we are following the the LDS dietary advice in the Doctrine and Covenants' Word of Wisdom, which I am, then we would only eat the high fat fruits such as nuts and avocadoes in the seasons they were intended for, around Christmas time.  I guess we could also use that advice for all foods...watermelon for summer, oranges for winter, squashes for winter.....  I will have to put some more study to that.

John McDougall, M.D.points out in this video  that nuts are a delicacy and should only be eaten when they are ripe on the tree, sparingly, perhaps for special occassions, and out of their shells, not already shelled.

He is right, the fat you eat is the fat you wear.  Last year I ate nuts in my smoothies, on my salads, and as flour for my gluten free breads.  I gained 20 pounds from September to December of last year.  When I stopped eating nuts, I quickly lost that 20 pounds, from December to February of last year.

Nuts turn rancid so quickly.  I find that many nuts are rancid on the grocery store shelves.  Rancid nuts provide free radicals that cause damage to our tissues.

  Avocados should also be treated with the same type of respect as nuts.  As Dr. McDougall states, they are only in season on their trees for two weeks out of the year.  We should eat them when they are in season for our area, and as a special treat.  These high fat fruits are usually only available in the winter time when our bodies need more heat.  They can be eaten and appreciated with reason during the holiday season, but if we are to follow the dietary advice in the Word of Wisdom, I believe we do harm to ourselves if we consume too much in the summer.

The study of nitric oxide, and the practice of eating foods that increase nitric oxide in our bodies, bring great hope to those managing heart disease, and gives great hope to those who desire to work on completely reversing the disease.  

I recommend anyone who has heart disease to watch all of Dr. Esselstyn's lectures that they can find on YouTube and read his book, Prevent and Reverse Heart Disease as well as John McDougall's book,  The McDougall Program for a Healthy Heart: A Life-Saving Approach to Preventing and Treating Heart Disease.  Both of these books are ahead of their time in explaining the role of nitric oxide levels and how they relate to preventing heart attacks.

Also, if you haven't already, do a Google search on nitric oxide and heart disease, or nitric oxide and foods that are high in nitric oxide.  The information out there is very exciting, and shows that managing heart disease and our health is so much more in depth than we have been told, yet simple by eating a well-balanced plant-based diet.

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