Cheese For the Heart

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Cheese for the heart by jamie stanosOver the years, I’ve heard a whole lot of different proposed diets: Atkins, South Beach, Jenny Craig, Weight Watchers, all-carb, no-carb, you name it.  These mostly promise the same result: improved health and spectacular weight loss.  But all of them offer wildly varying, often contradicting, means to that end.  Yet a quiet revolution in mainstream scientific thinking has begun to take hold, one that views full-fat dairy products differently.

Cheese has almost always been viewed as a fattening food that’s dangerous to our heart health.  Yet directly in contrast to veganism and pretty much everybody’s preconceived notion, Dr. Arne Astrup, professor and head of the department of nutrition, exercise and sports at the University of Copenhagen, cheese is actually beneficial to cardiovascular health.  At the American Heart Association scientific sessions, Astrup declared that a diet of cheese plays a large part in managing type 2 diabetes and cardiovascular disease.  He doesn’t think that there’s any harmful effect from eating cheese, but is rather beneficial.  

In a recent comprehensive meta-analysis of 31 prospective cohort studies, a high dairy intake was associated with a 9% reduction in the risk of stroke, an 18% lower risk of coronary heart disease and a 13% reduction in risk of stroke.  Investigators in the Netherlands (a country known for their love of cheese) made a meta-analysis of 18 prospective cohort studies found that risk of stroke fell 7% for each 200 ml of dairy consumed every day, while consumption of 25 gm a day or more of cheese was associated with a 13% reduction in stroke risk and 8% lower risk of CHD.  A joint Chinese/Dutch meta-analysis found a 14% relative risk reduction for CHD and a 10% lower risk of stroke with high versus low cheese intake.  

This “classic lipid” hypothesis tied with cardiovascular disease says that dietary saturated fat raises blood cholesterol, which in turn accelerates atherosclerosis and CHD.  Yet recent studies indicate that not all saturated fats are equally harmful, and have vastly different biological effects.  For example, the saturated fatty acids and trans fats in red meat are damaging, yet those in dairy products are actually cardioprotective.  According to Dr. Astrup, fermented dairy products contain a long list of potentially beneficial nutrients in addition to saturated fats.  Strong evidence suggests that a diet high in dairy products reduces the risk of childhood obesity and enhances body consumption in adults.  Even the World Cancer Research Fund has weighed in, concluding that dairy products probably protect against colorectal, breast, gastric and bladder cancer.  

If you’d like to learn more, you can click here!

Former President of ACC Recommends Veganism

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jamies stanos heart

In 2014, the (then) president elect for the American College of Cardiology, Dr. Kim A. Williams,  published an article on MedPage Today that both explained his experience with veganism, and why he recommended the diet his patients suffering from hypertension and Type 2 diabetes (among other medical afflictions). The article brought on a great deal of backlash from the Cardiology community, as many medical professionals felt he was pushing a “radical” diet on everyone based on just his individual experience. Dr. Williams dismissed these claims as not being true.

Controversy aside, Dr. Williams’s article and experiences with veganism offer some interesting insight into (his experience) benefits of veganism.

Dr. Williams noted in his article that he became interested in the vegan diet after he learned that his LDL cholesterol numbers had increased by 60 points in just a few years. Dr. Williams noted that his exercise habits had faltered over those years, but he also had suspicions that his diet was also playing an active part in his cholesterol levels. The cholesterol levels found in food often has a negligible effect on blood cholesterol levels, but do have major effects on certain people, and Dr. Williams believed he was one of them.

Dr. Williams’s diet of no red meat, fried foods, and minimal dairy was clearly not doing the job at maintaining his health as he thought, so he switched to a “cholesterol free” diet, which was for all intents and purposes a vegan (plant based) diet. He found that in six weeks, his LDL cholesterol levels were significantly reduced and were a 90 at his next blood test.

Dr. Williams’s experience (and the results he saw) with his switch to a vegan diet were extraordinary, and definitely offered a glimpse of what veganism was capable of…for certain bodies. Even Dr. Williams acknowledges that the results from such a dietary switch can be variable.

In Dr. Williams’s article on MedPage Today, he also noted that the studies suggesting a connection between plant based diets and reduced heart disease are either “very large and observational or small and randomized” and “ larger randomized trials are needed. ”

Veganism continues to be a controversial topic, and research continues to look for solid links between plant based diets and overall health. While I always encourage a “healthy” diet, I continue to be interested in exactly what is truly considered “healthy”.

Is it a fully plant-based diet? Is it vegetarianism? 

As this article published by Harvard Health Publications stated,

there still aren’t enough data to say exactly how a vegetarian [or vegan] diet influences long-term health.”

It will be interesting to see what conclusions the medical field will be able to draw with continued research.

For additional sources for this post, please see the following articles: The New York Times and MedPage Today

Post-Op Atrial Fibrillation Treatment Methods Deemed Equally Efficient

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jamie stanos cardiac surgery

One of the most common complications that patients endure after undergoing cardiac surgery is postoperative atrial fibrillation. The unfortunate reality is that the condition can occur in up to 50% of post-op patients, and it can lead to everything from multiple hospitalizations to long-term mortality. There are currently two different approaches that cardiologist can take when addressing postoperative atrial fibrillation.

The two methods are rate control and  rhythm control, and researchers at the Cleveland Clinic recently carried out a large-scale randomized control clinical trial to determine which of the two methods was more effective.

Postoperative atrial fibrillation is a common complication of cardiac surgery and adversely affects patient recovery. In patients with postoperative atrial fibrillation, one strategy does not appear to have a net clinical advantage over the other, but there are clinical differences between these strategies. The results of this trial fill an important knowledge gap and should better inform therapeutic decisions for this common complication,”  – Annetine C. Gelijns, Ph.D.

When the rate control method is implemented, the heart rate is slowed down via medication.

When the rhythm control method is being used, the heart’s normal rhythm is restored through electrical shock.

Through their research, they determined that neither was better; the rate control and rhythm control methods are equally effective. Marc Gillinov, MD of the Sydell and Arnold Miller Family Heart & Vascular Institute noted that these results create a case for creating a standardized strategy of starting with rate control first, to avoid the toxicity risk related to the rhythm control agents.

Dr. Gillinov and his team studied 2,109 patients that elected to have cardiac surgery. 40% of the patients had coronary artery disease, 40% had heart valve disease, and the remaining 20% had a combination of the two conditions.  696 of the patients developed post-op atrial fibrillation, and 75% of those patients received randomized treatment (rhythm or rate control).

The results for both treatments were interesting:

  • The number of dates that all of the patients stayed in the hospital after receiving the treatment was equivalent
  • If the patients experienced serious adverse effects, they were similar between the two methods.
  • The differences that did occur between the two treatments ended up cancelling eachother out:
    • The rhythm control medication worked more quickly, but the side effects were so harsh that patients needed to switch treatments
    • Rate control treatment had a higher re-occurance rate

But, neither could be deemed more effective than the other.

 

To see the source article for this blog post click: here

 

New Sequencing Panel Allows For Detection of 174 Genes Related to Heart Disease

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genetics

 

From a genetic standpoint, one of the most commonly inherited diseases is heart diseased. Nearly 1% of the population is affected by inherited heart disease, but up until now, the testing process for the inherited genes has been extraordinarily difficult.

A sequencing panel has been developed that has the potential to change the face of cardiology for the better. In the past, testing for genetic signals of heart disease was a costly and unwieldy process. When trying to determine whether or not a patient’s heart conditions were genetic (or to determine what the genetics were that caused an inherited condition), medical professionals were limited to very specific tests that only focused on singular genes. It was impossible to efficiently test, and if the specific tests were inconclusive, then researchers and doctors would be forced to “serial test”, with the hopes of stumbling upon a solution.

The company Illumina has eliminated some of that inherent struggle with their development of TruSight. TruSight is sequencing panel that focuses specifically on genes that are associated with heart conditions. Trusight Cardio has made 174 genes associated with cardiac conditions available to be tested for, and Illumina has worked to include casual variants of the genes as well. This means that both “core genes” and genes that were considered emerging genes were included in the panel.

The senior product manager for Illumina’s generic health business was quoted saying:

“Existing gene panels for profiling genes related to inherited cardiac conditions tend to be smaller in size, leading to revalidation of bespoke panels, or having to send out tests when a particular set of genes are not available”.

Ilumina’s goal was to create a more flexible space for cardiologists and researchers.  With their new sequencing panel, clinical researchers now have the ability to see as many genes as they felt were necessary for the research situation at hand. Not only was there an increase in the availability of genes, but Illumina in the year of development, they also successfully created TruSight to have a quick turnaround in labs, and a reasonably low price point.

TruSight will make for a much more effective diagnosis process, and will inevitably save a great deal of time, money, and lives in the long term.

 

To see the articles that were used as resources, click here & here