B Vitamins and Heart Disease

Can B vitamins keep your heart healthy?

Sadly, the death of two young children who had died of massive strokes were the catalyst for a 1968 investigation. The Boston pathologist who investigated the death of the children found that they had extraordinarily high levels of a protein breakdown product in their blood. Both children’s arteries were blocked by cholesterol as well, resembling more closely the arteries of a middle-aged unhealthy person than those of a young child. These discoveries led to the hypothesis that elevated levels of this breakdown product (know as homocysteine) had contributed to the process of hardening of the arteries. This condition is called atherosclerosis. So, what is the connection between B vitamins and heart health?

Folate, vitamin B6 and vitamin B12 are instrumental in the body’s ability to convert homocysteine into methionine. Methionine is one of the 20 substances that help the body to build new proteins. Insufficient levels of any or all of these B vitamins can hamper the conversion process, driving homocysteine levels up. Sufficient levels of these vitamisn, on the other hand, can help to keep homocysteine at a safe level.

Many studies over the last few decades have shown that high levels of homocysteine can be associated with an increase in the risk of heart disease and stroke. Some studies have also shown that there is a causal relationship between high intakes of folate and the lower incidence of cardiovascular disease, hypertension and strokes. There cannot be a direct link made, however, between higher homocysteine levels and lower folate levels to an increased risk of heart disease. In other words, it cannot be definitely stated that lower homocysteine levels by taking more folic acid and other B vitamins will lower one’s risk of having a heart attack, stroke or other heart-related condition.

There have been several randomized trials involving B vitamins and heart health, but they have not conclusively shown any relationship between the two. In the studies adutl participants who had a history of heart conditions or who were in the upper risk categories for heart disease were given either a placebo or a pill that contained high doses of vitamins B6, B12 and folic acid. The result of the study was that taking the high doses of the three B vitamins did lower the levels of homocysteine present in the body, but that that reduction did not lead to a reduction in the number of cardiac events in the participants. There is some suggestion that the participants in this study were already too far gone in terms of heart health for the B vitamins to have an effect.

Recently, analysis of several studies seems to suggest that taking folic acid supplements can reduce the likelihood of a stroke in a person who had never before suffered a stroke. The risk reduction does not occur, however, in people who have already had a stroke. Further, folic acid was most effective in promoting heart health when combined with vitamins B6 and B12 as opposed to when it is consumed in isolation.

In the United States and in Canada, since the governments in those countries have mandated that certain products such as bread and pasta be fortified with folic acid, the rate of death from stroke has fallen dramatically. In the UK, where folic acid fortification is not yet mandated, there has been no significant change in the rate of death from strokes.

The long and the short of it is this: Folic acid supplementation may reduce the risk of heart disease in people who have lower levels of folate in their systems. This will typically include those people living in countries where folic acid fortification of food is not yet the rule. In countries where people already get adequate levels of folic acid from their food, further supplementation, even levels that are much higher than can be found in a standard multivitamin, has not been sufficiently shown to be of any significant benefit and, actually, may cause harm.

Currently, what constitutes a sufficient daily intake of B vitamins isn’t clearly defined. The definition would likely change over time anyway, as more data are collected from randomized trials. Currently in the United States, folic acid fortification of food has led to an increase in the percentage of adults who have adequate levels of folate in their systems. Still, only a small percentage of American adults currently get the recommended daily intake of all B vitamins derived just from their diets alone.

Superfoods help to boost your brain power

Ever stop in the middle of a room and can’t remember why you’re there. Don’t stress that you’re having a senior moment! Instead, stock your fridge with these healthy brain-boosting foods. Some are also good for your heart, because your brain is only as strong as the arteries leading to it. Others are rich in antioxidants to help repair cell walls and membranes.

Green Tea

You may have heard how great this drink is for weight loss. Sip a few cups each day and you’ll be slim and sharp: An antioxidant in green tea known as EGCG wards off the formation of beta amyloid peptides – proteins that make up the plaques in the brain associated with Alzheimer’s disease.

Brown Rice

Not only is it a healthy whole grain packed with fiber, but it also contains a substance called ferulic acid that’s been found to suppress those same memory-killing beta amyloid peptides. In fact, for a super smart and flavorful side dish, cook a batch of brown rice in green tea instead of water.

Skim Milk

Stuck inside all day? You’re probably not getting enough vitamin D, which is produced by the body in response to sun exposure. D is also found in fortified milk and dairy products. Research suggests that vitamins, linked with a lower risk for a slew of conditions from cancer to osteoporosis to heart disease, may also help prevent cognitive decline. Those who are deficient are more likely to experience loss of the executive function (thinking skills like planning and organizing) as they age.

H20

Need to clear away some mental cobwebs? Tip your glass. Being well hydrated increases healthy brian chemicals. If you want to make sure your memory, creativity, and focus are at their peak, drink 6 to 8 cups a day.

Romaine Lettuce

Fill your salad bowl to the brim with leafy greens. Along with beans and fortified foods like brad and cereal, they’re a great source of folate; this B vitamin keeps another protein called homocysteine from building up in the arteries. Research has shown that people with Alzheimer’s have higher levels of homocysteine in their brains than those without the disease.

Fish

A good part of the brain is made up of fatty tissue, and about a third of that is DHA, an omega-3 fat also found in cold-water fish like salmon and sardines. DHA from these foods (or from supplements and vitamins) can help rebuild brain cell membranes, boost intellectual performance, fight depression, and prevent the type of small stokes that lead to memory loss and dementia.

Eggs

Egg-white omelets are all the rage, but order tem exclusively and you’ll miss out on the best part: The yolk is chock-full of choline, a B vitamin that aids the body in manufacturing a substance called acetylcholine. Low levels of this neurotransmitter reduce your mental energy and ability to think clearly. In one study, college students who had tow boiled eggs for breakfast scored 10 to 20 percent higher on their exams.

Blueberries

Dark-colored fruits and berries get their color from a group of compounds called anthocyanins. These antioxidants protect brain cells against the free-radical damage caused by pollution, poor diet, and stress. Research has shown that eating more blueberries can improve your working memory within three weeks.

New Insight Into Cardiovascular Disease

A seldom-measured amino acid that is circulating in your blood may be an indication of cardiovascular disease. It is called homocysteine, and an increasing number of physicians and researchers are acknowledging that high levels of the chemical are associated with heart disease and stroke.

A summary of 15 studies revealed that elevated homocysteine levels produced a 70 percent increase in the risk of coronary artery disease and a greater risk for stroke. Previous studies have shown connections with schizophrenia, Alzheimer’s disease, hypothyroidism and anemia.

However, the evidence is not conclusive. “Five other studies found no link between homocysteine and cardiovascular disease,” says Oklahoma City internist Dr. E. Randy Eichner, a member of the Editorial Board of The Physician and Sportsmedicine, “but six studies did find a relationship. I think the balance of scientific evidence favors a homocysteine/CAD link.”

Atlanta cardiologist Dr. John Cantwell agrees with Eichner. “I recognize it as a possible risk factor, but the only time I measure it is when a person has a family history of heart disease without the more obvious risk factors.”

Dr. M. Rene Malinow, professor of medicine at the Oregon Health Sciences University and one of the nation’s leading homocysteine researchers, says we don’t yet know for sure that it is a cause of atherosclerosis. “We will have to wait for the results of clinical trials, and that could take several years.” Adds Malinow, “Although it is a relatively new risk factor by itself, it is possible that a high homocysteine level combined with traditional risks, such as hypertension or smoking, is even more significant.

Even those who think homocysteine is related to heart disease are not sure why it may have a harmful effect. One theory is that, in elevated amounts, it irritates the inner lining of the arteries and could cause blood clots to form. There is even a possibility that homocysteine levels increase after a stroke, not before.

Prevention

The good news is that a high homocysteine count can be prevented or treated by getting adequate amounts of folic acid (folate). Cantwell tells patients who have high levels to take 0.4 mg of folic acid per day, as well as a multivitamin supplement that includes B6 and B12. A high intake of folate by itself can mask other medical conditions, including a type of anemia.

The U.S. Food and Drug Administration has mandated that all enriched grain products be fortified with folate. Check the labels on cereal boxes. Most of them provide 25 percent of the daily folate requirement and many contain 25-35 percent of daily vitamin B6 and B12 needs. If you are eating a well-balanced diet, you probably don’t need the supplements.

Screening

Homocysteine screening is not very common. The American Heart Association is taking a very conservative position on the issue, saying that it’s too early to recommend general screening. Cantwell points out that the one-year cost of a folate and multivitamin supplement is approximately equal to the cost of a screening test.

Americans are well informed of the risk factors associated with heart disease. Sooner or later, a new one — elevated homocysteine levels — may be added to that list.

Folate is also good for unborn babies.

Folic Acid for Stroke

Cholesterol may not be the bad guy everyone thinks it is. Another substance in our blood seems to cause more harm to our arteries.

When real estate agent Liz Scotney suffered a mild stroke last year, it brought back frightening memories of her father’s final years. “He had, you know, lots of strokes where he was very disoriented and all that kind of thing,” said Liz.

Dr. William Feinberg is a neurologist who wants to protect people like Liz from future strokes. His weapon? A B-vitamin called folic acid.

William Feinburg, M.D., neurologist, University of Arizona, Tucson, Ariz., “Low intake of folic acid is associated with an increased risk of heart disease and stroke. We think that this is through an amino acid in the blood called homocysteine, which damages the blood vessels and makes atherosclerosis more likely.”

Dr. Feinberg gives stroke victims high doses of folic acid and vitamins B-6 and B-12. These vitamins are proven to prevent the buildup of homocysteine.

William Feinberg, M.D., “We hope that by giving more folic acid and lowering homocysteine, we can decrease the risk of heart attack and stroke.”

Liz says the vitamins give her hope that a second stroke will never happen. “If I can be helped not to have another stroke, that’s all I care about.”

Dr. Feinberg says screening for homocysteine may one day become as routine as having your cholesterol checked.

This study is a four-year trial involving 36 U.S. medical centers and 36-hundred patients who have suffered mild, non-debilitating strokes.

Homocysteine, Fibrinogen, Lipoprotein (A) and C-Reactive Protein

Homocysteine

Homocysteine is an amino acid that promotes free radical production. It also elevates trglycerides and cholesterol levels. Studies have indicated that high homocysteine levels are directly related to strokes, peripheral vascular disease, and cardiovascular disease.

Reasons that Homocysteine levels may be elevated

• Coronary artery disease
• Dementia
• Diabetes
• Drugs
• Elevated testosterone levels in women
• Hereditary predisposition
• Hypothyroidism
• Menopause
• Osteoarthritis
• Renal failure
• Rheumatoid arthritis
• Smoking
• Toxins

Eliminating alcohol, birth control pills, caffeine, diuretics, niacin, and tobacco can help decrease homocysteine.

Fibrinogen

Fibrinogen is a clot-promoting substance in your blood. Elevated levels of fibrinogen can cause a heart attack.

Ways to lower fibrinogen levels

• Bromelain
• EPA/DHA (fish oil)
• Estrogen hormone replacement
• Garlic
• Ginger
• Ginkgo
• Stop smoking
• Vitamin E

Lipoprotein (A)

Lipoprotein (a) is a small cholesterol particle that can cause inflammation and clog blood vessels when present in the body in elevated levels. High lipoprotein (a) levels can also greatly increase a person’s risk of developing heart disease. Along with diabetes and menopause, taking statin medications and eating soy has been shown to increase this particle’s presence in the body.

C-Reactive Protein

c-reactive protein is a protein found in the blood. Its levels become elevated when the body detects an infection or need for inflammation. C-reactive protein levels can also rise due to a previous infection, obesity, depression, or diabetes mellitus. In addition, raised levels may be indicative of future problems including cardiovascular disease and atherosclerosis.

Besides the supplements, exercise and the Metagenics product UltraInflamX can help lower elevated c-reactive proteins levels. One baby aspirin a day may also be effective, but check with your doctor regarding usage before starting this regimen.

Causes of increased C-reactive protein levels

• Depression
• Diabetes mellitus
• Inflammation
• Obesity
• Previous infection

Supplements to lower C-Reactive Protein levels

• Coenzyme Q10
• Curcumin
• EPA/DHA (fish oil)
• Grapeseed extract
• Green tea
• Quercetin
• Rosemary