Type 2 diabetes and heart disease

What is the link between Type 2 diabetes and heart disease?

Type 2 diabetes is more than simply a raised blood glucose level. You are also likely to develop various problems related to your heart and blood vessels – for example, high blood pressure and high cholesterol levels. Although the link between high blood pressure and diabetes is not yet fully understood, it is thought that it may result from high levels of insulin circulation in your blood as a result of insulin resistance (which is usual in Type 2 diabetes). As a result, your blood vessels become scarred and hard plaques form – this causes narrowing of your blood vessels, which makes it more difficult for your blood to flow. The risk of blockages in your blood vessels also increases; these can cause angina (severe chest pain) or a heart attack.

What is cardiovascular disease?

“Cardio” means heart and “vascular” means blood vessels. If you have Type 2 diabetes, you are prone to a range of cardiovascular problems including high blood pressure, hyperlipidemia (a high level of fat in your blood), angina (severe chest pain), heart attack, stroke, peripheral vascular disease (pain in yoru legs when walking or resting due to reduced circulation), and heat failure. You are also two to four times more likely to develop cardiovascular disease (CVD) than someone without diabetes. CVD is one of the major problems associated with Type 2 diabetes.

How would I know if I have CVD?

CVD does not necessarily cause any symptoms and may only become apparent when you have a heart attack or a stroke. But it is possible for your health professional to look for signs of CVD, such as high blood pressure and high levels of cholesterol in your blood. If tests are positive, you can have treatment for these conditions even though they do not make you feel ill. This is why you need to have your blood pressure and blood cholesterol levels checked regularly.

Can I take drugs to prevent CVD?

Taking regular low doses of aspirin (or other blood-thinning tablets if you can’t take aspirin) can help reduce your risk. You may also be prescribed pills to reduce your cholesterol level if you need them. Even if you need pills, eating healthily and becoming or staying active will play an important role in lowering your risk of CVD.

What exactly are “raised blood lipids”?

When you have Type 2 diabetes, your levels of cholesterol and triglycerides – two types of lipids (fats) in the blood – are likely to be raised, a condition known as hyperlipidemia. Both of these fats are essential in small amounts, but when their levels are raised they can damage your arteries. There are two types of cholesterol in your blood: high-density lipoprotein (HDL) and low-density lipoprotein (LDL). In a healthy person, the proportion of HDL to LDL is higher than it is in a person with Type 2 diabetes. Elevated levels of lipids in the blood are treated in order to lower your blood fats and to correct the ratio of HDL to LDL. This in turn prevents your arteries from narrowing.

How can losing weight prevent CVD?

If you are overweight, losing even a few pounds is one of the most important things you can do if you have Type 2 diabetes. Losing weight and becoming more active will help to lower your blood cholesterol levels and blood pressure. Your body will also become more responsive to the insulin you produce, and your heart will be under less strain.

Will physical activity help me prevent CVD?

Yes, just 30 minutes of moderate activity five times a week will help you control your blood pressure and reduce your cholesterol level, which in turn reduces your risk of CVD. Physical activity helps you lose weight because you not only burn more calories while you are active but you also speed up your metabolic rate so that your body uses up more calories even when you are less active.

How important is it to stop smoking now I have Type 2 diabetes?

Very important; if you smoke, you have a far higher risk of CVD, heart attack, and stroke. Having Type 2 diabetes further increases the risk. Going to smoking cessation clinics and using nicotine replacement therapy such as patches or chewing gum can help you give up.

My Type 2 diabetes was diagnosed after a heart attack. How can I prevent another?

Taking any medication you have been prescribed to reduce your blood pressure and cholesterol level, increase your blood flow, and control your blood glucose level will make a big difference. Relaxation therapy and attending your cardiac rehabilitation meetings will help to reduce your risk. Stopping smoking and being active – for example, walking every day – are also important.

Stroke

Also called a cerebrovascular accident, a stroke occurs when the blood supply to the brain is interrupted, and the brain is deprived of the oxygen it needs to function. An ischemic stroke, the most common type, is caused by a blocked blood vessel in the brain. A hemorrhagic stroke develops when an artery in the brain leaks or bursts. Brain damage can begin within minutes, so it is important to recognize stroke symptoms and act fast. Quick treatment can help limit damage to the brain and increase the chance of a full recovery.

Symptoms of a stroke, which happen quickly, typically include numbness or paralysis on one side of the body (usually the face, arm, or leg); dim, blurry, or double vision; difficulty speaking and understanding; dizziness; unsteadiness when walking; and severe headache. About 80 percent of strokes are caused by atherosclerosis, which results from a gradual buildup of plaque on artery walls, eventually causing them to close. High blood pressure is another major risk factor.

After experiencing a stroke, following your doctor’s orders is crucial for stabilizing your condition and reducing the risk of having another one. In addition to any prescribed medications and therapies, eating a well-balanced diet that includes lots of fresh vegetables, whole grains, and lean protein is recommended. This type of diet will help protect blood vessels, oxygenate tissues, and fight damaging free radicals. The following nutritional supplement program is designed to further support stroke recovery. However, if your stroke was hemorrhagic, do not take these nutrients until your physician confirms that there is no further risk of bleeding.

WARNING

If you experience any symptoms of a stroke, immediately call 911 or another emergency service. If the symptoms occur, but go away quickly, be sure to contact your doctor immediately. You may have had a transient ischemic attack (TIA). Also known as a mini-stroke, a TIA is often a warning that a stroke may occur soon. Seeking immediate treatment can help prevent it.

Supplements for Stroke Recovery

• Carnitine
• Coenzyme Q10
• EPA/DHA (fish oil)
• Glycerophospho-choline (GPC)
• NADH – Reduced and more active form of niacin
• Phosphatidylserine
• Vinpocetine – Do not take if you are taking a blood thinner
• Vitamin B3 (niacin)
• Vitamin B6 (pyridoxine)
• Vitamin B9 (folic acid)
• Vitamin B12 – High doses can deplete your body of other vitamins in the B complex

Cardiovascular Disease

Cardiovascular disease (CVD) is an umbrella term used to describe any abnormal condition characterized by dysfunction of the heart and blood vessels (including arteries and veins).

The most common cardiovascular diseases in the United States include

• Coronary heart disease (including myocardial infarction or heart attack, and angina pectoris, or chest pain)
• Stroke
• Heart failure

Most cardiovascular diseases are associated with atherosclerosis, a slow and progressive process in which arteries narrow and harden. During atherosclerosis, excess amounts of fat, cholesterol, calcium, and other substances build up beneath the cells that line artery walls and contribute to the formation of plaque. Over time, as plaque builds up, it narrows the opening of blood vessels, limiting the amount of oxygen-rich blood and nutrients that can flow to the heat or the brain. When blood flow to the heart is blocked, a heart attack occurs; when blood flow to the brain is blocked, a stroke occurs. Harmful blood clots can also break off and block a vessel.

Although they’re much less common, some forms of cardiovascular disease are caused by abnormal heart rhythm or heart valve function, or infection or toxins that make it harder for the heart to pump blood (as in cariomyopathy).

Cardiovascular disease (including high blood pressure) affects an estimated 81 million people in the United States. It is the leading cause of death and a major cause of disability among both men and women in the Unties States; it causes an estimated 700,000 deaths each year.

Although specific genes contribute to the development of some forms of cardiovascular disease (including congenital heart disease, an inherited condition present at birth), most often genetic tendencies (including family history), environment, and individual lifestyle factors interact and contribute to the development of cardiovascular diseases. Key risk factors for cardiovascular disease include

• High blood pressure
• Overweight and obesity
• High total or LDL cholesterol
• Low HDL cholesterol
• High triglycerides
• Diabetes
• Smoking
• Physical inactivity

How to Interpret Blood Values

A simple blood test taken after 9- to 12-hour fast can reveal your total, LDL, and HDL cholesterol and triglyceride levels.

Because cholesterol and triglycerides cannot dissolve in blood, they are carried in the blood and throughout the body by lipoproteins. The three main types of lipoproteins are as follows:

• Low-density lipoprotein (LDL)
• Very low-density lipoprotein (VLDL)
• High-density lipoprotein (HDL)

LDL cholesterol makes up most of the cholesterol found in the blood. It is known as “bad” cholesterol because high levels indicate an unhealthy buildup of cholesterol in the arteries; the more LDL in the blood, the greater the risk for heart disease. Too much saturated fat, trans fats, and (to a lesser extent) dietary cholesterol can contribute to high LDL levels.

HDL cholesterol, also known as “good cholesterol”, carries cholesterol from other parts of the body back to the liver; the liver is in charge of moving “bad” LDL cholesterol out of the body. Having low HDL cholesterol levels increases the risk of cardiovascular disease. Consuming too little dietary fat (less than 15 percent of total calories), having high triglycerides, being overweight or obese, and having hyperglycemia or diabetes all contribute to low HDL levels.

Almost all the lipids found in foods and in our bodies are in the form of triglycerides (made up of a molecule of glycerol attached to three fatty acids). Having a high triglyceride level increases the risk of cardiovascular diseases. Uncontrolled diabetes, kidney or thyroid problems, or a diet that’s low in protein and high in refined carbohydrates or alcohol can contribute to high triglyceride levels.

Some experts recommend using a ratio of total cholesterol to HDL cholesterol to estimate risk of cardiovascular disease. The goal is to keep your ratio below 5:1, but 3.5:1 is considered desirable. The National Cholesterol Education Program (NCEP) recommends that the following children be screened for high cholesterol starting at age 2 but no later than age 10:

• Those with a parent whose total cholesterol level is > 240 mg/dL
• Those with a family history of cardiovascular disease before age 55 in men and 65 in women
• Those who are overweight or obese or have diabetes, high blood pressure, or other risk factors

Children with “acceptable” cholesterol levels should be rechecked in 3-5 years; those with “borderline” levels should have their levels rechecked in 1 year.

Two other measurements that can be useful in determining a person’s cardiovascular risk include C-reactive protein (CRP) and homocysteine.

C-reactive protein is one of the proteins release by the body in response to an injury, an infection, or anything that causes inflammation. There’s evidence that high CRP levels predict future heart attacks or other cardiovascular events. A blood test called a high sensitivity C-reactie protein (hsCRP) assay is currently available. This test is used with people who have already suffered from a cardiovascular “event” (e.g., heart attack, stroke) to predict their risk for additional events or in those at high risk for them. If after consulting with a doctor you decide to have your hsCRP measured, what your values indicate:

• hsCRP < 1.0 mg/L – Low risk for cardiocascualr disease • hsCRP between 1.0 and 3.0 mg/L – Average risk for cardiovascular disease • hsCRP > 3.0 mg/L – High risk of cardiovascular disease

it’s important to note that those with autoimmune diseases, cancer, or other infectious diseases can have falsely elevated hsCRP levels.

Homocysteine is an amino acid that may provide you with a glimpse of your future risk for cardiovascular disease. Recent research has linked high homocysteine levels to a greater incidence of stroke and chronic heart failure, increased death from cardiovascular disease and other adverse diseases and conditions. Although population-wide testing of homocysteine levels is not currently recommended by the American Heart Association (AHA), many researchers and practitioners believe it can be quite useful for those at high risk for cardiovascular disease; discuss it with your physician.

Dietary Cholesterol

Dietary cholesterol is a fatlike substance found only in animal foods such as organ meats, egg yolks, fish and shellfish, beef and poultry, and dairy products. Plant foods do not naturally contain cholesterol.

You might be surprised to learn that although most foods that are high in cholesterol are also high in total fat and saturated fat, some low-fat foods such as shrimp and squid are also high in cholesterol; other shellfish contain lower amounts of cholesterol. Organ meats contain extremely high levels of cholesterol – 3 ounces of beef brain, for example, contains a whopping 1,696 mg cholesterol!

Although it might have less of an impact than high intakes of saturated and trans fats, too much dietary cholesterol can increase serum or blood cholesterol levels. When too much cholesterol builds up in blood vessel walls, it’s hard for blood to travel through the body and can cause a heart attack or stroke. When blood vessels that lead to the heat or brain become blocked, a heart attack or stroke can occur.

Some people in particular experience wide swings in their blood cholesterol levels in response to consuming varying amounts of dietary cholesterol. Although there’s not test to identify who is sensitive to dietary cholesterol, it’s prudent for all of us to limit or reduce our intake of dietary cholesterol.

Serum or blood cholesterol is cholesterol that circulates in the blood stream. Although most is made by the liver, some is obtained from the diet. Two main types of serum cholesterol include LDL (low-density lipoprotein cholesterol, also known as “bad” cholesterol) and HDL (high-density lipoprotein cholesterol, also known as “good” cholesterol).

Heart attack, also known as myocardial infarction (MI), occurs when blood flow to the heart is blocked.

Stroke, also known as a cerebrovascular accident (CVA), occurs when blood flow to the brain is blocked; this causes brain cells to die because they don’t’ get enough oxygen.

Daily Fat and Cholesterol Recommendations

The Institute of Medicine’s dietary reference intakes (DRIs) recommend acceptable macronutrient distribution ranges (AMDRs) for fat for children and adults. These ranges of daily fat intake (expressed as a percentage of total calorie intake) that provide enough fat to meet individual needs while reducing the risk of chronic disease:

• Children from 1 to 3 years old – 30-40 percent of total calorie intake from fat
• Children from 4 to 18 years old – 25-35 percent of total calorie intake from fat
• Adults from 19 to 70 years and above – 20-35 percent of total calorie intake from fat

The DRIs also recommend specific amounts of total fat (in grams) infants should consume each day; these estimated needs are based on adequate intakes (AIs), average intakes of dietary fat by most healthy infants:

• Infants 0 to 6 months – 31 grams of fat
• Infants 7 to 12 months – 30 grams of fat

Monounsaturated Fat

Although there are no specific DRIs for monounsaturated fats, the National Cholesterol Education Program Expert Panel on the Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) recommend up to 20 percent of total daily calorie intake to come from monounsaturated fats.

Polyunsaturated Fat

The Institute of Medicine’s DRI recommends a range of intake (expressed as a percentage of total calorie intake) for linoleic acid (an omega-6 PUFA) and alpha linolenic acid (an omega-3 PUFA) for children and adults as follows:

• Linoleic acid (LA) – 5-10 percent of total calories
• Alpha-linolenic acid (ALA) – 0.6-1.2 percent of total calories

Although there are no specific recommendations for EPA and DHA (the omega-3 fats found in fish), the American Heart Association (AHA) recommends everyone eat at least two fish meals (about 8 ounces cooked) each week, which provides about 500 mg/day EPA and DHA.

Saturated Fat

Dietary Guidelines for Americans and the AHA recommends that Americans should consume less than 10 percent of total calories from saturated fat. The AHA also recommends those with elevated bad LDL cholesterol (> 130 mg/dL) to aim for less than 7 percent of total calories from saturated fat.

Trans Fat

Although the current Dietary Guidelines for Americans recommend that people limit their intake of trans fats, and the Institute of Medicine’s DRIs recommend that trans fat intake should be as low as possible, the AHA has set a firm guideline for daily intake of trans fats. Based on their recent 2006 Dietary Guidelines, the AHA recommends that less than 1 percent of total calories should come from trans fats. That equals 1-3 grams of trans fat a day. Here are individual recommendations based on yoru daily calorie intake:

• If you consume 1,000-1,200 calories a day, consume no more than 1 gram per day.
• If you consume 1,400 calories a day, consume no more than 1.5 grams per day.
• If you consume 1,600-2,000 calories a day, consume no more than 2 grams per day.
• If you consume 2,200-2,400 calories a day, consume no more than 2.5 grams per day.
• If you consume 2,600 calories a day, consume no more than 3 grams per day.

Dietary Cholesterol

Dietary cholesterol is not something we need to consume; our bodies produce about 1,000 mg each day to meet our daily needs. Despite this, it would be very difficult for all but those who follow a vegan diet to eliminate dietary cholesterol from their diets.

The current Dietary Guidelines for Americans recommend a cholesterol intake of less than 300 mg per day. Less than 200 mg (or even less) is recommended for those with elevated LDL cholesterol level (> 130 mg/dL) or those diagnosed with heart disease.

A vegan diet is one that excludes all animal-derived foods (including meats, eggs, diary products, and foods made with animal fats).

USANA Vitamins Chocolate Whey Nutrimeal is a delicious way to get 15 grams of protein every day. USANA developed Chocolate Whey to offer a healthy blend of fats, whey protein, and good carbohydrates. Also, since it is low glycemic, USANA Chocolate Whey Nutrimeal is formulated for sustained energy to keep you satisfied longer.

Cholesterol and Fats

Cholesterol

Cholesterol is a waxy, fatlike substance that occurs naturally in your body and is made by your liver. Your body uses cholesterol for various functions, including protecting nerves, making tissues, and producing hormones. You take in extra cholesterol from the food you eat.

High levels of cholesterol in your blood can raise your risk of heart disease, including heart attack and stroke. This is because the higher the level of cholesterol in your blood, the more likely you are to develop plaque in your bloodstream. Plaque occurs when the cholesterol in your blood sticks to the walls of your arteries, blood vessels that carry blood from your heart throughout your body.

As plaque builds up, it can narrow your arteries and eventually block bloodflow. If an artery that supplies blood to your heart itself is blocked, you can have a heart attack. If an artery that supplies blood to your brain is blocked, you can have a stroke.

Men ages 35 and over and women ages 45 and over should have their cholesterol checked annually. You may need to have it tested more often if you have other risk factors. You are more likely to have high cholesterol if it runs in your family, if you are overweight, or if you have a high-fat diet.

If you do have high cholesterol, you may be able to lower it by exercising, eating more fruits and vegetables, and possibly taking medication. Smokers should stop smoking. If you are overweight, losing as little as 5 to 10 pounds can help. You should avoid eating saturated and trans fats and limit your overall cholesterol intake to less than 300 milligrams daily. Also steer clear of high-cholesterol foods such as eggs, fatty meats, and high-fat dairy products.

Additional Facts

1. LDL and HDL are specific types of cholesterol that are important to measure. LDL, delivers cholesterol to your body, while HDL removes cholesterol from your bloodstream. Too much LDL is bad for your body, whereas a high level of HDL is good.

2. A total cholesterol level of less than 200 is best, 200 to 239 is considered borderline high, and 240 or higher indicates an increased risk of heart disease.

Fats

Along with carbohydrates and proteins, fats are one of the three primary types of foods. An important source of energy, fats also help your body absorb vitamins and are essential for growth, development, and good health. Fats are especially important for infants and children.

There are three major types of fats: saturated fats, trans fats, and polyunsaturated and monounsaturated fats. Saturated fats are sometimes referred to as the solid fats in your diet. This is because this kind of fat sometimes forms a solid layer of fat at the top of food. Saturated fats are found in cheese, meats, whole milk and cream, butter, ice cream, and palm and coconut oils.

Diets that are high in saturated fats have been linked to coronary heart disease. Saturated fats also affect your cholesterol levels. No more than 10 percent of your daily calories should be from saturated fats.

Trans fat is found in vegetable shortenings, some margarines, crackers, cookies, snack foods, and foods made with partially hydrogenated oils. Partially hydrogenated oils are created through the process of hydrogenation, in which liquid oils are converted to solid fats. The trans fat in partially hydrogenated oils raise your LDL (“bad”) cholesterol, and decrease your HDL (“good”) cholesterol, both of which increase your risk of heart disease.

Fortunately, some companies have altered how they manufacture foods to decrease the amounts of trans fat in their products. Check the labels of the processed foods you buy to see whether they contain trans fat. It’s recommended that you reduce the amount of trans fat in your diet as much as possible.

Most of the fat you eat should be polyunsaturated fats and monounsaturated fats. These are the good fats. Unsaturated fats are found in avocados, flaxseeds, nuts, herring, salmon, trout, and the following oils: canola, corn, olive, safflower and high-oleic safflower, soybean, sunflower, and vegetable.

Additional Facts

1. Fats make food tasty and help you feel full.
2. Eating too much fat of any kind will cause you to gain weight.

The Benefits of Boosting Calcium: All the Way to Weight Loss

An estimated 44 percent to 87 percent of Americans don’t get enough calcium, including children, who are falling severely short on this mineral critical for proper growth and development. Unfortunately, there are not usually any obvious symptoms of a calcium deficiency, and people can go for years in a calcium-deficient state before any noticeable problems occur. Most of the symptoms that might occur due to a calcium deficiency would be seen only if calcium levels are low in the blood. Because the body is very good at keeping the blood calcium levels steady (often at the expense of bone strength), most people will never experience any symptoms of a deficiency until their bones are significantly weakened and fracture.

The benefits of boosting calcium go far beyond the obvious reasons of helping to normalize calcium levels and ensure healthy physiological processing. Several recent studies have shown links between increased calcium intake and specific health benefits in any array of conditions.

Premenstrual syndrome. It is found that a 50 percent decrease in PMS symptoms for women given calcium supplementation, compared to a 30 percent decrease for the placebo group. No other drug addresses all these symptoms as effectively. Another report, based on an epidemiological study of more than two thousand women, found a strong link between calcium and vitamin D intake and the risk of PMS. A high intake of calcium and vitamin D may reduce the risk of PMS.

Weight loss. Other studies have demonstrated links between increased calcium intake and weight loss. One of the researchers reported that calcium plays a key role in metabolic disorders linked to obesity, and also that high calcium diets lead to the release of a hormone that leads to the body’s fat cells losing weight. This is the basis on which the milk industry claims its product helps cinch a waistline, bolstering the “it does a body good” mantra.

High blood pressure. Clinical trials have also linked how calcium levels with high blood pressure. Argentinean research showed that women who take calcium during pregnancy may lower their children’s future risk of blood-pressure problems. Studies done at Rockefeller University showed that calcium supplements were of general benefit to both mother and baby during pregnancy.

Colon cancer. Researchers have linked calcium with the prevention of colon cancer.

Stroke. Harvard scientists reported on a link between increased calcium and the prevention of stroke.

Cholesterol. Researchers have shown that increased calcium can lower LDL (bad) cholesterol.

The Ex Factor

You know you can’t get through a health book without a mention of the “ex” factor, or exercise. Physical activity directly ties in to the conversation about bone and muscle health. Physical exercise, especially the weight-bearing kind, puts healthy stress on your bones to keep them strong and force them to be even stronger. It also works the muscles that keep you nimble and quick on your feet.

Young women and men who exercise regularly generally achieve greater peak bone mass than those who do not. Exercising allows us to maintain muscle strength, coordination, and balance, which in turn helps to prevent falls and related fractures. This is especially important for older adults and people who have been diagnosed with osteoporosis. The exercise you choose needn’t be complicated, boring, or overly challenging or demanding. The best exercise for your bones is the kind that forces you to work against gravity, even if its’ simply by working against your own body weight, as is the case for modern forms of yoga, mat Pilates, and the use of a resistance band. Other examples include weight training, hiking, jogging, climbing stairs, tennis, dancing, and of course, walking. It’s the constant pounding on the ground that translates to better muscle strength in the hips and lower back, maintaining or increasing bone density. These are the two places that are at highest risk for fracture.