Dad's got atherosclerosis - what to do?

[Guest guest]

My father, who is 65-years old, just had a CMIT scan which showed

arterial plaque build-up equivalent to that of an 80-year old. His

LDL was 157, HDL was " high " and triglycerides were low.

My dad has read most of Colpo's book on cholesterol and he

isn't worried about his LDL. He knows that high HDL and low

triglycerides are probably more significant. He is, however,

concerned about the arterial plaque build-up.

I'm not so certain whether that is cause for concern. Obviously the

mainstream theory is that heart attacks are caused by such plaque

build-up. But I've come across research which contradicts this. In a

1998 paper Murakami et al. found that only 49% of MI patients had

blockage. A 25-year autopsy study of MI patients found that only 25%

had sufficient blockage to " explain " their heart attacks.

Nevertheless, even those studies pointed out that there are other

dangers of plaque build-up even if it isn't the primary cause of heart

attacks.

My dad follows a low-carb diet (fairly close to Atkins) and exercises

religiously. His stress levels are high, however, which is a major

concern. He also eats some Atkins junk, like those low-carb tortillas

(finally got him off those last month when I was visiting) and

probably consumes a fair amount of vegetable oil. His antioxidant

intake may be lower than optimal.

What would you all suggest? I will recommend that he dramatically

reduce vegetable oils and start taking an antioxidant regularly (I was

thinking of Dr. Ron's formula; any other recommendations?) I'm also

going to suggest a stress-management program. But aside from that,

his diet is pretty good, he exercises regularly and he doesn't smoke.

His one weakness in terms of carbs is he drinks a moderate amount of

beer.

I will also recommend CoQ10, cod liver oil (to improve vitamin D

status - D deficiency has been repeatedly linked to heart disease),

magnesium (glycinate? which form is best for heart disease?) and

possibly L-carnatine.

Am I missing anything?

Thanks,

Chris

[Guest guest]

>

> My father, who is 65-years old, just had a CMIT scan which showed

> arterial plaque build-up equivalent to that of an 80-year old. His

> LDL was 157, HDL was " high " and triglycerides were low.

>

> My dad has read most of Colpo's book on cholesterol and he

> isn't worried about his LDL. He knows that high HDL and low

> triglycerides are probably more significant. He is, however,

> concerned about the arterial plaque build-up.

>

> I'm not so certain whether that is cause for concern. Obviously the

> mainstream theory is that heart attacks are caused by such plaque

> build-up. But I've come across research which contradicts this. In a

> 1998 paper Murakami et al. found that only 49% of MI patients had

> blockage. A 25-year autopsy study of MI patients found that only 25%

> had sufficient blockage to " explain " their heart attacks.

>

> Nevertheless, even those studies pointed out that there are other

> dangers of plaque build-up even if it isn't the primary cause of heart

> attacks.

>

> My dad follows a low-carb diet (fairly close to Atkins) and exercises

> religiously. His stress levels are high, however, which is a major

> concern. He also eats some Atkins junk, like those low-carb tortillas

> (finally got him off those last month when I was visiting) and

> probably consumes a fair amount of vegetable oil. His antioxidant

> intake may be lower than optimal.

>

> What would you all suggest? I will recommend that he dramatically

> reduce vegetable oils and start taking an antioxidant regularly (I was

> thinking of Dr. Ron's formula; any other recommendations?) I'm also

> going to suggest a stress-management program. But aside from that,

> his diet is pretty good, he exercises regularly and he doesn't smoke.

> His one weakness in terms of carbs is he drinks a moderate amount of

> beer.

>

> I will also recommend CoQ10, cod liver oil (to improve vitamin D

> status - D deficiency has been repeatedly linked to heart disease),

> magnesium (glycinate? which form is best for heart disease?) and

> possibly L-carnatine.

>

> Am I missing anything?

>

> Thanks,

> Chris

>

[Guest guest]

Two things: either chelation i.v.'s or oral edta. A month's worth of

Oral is equal to one i.v. You can up the amounts for more effect.

Also, nattonkinase to prevent drug sludge, a direct cause of heart attack.

This is relatively new information.

jp

> I will also recommend CoQ10, cod liver oil (to improve vitamin D

> status - D deficiency has been repeatedly linked to heart disease),

> magnesium (glycinate? which form is best for heart disease?) and

> possibly L-carnatine.

>

> Am I missing anything?

>

> Thanks,

> Chris

>

------------------------------------

[Guest guest]

I don't have any advice, but as someone following some similar lifestyle

decisions to your

father, I am curious at what age he adopted these lifestyle choices, like the

low carb diet?

[Guest guest]

There are some folks who claim that atherosclerosis is nothing more than

chronic scurvy (vit C deficiency). I don't know if they're right, but

vitamin C is cheap and non-toxic so it might be worth taking. These folks

generally recommend taking about 3 grams/day to prevent atherosclerosis, and

10+ grams/day if you already have it.

I can provide some links if interested.

On Fri, Jul 25, 2008 at 9:33 AM, Kresser <chriskresser@...> wrote:

> My father, who is 65-years old, just had a CMIT scan which showed

> arterial plaque build-up equivalent to that of an 80-year old. His

> LDL was 157, HDL was " high " and triglycerides were low.

>

> My dad has read most of Colpo's book on cholesterol and he

> isn't worried about his LDL. He knows that high HDL and low

> triglycerides are probably more significant. He is, however,

> concerned about the arterial plaque build-up.

>

> I'm not so certain whether that is cause for concern. Obviously the

> mainstream theory is that heart attacks are caused by such plaque

> build-up. But I've come across research which contradicts this. In a

> 1998 paper Murakami et al. found that only 49% of MI patients had

> blockage. A 25-year autopsy study of MI patients found that only 25%

> had sufficient blockage to " explain " their heart attacks.

>

> Nevertheless, even those studies pointed out that there are other

> dangers of plaque build-up even if it isn't the primary cause of heart

> attacks.

>

> My dad follows a low-carb diet (fairly close to Atkins) and exercises

> religiously. His stress levels are high, however, which is a major

> concern. He also eats some Atkins junk, like those low-carb tortillas

> (finally got him off those last month when I was visiting) and

> probably consumes a fair amount of vegetable oil. His antioxidant

> intake may be lower than optimal.

>

> What would you all suggest? I will recommend that he dramatically

> reduce vegetable oils and start taking an antioxidant regularly (I was

> thinking of Dr. Ron's formula; any other recommendations?) I'm also

> going to suggest a stress-management program. But aside from that,

> his diet is pretty good, he exercises regularly and he doesn't smoke.

> His one weakness in terms of carbs is he drinks a moderate amount of

> beer.

>

> I will also recommend CoQ10, cod liver oil (to improve vitamin D

> status - D deficiency has been repeatedly linked to heart disease),

> magnesium (glycinate? which form is best for heart disease?) and

> possibly L-carnatine.

>

> Am I missing anything?

>

> Thanks,

> Chris

>

--

Alan (alanmjones@...)

[Guest guest]

Vitamin C with Lysine and Proline are supposed to do what EDTA does plus

build up the body. Also Resveratrol decreases mortality from all causes and

softens blood vessels.

Jp

There are some folks who claim that atherosclerosis is nothing more than

chronic scurvy (vit C deficiency). I don't know if they're right, but

vitamin C is cheap and non-toxic so it might be worth taking. These folks

generally recommend taking about 3 grams/day to prevent atherosclerosis, and

10+ grams/day if you already have it.

I can provide some links if interested.

--

No virus found in this incoming message.

Checked by AVG.

Version: 7.5.524 / Virus Database: 270.5.6/1572 - Release Date: 7/25/2008

6:51 AM

[Guest guest]

>

>

> I don't have any advice, but as someone following some similar lifestyle

decisions to your

> father, I am curious at what age he adopted these lifestyle choices, like the

low carb diet?

>

>

>

,

I don't think he started the low-carb thing until about 8 years ago. His diet

probably wasn't

great before that. Also, he owned an advertising agency with about 150

employees and was

one of the most stressed-out people you can imagine. He has since moved on from

that but

he's still a very high-stress guy.

Chris

[Guest guest]

>

> There are some folks who claim that atherosclerosis is nothing more than

> chronic scurvy (vit C deficiency). I don't know if they're right, but

> vitamin C is cheap and non-toxic so it might be worth taking. These folks

> generally recommend taking about 3 grams/day to prevent atherosclerosis, and

> 10+ grams/day if you already have it.

>

> I can provide some links if interested.

>

I'm interested, but is the data sound (i.e. well-designed, peer-reviewed

studies)?

My dad has some (mild) intestinal problems and tends towards diarrhea. I can't

imagine he

could even tolerate 3g of C, much less 10g. How do people get around that

problem?

[Guest guest]

On Fri, Jul 25, 2008 at 12:40 PM, chriskjezp <chriskresser@...> wrote:

> I'm interested, but is the data sound (i.e. well-designed, peer-reviewed

> studies)?

>

You'll have to be the judge of that. It's a controversial theory, but as I

stated, it's cheap and non-toxic, so if the theory is wrong, what have you

got to lose?

> My dad has some (mild) intestinal problems and tends towards diarrhea. I

> can't imagine he

> could even tolerate 3g of C, much less 10g. How do people get around that

> problem?

>

The vit C proponents say, " titrate to bowel tolerance " , meaning, take as

much as your can as long as it doesn't give you the big D.

http://www.vitamincfoundation.org

http://orthomolecular.org

http://www.orthomed.com/

http://paulingtherapy.com/

--

Alan (alanmjones@...)

[Guest guest]

> You'll have to be the judge of that. It's a controversial theory, but as I

> stated, it's cheap and non-toxic, so if the theory is wrong, what have you

> got to lose?

I don't know about vitamin C in particular, but many other vitamins increase

total mortality

in random clinical trials. I would read the literature very carefully before

taking any

vitamin or other supplement.

Currently I am taking vitamin D. Only one trial in Nebraska or Kansas has said

supplementation reduces cancer, and there were issues with the trial. But with

vitamin D

the argument to supplement melds with an analysis of native lifestyles because

our

ancestors who spent the day outside would have had much higher circulating

vitamin D

than a modern person who spends most of their time indoors.

On the other hand, using biochemistry models, researchers like Trevor Marshall

denounce

vitamin D as suppressing the immune system's ability to fight off hard-to-detect

L-form

bacteria. So by taking vitamin D, I am placing a heavy bet that Marshall is

wrong about

vitamin D suppressing the immune system. If he is right, I could be killing

myself.

I also buy into the WAPF's hype on cod liver oil and high-vitamin butter oil,

but agonize

over the reality that, in the absence of definitive clinical trials on cod liver

oil, the WAPF

could be wrong that high doses of vitamin A and smaller doses of omega 3 PUFAs

are

safe. I got off of krill oil because of Masterjohn's report on PUFAs. I

was taking krill

oil because of a company-funded clinical trial where krill oil improved lipids

dramatically,

but as lipids are not the relevant clinical endpoint (mortality is), I went with

Chris's

theorizing and discontinued the krill oil.

Back on someone suffering from heart disease, I think Colpo mentions the mineral

niacin

for treatment of heart disease. There was also a Lyon study where a

Mediterranean diet,

including omega 3 PUFAs, reduced death.

[Guest guest]

It's more than just vitamin C - also lysine supplements together with

the C that makes it work - I went back and read up on ing and

Rath's work on this - they even applied for a patent on it.

>

> There are some folks who claim that atherosclerosis is nothing more

than

> chronic scurvy (vit C deficiency). I don't know if they're right,

but

> vitamin C is cheap and non-toxic so it might be worth taking.

These folks

> generally recommend taking about 3 grams/day to prevent

atherosclerosis, and

> 10+ grams/day if you already have it.

>

> I can provide some links if interested.

>

>

> On Fri, Jul 25, 2008 at 9:33 AM, Kresser <chriskresser@...>

wrote:

>

> > My father, who is 65-years old, just had a CMIT scan which showed

> > arterial plaque build-up equivalent to that of an 80-year old.

His

> > LDL was 157, HDL was " high " and triglycerides were low.

> >

> > My dad has read most of Colpo's book on cholesterol and he

> > isn't worried about his LDL. He knows that high HDL and low

> > triglycerides are probably more significant. He is, however,

> > concerned about the arterial plaque build-up.

> >

> > I'm not so certain whether that is cause for concern. Obviously

the

> > mainstream theory is that heart attacks are caused by such plaque

> > build-up. But I've come across research which contradicts this.

In a

> > 1998 paper Murakami et al. found that only 49% of MI patients had

> > blockage. A 25-year autopsy study of MI patients found that only

25%

> > had sufficient blockage to " explain " their heart attacks.

> >

> > Nevertheless, even those studies pointed out that there are other

> > dangers of plaque build-up even if it isn't the primary cause of

heart

> > attacks.

> >

> > My dad follows a low-carb diet (fairly close to Atkins) and

exercises

> > religiously. His stress levels are high, however, which is a

major

> > concern. He also eats some Atkins junk, like those low-carb

tortillas

> > (finally got him off those last month when I was visiting) and

> > probably consumes a fair amount of vegetable oil. His antioxidant

> > intake may be lower than optimal.

> >

> > What would you all suggest? I will recommend that he dramatically

> > reduce vegetable oils and start taking an antioxidant regularly

(I was

> > thinking of Dr. Ron's formula; any other recommendations?) I'm

also

> > going to suggest a stress-management program. But aside from

that,

> > his diet is pretty good, he exercises regularly and he doesn't

smoke.

> > His one weakness in terms of carbs is he drinks a moderate amount

of

> > beer.

> >

> > I will also recommend CoQ10, cod liver oil (to improve vitamin D

> > status - D deficiency has been repeatedly linked to heart

disease),

> > magnesium (glycinate? which form is best for heart disease?) and

> > possibly L-carnatine.

> >

> > Am I missing anything?

> >

> > Thanks,

> > Chris

> >

>

>

> --

> Alan (alanmjones@...)

>

>

>

[Guest guest]

I don't know about vitamin C in particular, but many other vitamins increase

total

mortality

> in random clinical trials. I would read the literature very carefully before

taking any

> vitamin or other supplement.

I've seen a lot of research correlating vitamin D deficiency with heart disease.

I've also

seen researching indicating the same for K2, which M. discusses in his K2

article in

the WAPF journal.

Colpo and many others also suggest CoQ10 on the basis of clinical trials, and

there is

some evidence for using mixed tocopherols and tocotrienols as well.

I've not seen the research you're referring to demonstrating that certain

micronutrients

increase mortality in CVD patients. Could you point me towards some of it?

> Currently I am taking vitamin D. Only one trial in Nebraska or Kansas has said

> supplementation reduces cancer, and there were issues with the trial. But with

vitamin D

> the argument to supplement melds with an analysis of native lifestyles because

our

> ancestors who spent the day outside would have had much higher circulating

vitamin D

> than a modern person who spends most of their time indoors.

> I also buy into the WAPF's hype on cod liver oil and high-vitamin butter oil,

but agonize

> over the reality that, in the absence of definitive clinical trials on cod

liver oil, the WAPF

> could be wrong that high doses of vitamin A and smaller doses of omega 3 PUFAs

are

> safe. I got off of krill oil because of Masterjohn's report on PUFAs. I

was taking krill

> oil because of a company-funded clinical trial where krill oil improved lipids

dramatically,

> but as lipids are not the relevant clinical endpoint (mortality is), I went

with Chris's

> theorizing and discontinued the krill oil.

I've gone back and forth on this as well. My sense is that if someone is

following a very

low PUFA diet the benefits of CLO outweigh the possible harm that the small

amount of

PUFA in a normal dose could do.

>

> Back on someone suffering from heart disease, I think Colpo mentions the

mineral

niacin

> for treatment of heart disease. There was also a Lyon study where a

Mediterranean diet,

> including omega 3 PUFAs, reduced death.

Niacin has been shown to raise HDL and lower triglycerides. However, my dad's

HDL and

triglycerides are at good levels. I'm not sure how much that would help, and

the

therapeutic levels used in studies are available only by prescription so his doc

would have

to agree.

Aspirin has been shown to be as effective as statins in reducing mortality from

heart

disease, but I'm a little concerned about recommending it because of his

elevated liver

enzymes.

Chris

[Guest guest]

--- Kresser <chriskresser@...> wrote:

> I will recommend that he dramatically reduce vegetable oils and

> start taking an antioxidant regularly (I was thinking of Dr. Ron's

> formula; any other recommendations?)

I think you're right about getting your dad to minimize PUFA in

his diet. As you know, it's pro-inflammatory and may be a significant

factor in his atherosclerosis. If he can keep PUFA and sugar intake

low, he may not need to supplement with anti-oxidants. Many

commercial and food anti-oxidants are plant pesticides that have to be

detoxified by the body and may be a double-edged sword.

> I'm also going to suggest a stress-management program. But aside

> from that, his diet is pretty good, he exercises regularly and he

> doesn't smoke.

The stress management sounds good too. I'd recommend dropping any

caffeine addiction as well, to help reduce bad reactions to stress.

> His one weakness in terms of carbs is he drinks a moderate amount of

> beer.

As long as he isn't overweight and isn't alcoholic, this shouldn't be

a problem.

> I will also recommend CoQ10, cod liver oil (to improve vitamin D

> status - D deficiency has been repeatedly linked to heart disease),

> magnesium (glycinate? which form is best for heart disease?) and

> possibly L-carnatine.

As you probably know, red meat is a good source of CoQ10 and

L-carnatine. Heart meat is especially high in CoQ10. Your

recommendation of high natural vitamin cod liver oil is a good idea.

Also, don't forget to make sure he includes one or more or the top

three foods that Weston Price identified with good health: animal

seafoods (shellfish in particular), organ meats, and dairy (preferably

raw and/or fermented). Clams, oysters, and scallops are good for

minerals. Caviar is quite high in magnesium (300 mg/100 g). Mackerel

(97 mg/100 g) and pollock (86 mg/100 g) are also fairly high in

magnesium. Cocoa powder (499 mg/100 g) and coriander (cilantro)

leaves (694 mg/100 g) are quite high in magnesium by weight, but I'm

not sure it's absorbed as well as from animal foods.

[Guest guest]

> I've not seen the research you're referring to demonstrating that certain

micronutrients

> increase mortality in CVD patients. Could you point me towards some of it?

For CVD specifically, there is a short literature review of clinical trials in

the journal

Circulation (2004, 637-641) by Kris-Etherton, et al. Ten studies are considered

that found

no effect, five with positive effects, and five with negative effects.

More disturbingly, there is a meta-analysis of trials by Bjelakovic et al in the

February 28,

2007 issue of JAMA. The authors find that beta carotene, vitamin A and vitamin E

increase

mortality. Vitamin C and selenium have no effect on mortality. None of the

supplements

considered reduce mortality. I think this review is important, because total

mortality is the

endpoint we should care most about. It is the best measured and allows for side

effects on

diseases that are not the primary focus of the study.

When I see this, I worry that I am buying into too much hype about the work of

Weston

Price when I take cod liver oil, which has high levels of vitamin A in it. Chris

Masterjohn

and others say A, D and K2 work synergistically and so are safer than A in

isolation. We

will see.

[Guest guest]

Do you guys know about " Track Your Plaque " ? It's a program by Dr.

that helps people reduce the plaque with lifestyle

changes. That's where I'd start in that situation. They have a huge

web site telling how and what and with testimonials and community

forum too.

Connie

>

> My father, who is 65-years old, just had a CMIT scan which showed

> arterial plaque build-up equivalent to that of an 80-year old.

His

> LDL was 157, HDL was " high " and triglycerides were low.

>

> My dad has read most of Colpo's book on cholesterol and he

> isn't worried about his LDL. He knows that high HDL and low

> triglycerides are probably more significant. He is, however,

> concerned about the arterial plaque build-up.

>

> I'm not so certain whether that is cause for concern. Obviously

the

> mainstream theory is that heart attacks are caused by such plaque

> build-up. But I've come across research which contradicts this.

In a

> 1998 paper Murakami et al. found that only 49% of MI patients had

> blockage. A 25-year autopsy study of MI patients found that only

25%

> had sufficient blockage to " explain " their heart attacks.

>

> Nevertheless, even those studies pointed out that there are other

> dangers of plaque build-up even if it isn't the primary cause of

heart

> attacks.

>

> My dad follows a low-carb diet (fairly close to Atkins) and

exercises

> religiously. His stress levels are high, however, which is a

major

> concern. He also eats some Atkins junk, like those low-carb

tortillas

> (finally got him off those last month when I was visiting) and

> probably consumes a fair amount of vegetable oil. His antioxidant

> intake may be lower than optimal.

>

> What would you all suggest? I will recommend that he dramatically

> reduce vegetable oils and start taking an antioxidant regularly (I

was

> thinking of Dr. Ron's formula; any other recommendations?) I'm

also

> going to suggest a stress-management program. But aside from

that,

> his diet is pretty good, he exercises regularly and he doesn't

smoke.

> His one weakness in terms of carbs is he drinks a moderate amount

of

> beer.

>

> I will also recommend CoQ10, cod liver oil (to improve vitamin D

> status - D deficiency has been repeatedly linked to heart

disease),

> magnesium (glycinate? which form is best for heart disease?) and

> possibly L-carnatine.

>

> Am I missing anything?

>

> Thanks,

> Chris

>

[Guest guest]

,

Thanks for the info on those studies. Very disturbing indeed. Did the authors

pose any

theories about why those micronutrients may have led to an increase in total

mortality?

The distribution of results of the first review (5 no change, 5 increase and 5

decrease)

might have nothing to do with micronutrients and just represent the normal

course of

disease for those patients. Did they control for other lifestyle factors such

as smoking,

intake of PUFA (probably not), physical activity, etc?

The meta-analysis in JAMA is potentially disturbing as well, although I have the

same

questions about that review as the one above. I completely agree with you that

total

mortality is the most important endpoint.

does present some convincing evidence on the synergism of A, D & K2. I

wouldn't

say it's conclusive, but the mechanisms are becoming clearer and it makes a lot

of sense

to me.

Thanks,

Chris

>

> > I've not seen the research you're referring to demonstrating that certain

micronutrients

> > increase mortality in CVD patients. Could you point me towards some of it?

>

> For CVD specifically, there is a short literature review of clinical trials in

the journal

> Circulation (2004, 637-641) by Kris-Etherton, et al. Ten studies are

considered that

found

> no effect, five with positive effects, and five with negative effects.

>

> More disturbingly, there is a meta-analysis of trials by Bjelakovic et al in

the February

28,

> 2007 issue of JAMA. The authors find that beta carotene, vitamin A and vitamin

E

increase

> mortality. Vitamin C and selenium have no effect on mortality. None of the

supplements

> considered reduce mortality. I think this review is important, because total

mortality is

the

> endpoint we should care most about. It is the best measured and allows for

side effects

on

> diseases that are not the primary focus of the study.

>

> When I see this, I worry that I am buying into too much hype about the work of

Weston

> Price when I take cod liver oil, which has high levels of vitamin A in it.

Masterjohn

> and others say A, D and K2 work synergistically and so are safer than A in

isolation. We

> will see.

>

>

>

[Guest guest]

> I'm not so certain whether that is cause for concern. Obviously the

> mainstream theory is that heart attacks are caused by such plaque

> build-up. But I've come across research which contradicts this. In a

> 1998 paper Murakami et al. found that only 49% of MI patients had

> blockage. A 25-year autopsy study of MI patients found that only 25%

> had sufficient blockage to " explain " their heart attacks.

Could you link to something that explains what constitutes " blockage "

and " sufficient blockage " in this study? When I have heard this

criticism made by others, it has struck me as nonsense. Basically, it

is argued that because the blockage itself is not sufficient to stop

blood flow, that is evidence that the blockage did not cause the

stoppage of blood flow. But the mainstream theory is that the rupture

of the lesion leads to a blood clot that causes the blockage, so the

argument is basically knocking down a straw man.

> My dad follows a low-carb diet (fairly close to Atkins) and exercises

> religiously. His stress levels are high, however, which is a major

> concern. He also eats some Atkins junk, like those low-carb tortillas

> (finally got him off those last month when I was visiting) and

> probably consumes a fair amount of vegetable oil. His antioxidant

> intake may be lower than optimal.

>

> What would you all suggest?

Getting him totally off all vegetables and supplementing with a combo

of CoQ10 and mixed tocopherols.

> I will also recommend CoQ10, cod liver oil (to improve vitamin D

> status - D deficiency has been repeatedly linked to heart disease),

> magnesium (glycinate? which form is best for heart disease?) and

> possibly L-carnatine.

Glycinate and taurate are good as far as I know but from what I've

seen glycinate is much less expensive. There's a form of carnitine

that is considered best for muscles that would probably be best for

heart too, which is different from acetyl-L-carnitine, but I don't

remember what it is. told me about it -- maybe if he's reading

he can chime in.

Chris

[Guest guest]

On 7/25/08, Alan <alanmjones@...> wrote:

> There are some folks who claim that atherosclerosis is nothing more than

> chronic scurvy (vit C deficiency). I don't know if they're right, but

> vitamin C is cheap and non-toxic so it might be worth taking. These folks

> generally recommend taking about 3 grams/day to prevent atherosclerosis, and

> 10+ grams/day if you already have it.

The idea that it is nothing more than C deficiency is untenable, but

the idea that C is a factor is very plausible. Support for collagen

synthesis will help prevent the fibrous cap of lesions from rupturing.

Chris

[Guest guest]

,

> More disturbingly, there is a meta-analysis of trials by Bjelakovic et al in

> the February 28,

> 2007 issue of JAMA. The authors find that beta carotene, vitamin A and

> vitamin E increase

> mortality.

I will have to wipe the cake off my face and take my foot out of my

mouth if I read the meta-analysis and find out I'm wrong, but it seems

to me like a silly meta-analysis to perform, since the two major

trials with beta-carotene also had groups that used it in conjunction

with alpha-tocopherol and retinol, when the mortality increases were

due to the beta-carotene. To mix up combo studies and blame the

combos on all the nutrients involved doesn't make any sense. In the

ATBC trial that used beta-carotene and alpha-tocopherol, if memory

serves correctly, the alpha-tocopherol only group did not have

increased mortality.

> Vitamin C and selenium have no effect on mortality. None of the

> supplements

> considered reduce mortality.

Selenium benefits people who have low blood levels and harms people

who have high blood levels, so it evens out. I think this is probably

because of missing cofactors like sources of bioavailable cysteine

(raw protein, acetyl-l-cysteine, vitamin b6) and because the studies

used selenomethionine rather than the form that animals use and found

in animal products, selenocysteine.

> When I see this, I worry that I am buying into too much hype about the work

> of Weston

> Price when I take cod liver oil, which has high levels of vitamin A in it.

> Masterjohn

> and others say A, D and K2 work synergistically and so are safer than A in

> isolation. We

> will see.

Are there any studies that showed vitamin A by itself to increase mortality?

Chris

[Guest guest]

..> There are some folks who claim that atherosclerosis is nothing more

than

> chronic scurvy (vit C deficiency). I don't know if they're right, but

> vitamin C is cheap and non-toxic so it might be worth taking. These

folks

> generally recommend taking about 3 grams/day to prevent

atherosclerosis, and

> 10+ grams/day if you already have it.

>

> I can provide some links if interested.

Alan, did you read the bit in Taubes' " Good Calories, Bad Calories " on

deficiency diseases, where he talks about the hypothesis that vitamin C

is only needed in large amounts to counteract the effect of excess

amounts of starch and sugar, because glucose uptake competes with vit C

uptake? Just curious to see if you had an opinion.

[Guest guest]

--- In , " Masterjohn "

<chrismasterjohn@...>

wrote:

> I will have to wipe the cake off my face and take my foot out of my

> mouth if I read the meta-analysis and find out I'm wrong, but it seems

> to me like a silly meta-analysis to perform, since the two major

> trials with beta-carotene also had groups that used it in conjunction

> with alpha-tocopherol and retinol, when the mortality increases were

> due to the beta-carotene. To mix up combo studies and blame the

> combos on all the nutrients involved doesn't make any sense. In the

> ATBC trial that used beta-carotene and alpha-tocopherol, if memory

> serves correctly, the alpha-tocopherol only group did not have

> increased mortality.

Keep in mind, the idea behind this meta analysis is that in individual studies,

there

typically is not a long enough duration or number of participants to detect a

statistically

significant effect on total mortality, because mortality risk of an individual

in any given

short time period is very small. The meta analysis combined many studies you

might have

never heard of because the original studies had other endpoints than mortality.

The meta

analysis authors then get the mortality data from the original authors and pool

all the

studies.

To answer your question, Table 5 of the meta analysis lists 24 studies for

vitamin E given

singly. There were a total of 47,000 participants, and the relative risk for

vitamin E was

1.02 with a confidence interval of 0.98-1.05. So we can statistically reject

that vitamin E is

very beneficial or very hurtful for total mortality. There were some studies

with " high risk

of bias " included in the list of 24. However, the story with vitamin E given in

combination

but with low risk only studies is about the same: a relative risk of around 1.

> Selenium benefits people who have low blood levels and harms people

> who have high blood levels, so it evens out. I think this is probably

> because of missing cofactors like sources of bioavailable cysteine

> (raw protein, acetyl-l-cysteine, vitamin b6) and because the studies

> used selenomethionine rather than the form that animals use and found

> in animal products, selenocysteine.

Interesting. Looking at the results, selenium looks like the best antioxidant to

consider. I

try to eat a few brazil nuts every two or three days.

> Are there any studies that showed vitamin A by itself to increase mortality?

Good question. There were only two studies that used vitamin A singly. Pooling

them gives

2400 participants, not enough to detect an effect on mortality. The point

estimate of the

relative risk for vitamin A is 1.18 (bad for you), but the confidence interval

of 0.84-1.68

means we cannot reject the possibilities that vitamin A is really bad for you or

actually

beneficial for you.

The conclusion that vitamin A is bad rests on five studies (including the two A

only

studies) satisfying " vitamin A given singly or in combination with other

antioxidant

supplements after exclusion of high-bias risk and selenium trials. " The

relative risk is

1.16 (bad) with a confidence interval of 1.10-1.24.

[Guest guest]

Chris

>

> Could you link to something that explains what constitutes " blockage "

> and " sufficient blockage " in this study? When I have heard this

> criticism made by others, it has struck me as nonsense. Basically, it

> is argued that because the blockage itself is not sufficient to stop

> blood flow, that is evidence that the blockage did not cause the

> stoppage of blood flow. But the mainstream theory is that the rupture

> of the lesion leads to a blood clot that causes the blockage, so the

> argument is basically knocking down a straw man.

It was referenced in the article on heart attacks by Dr. Cowan on the WAPF site.

I think

your criticism is valid. I do wonder, though, why some people with plaque don't

have

heart attacks and others do. Studies have shown that plaques with a higher

concentration

of PUFA are more likely to rupture, and I believe the relationship is continuous

and

monotonic.

>

> > My dad follows a low-carb diet (fairly close to Atkins) and exercises

> > religiously. His stress levels are high, however, which is a major

> > concern. He also eats some Atkins junk, like those low-carb tortillas

> > (finally got him off those last month when I was visiting) and

> > probably consumes a fair amount of vegetable oil. His antioxidant

> > intake may be lower than optimal.

> >

> > What would you all suggest?

>

> Getting him totally off all vegetables and supplementing with a combo

> of CoQ10 and mixed tocopherols.

Why off all vegetables? Or did you mean off all vegetable oil?

>

> > I will also recommend CoQ10, cod liver oil (to improve vitamin D

> > status - D deficiency has been repeatedly linked to heart disease),

> > magnesium (glycinate? which form is best for heart disease?) and

> > possibly L-carnatine.

>

> Glycinate and taurate are good as far as I know but from what I've

> seen glycinate is much less expensive. There's a form of carnitine

> that is considered best for muscles that would probably be best for

> heart too, which is different from acetyl-L-carnitine, but I don't

> remember what it is. told me about it -- maybe if he's reading

> he can chime in.

I read the meta-analysis linked to. The jury still isn't out on Vitamin

A, but it did

raise some cause for concern. The authors admit that " vitamin C and selenium

need more

study " . It's really hard to know what to do with so much uncertainty and

contradictory

information in the literature.

It seems like a moderate dosage of C along with methyl-selenocysteine would

likely not be

harmful and may be helpful. Would you agree?

It seems that the research is fairly clear on the benefits of D in

cardiovascular disease. But

is it advisable to supplement with D without adequate intake of K2 and A? I've

tried to get

my dad to eat grass-fed dairy, butter & meat and shellfish etc. He gives it

some effort,

but he struggles because he is so busy at work and still travels a lot which is

hard. So I

have to deal with the reality of the situation. Luckily his diet is not too far

from where he

needs to be - he's low carb and doesn't eat flour, pasta, sugar, or much

processed food at

all.

[Guest guest]

> > Selenium benefits people who have low blood levels and harms people

> > who have high blood levels, so it evens out. I think this is probably

> > because of missing cofactors like sources of bioavailable cysteine

> > (raw protein, acetyl-l-cysteine, vitamin b6) and because the studies

> > used selenomethionine rather than the form that animals use and found

> > in animal products, selenocysteine.

>

> Interesting. Looking at the results, selenium looks like the best antioxidant

to consider.

What about CoQ10?

>

> Good question. There were only two studies that used vitamin A singly. Pooling

them

gives

> 2400 participants, not enough to detect an effect on mortality. The point

estimate of the

> relative risk for vitamin A is 1.18 (bad for you), but the confidence interval

of 0.84-1.68

> means we cannot reject the possibilities that vitamin A is really bad for you

or actually

> beneficial for you.

>

> The conclusion that vitamin A is bad rests on five studies (including the two

A only

> studies) satisfying " vitamin A given singly or in combination with other

antioxidant

> supplements after exclusion of high-bias risk and selenium trials. " The

relative risk is

> 1.16 (bad) with a confidence interval of 1.10-1.24.

>

of course has written about the synergy between A, D & K2. I wonder if

the results

of these studies would be different if they considered these relationships. For

example,

what was the vitamin D and K2 status of the people who worsened on vitamin A

therapy?

The study didn't look at K2, either. In Chris's article on K2 there are a

couple of large

studies (if I recall) which indicate that K2 is protective against heart

disease.

So, we have a review that seems to suggest that beta carotene, A & E may

increase

mortality but that C & selenium " need further study " (i.e. inconclusive). OTOH,

CoQ10,

vitamin D and K2 have been shown to protect against heart disease. Correct?

It seems that at the least, CoQ10, D & K2 would be useful, and a case could

probably be

made for a moderate dosage of C and a selenocysteine supplement.

The main question for me now is whether to suggest that my father take CLO (is

the A

beneficial or dangerous?) or just supplement with D alone. If he does do D

alone, should

it be D3?

Chris

[Guest guest]

one more thing I forgot to ask. What about all of the studies indicating

that N-3 fatty

acids are beneficial for cardiovascular disease patients? Do you disagree with

their

conclusions?

If they are beneficial, do you think it's because the people in the studies

probably have a

high n-6 intake and the n-3s help counter the inflammatory effects of the n-6?

This has been an area of confusion for me, so I'd be grateful if you could clear

it up!

[Guest guest]

> Thanks for the info on those studies. Very disturbing indeed. Did the

authors pose any

> theories about why those micronutrients may have led to an increase in total

mortality?

It's not even clear free radicals are themselves bad. Quoting from the meta

analysis:

" There are several possible explanations

for the negative effect of antioxidant

supplements on mortality .

Although oxidative stress has a

hypothesized role in the pathogenesis

of many chronic diseases, it may be

the consequence of pathological conditions.

By eliminating free radicals

from our organism, we interfere with

some essential defensive mechanisms

like apoptosis , phagocytosis , and

detoxification. Antioxidant

supplements are synthetic and not

subjected to the same rigorous toxicity

studies as other pharmaceutical

agents. Be t t e r unde r s t a ndi ng of

mechanisms and actions of antioxi-

dants in relation to a potential disease

is needed.

> The distribution of results of the first review (5 no change, 5 increase and 5

decrease)

> might have nothing to do with micronutrients and just represent the normal

course of

> disease for those patients. Did they control for other lifestyle factors such

as smoking,

> intake of PUFA (probably not), physical activity, etc?

Randomized trials generally rely on randomization to control for these other

factors. This

is a bit problematic if the effect of the intervention on the outcome itself

varies with

factors, i.e. there is a synergy or interaction effect. But the randomization

should deal with

the issue that the other factors have independent effects on the outcome.

> does present some convincing evidence on the synergism of A, D & K2. I

wouldn't

> say it's conclusive, but the mechanisms are becoming clearer and it makes a

lot of sense

> to me.

M. is speculating, but what he says makes some sense. I might increase my

dosage

of high vitamin butter because of our alleged K2 deficiency. I'll ponder it some

more first.