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Preventing Heart Attacks

Seventy-two percent of patients admitted in American hospitals for their first heart attack have blood cholesterol levels in the normal range (American Heart Journal, January 28, 2009). This means that the cholesterol guidelines are missing the majority of patients who have heart attacks because either 1) the guidelines are not low enough or 2) something other than a bad LDL cholesterol is causing most heart attacks in the United States.

Many good studies support the present guidelines that everyone should get their bad LDL cholesterol below 100. However, it now appears that some other risk factor must be affecting many people who suffer heart attacks. In November 2008 I reported on the Jupiter study which showed that statin drugs caused people with normal cholesterol but with high C-reactive protein levels to suffer 54 percent fewer heart attacks, 48 percent fewer strokes, 46 percent fewer angioplasties or bypass operations and 20 percent fewer deaths from any cause than those taking placebos (NEJM, November 9, 2008). Statins are known to reduce inflammation as well as to lower LDL cholesterol. A C-reactive protein test (CRP) measures inflammation. Inflammation is caused by anything that keeps your immunity active such as chronic infections or anything that damages tissue such as smoking, having high cholesterol or high blood pressure.

I also reported a theory to explain why eating mammal meat causes inflammation and is associated with increased risk for premature death, cancers and heart attacks. Meat contains a molecule called Neu5Gc that humans do not have, so the immune system of humans attacks this protein as if it was an invading germ and eventually attacks the host itself to destroy the blood vessels and increase risk for heart attacks and strokes. On the basis of this theory I strongly recommend avoiding meat from mammals, including beef, pork and lamb. Today, the best strategy for avoiding a heart attack includes lowering LDL cholesterol by avoiding saturated and partially hydrogenated fats and refined carbohydrates; and eating plenty of fruits, vegetables, whole grains, beans, seeds and nuts. Reduce inflammation by treating chronic infections and high blood pressure, avoid being overweight, smoking and eating meat. Exercise regularly, and work up gradually to a program that includes some intense exercise. Your doctor may recommend statins both to lower cholesterol and to control inflammation.

Dear Dr. Mirkin: Why do apparently healthy, aging people lose their coordination and fall so frequently?

A study from University of Kansas in Lawrence shows that the loss of coordination with aging is caused primarily by loss of strength (Medicine and Science in Sports and Exercise, February 2009). Every muscle in your body is made up of thousands of individual fibers. Each fiber is innervated by a single nerve. With aging, everyone loses nerves and with the loss of its nerve, the innervated muscle fiber loses its ability to function. Muscles with fewer fibers are weaker, and what we interpret as loss of coordination is caused more by lack of strength than by anything else.

Since you cannot increase the number of fibers, you can only combat the loss of fibers by making each remaining fiber larger and stronger. Therefore all older people should lift weights and do other progressive resistance programs to retain their strength and coordination.

Dear Dr. Mirkin: I took estrogen at menopause but stopped several years ago. Am I still at increased risk for breast cancer?

The "Women's Health Initiative (WHI) Trial" divided women into two groups: one study group received estrogen plus progesterone daily and another group received placebo (NEJM. February 5, 2009). For the first two years, there were fewer breast cancer diagnoses in the group receiving the hormones than in the placebo group. This shows that there is a delayed effect of at least two years for the hormones to increase breast cancer risk. After two more years, the incidence of breast cancer in hormone takers rose to two times that of those taking placebo. However two years after stopping the hormones, the incidence was the same. We can conclude from this study that it takes about two years for the hormones to increase cancer risk and that two years after stopping the hormones, the risk of breast cancer is reduced to almost the same as in women who did not take hormones.

Recipe of the Week

Seafood Spanish Rice

You'll find lots of recipes and helpful tips in The Good Food Book - it's FREE

June 22nd, 2013
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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