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Good Carbohydrates Help to Prevent Heart Attacks

This month, separate studies from Denmark and Italy show that heart attack risk is lowered by replacing saturated fats with good carbohydrates that do not cause a high rise in blood sugar, while heart attacks can be caused by replacing saturated fats with carbohydrates that cause a high rise in blood sugar (American Journal of Clinical Nutrition, April 7, 2010; Archives of Internal Medicine, May 2010). Those who ate the most foods that cause high rises in blood sugar levels had more than twice the risk of having heart disease as those who ate the least.

In the 1940s, Ancel Keys, of the University of the Minnesota started groundbreaking research that showed that saturated fat in meat causes heart disease and premature death, while carbohydrates from intact plants in a Mediterranean-type diet help to prevent these complications. Further research showed that replacing saturated fats with polyunsaturated fats in plants also helps to prevent heart attacks.

Carbohydrates found IN plants are combined with other components that prevent a high rise in blood sugar. When these same carbohydrates are extracted from plants or ground into powders, they can cause blood sugar to rise too high.

• Whole grains are capsules with a tough outer coating that prevents a high rise in blood sugar. They can resist digestive enzymes and pass through your digestive system virtually intact. Grinding whole grains into flour breaks the capsule so the small particles are easily absorbed to cause a high rise in blood sugar.

• The carbohydrates in vegetables and fruits are attached to fiber that markedly slows absorption. When sugars are extracted from plants they pass into the bloodstream almost immediately (see the list of extracted sugars below.)

• Before food can pass from the stomach into the intestines, it must be converted to a liquid soup. No solid food passes into the intestines. When solid food enters your stomach, the pyloric sphincter at the end of the stomach closes and the stomach continuously squeezes the food until it is turned into a liquid soup. This can take up to four hours which markedly delays the rise in blood sugar. Therefore you want to limit foods made from ground-up grains (flour), extracted sugars, and sugars in liquid form including fruit juice, because they can cause the highest rises in blood sugar levels.

How a high rise in blood sugar causes heart disease: When your blood sugar level rises too high,
• your pancreas releases huge amounts of insulin which
• converts sugar to triglycerides, which clog up your bloodstream to increase risk for clots, so
• you use up huge amounts of your good HDL cholesterol in carrying triglycerides and your bad LDL cholesterol from your bloodstream into your liver.
• Low HDL (good) cholesterol causes heart attacks becaues HDL is not available to carry cholesterol and triglycerides from your bloodstream.
• High insulin levels constrict arteries to cause heart attacks. • High blood sugar levels cause sugar to stick to the surface membranes of cells to destroy them and cause all the horrible side effects of diabetes.
• High triglycerides in your liver cause a fatty liver that can lead to diabetes.

A diet rich in plants has also been shown to help prevent Alzheimer's disease (Archives of Neurology, April 2010). Based on these and many other studies, I recommend that you:

1) Eat unlimited amounts of unprocessed fruits, vegetables, whole grains, beans, nuts and other seeds.
2) Avoid all sugared drinks including fruit juices (except while you exercise; contracting muscles remove sugar from your bloodstream without insulin).
3) Restrict all ground up carbohydrates (foods made from flour).
4) Choose cereals made from whole grains and with little or no added sugar. See How to Pick a Breakfast Cereal
5) Restrict meat from all mammals. Poultry has not been associated with increased risk for heart attacks, and fish is associated with reduced risk.
6) Read labels on all processed foods. Extracted (added) sugars have many names, including: barley malt, beet sugar, brown sugar, buttered syrup, cane-juice crystals, cane sugar, caramel, carob syrup, corn syrup, corn syrup solids, date sugar, dextran, dextrose, diastase, diastatic malt, ethyl maltol, fructose, fruit juice, fruit juice concentrate, glucose, glucose solids, golden sugar, golden syrup, grape sugar, high-fructose corn syrup, honey, invert sugar, lactose, maple syrup, malt syrup, maltodextrin, maltose, mannitol, molasses, raw sugar, refiner's syrup, sorghum syrup, sucrose, sugar, turbinado sugar, yellow sugar.

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Dear Dr. Mirkin: Can vitamin D deficiency cause rheumatoid arthritis?

Researchers at Boston University School of Public Health have shown that women living in the northeastern United States suffer a much higher rate of rheumatoid arthritis, and the longer they live in areas of reduced sunlight, the more likely they are to suffer the disease (Environmental Health Perspectives, April 2010). Rheumatoid arthritis is associated with many laboratory findings caused by infection, but doctors have been unable to consistently find a germ that causes it. So they call it "auto-immune" which means that they do not know the cause. Many studies show that vitamin D deficiency limits your immunity and ability to kill germs. Living in northern latitudes, decreased sun exposure, and lack of vitamin D have all been associated with all "auto-immune" diseases such as multiple sclerosis, Crohn's disease or lupus.

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Dear Dr. Mirkin: If a competitive athlete needs to take blood pressure medication, which types are best?

Lifestyle changes (the DASH diet, weight loss and exercise) can control high blood pressure in more than 80 percent of North Americans. If you stil need medication, the safest and most effective may be a combination of a calcium channel blocker and an ACE inhibitor (The Physician and Sportsmedicine, April 2010). Diuretics and nonselective beta blockers tire you earlier during exercise. Diuretics reduce blood volume and beta blockers reduce exercise heart rate, the maximum amount of oxygen you can take in (VO2Max) and your perceived exertion (RPE).

The incidence of high blood pressure in athletes is more than 50 percent lower than in the general population, but it is the most common medical condition in athletes. Calcium channel blockers should be the first drugs that you use because they are the most effective drugs to prevent high blood pressure variability, a major risk factor for stroke and heart attacks. However, they are among the weakest of blood pressure medications and often have to be used in combination with other medication. The second drug therefore should probably be an ACE inhibitor.

Calcium Channel Blockers: amlodipine (Norvasc), clevidipine (Cleviprex), diltiazem (Cardizem), felodipine (Plendil), isradipine (Dynacirc), nifedipine (Adalat, Procardia), nicardipine (Cardene), nimodipine (Nimotop), nisoldipine (Sular), and verapamil (Calan) Isoptin.

ACE Inhibitors: benazepril (Lotensin), captopril (Capoten), enalapril (Vasotec), fosinopril, (Monopril), lisinopril (Prinivil, Zestril), quinapril (Accupril), ramipril (Altace).

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Recipe of the Week:

Mix & Match Salad

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

June 21st, 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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