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Most Heart Attacks Are Preventable

It is now established that arteriosclerosis is reversible and that most cases of heart attacks are preventable (Journal of Cardiovascular Drugs and Therapy, published online June 15, 2010). Most heart attacks occur in people with known risk factors:

Plaques caused by cholesterol:
Fatty plaques are covered by a fibrous cap that shields the fat inside from the bloodstream. Rupture of this cap releases fats from plaques into the bloodstream. The released fat causes clots that block the arteries to cause a heart attack. Heart attacks are not caused by plaques causing progressive narrowing of these arteries. Since the bad LDL cholesterol causes plaques to form, and the good HDL cholesterol prevents plaques from forming and rupturing, people with high LDLs or low HDLs are at high risk for heart attacks.

Most people could control cholesterol with diet. If this diet does not lower your LDL cholesterol below 100 or raise your HDL cholesterol above 40, your doctor may prescribe medications.

Inflammation:
Your immunity is supposed to be good for you. When bacteria or viruses enter your body, you make proteins and cells to kill them. As soon as the germ is gone, your immunity is supposed to stop making large amounts of these antibodies and cells. However, if your immunity stays active, these white blood cells continue to produce cytokines that are supposed to dissolve the membranes of bacteria. Instead, they dissolve the caps of plaques to release fat from plaques into your bloodstream to cause clots that block arteries to cause heart attacks. Your doctor can diagnose an overactive immunity with blood tests called CRP (above 1) or Sed Rate (above 15).

Any chronic infection can turn on your immunity to increase risk for a heart attack. Check with your doctor if you have symptoms of any infection, such as bladder problems (burning on urination, frequency, night-time urination, urgency when your bladder is full), stomach problems (belching, burping, burning in your abdomen), a chronic sore throat, chronic cough, or chronic joint or muscle pains.

Metabolic syndrome (pre-diabetes) or diabetes:
People with high rises in blood sugar are at high risk for heart attacks and strokes, even if they are not diagnosed with diabetes. A high rise in blood sugar can cause plaques to rupture. You can tell if you have high rises in blood sugar if you store fat in your belly, have small buttocks, a HDL cholesterol below 40, an LDL cholesterol above 100, or triglycerides above 150. When your blood sugar rises too high, your pancreas releases large amounts of insulin (=high insulin) which causes fat to be deposited in your belly (=large belly). Insulin converts sugar to triglycerides (=high triglycerides). Then you use up your good HDL cholesterol to carry triglycerides from your bloodstream into your liver (=low HDL).

If you have metabolic syndrome or diabetes:
1) Check your vitamin D3 level. If it is below 75 nmol/L, you need more sunlight or vitamin D pills. Lack of vitamin D blocks insulin receptors to raise blood sugar levels.
2) Avoid refined carbohydrates. Altered carbohydrates cause higher rises in blood sugar. The worst offenders are flour and sugared beverages.
3) Restrict meat from mammals. The saturated fats in meat may block insulin receptors.
4) Eat plenty of vegetables and fruits. They do not cause high rises in blood sugar.
5) Lift weights. Larger muscles draw more sugar from the bloodstream.
6) Lose excess fat. Full fat cells produce hormones that prevent your cells from responding to insulin.
7) Exercise. Contracting muscles remove sugar from your bloodstream without needing insulin.

Other risk factors to avoid:
• Do not smoke or live with a smoker.
• Do not take more than two alcoholic drinks a day (a drink is a 5-ounce glass of wine, 12 ounces of beer, or 2/3rds of a shot glass of alcohol).

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Dear Dr. Mirkin: Does taking cold fluids improve exercise performance in hot weather?

Yes; drinking cold fluids lowers body temperature. More than 70 percent of the calories that you use to convert food to energy are lost as heat. So the more intensely you exercise, the more heat you produce. A rise in body temperature slows you down because the heart has to work harder to pump extra blood from your hot muscles to your skin to dissipate the heat. Seven studies show that cold beverages lower body temperature and improve performance by an average of 10 percent (International Journal of Sport Nutrition and Exercise Metabolism, April 2010).

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Dear Dr. Mirkin: Do statin drugs to lower cholesterol decrease strength and endurance?

Yes, in some, but not all, people. A search of the scientific literature found six studies on the effects of statins on strength and nine on endurance suggesting that statins reduce strength in some older people and endurance in some exercisers (Current Opinion in Lipidology, August 1, 2010). Nobody really knows how statins do this.

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Recipe of the Week:

Artichoke-Wild Rice Salad

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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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