Selenium Vit C and Dr Porter

I recently had an exchange with Dr Mark Porter. I took exception to his recent article in the Times which more or less trashed the idea of people using Vitamin supp’s to combat disease. I challenged this firstly on the Vit C front (but also on others) and I am glad I did because you always learn something when you talk to people with opposing views. It gets you off your backside to investigate. Dr Porter kindly replied and sent me a link to a meta analysis that essentially showed that no Vitamin was beneficial in a statistically significant way in relation to heart disease amongst other diseases, when supplemented, although selenium came pretty close. A meta analysis by the way is when a researcher takes all the research papers done on a topic and then pools together all the results to form one overall result. It also enables them to filter out badly designed studies. I decided to dig a little deeper into the meta analysis and in particular the heart disease and Vit C category. I am convinced that Vit C can impact Lp(a) and hence CVD. When I looked closely at the 7 studies forming the meta analysis on Vit C I noticed that they had weighted them. Now I forget the exact method of weighting but it sure wasn’t based on dosage because one study was weighted with 78%!! of the overall value of the analysis and this study only used 250mg of Vit C per day on people with heart disease. This study came out as pretty much neutral on Vit C and given that the overall score OR was 0.99 for Vit C (the more below 1 the better) you can see that this one study had massive or should I say 78% effect on the overall outcome of the meta analysis. As I said to Dr Porter, Linus Pauling would have laughed at 250mg even for healthy subjects. Incidently getting back to Selenium there is an interesting Swedish study that showed in subjects over 60 that a combo of Selenium and Coq10 slashed risk by 50%.

Footnote – Just discovered that Dr Porter has recently adopted a similar attitude to Carb’s as myself

https://web.archive.org/web/20160526203646/http://drmarkporter.co.uk/low-carb-diet-my-6-week-experiment-to-see-how-cutting-back-on-carbs-impacted-on-my-blood-cholesterol-lipid-profile

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Japanese Total to HDL ratio

Over the last three decades total cholesterol has risen in japan but Heart disease has dropped. The linked report suggests that the reason for this may be their higher than average HDL and healthy Total to HDL ratios. The other interesting aspect of the report was the differences logged in Dietary intake between the Japanese, American and Australian subjects monitored. The main differences were

Fats significantly lower in Japanese
Fish and sea food much higher in Japanese
Eggs much higher in Japanese
Tofu and related products much higher in Japanese
Mushrooms much higher in Japanese
Fruits higher in Japanese

Cereals
Potatoes
Meats
Milk
Vegetables

were pretty much the same across the three countries.

Report http://circ.ahajournals.org/content/96/9/2830

Magnesium and CVD

With soil being continually depleted of magnesium we are getting less and less in our food supply. The research list connecting Magnesium deficiency and heart disease is long. here are just a few

https://www.ncbi.nlm.nih.gov/pubmed/21849940

https://www.ncbi.nlm.nih.gov/pubmed/24436973

https://www.ncbi.nlm.nih.gov/pubmed/26729158

https://www.ncbi.nlm.nih.gov/pubmed/26802105

Lazy solution – Eat a handful of almonds and or pumpkin seeds with your breakfast

Myeloperoxidase Test

I have mentioned before that pretty much all my ratios and markers are good eg Total to HDL ratio, ApoB/Apo A ratio, Lp(a), Homocysteine. One marker that I have found on two occasions to be too high is Lp-PLA2. This is a marker that is believed to signify unstable plaque within the arteries. So far I have not managed to lower it. I have however just got the results back for another test that looks at oxidative stress and a predictor of unstable plaque, namely Myeloperoxidase. I was kind of expecting this one might come back on the high side given that it appears to be a close cousin of Lp-PLA2 or at least testing a similar condition. I was very happy therefore to find that my reading was super low. Greater than 5 IU/ml is considered positive but I came back at less than 0.01.

The test was done with Blue Horizon and cost around £95. I will retest Lp_PLA2 later in the year and if it has not diminished perhaps try a spell on aspirin and see if that puts a dent in it or perhaps take solace from this test, surely they can’t both be right.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2276594/

Good explanation here of the difference between Myeloperoxidase and Lp-PLA2

http://www.revolutionhealth.org/inflammatory-markers/

It would appear that the obvious approach to lowering Lp-PLA2 would be Niacin (Vit B3)

Iodine Deficiency

A couple of posts ago I mentioned Leptin resistance and its role in causing problems for getting LDL particles out of the blood stream when they have done their job of delivering cholesterol to cells. Iodine deficiency is one of the possible reasons for this problem with the Thyroid and Leptin resistance and it ties in nicely with a at least a couple of population studies.

The Japanese have very low rates of heart disease, even lower before they started to discover westernised food. We are usually quick to credit this to their consumption of fish but it may not only be this sole source of sea food. The Japanese consume large quantities of sea weed using it as an additive in stews and soups such as Miso soup. Sea weed is a very rich source of Iodine and perhaps their super rich Iodine content diet is a big factor in their heart protection.

Backing this up was a studies in the 1950’s in Finland which had very contrasting levels of heart disease were although both east and west were poor the east was far unhealthier when it came to cardio vascular health. This prompted an in depth study of the dietary habits of east and west and the most significant disparity was that the west consumed significantly more Iodine which may be why they have less heart disease than the East. More on this at the link below.

http://www.iodineresearch.com/files/cann_2006_iodine_in_cardiovascular_disease.pdf

Needless to say I now take a 200mcg Iodine supplement daily via a Sea Kelp tablet and so far my stomach seems to tolerate these quiet well with no irritation.

Lipid Levels on Hospitalization for CAD

Given the current guidelines for getting your LDL as low as possible to reduce heart disease risk you would naturally expect that when patients are wheeled into hospitals for Coronary Heart Disease ailments such as heart attacks or angina attacks, their LDL levels would on average be rather high. If we looked at a thousand such patients what percentage would you expect to have LDL levels above 2.6 mmol ?. Maybe 60% or perhaps 70%, surely it has got to be above 50% given that we are advised to get our levels below 3 mmol. Well according to a large study done on nearly 137,000 hospitalisations in America for CAD symptoms it was only 50.4%. Taking only those who were admitted for the first time for CAD symptoms did not really change the underlying message that much.

The other interesting thing is that when you talk to cholesterol advocates about the stats showing that low cholesterol means greater all risk of dying ie from all causes, they tend to shout reverse causation. What they mean by this is that disease, including heart attacks, tend to lower cholesterol levels thus giving a false low impression of cholesterol levels on death. Would this really skew the results shown in the study to the degree shown ? and if it did move the spread you would still have less people in the higher ranges of LDL than the lower ranges maintaining the underlying message in the study that more people are coming in with ‘low’ LDL than ‘high’. The real culprits within the data seem to be low HDL and high Trig’s.

http://www.ahjonline.com/article/S0002-8703(08)00717-5/pdf

LDL Receptor Activity

Try this: the LDL particle is a cargo ship. It is supposed to land at various docks to deliver over the goods. However, it is also supposed to protect the goods so that they are in good shape when the ship gets to the dock. However, there are often pirates at sea, and they may attack both the people at shore as well as the cargo ships. If they block entry to the dock, the ship cannot refuel or purchase more ammunition for defense. If the ship is thus left at sea, it runs out of ammunition and the pirates are then able to effectively sabotage it, ruin its goods, and purposefully plant explosives and release infectious diseases on the boat. Then, when it does get near shoreline, the folks at the dock catch illnesses and are caught in terrorist explosions. Thus, the immune system, like a navy and national guard, rescues the cargo ships that have been attacked (oxidized LDL), and quarantines them and any toxic factors released from them in something like a superfund site, where the surrounding community is protected as best as possible.

The above is quoted from Chris Masterjohn, an expert on lipids and someone who does not appear to be selling anything. I like guys who are not flogging me supplements or Statins and clearly have something interesting to say.

The above is taken from an interview he did with Chris Kresser. What he is saying in the above is that landing at docks simply means delivering cholesterol to the various cells that need it and also being taken eventually and promptly out of the blood stream by the liver. The ammunition and defence taken on board are antioxidants needed to fight off oxidisation of the LDL membrane which has a polyunsaturated element to it. The LDL is capable of fighting off this oxidisation for a while but if it stays in the blood stream too long this ability breaks down and then oxidised LDL, the main cause of heart disease via plaque build up (quarantine), prevails.

This prolonged stay in the blood stream of LDL happens when we have a deficient LDL receptor activity and one of the main promotors of this is leptin resistance. Notice we have not mentioned Cholesterol at all. He makes a fascinating point when he cites the guy (name escapes me) who probably got the whole ball rolling on cholesterol back in the 1920’s when he performed experiments on rabbits. He induced plaque build up very similar to that found in humans by feeding them a high cholesterol diet. This experiment has been much criticised as irrelevant to humans as rabbits do not normally consume cholesterol and are therefore bound to have ill effects. However what he also found was that when you injected cholesterol into the rabbits nothing happened. The processing of cholesterol into LDL particles was required to induce plaque build up hence the clue that the LDL particle is the main problem not the cargo on board.

If all this Somalian pirate talk sounds pretty confusing then simply get the DVD out with Tom Hanks in the lead role. Eat some sea weed (iodine) and Brazil Nuts (selenium) whilst watching the film, your Leptin will thank you.

India South & North

India has far greater incidence of heart disease in the north than in the south and yet looking at the lipid levels of the two populations seems to show that LDL may not be the culprit. Average levels of LDL for 40 to 50 year olds stood at 3.05 mmol in both regions. Not outrageously high by most standards. HDL however in the south averaged at 1.6 mmol whilst in the north it averages at a miserable 0.8 mmol. Triglycerides are also high in the north at 1.8. There is no data for the south generally but in Gujarat it stands at 1.2.

This seems to add weight to the hypothesis that HDL and Triglycerides are more important than LDL cholesterol in connection with heart disease. Drug companies have not surprisingly focused on LDL as it is more easily manipulated by chemical means.

You can take a look at the data here

http://medind.nic.in/gaa/t09/i2/gaat09i2p25.pdf

More Vitamin C

I have posted before about the Linus Pauling Vitamin C hypothesis to curing heart disease. The idea that heart disease is really a form of arterial scurvy and that as one of a handful of species that cannot produce its own vitamin C we are more vulnerable than those that can. In fact species that produce their own Vitamin C do not seem to get heart disease.

here are some supporting figures taken from a large scottish study and published in the British Medical Journal

Ascorbic acid intake (mg/day)
14.9 34.7 44.2 54.5 70.2 116.1 50 10.9 30.5 42.1 55.2 72.3 118.5 30
All CHD 1 0.87 0.83 0.63 0.52 0.85 (0.80 to 0.91) *** 1 0.59 0.85 0.81 0.56 0.92 (0.82 to 1.02) NS
CHD deaths 1 0.98 1.03 0.86 0.72 0.93 (0.83 to 1.04) NS 1 1.17 2.12 1.61 0.76 0.99 (0.81 to 1.21) NS
All deaths 1 1.09 1.00 0.87 0.85 0.95 (0.88 to 1.02) NS 1 0.98 0.79 1.03 0.72 0.95 (0.86 to 1.04) NS

You can take a look at a neater version here (apologies for messy presentation above)

http://www.bmj.com/highwire/markup/608368/expansion?width=1000&height=500&iframe=true&postprocessors=highwire_figures%2Chighwire_math

or the full report where you can click on the last pop table to get the Vit C data at

http://www.bmj.com/content/315/7110/722

The figures from left to right show hazard ratios for different levels of intake of Vitamin C among the study subjects. The more Vitamin C taken the lower the hazard for Cardio Vascular Disease and CVD death. The 3 stars *** mean that the data for Vit C is highly statistically significant. There are 3 stars next to Vit C and men and incidence of CVD meaning the less men took the more likely they were to suffer from CVD.

My policy is to take a pink grapefruit with my breakfast every day and a Vit C supplement. Doing this has resulted in my own lowest reading of Lp(a), a well documented risk factor for heart disease.

The confusing aspect of the study is that Total cholesterol levels were also shown to be an increasing hazard as levels increased and were also statistically significant.

Gut Microbiome

Eat lots of veggies, fruits and whole foods. Avoid processed foods, grains and sugar. All seems like good advice but why are veggies better for us. What is the mechanism behind the digestion of these foods that eventually results in better heart health ?.

Dr Rhonda Patrick gives a pretty good explanation here about how a compromised gut microbiome might be the underlying cause of heart disease.