Thursday, March 14, 2013

Atherosclerosis is an Ancient Problem

There are some who attribute modern degenerative diseases to the modern lifestyle. Some argue that cancer and heart disease were virtually non-existent in the good ol' days. This recent study (full text at link) found that 1/3 of all mummies examined had evidence of atherosclerosis. You can read the Australian ABC news release here. 

Over recent decades we have been assailed with all manner of diets that purportedly will stave off cancer, dementia, and heart disease. From the paleolithic to the Atkins to the Mediterranean there is an endless stream of advice on how to avoid the consequences of aging. The latest one is the 5+2 diet, which advises that 2 days out of 5 we should restrict our caloric intake to 500. Fat chance of that, try doing a full working day on 500 calories and you'll likely experience fatigue, cognitive fog, and a burning desire to consume enough caffeine to keep the home fires burning long enough until the next day but that day will be problematic because restricting caloric intake boosts cortisol which inhibits sleep. From a metabolic perspective there is good evidence to support intermittent fasting, I have previously promoted the same, but our modern lifestyle very much mitigates against such a diet. As for full blown caloric restriction over the long term that creates more problems than it solves.

The fundamental problem with all this dietary advice is that these presume that the results of epidemiological studies are applicable to specific individuals. That is a misunderstanding of statistical analysis. If you're looking for the best diet for yourself then you have to design a diet that specifically addresses the requirements of your lifestyle and physiology. There is no generic answer.

One of the most frustrating aspects of modern health advice is that over the years the vigorously promoted claims have been found to be wanting. There is now an ongoing debate about just how dangerous saturated fats are, and despite of decades of research the relationship between cholesterol and heart disease remains weak. A better approach is to think about calcium deposition as a primary driver in atherosclerosis. Some recent studies have advised that women over 50 should think very carefully about taking calcium supplements because women taking calcium supplements were found to have twice the risk of heart disease. This recent news release provides a different and interesting perspective on atherosclerosis. The calcium issue is complex, we have been neglecting the value of taurine and Vitamin K2 as very important regulators of calcium metabolism. Vitamin D alone is not sufficient, I suggest that vitamin D and calcium supplements are not going to help because in the absence of Vitamin K2 in particular calcium deposition, a big problem in aging, will be ongoing. As the cardiologist notes:

Sources of K2

One little appreciated risk factor for atherosclerosis is thyroid function. As the cardiologist recommends, iodine supplementation is worth thinking about. If you suffer from depression with no obvious cause, if you have evidence of atherosclerosis, if losing weight seems nigh impossible, get your thyroid checked. 

Of all the modern dietary interventions proposed the Paleolithic diet was the most laughable I have encountered. It made enormously silly assumptions about the diets of our ancestors and completely ignored the fact that our ancestors ate what is available in their immediate environment. Anyone who claims to know the diet of our ancestors is either naive or trying to make money.

One approach I have been exploring of late is the idea of not having huge quantities of any fat in a single meal. The same goes for iron and sugar. My thinking is as follows:

Our physiology has a window of tolerance for various foods. If we eat too much saturated fat in one meal that will not only boost inflammation but keep it boosted for many hours. If we eat too much iron in one meal that could drive intestinal inflammation(studies do indicate heme is a driver of colorectol cancer). Even a high intake of omega 3 fatty acids in one sitting is problematic because these omega fatty acids are very easily oxidised which is why fish should be not be fried because the high heat damages these fats. There are now studies showing that a high intake of fried fish actually increases the risk of stroke.We can enjoy all foods but as the old saying goes: moderation in all things.

Can you introduce lifestyle factors to ameliorate the risk? Most definitely but here's the catch: you will need to work that out for your body and that is hard work. I'm sorry if you were expecting ready made solutions, if you are looking for those remedies you have come to the wrong place.

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