Tag: cholesterol

Vitamin C against atherosclerosis (hardened arteries)

Claus Hancke

March 23, 2006

So far a British research study is showing that C vitamin fights inflammation. Therefore it is very possible that it also fights hardened arteries and blodclots.

If one compares peoples’ eating habits with their risk of blood clots in the heart, one gets the impression that vitamin C prevents blood clots. So far it has been hard to prove through randomised trails that vitamin C supplements protect high risk patients from blood clots. This is how it has been up to now, even though one can claim that many of the studies have been lacking.

Whatever the objections, it is widely believed that the debate over.

It is currently said that vitamin C does not protect against atherosclerosis, but is it true? A recent summary could indicate that the debate is long from over. It shows that vitamin C counteracts inflammation, which is to say infection-like reactions. There is also widespread agreement that atherosclerosis is due to inflammation. Does vitamin C therefore protect against atherosclerosis?

In order to understand the problem it is necessary to take a little detour in this discussion:
Until 20-30 years ago, atherosclerosis was believed to be a process which was roughly due to the depositing of cholesterol in the walls of the blood vessels followed by the build up of calcium. Today it is understood the vessel walls are composed of living cells, and that both the build up of cholesterol and the thickening of the vessel walls are related to inflammation. The same is true for the bursting of the surface against the blood stream, with the emptying of cholesterol and cell products, which causes the platelets (etc.) to clump together, causing a blood clot.

Inflammation appears, curiously enough, to be a part of the sales success of the cholesterol lowering medications, the so called statins. It cannot be denied that they save lives, but is it because they lower the blood’s cholesterol level?

Vitamin C lowers CRP
Here there is doubt. Statins do not only lower cholesterol, but also reduce inflammation. This can be directly measured by a simple blood test (CRP) which hundreds of thousands of Danes get taken when their doctors what to know if they have infection in their bodies. The two effects of statins, the lowering of CRP and the reduction of cholesterol, are not necessarily related, but the risk of blood clots in the heart is more related to CRP than to cholesterol levels. In a study where statins were shown to reduce the risk of heart disease by ca. 30%, their favourable effect was statistically shown to be related to CRP levels, regardless of the cholesterol level! It looks like CRP is more important than cholesterol!

With this we can return to vitamin C. Does vitamin C reduce CRP, just like statins?

In a couple of small randomised studies it was examined whether or not this is the case. In both studies the daily dose of vitamin C was about 500 mg. In the first (with smokers as the participants) CRP was markedly reduced, in the second nothing happened. The contradictory results have now been explained by a study with 3258 reasonably cardio-vascular healthy men between the ages of 60-79.

The primary result was that the more vitamin C that the men had in their blood (serum), the lower their CRP. The quarter of the participants who had the highest level of vitamin C in their blood (with or without consideration of supplements), had the lowest CRP values. The difference was overwhelmingly statistically certain. Concurrently, other measurements indicated that the likelihood for “irritability” of the vessel walls (endothelial dysfunction) was also the lowest in the highest vitamin C group. There is common agreement that this “irritability” mirrors a tendency for atherosclerosis.

Vitamin C is therefore believed to lower CRP, which is an important indicator for inflammation, and therefore the risk of dying of a blood clot. The debate rages on!

By: Vitality Council

References:
1. Ridker et al. C-reactive protein levels and outcomes after statin therapy. N Engl J Med 2005;352:20-8
2. Ridker PM, C-reactive protein levels and outcomes after statin therapy. N Engl J Med. 2005 Jan 6;352(1):20-8
3. Libby P. Inflammation and cardiovascular disease mechanisms. Am J Clin Nutr 2006;83(Suppl):456S-60S
4. Goya S et al. Associations of vitamin C status, fruit and vegetable intakes, and markers of inflammation and hemostasis. Am J Clin Nutr 2006;83:567-74
5. Ishwarlal J et al. Is vitamin C an anti-inflammatory agent? Am J Clin Nutr 2006;83:525-6
6. Mora S Justification for the Use of Statins in Primary Prevention: an Intervention Trial Evaluating Rosuvastatin (JUPITER)–can C-reactive protein be used to target statin therapy in primary prevention?Am J Cardiol. 2006 Jan 16;97(2A):33A-41A. Epub 2005 Dec 1.
7. Bruunsgaard H, Long-term combined supplementations with alpha-tocopherol and vitamin C have no detectable anti-inflammatory effects in healthy men. J Nutr. 2003 Apr;133(4):1170-3.
8. Block G Plasma C-reactive protein concentrations in active and passive smokers: influence of antioxidant supplementation. J Am Coll Nutr. 2004 Apr;23(2):141-7.

content.nejm.org
www.ajcn.org
www.nutrition.org

Vitamin E Lowers Cholesterol Levels in Diabetics

Claus Hancke

December 13, 2005

There are at least eight different kinds of Vitamin E, but typically we only get one of those in vitamin pills. One of the other kinds prevents arteriosclerosis, while a third kind has been shown to effectively lower the blood cholesterol levels of diabetics.

When you buy vitamin E in pill form, you almost always get alpha-tocopherol. Alpha-tocopherol (natural and sometimes, unfortunately, synthetic) has also been used exclusively in almost all of the studies on vitamin E’s effectiveness against cardiovascular disease.

There are other tocopherols than alpha-tocopherol. They all share the same basic chemical structure but differ in their side chains. Tocopherol can come in alpha, beta, gamma, or delta forms depending on the position of its side chains. Apha-tocopherol, the type used in vitamin pills, has the greatest effect as a vitamin.

Tocotrienols, another vitamin E form, are less well known. They differ from the other forms by having three double binds in their side chain. They are found in palm oil as well as grains such as oats, barley, rice, and corn. Tocotrienols can also be found in alpha, beta, gamma, and delta forms.

These tocotrienols are coming into the spotlight. For many years, on the basis of animal studies and small studies using humans, there has been the suspicion that they are effective against atherosclerosis. For example, ten year ago an American randomised study with 50 test subjects showed that tocotrienols from palm oil definitely counteracted atherosclerosis of the carotid arteries. Unfortunately no follow up study has been preformed.

Recently an Indian randomised study has surfaced. It shows that tocotrienols from rice sources sink the cholesterol concentration in the blood of type 2 diabetics (old age diabetes). In this study 19 diabetics received placebos for a period of 60 days. Before or after this 60 period they received, for a similar period, capsules containing rice with high concentrations of tocotrienols (each participant received 3 mg tocotrienol per kilo bodyweight per day). The study was designed so that no one knew which participants received which pill at what time until the study was completed.

Unsolved problems
The results showed that the tocotrienols reduced the total cholesterol levels of the participant’s blood by no less than 30%. Even more encouraging, the “bad” cholesterol, (LDL cholesterol) which can become oxidised and cause atherosclerosis, fell by an astonishing 42%. This effect is just as pronounced as seen with traditional cholesterol lowering medication, the so called statins.

It seems that anyone who can get a hold of tocotrienols is free from seeking traditional cholesterol lowering treatment. But before this is certain and becomes common practice, a few things should be further looked analysed.

First and foremost, can the results of the aforementioned study be reproduced? As stated earlier tocotrienols were effective against atherosclerosis in the carotid arteries, but in the study which showed this effect, the participants’ total cholesterol was unchanged! Tocotrienol does not always lower cholesterol. But does it always counteract atherosclerosis? At best the answer is maybe, we don’t know. After looking at the results of the two studies we can hypothesise that the differences in their results could be the result of the different tocotrienol blends used. The first study used a palm oil extract while the second used a rice source. The differences between alpha, beta, gamma, and delta tocotrienol is sufficient, their effects should differ.

Other things which we understand even less could also play a role. The likely cholesterol lowering effect of the rice tocotrienol should also be tested for possible side effects and the results of this should be compared with the side effects of traditional cholesterol medicine. A big job awaits researchers.

Meanwhile, the studies have shown with certainty that (apart from that oatmeal and brown rice are healthy) we are not finished with vitamin E or, more to the point, the E vitamins. There are many of them, and they have different effects. Their potential is very promising.

By: Vitality Council

References:
1. Tomeo AC, Geller M, Watkins TR, Gapor A, Bierenbaum ML. Antioxidant effects of tocotrienols in patients with hyperlipidemia and carotid stenosis. Lipids. 1995 Dec;30(12):1179-83.
2. Qureshi AA, Salser WA, Parmar R, Emeson EE. Novel tocotrienols of rice bran inhibit atherosclerotic lesions in C57BL/6 ApoE-deficient mice. J Nutr. 2001 Oct;131(10):2606-18.
3. Baliarsingh S, Beg ZH, Ahmad J. The therapeutic impacts of tocotrienols in type 2 diabetic patients with hyperlipidemia. Atherosclerosis. 2005 Oct;182(2):367-74. Epub 2005 Apr 20.

www.aocs.org/press
www.nutrition.org
www.athero.org
www.iom.dk

Press Release from the Danish Society for Orthomolecular Medicine (DSOM)

Per Larsen

November 12, 2002

The Danish Society for Orthomolecular Medicine (DSOM):
Rumours that antioxidants should have no general effect on secondary prevention of heart disease originates from The Heart Protection Study published in July 2002 in the magazine The Lancet. The study was financed by e.g. the pharmaceutical companies Merck & Co. and Roche Vitamins.

The purpose of the study was, among others, to investigate Merck’s cholesterol lowering drug Zocor’s effect on various parameters such as blood clots in the heart and heart disease, etc. The study included 20,536 high-risk patients – ie. patients with known cardiovascular disease or dispositions for this – eg. diabetes.

The patients were randomized to 4 groups, of which 5000 patients received 600 mg vitamin E, 250 mg Vitamin C and 20 mg betacarotene. 5000 patients received both Zocor and vitamins. 5000 patients received Zocor only and 5,000 patients served as a joint control group. This means that the part of the study containing the vitamin group plus a joint control group comprised 10,000 people and not 20,536 persons as stated elsewhere.

Not surprisingly, the main result of the study showed that Zocor had a positive effect even at very low cholesterol values, which undoubtedly significantly increases the indication range for Zocor.

However, there are several criticisms, apart from the fact that the number of trial participants is exaggerated:

  • Dosage of vitamin E and vitamin C are not proportional to each other. The two vitamins are closely linked in the antioxidant protection of the cell. If there is an excess of one vitamin, it can have a pro-oxidant effect.
  • One will usually not give more than 100 – 200 mg of Vitamin E. Vitamin C should be given several times a day or as a prolonged-release preparation.
  • Vitamin C, as a single dose in a dose of 250 mg will only have an effect for a few hours. The half-life of vitamin C is approx. 4 hours, i.e. that from a daily dose alone you can not expect an effect at all – rather the opposite.
  • Beta-carotene has previously been tried alone in a major trial for lung cancer and smokers. Here, it appeared that this vitamin had a prooxidant effect with a prevalence of lung cancer in smokers as a result. The Heart Protection Study has not been able to confirm such an effect of an incorrectly unbalanced dosage.

The results of the study also coincide with the results found in the HOPE study, namely that there was no secondary preventive effect when consuming individual vitamins.

  • You can not study the effect of individual vitamins on diseases that have taken decades to develop. Vitamins act as co-factors and as antioxidants, they are involved in a complicated interaction with the body’s own enzymatic antioxidants in a way that we do not yet fully understand.
  • Individual vitamins or random combinations of two or three individual vitamins should not be perceived as a medicine that cures a disorder in the traditional sense, but as a method that can strengthen the body’s own antioxidant defenses.
  • You cannot simplify and define 3 different vitamins in an illogical mutual dosage for antioxidants generally. The antioxidant system reduces oxidized molecules. This is done according to the thermodynamic laws. The individual steps in this process, of which there are many, depend on the redox potential of the individual molecule. For example, urate is part of this chain. Urate is not an antioxidant in the traditional sense in everyday speech but possesses antioxidant properties just like albumin. A generalization is therefore completely incorrect.
  • The individual may have several or individual nutrient deficiencies. It is therefore not correct to study the effect of individual vitamins on chronic diseases.

Only in the last year has it become common knowledge that a substance such as Homocysteine (indicator of low B vitamins) has the greatest significance for risk and heart disease.

The content of the B vitamins: B12, B6, and folic acid in our food has decreased significantly since the Danish Ministry of Food began systematic studies of these in 1993. Thus 24% to 50% of the male population is at risk of deficiency diseases. Despite the private Nutrition Council’s stubborn adherence to the opposite, the Ministry of Food, Agriculture and Fisheries in Denmark is aware of this, but states that they are simply keeping an eye on developments.

The iron content of e.g. oatmeal has been reduced by 10% within just the last 5 years. The website of the British Ministry of Agriculture reports a 50% drop in selenium intake compared to 1983 and today.

………………………

By: Per Tork Larsen, M.D., DSOM

(No references)

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www.heartprotectionstudy.com/heartprotection/heartprotection/index.jsp
www.akudoc.dk
www.iom.dk