Fend off a 2nd Heart Attack with Fruit and Fiber

Each year, at least 20 million people worldwide survive a heart attack or stroke. Most of them, will then be prescribed a veritable cocktail of drugs including lipid-lowering agents, beta blockers, aspirin, anti-platelet medications, and angiotensin modulators.

In the misguided belief that this polypharmacy will guard against future catastrophic cardiovascular events, many patients think they don’t need to follow a healthy diet.

However a new, 5-year study of almost 32,000 patients in 40 countries showed those who ate a heart-healthy diet rich in fruits, vegetables and fish had an average:

• 35% reduction in risk for cardiovascular death
• 14% reduction in risk for new heart attacks
• 28% reduction in risk for congestive heart failure
• 19% reduction in risk for stroke

Researchers from McMaster University were able to demonstrate, for the first time, that while drug treatments, substantially lower the risk of another heart attack, a high quality diet also significantly lowers the risk.

Mahshid Dehghan, the study’s lead author and nutritionist at McMaster University’s Population Health Research Institute (PHRI) and his team assessed the association between diet quality and the risk of cardiovascular disease using information collected from men and women who participated in two major McMaster-led global studies: ONTARGET, and TRANSCEND.

Participants with cardiovascular disease were asked how often they consumed milk, vegetables, fruits, grains, fish, nuts, meat and poultry over the past 12 months. They were also asked about lifestyle choices such as alcohol consumption, smoking and exercise. A healthy diet was indicated by a high intake of fruits, vegetables, whole grains and nuts as well as a high intake of fish compared to meat, poultry and eggs.

The results showed that a heart-healthy diet offered a “consistent benefit” over and above the benefits of taking medications to reduce the risk of heart attack and stroke.

Globally, healthy eating was associated with a lower risk of cardiovascular disease by more than 20% in all regions of the world and across all income groups.

“Physicians should advise their high-risk patients to improve their diet and eat more vegetables, fruits, grains and fish,” Dehghan said. “This could substantially reduce cardiovascular recurrence beyond drug therapy alone and save lives globally.”

The Ultimate Life Test?

Imagine a simple blood test that could tell you if you’re going to die. Would that be super cool or super scary?  Well, imagine no more, it turns out there is such a test.

Researchers at McMaster University have found a test that can identify people who are at high risk of dying in the month after surgery.  Apparently elevated levels of troponin T (a protein marker of heart injury) correlate with an increased risk of death.

Currently, troponin levels are not commonly measured after most types of surgery.

The results from the Vascular Events In Non-cardiac Surgery Patients Cohort Evaluation (VISION) study, the largest international prospective study evaluating complications after surgery, have just been published in the Journal of the American Medical Association (JAMA).

VISION enrolled 15,133 adult patients in North and South America, Asia, Australia, and Europe.  Troponin T was measured daily during the first three days after surgery. Patients were followed while in the hospital and at 30 days after surgery.

“VISION demonstrated that a simple blood test strongly identifies which non-cardiac surgery patients are at high risk of dying in the next 30 days,” said Dr. P.J. Devereaux, VISION principal investigator.

According to Devereaux the results also demonstrated that most patients did not die until an average of six or more days after their troponin T blood test was identified as elevated. “This holds out great hope that there is time to intervene.”

Knowing who is at risk through the test can help physicians target patients who need enhanced observation or interventions.

Surgery activates pathways of inflammation, stress, and clotting that predispose the heart to injury. As a result, many patients suffer heart attacks after surgery. The majority of these patients, however, will not experience chest pain. Evidence from this study supports experts who have advocated the use of troponin blood tests after surgery.

The VISION study suggests that myocardial injury detected through elevated troponin T may explain 42% of deaths that occur after surgery.

“This study has substantial potential to change how patients are monitored after surgery,” said Dr. Jean Rouleau, scientific director of the Institute for Circulatory and Respiratory Health of the Canadian Institutes of Health Research. “These results hold substantial promise that through measuring troponin blood tests after surgery, physicians can identify which patients are at high-risk of dying and this can allow them to consider enhanced monitoring and interventions in an attempt to improve outcomes. This is a good example of how a carefully conducted clinical study can impact  patient care.”

SRxA’s Word on Health would like to know if you would take the test.

An aspirin-a-day keeps fat away

Aspirin is one of the most widely used medications in the world. A staggering 40,000 tons of it are consumed each year.

It’s also one of the oldest known medicines. First reports of its use date back to an Egyptian papyrus in 1543 BC. Hippocrates, the father of modern medicine, who lived sometime between 460 BC and 377 BC, left historical records describing the use of powder made from the bark and leaves of the willow tree to alleviate headaches, pains, and fevers. The active ingredient of this willow bark extract – salicylic acid.

In addition to its use as an anti-inflammatory pain reliever, aspirin is also used  as an anticoagulant / antiplatelet agent  to prevent strokes and heart attacks, and to stop coronary and carotid stents from blocking and to prevent deep vein thrombosis associated with long distance travel.

Aspirin has also been theorized to reduce cataract formation in diabetic patients and three studies published last month suggest that taking an aspirin every day may significantly reduce the risk of many cancers and prevent tumors from spreading.

Now, a group of researchers from Canada, Scotland and Australia have discovered that salicylate, the active ingredient in aspirin, directly increases the activity of the protein AMP-activated protein kinase (AMPK).  AMPK is a key player in regulating cell growth and metabolism.  It is considered a cellular fuel-gauge which can be switched on by exercise and the commonly used oral anti-diabetic medication metformin.

“We’re finding this old dog of aspirin already knows new tricks,” says McMaster University associate professor of medicine Dr. Greg Steinberg.  The research shows that, in contrast to exercise or metformin which increase AMPK activity by altering the cells energy balance, the effects of salicylate depend on a single amino acid.

Salicylate increases fat burning and reduces liver fat in obese mice which does not occur in genetically modified mice lacking the beta1 subunit of AMPK.

These findings are important as a large clinical trial is currently underway testing whether salsalate (a well-tolerated aspirin derivative), can prevent Type 2 diabetes.  With many recent studies showing that metformin may be important for cancer prevention the authors’ study raise the interesting possibility that aspirin may also be working in a similar manner.

While further studies are needed, the prospect that this cheap, over-the-counter drug can increase fat burning while simultaneously preventing pain, clotting problems and possibly cancer, is probably one of the best health news stories of the year.

Exercise Keeps You Young

Duh, not exactly the sort of groundbreaking news you’ve come to expect from SRxA’s Word on Health.  However, before you click away from our humble blog, today we’re asking and answering the question “Just how young?”

Well, how about no gray hair, lots of energy, superior muscle mass and brain volume, and that’s just for starters.

At least that’s the case in mice. According to Canadian researchers when mice, who were genetically programmed to age quickly, exercised regularly starting at 3 months old for five month,s they aged dramatically differently than the mice who were sedentary. Those poor inactive mice were balding and frail, while the super-mice who ran the equivalent of a human 10K (6 miles), three times a week starting at age 20, were lean, muscular and youthful. They did not have the expected age-related shrinkage of their brains, hearts, muscles, skin, hair, ovaries, testicles, spleen, kidneys, and liver.

They were even were able to balance on narrow rods…though why a mouse would want to do that is beyond us!

The explanation for these incredible findings appears to be in the mitochondria. Aging in humans cause mitochondria to malfunction and die making you  look older. Additionally, anything that reduces the number or efficiency of mitochondria interferes with your body’s ability to burn fat and sugar for energy.  As a result, blood sugar, fat and cholesterol levels rise and you gain weight.

Exercise however, increases the number and size of mitochondria in your cells .

No doubt, the fact that their gonads were healthy made the students working with researcher, Dr. Mark Tarnopolsky, a professor of pediatrics at McMaster University in Hamilton, Ontario, very, very impressed (and quite possibly, training for their first marathon).

We’d love to tell you more, but we too are going out for a run!

The skinny on blood transfusions: a modern day miracle?

Most of us have read the biblical accounts of water being turned into wine.  Now Canadian scientists have discovered how to turn skin into blood.  This miraculous breakthrough could revolutionize cancer treatments and solve the blood donor shortage.

What is more because the blood is made from the patient’s own cells, there is no danger of either rejection or infection.

The team from McMaster University, Ontario say that the process has been so successful that treatment could be available within two years.

Dr Mick Bhatia who headed the team said “People will effectively become their own donors. We are very excited and very enthusiastic about it. There is a lot of work to be done but I would be disappointed if we were not trying it on patients by 2012.”

The research, published in Nature, is part of ongoing attempts across the world to revert adult cells back to their original stem cell form. Stem cells are “master cells” which can potentially be manipulated in a laboratory to become any other cell in the body.

Human Skin Cells

What’s unique about this process is that it misses out the “in-between” stage of turning the skin cells back to stem cells and then converting them to blood cells. Instead, the cell is reprogrammed directly by inserting a specific transcription factor – a protein that interacts with DNA to activate genes – and applying cytokines or signaling molecules.

The result – within a month the skin is converted to blood.

Leukemia patients are likely to be the first to receive transfusions of perfectly matched blood generated from their own skin. In future, laboratory manufactured blood could help to plug the gap caused by donor shortages. The technique also holds out the promise of making other kinds of cell, including neurons with the potential to treat brain diseases such as Parkinson’s and Alzheimer’s.

Skin cells from both young and old people were used in the research to prove that age of donor made no difference to the process.

Next the team plans to assess what kind of production capacity might be possible with the cells, and whether they can successfully be stored in deep freeze.

As always, SRxA’s Word on Health will be watching these developments and bringing them straight to you.