‘Sweet’ New Way to Prevent Heart Disease

Preventing heart disease never sounded so sweet.

According to a study published in the British Medical Journal in late August 2011, people who ate more chocolate reduced their risk of heart disease by 37 percent, their risk for stroke by 29 percent.

Eating chocolate clearly reduces the risk of cardiovascular disease, but this should come as no surprise. Chocolate is made from cocoa beans, and the less it is processed, the greater the health benefits to the human body. When selecting chocolate to eat, the less fat content and the more cocoa, the better. Dark chocolate is a palatable way to get your daily fix. Eating about 150 calories worth of chocolate each day, at 60-percent or higher cocoa content, should be part of a heart-healthy dietary plan for many at-risk patients.

Consumption of dark chocolate lowers your bad cholesterol and blood pressure, and also protects your blood vessels. It raises good cholesterol and may even increase cognitive function by increasing blood flow to the brain. This commonly available candy also reduces the risk of stroke and heart disease.

Chocolate, like meditation and walking, increases the feel-good compound nitric oxide in the bloodstream. The production of nitric oxide can help with sexual dysfunction in males. Cocoa consumption can even help guard against the damaging effects of sun exposure.

In a challenging financial climate where medical and pharmaceutical costs are skyrocketing, we finally have a sweet answer to several cardiovascular threats: Daily chocolate consumption.

Look out Lipitor – we have a better over-the-counter product that is cheaper, safer and widely available to adults and children alike.

New Guidelines for Fighting Obesity and Heart Disease in Children

There are new recommendations on cholesterol screening, and much more, just issued by the National Heart, Lung and Blood Institute (NHLBI). TheirBob Tozzi at the November 2011 AHA Conference mission is clear from the document’s title: “Cardiovascular Risk Reduction in Children and Adolescents: The New NHLBI Guideline.”

The document is in direct response to the alarming proportion of children who have markedly abnormal cholesterol levels and evidence of atherosclerosis – a disease normally thought of as an adult medical problem. These recommendations are designed to help reverse the epidemic of obesity and the related diseases that are growing at an alarming rate in our children.

At the November 2011 American Heart Association Convention in Orlando, as I observed the NHLBI presentation about these new and much-anticipated recommendations for preventing heart disease in children, I looked around at the sparsely-filled room. It was set up with seats to accommodate 600 professionals. There were fewer than 200 in attendance. Perhaps this was because it was an evening presentation, or maybe it reflects physician frustration at the enormity of the public-health issue of obesity, with its secondary problems of hypertension, hypercholesterolemia and resultant heart disease.

In any case, the guideline document needs to be widely disseminated within the medical community.

The comprehensive NHLBI review began with a computer-generated initial list of 1 million articles. The final document incorporated the best-of-the-best research on the topic, representing a derived-consensus document.

These are the significant take-away points:

  • High cholesterol in children is related to the development of heart disease in the adult.
  • With the obesity epidemic, cholesterol levels are rising even higher. Reduction in obesity will lower cholesterol levels.
  • Early intervention is needed for hypercholesterolemia and poor health habits in children (the behaviors as well as the diseases continue into adulthood).
    Initial management for abnormal serum cholesterol is education about healthy diet and exercise.
  • Healthy diet-education is best handled with the entire family involved and a dietitian.
  • Examples of healthy diet include the DASH diet and the Mediterranean diet.
  • There should be universal screening for elevated cholesterol for ages 9-11 years.
  • There should be earlier screening for high-risk individuals.
  • Medications may be needed in about 1percent of children (upwards of 200,000 children).
  • Parents must increase the activity level of children and reduce TV and computer time. The recommended activity level for 5 years and older is one hour of moderate to vigorous exercise per day.

Quite simply, this list should be posted in every pediatric physician’s office across the United States.

Video: The Watanabe Rabbits

The Top 10 Reasons Why School Sports are Unhealthy

I believe that high school sports, and behaviors related to school athletics, are fostering obesity, eating disorders and illness in America. Here is my Top 10 List of reasons why school sports are – counter-intuitively – leading to bad habits and worse health for America’s young people.

1)    Rapid weight-gain in childhood is associated with life-long obesity and heart disease. Bad behaviors that are associated with school athletics include bulking up for football, dropping and gaining weight for wrestling, and ultra-thin eating habits, leading to anorexia in young gymnasts.

2)    The concept that, “You’re an athlete – you’re working out, so you can eat whatever you want to eat,” promotes consumption of junk foods, which also extends to the spectators who consume junk foods sold at sporting events.

3)    Teaching the concept that endurance and intense aggressive training is a healthy lifestyle – “no pain, no gain” – reduces the likelihood that voluntary athletic behavior will continue into adulthood.

4)    If “winning isn’t everything, it’s the only thing” as the goal in sports participation, then inevitably there will be many losers. Ultimately this concept becomes a psychological negative when one thinks of health and its relationship to exercise.

5)    Lengthy afterschool practice sessions, combined with late-evening competition in Junior Varsity team sports, leads to missed hours of sleep, a drop in metabolism and a propensity toward obesity.

6)    Head injuries in soccer and hockey, as well as football concussions, are becoming a common cause of extended illness in young people.

7)    Repetitive damage to joints results in long-term disability, including back, knee and hip disease.

8)    This results not only in limiting one’s ability to ambulate as an adult, but subsequently results in weakened cardio-pulmonary function due to a lack of mobility, thereby increasing the likelihood of obesity, hypertension, diabetes, heart disease and stroke.

9)    Sadly, school athletics encourage the culture of drugs:  Taking stimulants for added stamina, including energy drinks such as Red Bull, often leads to the accepted use of steroids and other harmful and/or prohibited substances.

10) The overriding concept that winning is the most important part of the game is perhaps the umbrella theme promoting all the other unhealthy behaviors that affect today’s young athletes.

Are Your Supplements Killing You?

Certain benefits that have been widely publicized for many years regarding dietary supplements may be ill-advised at best, according to a recent study in the Archives of Internal Medicine.

Indeed, one might almost say that confusion abounds. This new study on women’s health reports that dietary supplements are resulting in a higher mortality rate for women. But before we start to panic, let’s look at a few facts.

1) This study was conducted on older women with a mean age of 61 years.

2) Those taking iron supplements showed the greatest risk of earlier mortality.

Excess iron in the bloodstream is associated with increased atherosclerosis and subsequent heart attacks and strokes. It acts as a catalyst that increases the risk of free radical damage to the vascular system and associated tissue, thereby accelerating the aging process.

But back to the study.

When attempting to analyze this study, the most important piece of information is that these women are in a post-menopausal group that would no longer need to take extra iron to maintain health. After loss of menses, the risk of iron-deficiency anemia is low, and the risk of over accumulation increases.

Of course, most women who are trying to stay healthy are probably getting enough iron from fortified foods and dark green vegetables, as well as the occasional intake of red meat.

So here’s the bottom line: Iron supplementation is needed for the iron-deficient person. This is much more common in younger women, especially those who experience a heavy menstrual flow each month.

So, my recommendation for older men and women is to be smart, have blood work to check your iron status. Unless you receive a doctor’s indication that you are iron deficient, it’s best to skip that vitamin that contains iron.

High Cholesterol in Children: To Screen or not to Screen?

When there is a family history of early-onset coronary artery disease, or a family history of high cholesterol, the current recommendation is to screen a child for elevated cholesterol levels. In addition, screening for high cholesterol is required if a child is obese or suffering from childhood forms of hypertension or diabetes. It is currently recommended that this screening should occur between the ages of two and 10 years.

Unfortunately, these recommendations do not go far enough, and physicians risk missing many cases of significantly elevated levels of cholesterol in children.

How early should parents intervene in order to prevent potential development of coronary artery disease in their baby? The answer is that it is never too early to intervene.

A little known medical fact is that the damage caused by high cholesterol, called dyslipidemia, can begin to occur before a child’s birth, during fetal life. The diet and eating habits of the mother during pregnancy lay the groundwork for blood vessel development in the gestational fetus. After birth, the single most important and protective food a child can consume is its mother’s breast milk. Many studies have shown that breast-fed children develop far fewer chronic diseases as they grow into young adulthood, with fewer incidences of obesity, hypertension, diabetes and heart disease.

When being transitioned away from breast milk or formula, children still need a certain intake of fats, but these need to be healthy fats. Between one and two years of age, low-fat dairy foods are acceptable, and above two years of age, non-fat dairy can be introduced as part of the regular diet. When integrating eggs or meat as part of the daily menu, it is best to be assured that both poultry and cattle were raised as grain-fed livestock. A grain-based diet for these animal sources results in foods that have a higher concentration of healthy fats for the child’s intake.

To screen or not to screen may be the question of the day, but the answer to being healthy lies in what you eat. The following foods and adjustments to diet have been proven to lower serum cholesterol:

  1. Whole citrus (the pulp absorbs cholesterol)
  2. Nuts and seeds (ligands bind cholesterol)
  3. Ground flaxseed (ligands bind cholesterol)
  4. Soy protein
  5. Chick peas (hummus)
  6. Fish or fish oil 2 grams per day
  7. Dark chocolate
  8. Dark green vegetables like spinach (they are the anti-diabetes food and a good source of Omega 3)
  9. Whole grains (even instant oatmeal)
  10. Reduce the simple sugar

Eat the fruits and vegetables that stain your clothes (these tend to come from the more moderate climates like the Mediterranean region). In general, limit the fruits from the more tropical regions. Tropical fruits are healthy, but they tend to have higher free-sugar content, and if consumed to excess, they may increase the level of bad cholesterol.

Finally, do not forget the best exercise: Walking. Walking is the live-longer, anti-diabetes and lower-your-cholesterol sport for all weathers and all ages, starting in early childhood – just as soon as your toddler learns to stand on his or her own two feet.

In fact, in the healthiest cultures, there is a common proverb that sums up the basis of health living: “We have with us at all times two doctors – the right foot, and the left foot.”

“Studies Show…”: Beware of Medical Bills of Goods

During this last week, I became upset when I heard doctors quoting from an article published in the journal Pediatrics, suggesting that the use of stimulants to treat ADHD in children is a safe practice and we do not need to screen them for heart disease.

Shortly afterward, I noticed that Medscape published an educational piece for doctors and other health professionals, using the same flawed study to support their view. The Medscape article is titled “No Increase in Cardiac Events or Death with ADHD Drugs.”

The article opens with this statement: “Children and adolescents who take medication for attention-deficit/hyperactivity disorder (ADHD) are not at increased risk for cardiovascular events and death, according to results of a large observational cohort study.”

That statement is just not true. That conclusion could not be asserted in the study, because the incidence of sudden death among study participants was very low; as a result, the authors concede that no final conclusions could be made.

Once again, industry-supported research fools the scientific and medical community.

This study is flawed, and its group sampling is, unintentionally or otherwise, biased to suggest that the medications are safe. The study compared populations of children who take stimulants to treat symptoms of ADHD with populations who do not. The purpose of this observational study was to measure if there is a higher rate of cardiac events in the stimulant-using group.

The major flaw in this study is that physicians and parents are hesitant to place children on stimulants, especially if there are indications of heart disease that would increase the risk of sudden death. As a result, many of the children at risk are placed automatically in the non-treatment group. This built-in bias would make it virtually impossible to prove that stimulants had any detrimental effect on at-risk patients. And what the study did purport to show was that more children died suddenly in the untreated group than in the group taking stimulant drugs.

For added perspective: We have millions of Americans being treated with stimulants. Amphetamines are being prescribed to children and adults alike. All too commonly, I hear from high school or college students, who happen to be my patients, that they are able to obtain these drugs illegally from friends. This time of year I hear it more often, as such stimulants are popular as illegal aids to promote wakefulness in students studying long hours for final exams. The dangers posed by such uncontrolled availability among young people are too obvious to require extended commentary from me in this column.

To summarize, administering a stimulant to children with an underlying disease like WPW, LONG QTC or HCM will increase their risk of sudden death. If we do not require childhood screening for those diseases (as well as others), then placing groups of children on these medications will almost certainly increase their incidence of sudden death.

The question is not whether the use of these stimulant drugs will increase the risk of sudden death for these patient groups, but whether that risk is acceptable to the parents, regardless of the attitudes now current in the pharmaceutical and medical communities.

Hypertrophic Cardiomyopathy

The Saving America Series

Physicians commonly make mistakes in EKG readings for children!

In a study published July 2011 in The Journal of Pediatrics, it is made clear that mistakes are occurring too often in the reading of EKG for children and young athletes. Unfortunately, some in the medical community seize upon the flaws in childhood screening to conclude that it is just not worth screening children.

I am flabbergasted that more professionals do not view these documented flaws in test reading as an urgent call to do better.

I have proposed a systematic approach to screening children that has both accountability and education built into the system. Designing screening programs that are specialized to accomplish a specific medical task can reduce mistakes and increase the accuracy of results. This approach also reduces the cost of screening and, most important, does a better job of protecting our children’s health.

We live in a culture where millions can be spent to perfect the perfect aluminum baseball bat to ensure a greater number of home runs, even though it increases the risk of injury and death to our children.

Let’s begin to get our priorities straight and put our efforts where it counts: our children’s health and future security.

Early Screening as a Priority

The Saving America Series

Physicians commonly make mistakes in EKG readings for children!

In a study published July 2011 in The Journal of Pediatrics, it is made clear that mistakes are occurring too often in the reading of EKG for children and young athletes. Unfortunately, some in the medical community seize upon the flaws in childhood screening to conclude that it is just not worth screening children.

I am flabbergasted that more professionals do not view these documented flaws in test reading as an urgent call to do better.

I have proposed a systematic approach to screening children that has both accountability and education built into the system. Designing screening programs that are specialized to accomplish a specific medical task can reduce mistakes and increase the accuracy of results. This approach also reduces the cost of screening and, most important, does a better job of protecting our children’s health.

We live in a culture where millions can be spent to perfect the perfect aluminum baseball bat to ensure a greater number of home runs, even though it increases the risk of injury and death to our children.

Let’s begin to get our priorities straight and put our efforts where it counts: our children’s health and future security.

Technology & the Natural Approach to Medicine

Cardio TheaterAs recent medical history demonstrates, it is not a question of making a choice between natural approaches to health vs. technology.

What is required is a new synergy that can only come from a greater human respect for nature and the natural needs and responses of the human body, to be followed by the intelligent application of lessons learned.

Man’s technological arrogance has led us down a mistaken path in medicine on more than one occasion, only to reveal the damage that results from a lack of applied wisdom.

In the 1980s, a study was designed to test how we could improve the survival of men who had suffered a heart attack.

The first trial was meant as a study of the efficacy of Drug A. When Drug A caused statistically more deaths when taken by study participants than if no drug had been taken, it was abandoned. A new trial was begun to study the efficacy of Drug B. The result of the tests using Drug B was the same as the tests using Drug A: More men dying. Based on the overall results, the entire study was eventually abandoned.

Some years later, a review of the study revealed that the men who were more likely to survive had one peculiar thing in common: They were frequent dog-walkers.

But was this really an unpredictable revelation? Walking has been perceived as man’s best medicine since it was first proclaimed as such by Hippocrates in 450 BC.

What should we do with this knowledge? Prescribe scooters to overweight post-MI patients? Operate on patients with coronary artery disease who could have been treated, along with obesity, hypertension and diabetes, by regular walking? Perform leg-bypass operations on individuals with claudication who could have been equally well treated with a regimen of walking and a healthy lifestyle?

Or do we come to a realization that spending billions of dollars bailing out the automobile industry only fuels the fire of mass inactivity – regardless of the effects on the manufacturing sector and the broader economy.

Curiously, the relatively new phenomenon of “exergaming” may be one persuasive answer to preventing obesity, diabetes and hypertension in our youth.

Exergaming is the catch-name for video games and technology-based activities that result in calorie burning. One of the more commonly known exergames is Wii Fit. The problem is that “evidence exists that spending time outdoors is the strongest correlate of physical activity among preschool-aged children,” as quoted from the July 2011 Archives of Pediatric & Adolescent Medicine, 2011; 165(7): 667-669.

I have repeatedly cautioned about using technology-based answers to problems that are for the most part a result of technology dependency.

An easy, simplistic example that highlights the unintended consequences of this type of approach is the handicapped scooter. With obesity at the root of so many of our nation’s health and financial problems, we have companies marketing scooters directly to the public as a medically necessary device. At first glance, these scooters may appear as a great solution that enables handicapped people to be mobile indoors and out. But the ultimate effect is that the overweight diabetic person moves less, resulting in more weight gain, worsening diabetes and the deterioration of vascular health. This further results in even poorer blood flow to the legs, further limiting the patient’s mobility.

Which leads me to conclude by reprising another oft-repeated piece of advice that I impart to all of my patients.

Do not forget the best exercise: Walking.

Walking is the live-longer, anti-diabetes and lower-your-cholesterol sport for all weathers and all ages, starting in early childhood – just as soon as your toddler learns to stand on his or her own two feet.

In fact, in the healthiest cultures, there is a common proverb that sums up the basis for healthy living: “We have with us at all times two doctors – the right foot, and the left foot.” Words to live by.

Video: Powerful Associations

Death on the Playground: Anthony’s Story

One ordinary day on the playground, a 12-year-old boy announces to his friends, “I have no pulse.” He then collapses to the ground in an apparent full cardiac arrest.

More than a decade ago, this tragic scenario played out for real.

Young Anthony’s heart had stopped beating, and he was judged to be clinically dead. The boy was air-lifted to Cincinnati Children’s Hospital. While en route, he had 13 electrical shocks applied to his chest in a desperate attempt to revive him. Eventually his heart was shocked back into its beating state; but by that time, severe, irreversible brain damage had occurred.

This preventable and treatable cardiac arrest left Anthony in a coma for more than a year. Once out of the coma, he was left with severe handicaps that will require a lifetime of special care.

The cardiac condition that caused this tragedy is called Wolff-Parkinson-White Syndrome (WPW). Simply described, the syndrome involves an extra piece of muscle woven into the overall mass that creates an electrical short circuit in the heart’s tissue. In some individuals, this condition is benign; in others it can lead to palpitations or tachycardia; but, in a few, as in Anthony’s case, it can be deadly, leading to sudden and unexpected full cardiac arrest.

In the most recent large-scale school screenings, this condition has been identified in up to one child per 100-1000. The good news: WPW is 100 percent curable. A simple procedure, called an ablation, is used to remove the excess heart muscle, which removes all future risk of sudden death.

But how can you detect a disease that may have no symptoms, even right up to last second, just before the onset of cardiac arrest? A simple EKG can make the diagnosis.

Anthony’s parents have chronicled his story in their book “Resurrecting Anthony.” I had the pleasure to meet with this heroic couple during a Fox News interview in which I participated. The following is excerpted from an e-mail that Anthony’s mother, Linda Cole, sent me.

“Dear Dr. Tozzi,

It was such a pleasure meeting you and your wife on Tuesday at Fox. I am quite excited that you are pursuing cardiac screening for children. This would save many families much needless heartache. I also believe that it would save Medicaid dollars in the long run. If nothing else, I hope that parents can at least be educated and given the option of paying for an EKG…”

Anthony’s mom is right. This tragedy could have been avoided in two ways:

  1. Required early cardiac screening for children
  2. Rapidly available automated external cardiac defibrillator units at all schools, playgrounds, athletic fields and public places in general.

The alternatives are starkly defined:

By using established EKG technology that costs about $40 per patient, physicians can diagnose and cure virtually all detected incidences of the bad form of WPW in young children, who will go on to lead normal, productive lives. And tragedies like Anthony’s, which can result in subsidized healthcare costs mounting into the hundreds of thousands over a lifetime, can become, literally, a thing of the past.

Read more: http://www.foxnews.com/health/2011/06/24/death-on-playground-anthonys-story/#ixzz1TJyeX1Hs