Originally published December 17 2007
The Cause of Heart Disease: High Cholesterol or Excess Calcium?
by Bill Sardi
(NaturalNews) The cholesterol controversy has been waged now for over five decades. Volumes of books, articles, and journals have been written on the subject of the role cholesterol and diet plays in the arterial disease process.
Since the 1950's the "Lipid Hypothesis," also known as the "Diet-Heart Idea", states that saturated fat and high cholesterol play a major role in the causation of atherosclerosis and cardiovascular disease, and gained increasing support from the majority of the medical and scientific communities.
But over the last two decades, with marked advances in science and technology, the most recent research into lipid chemistry and coronary pathology are revealing that the "lipid theory" or "diet-heart" hypothesis might not be as definitive as once thought as being the major cause of coronary heart disease.
In fact, much of the latest research that has been done on cholesterol shows just how vital a role this group of fats, called sterols, really are to every cell, nerve, and major organ of the body.
Is Excess Calcium The Real Culprit?
In the past decade, and into the 21st Century, many well known doctors from across the globe have broken ranks with the conventional "Lipid Theorists" in espousing what they believe to be a more likely cause of arterial disease, and that is the accumulation of excess calcium plaque in coronary arteries.
One of these renowned doctors, Arthur Agatston, a Florida cardiologist who is better known as the author of a diet book "The South Beach Diet", became well known for his studies into the excess calcification that was consistently found in his patients with arteriosclerosis and coronary artery disease. He developed the severity scoring sheet for calcification of the arteries, now known as the Agatston Score.
The Agatston Score
The amount of calcium in coronary arteries can be measured. The Agatston Score refers to the amount of calcium based upon the size and the density of the calcified plaques.
Absolute Agatston scores of less than 10, 11-99, 100-400, and above 400 have been proposed to categorize individuals into groups having minimal, moderate, increased, or extensive amounts of calcification, respectively. The amount of calcification can give, to some extent, an indication of the overall amount of atherosclerosis (arterial disease).
It is well established that individuals with Agatston Scores above 400 have an increased occurrence of coronary artery procedure (bypass, stent placement, and angioplasty) and events (heart attack and cardiac death) within the 2 to 5 years after undergoing a coronary artery calcification assessment. Individuals with very high Agatston scores over 1000 have a 20% chance of suffering a heart attack or cardiac death within a year (1).
In a study of 156 patients who had experienced a first-time heart attack, coronary artery calcifications were present in 148 patients with a mean 'Agatston Score' of 589.2. The 'Agatston Score' was greater than 400 in 44% of the patients. The average total cholesterol in these 156 patients was 213, their LDL cholesterol at 154 and HDL cholesterol at 40. Coronary calcifications were detected in 95% of patients with a first-time heart attack compared to 53% of adults who have not yet experienced a heart attack or other symptoms like angina (2).
Another study was conducted in Germany among 192 relatively young patients (19-59 years of age, 88% male) who had experienced a sudden acute heart attack with no prior history of heart or artery disease. Coronary artery calcification was assessed by the Agatston score 1-14 days after their heart attack. Calcifications were present in 95% of patients with acute heart attack and 59% of subjects without known coronary artery disease. The mean Agatston Score was 529 in the patients who had experienced a heart attack and 119 in the healthy group (3).
It was cardiologist Dr. Stephen Seely who published a treatise in the International Journal of Cardiology in 1991, entitled "Is Calcium Excess in the Western Diet a Major Cause of Arterial Disease?". In this article, Dr.Seely states that he believes excess calcium intake is a major cause of atherosclerosis in Western countries.
He contended that young adults need only 300-400 mg of calcium daily, and older adults need even less. In countries where the daily calcium intake is 200-400 mg, arterial diseases are non-existent and blood pressure does not increase with age.
Dr. Seely also stated that in other countries where the calcium intake is 800mg and above (USA, New Zealand, Scandinavian countries, Ireland), arterial disease is the leading cause of mortality. Dr. Seely points out that cholesterol only represents 3% of arterial plaque, while calcium makes up 50% (4).
It seems now the American Heart Association (AHA) is paying more attention to the excess calcium theory of arterial disease.
After six years of debate, the AHA has finally approved CT scanning for arterial calcifications for high-risk individuals. Only a few years ago the AHA dismissed the use of CT scanning for any reason, so this is a big change.
Dr. Seely recommended that the best remedy for this problem would be prevention, by reducing calcium consumption only to the level needed by the body. "This could be achieved only by drastically making cuts in consumption of milk. Failing that, we could utilize nature's own calcium antagonist, IP6 phytate (rice bran extract)," he says.
IP6 phytate is available as a dietary supplement extracted from rice bran by Tsuno Foods & Rice Co. in Wakayama, Japan, and sold under various brand names such as Source Naturals, Jarrow Formulas, and Purity Products.
Natural Antidotes To Arterial Calcifications
There are a number of natural antidotes to arterial calcifications, but we will take a look at the four most effective at inhibiting the calcification process in the arterial wall.
Vitamin D: Numerous studies have shown the correlation between adequate levels of Vitamin D in the body and the absence of extensive arterial calcification.
There has been much controversy on just how much Vitamin D can be tolerated by the body without being toxic. Most physicians and dietitians will warn the public away from so-called high dose Vitamin D supplements because of the notion that Vitamin D actually induces calcifications. But it seems this effect has only been demonstrated in animals at lethal doses - 2.1 million units of Vitamin D (5).
Dr. Reinhold Vieth, PhD, at the University of Toronto, says the toxicity of Vitamin D doesn't begin until 40,000 units are consumed (6). Dr. Vieth also noted that an hour of total-body exposure to unfiltered sunlight in the summer at southern latitudes would produce about 10,000 units of vitamin D without any known side effects.
Vitamin D is a vitamin/hormone produced in the skin upon sun exposure. It is widely known that more heart attacks occur in winter months when Vitamin D levels are low.
Dr. Joe Prendergast, a practicing endocrinologist in Redwood City, California, now treats his patients with 5000 units of Vitamin D to successfully reverse hardening of the arteries.
Magnesium: Magnesium has been found to be another natural calcium blocker and is another natural antidote to arterial calcification (7).
It is interesting to note that Magnesium addresses the same biological target as the statin drugs - the enzyme that controls cholesterol production in the liver. Both statin drugs and magnesium inhibit the enzymatic pathway. Magnesium lowers cholesterol and triglycerides and raises HDL cholesterol. It turns out that magnesium is a natural statin (8).
Another important factor afforded to magnesium is, in addition to preventing calcifications, it also inhibits the formation of coronary-artery-blocking blood clots that eventually occur as a result of calcifications within these arteries. The American diet, due to changes in fertilizers and higher intake of processed foods and lower intake of whole grains, provides less and less magnesium on a daily basis. A rich supply of magnesium can be found in spinach, various nuts, and pumpkin seeds.
Vitamin K: Vitamin K has been shown to reduce coronary heart disease mortality and aortic calcium scores by more than 50% in groups who consume high amounts from direct dietary sources. Vitamin K is naturally found in spinach, broccoli, and turnip greens.
Vitamin C: Still another way to inhibit calcifications on the inside of arterial walls is Vitamin C. Smooth cells called endothelial cells line the inside of arteries. When these cells are disrupted, in disrepair and cannot be regenerated fast enough, blood vessel disease can begin. Without proper maintenance of endothelial cells, cholesterol can be deposited underneath them, and calcification and blood clots can form.
Among young men, ages 18-30 years, low circulating levels of Vitamin C more than doubles the deposition of calcium inside coronary walls (9).
Low Vitamin C intake will likely result in a problematic artery scan. It is suggested that approximately 2000 mg � 4000 mg of Vitamin C should be supplemented daily for effective maintenance of arterial walls.
The Most Convincing Evidence Of The Calcium Theory
The most convincing evidence for the calcium theory of heart disease is found in the European Heart Journal (10). In the study, a group of adults over the age of 55 years had their coronary artery calcifications ranked by the Agatston scoring method. Blood pressure, cholesterol, smoking, and blood sugar, all common risk factors of cardiovascular disease were measured over a seven year period, along with the calcium artery scores.
Here are the disturbing numbers: 29% of the men and 15% of the women who had no cardiovascular symptoms and exhibited no other common risk factors (no elevated cholesterol, hypertension, etc.), had extensive coronary artery calcification.
These patients had a low-to normal cholesterol number and mistakenly thought they were at low risk for a heart attack.
It should also be noted that an x-ray/dye photo of coronary arteries, commonly used by cardiologists, cannot detect calcifications. Ultra fast computed tomography (CT scanning) and intravascular ultrasound can measure arterial calcification. Better than 90% of patients that experience a heart attack have coronary calcifications. It is also of interest to note that some 45% of patients that experience a heart attack and are admitted to a hospital have a "normal level" of cholesterol (11).
References:
1) Circulation 108:e50, 2003
2) International Journal Cardiology (2); 231-6, 2006
3) Heart 89; 625-28, 2003
4) International Journal Cardiology 1991, Nov; 33 (2): 191-8
5) Current Opinion Lipidology (1):41-6, 2007
6) American Journal Clinical Nutrition 1999 May, 69 (5): 842-56
7) The American Journal of Clinical Nutrition 2004 Oct; 23(5): 501S-5055
8) Journal American College Nutrition - 23:501, 05S, 2004
9) American Journal Epidemiology 159: 581-88, 2004
10) European Heart Journal 25: 48-55, 2004
11) Atherosclerosis 149: 189-190, 2000; Medical Hypotheses 59: 751-56, 2002
About the author
Bill Sardi is a prolific natural health author and founder of Knowledge of Health (http://www.knowledgeofhealth.com). He has written numerous books and articles on cancer, nutrition and disease prevention.
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