Effective Therapies for Heart Health: Revisiting Standard Recommendations

Heart Health Tips

How do you maintain a healthy heart? Is it enough to follow a low-fat diet, take your Lipitor® and work out on a treadmill every day? The answers may surprise you.

Prevention and treatment of cardiovascular disease has come a long way during the past few decades. Advice once accepted as standard has been expanded and improved. There’s a lot more to a healthy heart than maintaining a low level of low-density lipoprotein (LDL) cholesterol and avoiding dietary fat. And while most types of safe exercise benefit the heart, some forms may be more effective than others.

Learn more about heart health below and listen to the Live Foreverish Podcast with Life Extension’s own Michael A. Smith, MD, as he discusses “The Heart of the Matter.”

How can you improve your heart health? Statins alone may not be enough.

Statin drugs that reduce low-density lipoprotein cholesterol (LDL), such as Lipitor®, are among the most well-studied cardiovascular pharmaceuticals. In “Statins for Prevention of Cardiovascular Disease in Adults: Evidence Report and Systematic Review for the US Preventive Services Task Force,” which appeared in the Journal of the American Medical Association in 2016, researchers analyzed 19 trials that compared the effects of statin therapy to a placebo or no statin in a total of 71,344 participants without prior cardiovascular events.1 Statin therapy was associated with a 14% lower risk of all-cause mortality, a 31% lower risk of cardiovascular mortality, a 29% lower risk of stroke, a 36% lower risk of heart attack and a 30% reduction in composite cardiovascular outcomes. However, a recent study that included 165,411 participants who did not have cardiovascular disease prior to statin therapy found that more than half of the subjects failed to achieve optimal reduction of LDL within two years of starting the drugs.2 However, the authors remark that “variations in individual patient genotypes, and probably non-adherence, may be an important explanation for this phenomenon.”

Related Article: Are Standard Lipid Profile Tests Enough? Advanced Cholesterol Testing

“Despite aggressive LDL-cholesterol management with statins, there remains a residual risk for coronary heart disease events in high-risk patients,” write E. Dembowski and M.H. Davidson in a recent view. “Secondary targets have been proposed to decrease this risk, including non–high-density lipoprotein cholesterol, high-sensitivity C-reactive protein, and apolipoprotein B, as well as other emerging targets, including LDL particle number and lipoprotein(a). In many high-risk patients, statin monotherapy is unlikely to achieve goals, and combination therapy with other agents is a safe, effective, and optimal therapeutic approach.”3

The secondary targets listed by the authors are among a number of factors that increase the risk of cardiovascular events. In fact, Life Extension® has identified 19 factors associated with cardiovascular disease risk.

If you’ve been prescribed a statin drug by your physician, it is important to take this medication as recommended. Nutritional supplements such as pantethine, red yeast rice extract, Indian gooseberry (amla) and niacin may also help lower LDL.4-8

How to improve heart health naturally

Is the long-recommended low-fat diet best to prevent heart disease?

Research continues to reveal heart-healthy effects for a Mediterranean diet, which includes high amounts of fruits, vegetables, whole grains, legumes, fish, nuts and olive oil, and limits butter and spreadable fats, red and processed meat, and commercial baked goods. A meta-analysis of six trials that compared Mediterranean with low-fat diets concluded that a Mediterranean diet had more favorable changes in systolic blood pressure, diastolic blood pressure, fasting glucose, total cholesterol and high-sensitivity C-reactive protein, a marker of inflammation, leading the authors to conclude that “Mediterranean diets appear to be more effective than low-fat diets in inducing clinically relevant long-term changes in cardiovascular risk factors and inflammatory markers.”9

While the Mediterranean diet is relatively low in saturated fat compared with the standard American diet, it does provide healthy fats that may be marginalized in a low-fat diet. Additionally, prepackaged low-fat products consumed by many individuals may contain higher amounts of simple sugars, which contribute to inflammation and other health hazards.

What is the best exercise routine for heart health?

Aerobic exercise, like that done on a treadmill or cycle, can help boost cardiovascular health. However, some recent research suggests that circuit training may be more beneficial than the commonly practiced routine consisting of an uninterrupted stretch of “cardio” combined with resistance (weight) training.

Circuit training involves participating in a series of different exercises performed in rotation, with a little rest between them. It can involve exercises using weights or other equipment, or short bursts of aerobic activity. Quickly moving from an exercise involving one body part to that involving another part allows the first exercised area to rest and recover while another area is being trained.

A recent study compared the effects of circuit-based aerobic resistance training with combined resistance training and aerobic exercise in 34 sedentary women. Seventeen women were assigned to a circuit-based whole-body aerobic resistance training group that involved various exercises using only body weight as resistance. The remaining women participated in aerobic exercise plus resistance training that mainly involved the use of weight machines.

How to keep your heart healthy and strong

Pre- and post-training assessments revealed improvement in cardiorespiratory fitness in the circuit-trained group while the aerobic fitness of those who engaged in combined training did not improve. “Our results suggest that a circuit-based whole-body aerobic resistance training program can elicit a greater cardiorespiratory response and similar muscular strength gains with less time commitment compared with a traditional resistance training program combined with aerobic exercise,” Terrence R. Myers and colleagues conclude.10

However, any physical activity is better for heart health than none unless you have a medical condition that requires you to avoid physical activity. If you don’t have access to circuit-training facilities, aim for 150 minutes weekly of moderate-intensity physical activity, such as tennis, brisk walking, water aerobics or leisurely biking. Alternatively, you can target 75 minutes per week of high-intensity activity, such as running, hiking uphill or backpacking, swimming laps or jumping rope.

How to have a healthy heart for life

Standard recommendations for heart health and useful medical knowledge are constantly evolving. By keeping up with the latest findings and putting them into practice, you can ensure your heart will be better able to keep up with the demands of living a longer and fuller life.

About Live Foreverish: Join Dr. Mike as he sits down with some of today’s leading medical, health and wellness experts to discuss a variety of health-related topics. From whole-body health to anti-aging and disease prevention, you’ll get the latest information and advice to help you live your life to the fullest. If you like what you hear, please take a moment to give Live Foreverish a 5-star rating on iTunes!

References
  1. Chou R et al. JAMA. 2016 Nov 15;316(19):2008-2024.
  2. Akyea RK et al. Heart. 2019 Apr 15. [Epub ahead of print].
  3. Dembowski E et al. J Cardiopulm Rehabil Prev. 2009 Jan-Feb;29(1):2-12.
  4. Evans M et al. Vasc Health Risk Manag. 2014 Feb 27;10:89-100.
  5. Liu J et al. Chin Med. 2006 Nov 23;1:4.
  6. Upadya H et al. BMC Complement Altern Med. 2019 Jan 22;19(1):27.
  7. Kim SH et al. Clin Ther. 2011 Oct;33(10):1357-64.
  8. Elam MB et al. JAMA. 2000 Sep 13;284(10):1263-70.
  9. Nordmann AJ et al. Am J Med. 2011 Sep;124(9):841-51.e2.
  10. Myers TR et al. J Strength Cond Res. 2015 Jun;29(6):1592-600.

Why is High Blood Pressure a Silent Killer?

What’s the No. 1 risk factor for cardiovascular disease?

Is it high cholesterol? Stress? Being male? If you guessed high blood pressure (hypertension), you’re ahead of many of us. High blood pressure is one of the strongest risk factors for cardiovascular disease.1 However, a large number of people are unaware they have high blood pressure because they have no symptoms. No wonder they call it the silent killer.

Some risk factors for cardiovascular disease are not controllable. Older age, male gender, being postmenopausal and having a family history of the disease are uncontrollable risk factors. Fortunately for many, hypertension is among the controllable risk factors, in addition to smoking, being overweight, having diabetes or metabolic syndrome and the presence of elevated triglycerides and cholesterol.

How many of us know our average blood pressure reading and have had it recently measured? And how many who have been told they have high blood pressure have taken steps to control it?

Listen to Life Extension’s Michael A. Smith, MD, and Crystal Gossard, DCN, CNS®, LDN, as they review the importance of blood pressure in heart disease on www.LiveForeverish.com

What is normal blood pressure?

Normal blood pressure is less than 120/80 mm Hg. When the top number (systolic) is between 120 and 129 mm Hg and the bottom number (diastolic) is less than 80 mm Hg, blood pressure is elevated. Stage 1 hypertension occurs when the systolic reading is between 130 and 139 mm Hg and the diastolic reading is 80 to 89 mm Hg. Stage 2 hypertension is categorized as blood pressure greater than 140/90 mm Hg.2

Some evidence suggests that a target blood pressure of 115/75 mm Hg may be optimal.

Blood pressure meaning

Blood pressure is a measure of the pressure inside the blood vessels when the heart beats and when the heart is at rest.

Systolic blood pressure (the top number) measures the pressure inside the blood arteries when the heart beats. Diastolic blood pressure (the bottom number) reflects the pressure within the arteries when the heart is at rest between beats.

When pressure against the walls of the arteries is chronically elevated, it slowly damages the blood vessel lining. This makes the arterial lining susceptible to the buildup of plaque, which narrows the arteries and further increases pressure. If plaque ruptures, a blood clot can form that blocks narrowed arteries and impedes blood flow. When blockage occurs in the arteries that provide blood to the heart muscle, it is called a heart attack (myocardial infarction). When it occurs in the vessels that nourish the brain (due to blood-clot formation within the vessel, or a blood clot or plaque that traveled through the bloodstream), it is known as a stroke (cerebrovascular accident). High blood pressure can also cause a blood vessel in the brain to burst, which is known as a hemorrhagic stroke.3

Blood pressure measurement

Blood pressure is measured with a device known as a sphygmomanometer. Many of these devices are now electronic and can rapidly deliver accurate blood pressure measurements when applied to the arm or wrist. Because blood pressure changes throughout the day and may be higher than usual when measured in a medical practitioner’s office due to “white coat syndrome” (patient anxiety), monitoring blood pressure at home is an ideal way to gauge the effectiveness of one’s blood pressure maintenance program.

How to lower blood pressure

You’ve heard it before, but not smoking; maintaining a healthy weight; consuming a healthy diet (such as the DASH or Mediterranean diet) that contains a low amount of salt; engaging in regular, physician-approved exercise; and periodic monitoring of blood pressure by a medical professional, along with taking any prescribed medicines as directed, are essential for blood-pressure control.

Long-term stress management is also important. Learn how to handle life’s challenges in a positive manner. Meditation, walking or engaging in other relaxing activities can be helpful. Those who need more help may wish to ask their physicians about biofeedback therapy, which helps train the user to modify factors that affect blood pressure. In one study of biofeedback training among hypertensive patients, more than half lowered their blood pressure sufficiently enough to eliminate the need for medication.4 Similar reductions in blood pressure occurred among those who were not using blood pressure medications.

Foods to reduce blood pressure

As part of a comprehensive program to support healthy blood pressure, fruits and vegetables that are naturally low in sodium are good dietary choices. The Dietary Approaches to Stop Hypertension (DASH) diet recommends fruit and vegetables, whole grains and low-fat dairy products to lower blood pressure.5 Combining this eating pattern with sodium reduction has been associated with an even greater benefit.6

Nutritional supplements can be added to the diet to further improve blood pressure management. Research suggests that quercetin, stevioside (from stevia), fish oil, magnesium, pomegranate and potassium may be helpful.7-12

Although it often has no symptoms, high blood pressure is nothing to ignore. It’s critical to have blood pressure checked periodically, particularly as we get older. If you have high blood pressure, count yourself among the lucky individuals who have a health condition that is largely controllable. You’ll find that the recommended lifestyle changes that help control blood pressure will benefit many other aspects of health and well-being and lower the risk of other aging-associated conditions.

About Live Foreverish: Join Dr. Mike as he sits down with some of today’s leading medical, health and wellness experts to discuss a variety of health-related topics. From whole-body health to anti-aging and disease prevention, you’ll get the latest information and advice to help you live your life to the fullest. If you like what you hear, please take a moment to give Live Foreverish a 5-star rating on iTunes!

References

1. Kjeldsen SE et al. Pharmacol Res. 2018 Mar;129:95-99.
2. Whelton PK et al. Circulation. 2018 Oct 23;138(17):e426-e483.
3. Available at: https://www.heart.org/en/health-topics/high-blood-pressure/health-threats-from-high-blood-pressure
4. Fahrion S et al. Biofeedback Self Regul. 1986 Dec;11(4):257-77.
5. Chiu S et al. Am J Clin Nutr. 2016 Feb;103(2):341-7.
6. Sacks FM et al. N Engl J Med. 2001 Jan 4;344(1):3-10.
7. Larson AJ et al. Adv Nutr. 2012 Jan;3(1):39-46.
8. Liu JC et al. Pharmacology. 2003 Jan;67(1):14-20.
9. Geleijnse JM et al. J Hypertens. 2002 Aug;20(8):1493-9.
10. Rosanoff A et al. Magnes Res. 2013 Jul-Sep;26(3):93-9.
11. Asgary S et al. Phytother Res. 2014 Feb;28(2):193-9.
12. Filippini T et al. Int J Cardiol. 2017 Mar 1;230:127-135.

Are Standard Lipid Profile Tests Enough? Advanced Cholesterol Testing

With heart disease being a leading cause of death among Americans, you may be wondering: How healthy is my heart?

You eat right, exercise and know how to manage stress. Your annual physical includes the standard blood tests, including a lipid (cholesterol) profile to evaluate heart disease risk, cholesterol (HDL and LDL) and triglycerides. Your blood pressure and electrocardiogram (ECG) results may be normal. Everything looks OK, so there’s nothing to worry about . . . right?

A standard lipid panel that tests for serum total cholesterol, high-density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL) and triglycerides is a necessary part of regular blood work and a way to screen for factors that contribute to heart disease. But there are other blood tests available that provide a much clearer picture of where you stand heart-health-wise.

Listen to Life Extension’s Michael A. Smith, MD, and Crystal Gossard, DCN, CNS®, LDN, as they bring their audience up-to-date on the latest tests for cholesterol and more on the Live Foreverish Podcast.

Advanced heart tests

There’s more to cholesterol than HDL and LDL.

Cholesterol, an important fat-like substance found in all cells, is needed to produce steroid hormones and forms a part of cell membranes, among other functions. Although some cholesterol is provided by the diet, most is made by the liver. Cholesterol is transported by low-density lipoprotein to tissues, while high-density lipoprotein delivers excess cholesterol back to the liver, where it is broken down and eventually excreted. Having an HDL level of 50 mg/dL or higher, an LDL level of less than 80 mg/dL and fasting triglycerides that are lower than 100 mg/dL is optimal for most individuals without other risk factors.

What are the best blood tests for predicting heart problems?

One of the best tests you can take is the NMR Lipoprofile® test, which measures the standard lipid levels in addition to LDL particle size and number. Low-density lipoprotein should be large, fluffy and buoyant (described as pattern A) as opposed to small and dense (described as pattern B). Small, dense LDL particles are likelier to infiltrate the arterial wall, leading to plaque formation. They are therefore a good marker for predicting cardiovascular disease.1 The NMR Lipoprofile® test also provides an assessment of insulin resistance that can help detect the risk of type 2 diabetes, a disease that increases the risk of cardiovascular disease.2

Apolipoproteins bind fat and cholesterol to form lipoproteins. While there are a number of apolipoprotein classes, the ones we’re going to look at are apolipoprotein A and apolipoprotein B. Apolipoprotein B (ApoB) is a component of some of the “unhealthier” lipoproteins, including low-density lipoprotein (LDL), very low-density lipoprotein (VLDL) and intermediate-density lipoprotein (IDL) particles. Apolipoprotein A1 (ApoA1) is a component of high-density lipoprotein (HDL) particles and is potentially helpful in reducing build-up of arterial plaque. The Apolipoprotein Assessment, which measures apolipoprotein B and apolipoprotein A1, is important because the ApoB-to-ApoA1 ratio has a stronger association with cardiovascular disease risk than better-known lipoprotein cholesterol fractions.3

Best Blood Tests for Heart Disease Detection: Does LDL Matter?

Yes, knowing one’s LDL level is of vital importance in assessing one’s risk of cardiovascular disease. Testing for oxidized lipoproteins is also important. Oxidized LDL can be compared to rancid fat that is likelier to trigger inflammation and plaque formation than LDL that is not oxidized. Increased serum or plasma oxidized LDL is a marker for coronary artery disease.4

Tests for inflammation are valuable in the assessment of cardiovascular disease risk. While C-reactive protein (CRP) is a better-known test for systemic inflammation, myeloperoxidase (an immune system enzyme that is a biomarker of oxidative stress) testing can assess inflammation specific to the arterial wall. Testing for CRP and myeloperoxidase may be as important as cholesterol levels to evaluate the risk of cardiovascular disease.5

Another advanced heart test is the PLAC® test for lipoprotein-associated phospholipase A2 protein (Lp-PLA2) activity. Lp-PLA2 is a vascular inflammatory marker that plays an important role in the formation of arterial plaque that is vulnerable to rupture.6 This test measures the function of Lp-PLA2 in the walls of the arteries to help predict the risk of coronary heart disease events.

Heart tests for chest pain

Chest pain should be immediately evaluated. Although it may not always be caused by a heart attack, it’s better not to take chances. An ECG is usually the first test that is administered to people complaining of chest pain. This test measures the heart’s electrical activity and can reveal damage that has occurred.

Troponin is a protein that increases in the blood in response to damage to the heart muscle. This is measured in the emergency department following an ECG assessment of suspected heart attack. Troponin testing confirms acute heart attack diagnosis but does not indicate the mechanism of damage inflicted upon the heart.7

Chest x-rays and CT scans are other tests that may be employed to evaluate individuals who report chest pain. They may be repeated at follow-up, along with ECG stress tests and/or an angiogram, which enables visualization of the heart’s arteries.

Chest pain that comes and goes

Chest pain that comes and goes over an extended period of time may not be due to a heart attack but should still be evaluated by a physician. There are a number of tests and procedures that can help identify the cause of chest pain.

Availing yourself of some of these advanced tests can provide a more complete picture of heart health than standard blood tests. If an increased risk of cardiovascular disease is identified, preventive measures can be taken. By proactively assessing your risk factors, you can act immediately to reduce the risk of becoming one of the casualties of the world’s leading cause of death.

About Live Foreverish: Join Dr. Mike as he sits down with some of today’s leading medical, health and wellness experts to discuss a variety of health-related topics. From whole-body health to anti-aging and disease prevention, you’ll get the latest information and advice to help you live your life to the fullest. If you like what you hear, please take a moment to give Live Foreverish a 5-star rating on iTunes!

References
  1. Ivanova EA et al. Oxid Med Cell Longev. 2017;2017:1273042.
  2. Balakumar P et al. Pharmacol Res. 2016 Nov;113(Pt A):600-609.
  3. Walldius G et al. J Intern Med. 2006 May;259(5):493-519.
  4. Holvoet P et al. Arterioscler Thromb Vasc Biol. 2001 May;21(5):844-8.
  5. Heslop CL et al. J Am Coli Cardiol. 2010; 55: 1102-1109.
  6. Kolodgie FD et al. Arterioscler Thromb Vasc Biol. 2006 Nov;26(11):2523-9.
  7. Foy AJ et al. Med Clin North Am. 2015 Jul;99(4):835-47.

Exercise Science: Health Benefits and Tips for Maintaining Muscle Mass

Do you find yourself making excuses for not exercising? If so, you’re not alone. However, you may not realize that failure to exercise is part of a vicious cycle that, if not reversed, could set you up for muscle loss, frailty and a loss of independence.

The human body was built to move. Anthropological evidence provides clues that running after prey was essential to our survival. But if the fitness of humans in developed countries is any indication, we’ve forgotten our birthright. The majority of waking life for many of the world’s people is spent seated in front of a flickering screen.

Learn more about exercise below and listen to the Live Foreverish Podcast with Life Extension’s own Michael A. Smith, MD, as he discusses “Getting Your Workout to Work.”

Why is exercise so hard?

Inertia is a common experience among humans, particularly as we get older. In psychological terms, inertia describes indisposition to change that occurs among those who know they need to accomplish a task but have trouble finding the motivation to get started.

In our culture of instant gratification, the long-term benefits of exercise don't always appear real or worth the continual investment of time and energy.

There’s a vicious cycle involved in failing to exercise: Without it, muscle mass diminishes, and with weakened muscles—or even frailty—people are less likely to exercise.

Although some people have injuries or illnesses that prevent them from exercising the way they’d like to, others do not. Sometimes all that’s needed is a sobering re-examination of priorities in light of what we know concerning the essentiality of regular physical activity to our health.

Does exercise really matter?

When it comes to health and well-being, exercise is one of the most important factors.

According to the World Health Organization, the determinants of health are:

· the social and economic environment
· the physical environment
· the person’s individual characteristics and behaviors

These behaviors include keeping active, as well as balanced eating, not smoking, moderation in drinking, and being able to cope with stress.1

A study published in the British Journal of Sports Medicine reported more than double the percentage of individuals who experienced healthy aging (defined as not developing chronic disease, depressive symptoms, or physical or cognitive impairment over eight years of follow-up), among men and women who engaged in moderate activity in comparison with inactive subjects.2 For those who reported vigorous activity at least once per week, there was an even greater increase. Furthermore, becoming active over the course of the study was associated with more than three times the chance of experiencing healthy aging, and for those who remained active, the increase was over seven times greater in comparison with remaining inactive during follow-up.

If the prospect of healthy aging isn't enough to motivate you, consider the results of a study published in the BMJ, which analyzed 16 meta-analyses (including 305 randomized controlled trials with a total of 339,274 participants) of the effects of exercise and pharmaceutical trials on mortality.3 Husyein Naci and John P.A. Ioannidis found that physical activity interventions were more effective than drugs at preventing death in men and women recovering from stroke. It was also observed that “no statistically detectable differences were evident between exercise and drug interventions in the secondary prevention of coronary heart disease and prediabetes.” And in another study, researchers from Australia found that men and women who engaged in a high amount of recreational physical activity had an 84% lower risk of mortality from cardiovascular disease than those with a low activity level, and an 88% lower risk of mortality from coronary heart disease.4

Immediate health benefits of exercise

While it may be hard to think about the effects of exercise that you'll experience eight years from now, or even in a month when your clothes fit better, some benefits are immediately noticeable. Despite the possibility of temporary muscle fatigue, mental fatigue may vanish, mood may lift and "inertia" may lessen in a short period of time. People who exercise may feel more energetic, think more clearly, sleep better and remember more. Exercise can sometimes help banish a blue mood, worry or grief in a very short time.

Importance of exercise

Exercise is important in the prevention of aging-associated diseases such as cardiovascular disease and Alzheimer’s disease, as well as a condition known as sarcopenia. 5,6 Sarcopenia is defined as a loss of muscle mass and function. The condition, which occurs in 5% to 10% of those over the age of 65, can lead to loss of mobility and function, falls and premature mortality. The condition can be the result of several causes, and lack of regular exercise can be a contributing factor. Exercise, particularly resistance exercise, is one of the treatments for sarcopenia, along with vitamin D and protein supplementation.7

Older individuals who exercise may find it more challenging to build muscle compared with when they were younger. As people age, they become more susceptible to a slowdown in the body’s ability to rebuild muscle.8

Fortunately, a supplement known as HMB (beta-hydroxy-beta-methylbutyrate), a metabolite of the amino acid leucine, helps support muscle growth in response to exercise, which could be a boon to older individuals who find it difficult to maintain muscle mass.9,10 In a study involving older individuals, supplementation with HMB improved strength and muscle quality even in the absence of resistance exercise.11

Long ago, the philosopher Lao Tzu remarked that "a journey of a thousand miles begins with a single step." One might add that the step that is the most difficult is the first one. Humans are creatures of habit. By literally taking the first step in any exercise routine, you are beginning a journey that is much more certain to approach the elusive Fountain of Youth than any of the travels of Ponce de Leon.

About Live Foreverish: Join Dr. Mike as he sits down with some of today’s leading medical, health and wellness experts to discuss a variety of health-related topics. From whole-body health to anti-aging and disease prevention, you’ll get the latest information and advice to help you live your life to the fullest. If you like what you hear, please take a moment to give Live Foreverish a 5-star rating on iTunes!

References
  1. World Health Organization. Health Impact Assessment. https://www.who.int/hia/evidence/doh/en/
  2. Hamer M et al. Br J Sports Med. 2014 Feb;48(3):239-43.
  3. Naci H et al. BMJ. 2013 Oct 1;347:f5577.
  4. Dhaliwal SS et al. PLoS One. 2013 Dec 26;8(12):e83435.
  5. Maliszewska-Cyna E et al. Curr Alzheimer Res. 2017;14(1):47-60.
  6. Hamer M et al. Adv Exp Med Biol. 2017;999:3-18.
  7. Morley JE et al. J Cachexia Sarcopenia Muscle. 2014 Dec;5(4):253-9.
  8. Cuthbertson D et al. FASEB J. 2005 Mar;19(3):422-4.
  9. Wilkinson DJ et al. Clin Nutr. 2018 Dec;37(6 Pt A):2068-2075.
  10. Panton LB et al. Nutrition. 2000 Sep;16(9):734-9.
  11. Stout JR et al. Exp Gerontol. 2013 Nov;48(11):1303-10.

Acid Reflux: Supplements, Foods to Avoid, and What to Eat

Heartburn—that painful, burning sensation in the upper chest that usually follows a meal—is a familiar sensation to many of us. The condition is often accompanied by stomach upset, belching and other symptoms of indigestion. It is usually treated with over-the-counter remedies such as calcium carbonate tablets or something as simple as baking soda in water.

But when heartburn frequently returns—sometimes after every meal—it may be more than a simple case of too much of the wrong food. Heartburn is caused by acid reflux, an upward flow of stomach acid into the esophagus. In gastroesophageal reflux disease (GERD), chronic acid reflux exposes the esophageal lining to the stomach’s powerful acid on a regular basis. This damage can lead to a condition known as Barrett’s Esophagus, which is associated with an increased risk of esophageal cancer. Clearly, acid reflux can be more than an occasional annoyance.

Learn more about acid reflux below and listen to the Live Foreverish Podcast, in which Life Extension’s own Michael A. Smith, MD discusses the latest information.

What causes acid reflux?
Acid reflux is caused by a backflow of the stomach’s hydrochloric acid upward past the lower esophageal sphincter into the esophagus, which is the passage taken by food when it travels from the mouth to the stomach. While the lower esophageal sphincter normally prevents the passage of the stomach’s contents into the esophagus, relaxation or weakening of this muscular band allows stomach acid to flow backward, resulting in irritation to the esophageal lining.

One cause of acid reflux is hiatal hernia, which occurs when the upper part of the stomach and lower esophageal sphincter move above the diaphragm. Acid reflux is also a common occurrence during pregnancy. A major cause of acid reflux is being overweight or obesity, when abdominal fat exerts pressure on the stomach.

Acid reflux foods to avoid

In addition to overeating in general, some foods can make acid reflux worse. Fatty and fried foods, spicy food, coffee, tea, citrus fruit (which includes tomatoes), mint, chocolate and carbonated or alcoholic beverages are among the more notorious culprits. This does not necessarily imply that these foods can never be consumed, but if one or more is associated with your symptoms, try consuming it in smaller quantities or less frequently.

Foods that reduce stomach acid

Broccoli, kale, radish, cucumber, cold milk and milk curd were shown in a recent study to have acid-neutralizing effects. Of these foods, broccoli and cold milk had the greatest antacid activity, which was similar to baking soda.1 In fact, consuming ½ teaspoon of baking soda mixed in a small glass of water is a great way to temporarily treat acid reflux symptoms by neutralizing stomach acid.

While neutralizing stomach acid may help ease acid reflux symptoms, keep in mind that the stomach’s acid is essential for digestion and helps protect against infection by food-borne pathogens. Neutralizing stomach acid’s pH is ideally a temporary solution; however, some patients may be treated long-term with drugs that neutralize or reduce the production or release of stomach acid.

Supplements and foods to ease heartburn

Other than neutralizing stomach acid, there are other dietary measures that can help improve the symptoms of acid reflux. While snacking on sugar-laden licorice candy may not be helpful, licorice root extract may help prevent the formation of esophageal ulcers.2 Furthermore, flavonoids in deglycyrrhizinated licorice (DGL) may encourage a healthy inflammatory response by inhibiting the production of signaling molecules that promote inflammation.3,4

Calcium carbonate is a common ingredient in over-the-counter heartburn relief products that, when chewed, neutralize acidity in the esophagus without affecting the stomach’s acid.5 Magnesium carbonate is another mineral salt that can be helpful.6 Calcium carbonate and magnesium carbonate have the added benefit of contributing to the body’s essential need for calcium and magnesium.

Aloe vera juice has long been used for gastrointestinal complaints. Aloe vera liquid was associated with a reduction in GERD symptom frequencies in a pilot trial.7 If you choose to try aloe vera liquid, look for one that is free of aloin, a naturally occurring compound that can be an irritant.

Digestive enzymes consumed with food may aid in the prevention of acid reflux symptoms. Eating slowly also helps.

If you have acid reflux, what should you eat?

A study reported in JAMA Otolaryngology Head and Neck Surgery found that consuming alkaline water and a Mediterranean diet, which is high in vegetables, fruit and whole grains and low in red meat, was associated with a greater reduction in reflux symptoms than proton pump inhibitors (PPI), which are a standard drug treatment for acid reflux.8 The finding is important because long-term PPI use is associated with a number of adverse conditions. The drugs’ ability to lower the production of stomach acid may result in reduced absorption of certain nutrients such as magnesium.9

How much one eats is also important. Since having a greater amount of belly fat puts pressure on the esophagus and stomach, losing some of that fat can improve reflux symptoms.10 Eating less may not only result in fewer acid reflux symptoms during a meal but can also help with long-term acid reflux management.

Fortunately, acid reflux is treatable and often reversible. By making a few dietary changes—and sticking to them—acid reflux can be prevented in many cases. However, do not discontinue the use of any medications to prevent acid reflux that have been recommended or prescribed by your physician without his or her approval.

About Live Foreverish: Join Dr. Mike as he sits down with some of today’s leading medical, health and wellness experts to discuss a variety of health-related topics. From whole-body health to anti-aging and disease prevention, you’ll get the latest information and advice to help you live your life to the fullest. If you like what you hear, please take a moment to give Live Foreverish a 5-star rating on iTunes!

References:
  1. Panda V et al. Complement Ther Med. 2017 Oct;34:111-115.
  2. Aly AM et al. AAPS PharmSciTech. 2005 Sep 20;6(1):E74-82.
  3. Thiyagarajan P et al. Inflammopharmacology. 2011 Aug;19(4):235-41.
  4. Chandrasekaran CV et al. Phytomedicine. 2011 Feb 15;18(4):278-84.
  5. Robinson M et al. Aliment Pharmacol Ther. 2002 Mar;16(3):435-43.
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