Heart health tip: limit screentime to 2 hours each day

January 19, 2011 by  

When flying long haul (and I’ve done lots lately – covering almost 40,000 km in the last 3 weeks), I make sure that I wear the so-called “compression” socks. In addition, I make sure I stand up, walk around and do stretching regularly. This is to help prevent a life-threatening condition called deep vein thrombosis (DVT) that can lead to pulmonary embolism.

However, this vascular problem is not only restricted to frequent flyers. It seems that we can easily suffer from DVT any time while sitting at our office or even at home. While sitting in front of our computer screens, to be more precise. An example was

“…a [2003] case from New Zealand in which a young man who spent up to 18 hours a day sitting at his computer nearly died after developing a massive blood clot that formed in his leg veins, broke off and traveled to his lungs.

This disorder has been dubbed as “e-thrombosis.”

I read a more recent report in the New Zealand Herald last week which cited not just one case but a study reported in the Journal of the American College of Cardiology (JACC) which goes:

“… the risk of heart attack and stroke for those that spend over the allotted four hours in front of a screen (TV or computer monitor) increased by 113 per cent. The risk of death by any cause increased by almost 50 per cent. Those numbers are as compared to people who spend less than two hours in front of a screen. The findings come from a survey of 4,500 adults…”

I looked up the original source paper, which was conducted by British researchers and used the term “screen based entertainment time”. This new report suggests that it is not only time spent in front of the computer but overall “screen time” which includes time spent in front of the TV or video console that is detrimental to our health. In addition, it is not only e-thrombosis that threatens out health but a whole range of cardiovascular problems that come with leading a sedentary lifestyle. It indicates that each and every one of us who live in the digital age may be at risk for these health problems.

In the coming days, I’d be bringing you some specifics on this issue. Considering the attention that the film “The Social Network” is getting (a film which I saw twice on the return long-haul flight), this is a very relevant and timely topic.

In the meantime, I give you the conclusions of the authors of the JACC study:

“This is a new research area, which has attracted attention only in the past 18 months to two years, but it has implications both for public-health recommendations and clinical guidelines. I think there is a direct message from our research, which is that there should be a cut-off of two hours daily screen time as a maximum during leisure hours.”

Two hours? What can you achieve in two hours? And what about screen time during working hours?

Walnuts against stress

October 14, 2010 by  

Here is another autumn health superstar that we shouldn’t forget about: WALNUTS.

This nut that closely resembles the brain has been shown to be good for heart health, a delicious brain food, and may even have some anti-cancer properties.

Latest research shows that walnuts may also be a great ally against stress that in turn adversely affects cardiovascular health. Researchers at Pennsylvania State University studied 22 health adults who were provided specially planned meals for 6 weeks (source: WebMD). Three types of diets were tested, as follows:

An “average American diet which did not include nuts

  • A diet with some fat and protein substituted with 1.3 ounces of walnuts (about 18 walnut halves) and a tablespoon of walnut oil.
  • A diet with some fat and protein substituted with walnuts, walnut oil, and 1.5 tablespoons of flaxseed oil

Stress levels and blood pressure were measured at the end of each intervention.

Researcher and study author Dr. Sheila G. West explains the objective of the study:

“People who show an exaggerated biological response to stress are at higher risk of heart disease. We wanted to find out if omega 3-fatty acids from plant sources would blunt cardiovascular responses to stress.”

The results showed positive results in favor of diet rich in walnuts. Walnuts and walnut oil lowered both resting blood pressure and blood pressure responses to stress by 2 to 3 points.

Dr. West continues:

“This is the first study to show that walnuts and walnut oil reduce blood pressure during stress says. This is important because we can’t avoid all the stressors in our daily lives. [The study] shows that a dietary change could help our bodies better respond to stress.”

Indeed, many studies have shown that stress is very bad for cardiovascular health and promotes the development and progression of heart disease. There are many recommended interventions to reduce stress including physical exercise, yoga, some types of martial arts (e.g. tai chi) and music therapy. A healthy diet is also known to help counteract stressors and it seems that walnuts are one of them.

In addition, flaxseed oil added to the walnuts in the study also added improvement to vascular health. Flaxseed oil is another source of fat that is good for the heart. It seems that walnuts and flaxseed oil in our diet might be an unbeatable combination against stress and cardiovascular disease.

Alcohol and heart health: the latest updates

September 6, 2010 by  

Alcohol. Is it or is it not good for our health? Over the years, there have been hundreds of studies investigating this topic but the results have been contradictory. Below, we look at 3 of the most recent studies and what they have to say.

More evidence of benefit of light/moderate drinking
In a large study of 245,000 Americans, researchers at the Beth Israel Deaconess Medical Center in Boston report that light to moderate alcohol consumption is actually better than complete abstention when it comes to benefits for cardiovascular health. According to the authors:

“These data bolster previous epidemiological studies that have found lower rates of incident cardiovascular disease among moderate drinkers but also provide cautionary evidence that drinking above recommended limits eliminates this risk reduction.”

Binge drinking heightens death risk in those with high blood pressure
Binge drinking? Watch your blood pressure! This is according to Korean researchers at the Yonsei University in Seoul. Heavy drinking brings you closer to the grave. And the main effect of too much alcohol is on the cardiovascular health, especially on the blood pressure. Thus those with hypertension should especially be careful because binge drinking increases their risk of dying 12-fold.

The study participants consisted of 6100 residents of Kangwha County. The authors defined binge drinking as having six or more alcoholic drinks within a short period of time. Based on this classification, 20.4% of the study participants are actually binge drinker. Although the cardiovascular mortality risk increased with heavy drinking, the specific risk for stroke is not increased.

Does drinking alcohol temporarily heighten stroke risk?
Ok, so heavy drinking is bad for the health, that is clear. And light to moderate alcohol consumption can actually do one some good. Or does it? Results from the Stroke Onset Study indicate that even 1 single alcoholic drink can double the risk of ischemic stroke 1 hour after its consumption. The researchers looked at 390 patients who were hospitalized for stroke. The patients were interviewed about their activities and alcohol consumption during the hours before stroke attack as well as their habitual drinking pattern. The interview revealed that 3.6% of interviewees consumed alcohol an hour before stroke symptoms started, 27% imbibed within 24 h, and 64% within the year prior to their stroke. Statistical analysis showed that alcohol, no matter how little, increases the risk for a stroke even within 1 hour of consumption.

Alas, which study results do we believe? In research, the bigger the sample size, the more robust and reliable the data that come out. The third study, with its preliminary data from less than 400 participants is less credible than the first one with almost 250,000.

For me, the safest bet is to stick to light alcohol consumption and avoid heavy binge drinking. And that is what I do.

The US President’s cardiovascular health

March 10, 2010 by  

Whatever happened to privacy and doctor-patient confidentiality? Well, if you are the leader of a country like the US, the results of your physical check up is a matter of national importance because it would answer the question: Are physical fit enough to lead and occupy the highest office? Which is why the results of US President Barack Obama’s First Periodic Physical Exam are openly available to the public.

So let us take a look at the tests and results.

Cardiovascular Health

  • Body mass index: 23.7
  • Heart rate at rest: 56 bpm
  • Blood pressure at rest: 105/62 mmHg
  • ECG: normal
  • Pulse-oximetry: 98%
  • Total cholesterol: 209 mg/L
  • Good cholesterol HDL: 62 mg/L
  • Bad cholesterol LDL:138 mg/L
  • Triglycerides: 46
  • Homocysteine:11.6
  • C-reactive protein (CRP): 0.015
  • Fasting Blood Sugar (FBS): 87

Homocysteine is an indicator of coronary heart risk. CRP is a biomarker for inflammation. Total cholesterol level should ideally be below 200 mg/L. The value of 209 mg/L is “borderline” high. The optimal LDL value is less than 100 mg/dL. Desirable HDL value for men is around 60 mg/L. All values are within the normal range except total cholesterol and LDL cholesterol.

Cancer screening

  • CT-colonography was performed to screen for colorectal cancer. Results: Normal. Follow up screening recommended in 5 years.
  • No prostate nodularity or hypertrophy was observed. PSA was within the normal range (0.70).

Other relevant info

  • Standard lab tests all normal
  • Up-to-date immunizations, flu shots (seasonal and 2009 H1N1 flu), malaria prophylaxis
  • Use of nicotine replacement therapy
  • EENT: eyes, ears, nose, throat normal
  • No other significant illnesses
  • No past surgical history


Two clinically relevant findings are elevated cholesterol and chronic tendonitis nothing major to be concerned about. Thus, the doctor declared President Obama “fit for duty” and recommended another check up when the President turns 50

What do the health experts outside the White House have to say? Most agree that the President has very good risk factor profile. There is some discussion as to whether he should be prescribed statins or not. However, with his low CRP values, this might not be necessary for the moment.

Dr Howard S Weintraub of New York University School of Medicine tells heartwire:

“I disagree with the president’s physician who says don’t worry, come back in a year in a half. I would want his blood tests repeated in three to six months, and I’d also want to be sure that he is making greater efforts to stop smoking. Our absence of concerns could rapidly change. I don’t want to give him a year or more to bathe his coronaries in atherogenic goop.”

Dr Christopher Cannon of Brigham and Women’s Hospital, Boston, MA:

“His cholesterol is a bit high, but I calculated his Framingham risk score—it is 2%. He apparently had an EBCT, but the exact result has not yet been released. I would be very interested in his calcium score.  If it were 0, then I would likely recommend diet intervention and rechecking. But if his calcium score were elevated, that would suggest that the process of atherosclerosis had started, and a statin would be more reasonable.

Heart health defined: AHA’s Life’s Simple 7

February 2, 2010 by  

What is cardiovascular health? What are the criteria to meet in order to be considered as “heart-healthy?” At last, the American Heart Association (AHA) has sought to answer these questions. The health group has defined poor, intermediate, and ideal cardiovascular health status based on 7 simple measures.

Why do we need such measures? Because what we believe about our health is not necessarily the reality. An AHA survey, for example, found that 39% (almost 4 out of 10) Americans believe that they have an ideal heart health status. However, 54% of these people had been assesses as having at least 1 risk factor for heart disease. Thus, AHA decided once and for all to try and define clear criteria that tell the truth about our health.

The seven health measures (Life’s Simple 7) as defined by AHA are:

And most, if not all of these measures can actually be met through lifestyle and behaviour changes.

This is one of the first steps in AHA’s efforts to achieve a new goal for 2020, that is, improve the cardiovascular health of all Americans by 20 percent while reducing deaths from cardiovascular diseases and stroke by 20 percent.

According to Dr. Clyde W. Yancy, AHA president:

“To date, there has been great success in reducing disability and death from heart disease and stroke in part through aggressive improvements in the diagnosis and treatment of these diseases and in limited uptake of measures to prevent heart disease and stroke. We achieved our 2010 goal of reducing death by heart disease and stroke by 25 percent — earlier and by a wider margin than we had targeted. However, too many people continue to have unrelenting exposure to known important risk factors for heart disease and stroke to the point that we are likely to begin seeing an increase in these diseases — and at an earlier age. That is a cause for alarm and a trend we need to stop now.”

In the AHA site, you can access Life’s Simple 7 (Seven Simple Steps to Live Better) and take the following steps:


Photo credit: stock.xchng

Lead exposure and heart health

November 24, 2009 by  

We are constantly exposed to the environmental pollutant lead. What are the health effects of this  exposure?

There have been studies that linked concentrations of lead in the blood to cardiovascular disease but supporting evidence has been weak. Researchers at the Harvard School of Public Health (HSPH) and the University of Michigan School of Public Health believe they may have found a better indicator of cumulative lead exposure, an indicator that can be linked to number of diseases including cardiovascular disease. The researchers look at levels of lead in the bone.

Where does the lead come from?

Lead is everywhere. In the food we eat, in the things we use daily. In the air we breathe. Air pollution has been the main source of lead exposure, mainly from emissions from cars using leaded fuel. Since the introduction of lead-free gasoline and the banning of leaded fuel in many countries (including the US in the 1990s), the lead levels in the air have significantly decreased. However, lead accumulates in the body especially in the bone and remains there for years. Thus, health problems due to lead exposure are not brought about by acute but rather by chronic toxicity. People in US who were born before the 1990s have been exposed more to lead than the younger generation and are still carrying the pollution burden in their body.

The researchers looked at the levels of lead in the blood and bone of 868 male study participants. The results showed that

  • High levels of lead accumulated in the bone are associated with high risk of mortality from all causes, especially cardiovascular disease.
  • Men with the highest lead levels are 2.5 more likely to die from any disease than those with the lowest levels.
  • Men with the highest lead levels are 6 times more likely to die from cardiovascular disease than their peers with the lowest levels.

This increased risk for death is not dependent on socioeconomic factors such as age, smoking, education, race, alcohol, physical activity, or underlying conditions such as obesity, high density lipoprotein or total cholesterol levels, hypertension or diabetes.

According to lead author Dr. Marc Weisskopf,

“The findings with bone lead are dramatic. It is the first time we have had a biomarker of cumulative exposure to lead and the strong findings suggest that, even in an era when current exposures are low, past exposures to lead represent an important predictor of cardiovascular death, with important public health implications worldwide.”

So what does lead do? Lead might badly affect our health due to oxidative stress, a mechanism closely linked to cardiovascular disease. Lead exposure has also been linked to stiffening of the arteries and hypertension.

Photo credit: stock.xchng

Soccer for female cardiovascular health

October 21, 2009 by  

woman sportsIt’s known as soccer in the US and Canada. It’s called football in the rest of the world. And while the excitement for next year’s Football World Cup in South Africa is building up, people take very little notice that football is a sport for everybody regardless of gender. The German national women football team won the World Championship a couple of months back. Nobody pays attention as national men’s team still had to struggle to qualify for next year’s tournament. My kids just finished a one-week football camp during the autumn break. It was a camp of more than 50 boys and no girls.

But researchers at the University of Copenhagen report that soccer or football may just be the ideal sport for women in order to keep fit. On top of the list of the sport’s benefits is cardiovascular health.

Women generally find it difficult to find the time for physical exercise, what with many juggling between family and jobs. The most common form of exercise women go for are those that is flexible timewise such as working out in the gym or going for a jogging run.

The study looked at 100 women aged 19 to 47 years with no previous experience in playing football. They were divided into 3 groups: one group took up football (2 times 1 hour per week), another took up running, and a third group did not perform any regular exercise and served as controls. The study participants were followed up for 2 years.

The study results show that women who played football were the fittest of the 3 groups.

According to study leader Peter Krustrup:

While playing soccer, the women have high heart rates and perform many sprints, turns, kicks and tackles, making soccer an effective integration of both cardio and strength training.”

It also showed that it is more difficult for women to stick to their exercise routine given too much flexibility. Recreational football however, which requires a fixed time and place for training is reportedly easier to stick to. 

In addition to the cardiovascular benefits, the researchers report the following additional benefits of recreational football:

  • Improvement in muscle strength and growth
  • Promotion of social interactions, expansion of social networks
  • Improvement in general well-being

Hmmmm…I must say I don’t have a problem sticking to my jogging runs but football sounds tempting.

The research further reports that family responsibilities, especially for women with small children, are the principal barrier that hinders them to engage in regular physical activity.

Traffic noise and your blood pressure

September 28, 2009 by  

traffic poillutionFor those thousands who are on the road every week day, have you ever wondered about how traffic affects your cardiovascular health? I already have tackled several aspects of traffic before in this blog and how they affect health. Here’s an update and another aspect of traffic we haven’t thought about yet – noise pollution.

Air pollution

Vehicular traffic generates air pollution. Environmental problems aside, many studies have shown that air pollution affects the heart, the brain, and the immune system, leading to chronic physical health problems such as asthma and heart disease as well as cognitive problems in children. See previous posts for a comprehensive of the global air pollution problems.


You cannot deny it. Driving to and from work and getting stuck in the traffic jam generates stress. Researchers have linked increased incidence of heart attack to heavy traffic and have found indication os synergy between stress and air pollution.

Noise pollution

It’s not only what you smell and what you feel – it’s also what you hear. In a recent study by Swedish researchers, traffic noise is also associated with cardiovascular effects that lead to increased blood pressure. According to lead author Theo Bodin of the Lund University Hospital,

“Road traffic is the most important source of community noise. Non-auditory physical health effects that are biologically plausible in relation to noise exposure include changes in blood pressure, heart rate, and levels of stress hormones. We found that exposure above 60 decibels was associated with high blood pressure among the relatively young and middle-aged, an important risk factor for cardiovascular diseases such as heart attack and stroke.”

The researchers looked at 27,963 residents of Scania, Sweden and the effects of road traffic on their health. Results of the survey showed:

  • Exposure above 60 dBA (decibels) led to changes in cardiovascular parameters, most especially elevated blood pressure.
  • All age groups were exposed to traffic noise levels below 60 dBA, a level which is considered moderate.
  • Effects of traffic noise were more noticeable in young- and middle-aged members of the population and less in older age groups (e.g. 60 to 80-year olds).

The authors hypothesize on the reason for the different responses between age groups:

“The effect of noise may become less important, or harder to detect, relative to other risk factors with increasing age. Alternatively, it could be that noise annoyance varies with age”.

Sweden is comparably sparsely populated relative to many other developed countries. Scania is also a relatively small city by European standards. Can you imagine the amount of traffic noise that residents of large cities like Mexico, Sao Paolo, London, or Bangkok are exposed to? In the European Union alone, 30% of the population are exposed to day-night traffic average noise of 55dB(A). So next time you are tempted to press the accelerator or the horn, think about your health and that of others. Think about heart and your blood pressure.

Smokeless tobacco is deadly for the heart, too.

September 2, 2009 by  

heart-with-bandageThe use of smokeless tobacco products is on the rise. This has probably something to do with the widespread implementation of anti-smoking bans in many countries of the world. Thus, the age old practice of using products such as snuff and chew or spit tobacco, used to be thought as “unhip” and “gross” has recently been revived. Of course the very hip goes for e-cigarette, an electronic nicotine-containing smokeless cigarette.

It is a common misconception that it is the smoke that  makes cigarette smoking unhealthy. Without the smoke, chewing tobacco or using snuff are supposedly harmless. However, there is a growing body of evidence that indicates that smokeless tobacco products can be just as deadly. They have already been linked to several types of cancer, including pancreartic and esophageal cancer.

A recent meta-analysis by Swedish researchers shows that the use of chewing tobacco and snuff also significantly increase the risk for suffering and dying from a heart attack or a stroke.

In all in all, the researchers looked at eight studies from Sweden, where the use of snus (wet snuff)  is quite common and three studies from the US. Except for 2 studies, all participants of the other studies never smoked tobacco. Here some of the results of the study:

  • It is estimated that in 2000 alone, 0.5% of deaths from heart attack and 1.7% of deaths from stroke in American men were due to the use of smokeless-tobacco.
  • Among Swedish men, 5.6% of deaths from heart attack and 5.4% of deaths from stroke were due to smokeless-tobacco use.

According to author Dr Kurt Straif, researcher at International Agency for Research on Cancer

“Given the recent increase in use of smokeless tobacco, it is important to stress that all forms of tobacco are harmful and that the best prevention is not to start using any kind of tobacco, or-for users-to stop using all kinds of tobacco.”

The researchers think it is important that the public should be aware of the health risks of smokeless tobacco products. Several baseball players in the US are known to chew and spit tobacco during games, thus, setting a bad example to audience as well as TV viewers.

In addition, medical professionals tend to overlook smokeless tobacco products when taking medical history, assessing risks, and diagnosing symptoms.

American Heart Association spokesperson Dr Nieca Goldberg comments:

“Cardiologists [and other physicians] need to remember to ask patients not only about cigarettes but also about smokeless tobacco.”

Unfortunately, the meta-analysis did not elaborate on the substances responsible for the cardiovascular problems.  In view of the current controversy (and popularity) of e-cigs, it is of utmost importance whether the health risks in smokeless tobacco are also true for e-cigs.

Eat red for a healthy heart

May 14, 2009 by  

cherryWhen can we eat cherries, mom?”, asked my two pre-schoolers. “In the summer,” I replied. My kids are not the only ones looking forward to the cherry season. I am quite partial to this red seasonal fruit myself. Besides being yummy-tasting, cherries are one of the super red fruits that seem to be highly beneficial to our health. The red color is mainly due to antioxidants called anthocyanins in the fruit. According to researchers at the University of Michigan, a cup and half (equivalent to one and a half servings) of tart cherries can significantly increase your antioxidant levels. And they need not be fresh cherries which are not available the whole year round. Frozen cherries will do.

In the study, researchers analyzed the level of five types of anthocyanins in the blood and urine of the study participants after they ate the cherries either one and a half or three cups of cherries. The study results showed that antioxidant levels significantly increased even with just a small portion of the fruit and that this increased activity can last for up to 12 hours after eating cherries. In turn, this boost in antioxidant activity can provide protection against chronic illnesses, especially cardiovascular disease.

According to lead researcher Dr. Sara L. Warber of the University of Michigan Integrative Medicine

“This study documents for the first time that the antioxidants in tart cherries do make it into the human bloodstream and is coupled with increased antioxidant activity that could have a positive impact. And, while more research is needed, what’s really great is that a reasonable amount of cherries could potentially deliver benefits, like reducing risk factors for heart disease and inflammation.”

Aside from their cardioprotective properties, cherries can

  • have anti-inflammatory effects
  • lower blood cholesterol levels and reduce triglycerides

Because of these properties, cherry-enriched diets can be beneficial to people with arthritis, gout, type 2 diabetes, and vascular disorders.

Dr. Warber concludes:

“It’s encouraging when research like ours finds that great-tasting fruit can lead to real-life benefits, continuing to underscore the importance of whole foods in the diet.”

Another U of Michigan study last year also showed that cherries can help in weight reduction and getting rid of abdominal fat

According to lead author and cardiac surgeon Dr. Steven F. Bolling

“We know excess body fat increases the risk for heart disease. This research gives us one more support point suggesting that diet changes, such as including cherries, could potentially lower heart disease risk.”

Cherries, which are a member of the rose family, are available fresh in the summer months. However, you can also buy them frozen or dried or in the form of juice during off season.

For more information about cherries, its nutritional properties, and cherry recipes, check out www.choosecherries.com.

Photo credit: stock.xchng

Traffic exposure can trigger a heart attack

April 15, 2009 by  

traffic-jam2We are exposed to traffic everyday, whether as a commuter or as a driver. Some of us are even exposed as part of our jobs, e.g. as traffic policemen, bus drivers, tec. This post explores the link between traffic exposure and cardiovascular health.

Previous studies have shown that heart attacks may be triggered by strenuous activities. This recent study by German researchers suggest that exposure to traffic can have some serious consequences on people’s heart health. The researchers looked at time spent on any form of traffic exposure by using some form of transport, be it by car, by public transport, or by bicycle and its triggering effect on heart attacks. However, driving a car was the most common source of traffic exposure among the 1,454 study participants. The results of the study indicate that people exposed to any form traffic exposure have a 3.2 times higher risk of having a heart attack than those without exposure. For those exposed, there is a small but significant increase in the likelihood that a heart attack can occur with 6 hours of exposure. Those who were especially at risk were

  • women
  • elderly men
  • people who are unemployed
  • people who have a history of angina pectoris (chest pains)

According to lead author Dr. Annette Peters

Driving or riding in heavy traffic poses an additional risk of eliciting a heart attack in persons already at elevated risk. In this study, underlying vulnerable coronary artery disease increased the risk of having a heart attack after driving in traffic… one potential factor could be the exhaust and air pollution coming from other cars. But we can’t exclude the synergy between stress and air pollution that could tip the balance.”

This isn’t the first study to find a link between cardiovascular disorder and air pollution. British and Swedish researchers found that diesel exhaust increased the rate of blood clot formation as well as blood platelet activity even in healthy people – leading to increased risk of having heart attack and stroke. The increased cardiac event risk due to traffic pollution is evident even when fine particulate matter concentrations are considered low or safe.

In a previous resource post, I have reviewed the most recent medical evidence that linked air pollution to cardiac events. In one study, it was shown that fine particulate matter can interfere with the heart’s electrical functioning.

In the same way, stress can be a triggering factor towards a cardiac event. In a previous post, I discussed about the effect of stress on driving and vice versa.

We all need some form of transport to get somewhere and many of us are on the move to get to our jobs 5 days a week. What would be interesting to find out is a risk comparison between drivers and public transport commuters, e.g. which form of traffic exposure has the least adverse effect on our cardiovascular health.

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How anger and hostility affect your heart health

March 16, 2009 by  

heart-burningNegative feelings can have adverse effects on your cardiovascular health. We know that depression and stress are not good for the health. But what about anger and hostility? In many films we see, anger is classically featured as an emotion that triggers heart attacks. However, research studies over the years have actually failed to provide conclusive evidence to support this. Until now.

Researchers from the University College London, UK performed a meta-analysis of studies that looked at the link between heart disease and the mind states anger and hostility. The studies covered almost 80,000 participants both healthy as well as those with pre-existing coronary heart disease (CHD) in Australasia, Europe, and America.

The results of the meta-analysis show that

anger and hostility were associated with a 19% increase in coronary heart disease (CHD) events in healthy individuals and a 24% increase in risk among those with preexisting CHD.”

The results of the analysis have been published in the most recent issue of the Journal of the American College of Cardiology.

Other notable findings are:

The findings indicate that symptoms of anger and hostility should be taken serious when diagnosing and treating cardiovascular disease. However, suppression of these negative emotions does not actually lead to prevention but actually to the worsening of the problem.

To reduce the problem, the authors recommend the following:

The authors add that anger is not necessarily bad for the heart because it is a natural emotion that may have some evolutionary significance (e.g. warning signal, self-preservation, protection of the young, etc.). Instead the emotion should be “regulated and used in a socially meaningful and adaptive way.”

Music for your heart and health

December 1, 2008 by  


The brain plays a very important role in cardiovascular health. And whatever soothes the brain is good for the heart. Like music.

Music has been shown to have a therapeutic effect on people, from fussy babies to stressed professionals. But how does it really work?

Researchers from the University of Maryland in Baltimore demonstrated for the first time the positive effects of the positive emotions triggered by music on endothelial function.

“We believe that the brain plays a pivotal role in vascular health. High cholesterol and high blood pressure are very important, but some individuals lacking these risk factors develop significant heart disease, and that may be partly related to their response to stress… If music can evoke positive emotions to counteract negative stresses of everyday life, it could have a very important influence on vascular health. It should be incorporated into a healthy lifestyle, just as we might incorporate other healthy habits,”

according to lead researcher and author Dr Michael Miller.

The study involved 10 healthy, non-smoking adults (7 men, 3 women) with the average age of 36 years. Endothelial function was measured as “brachial-artery-flow-mediated dilation” – indicated by measurements of blood flow in the upper arm. The assessments were done while the study participants were exposed to following stimuli:

  • Music that triggered positive emotions
  • Music that triggered anxiety
  • A funny video clip
  • A relaxation tape

The results are as follows:

The authors think that compounds called endorphins may play a role in this “mind-heart” connection. When released from the brain, endorphin-like compounds have a direct effect on the vascular system.

In a previous study by researchers fromOhio State University, classical music was observed to be beneficial for cardiac rehabilitation.

Listening to Vivaldi’s Four Seasons while on the treadmill, patients had a significant 3% higher scores on postexercise verbal fluency. Howevever, the music has no effect on depression, anxiety, or hemodynamic parameters.

Mental and emotional stress in out everyday life leads to vasoconstriction. These studies show that music cna actually counteract this. Although the effect of music on people is thought to be short-lived – about 30 minutes, it is though that when used on a regularly basis, it can have some cumulative benefit that may prove to be a strong preventive measure against cardiovascular disease.

So what more can we ask? As a preventive therapy, music is cheap, makes us happy, and comes with no side effects!

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Cranberry and your cardiovascular health

November 27, 2008 by  

This is probably not the first time that you heard it – cranberry is good for your health. Especially cardiovascular health. And Thanksgiving is the best time to remind us of this. Here are some of the latest good news about cranberries:

This paper reviewed the cardioprotective properties of cranberry.

“Cranberries are one of the most important sources of flavonoids that have a strong antioxidant and anti-inflammatory capacities. Thus, consumption of cranberries or their related products could be of importance not only in the maintenance of health but also in preventing CVD.”

You know what damage oxidative stress can do to your cardiovascular health. This study by researchers at Texas A&M University showed that cranberry juice increases antioxidant status, thus counteracting oxidative stress. This was demonstrated in the lab using rats.

Cranberry is one of the most commercially important fruit in the US. According to this paper,

“a growing body of evidence suggests that polyphenols, including those found in cranberries, may contribute to reducing the risk of cardiovascular disease (CVD) by increasing the resistance of LDL to oxidation, inhibiting platelet aggregation, reducing blood pressure, and via other anti-thrombotic and anti-inflammatory mechanisms.”

In this study on male humans by Canadian researchers, cranberry juice consumption brought about an increase in the levels of HDL (“good”) cholesterol. This is another supporting evidence that flavonoid-rich fruits like cranberries have cardioprotective properties.

Intake of fruits and vegetables, though necessary, can nevertheless cause glycemic control problems among people with type 2 diabetes. Low-calorie unsweetened cranberry juice may be the solution to the problem.

It “provides a favorable metabolic response and should be useful for promoting increased fruit consumption among type 2 diabetics or others wishing to limit carbohydrate intake.”

Want to know more about cranberries? The table below is from the USDA National Nutrient Database for Standard Reference, Release 21 (2008). The nutrient values and weights are for unsweetened cranberry juice.



Value per
100 grams













Total lipid (fat)






Carbohydrate, by difference



Fiber, total dietary



Sugars, total



Calcium, Ca



Iron, Fe



Magnesium, Mg



Phosphorus, P



Potassium, K



Sodium, Na



Zinc, Zn



Copper, Cu



Selenium, Se



Vitamin C, total ascorbic acid












Vitamin B-6



Folate, total



Folate, food



Folate, DFE



Choline, total



Vitamin A, RAE



Carotene, beta



Vitamin A, IU



Lutein + zeaxanthin



Vitamin E (alpha-tocopherol)



Vitamin K (phylloquinone)



Fatty acids, total saturated









Fatty acids, total monounsaturated



16:1 undifferentiated



18:1 undifferentiated



Fatty acids, total polyunsaturated



18:2 undifferentiated



18:3 undifferentiated



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Lifestyle changes in many populations may be changing cardiovascular health – for the worse

August 26, 2008 by  

When I was growing up in an Asian country in the Pacific, the daily fare was rice, fresh fish, vegetables, and fruit. That was before the fast food invasion. Several decades, the daily diet has drastically changed – burgers, pizza, fries galore.

This is happening all over as globalization proceeds in a very fast pace. With lifestyle changes come changes in diet and physical exercise with consequences on our health. Below are some examples of how lifestyle changes are adversely affecting the cardiovascular health of once primarily healthy populations.

Alaskan Eskimos

Traditionally, Alaskan Eskimos have very robust cardiovascular health. They ate lots of fish rich with omega 3 fatty acids and stayed active even in cold temperatures. All that is changing now as the new generations of Eskimos embrace modern lifestyles and pick up bad habits which include smoking, eating fast food rich in saturated and trans fats and doing less physical exercise in favour of television or the internet.

An article published in Stroke: Journal of the American Heart Association reports that Alaskan Eskimos have significantly higher rates of artery plaques compared to the general population.

…more than half of Alaskan Eskimo adults smoke, their level of physical activity has decreased from traditional levels, and their intake of saturated and trans fats, rather than heart-healthy omega 3 fatty acids (found in fish), has increased.


India has the highest incidence of acute coronary syndromes in the world, according to a report in the journal The Lancet. And it is still increasing so that in 2 years, it is predicted that India will account for 60% of heart disease cases globally.

A large proportion of the Indian population used to be vegetarian. The economic development in India has brought about changes in lifestyle which proved to be high risk factors for cardiovascular disease. These changes include higher incidence of smoking and diet rich with saturated fat.


Obesity used to be very rare in China. The past 20 years observed a rapid in the economy resulting in lifestyle changes in the Chinese population. These changes are especially evident among high-income urban residents and resulted in increased incidence of obesity and obesity-related chronic diseases such as hypertension, heart disease and diabetes. This was according to a report published in the International Journal of Obesity.

Another report in the Chinese Medical Journal estimates that 1 in every 5 Chinese is overweight. The causes can be traced to poor nutrition and lack of physical exercise. The once agricultural country is now highly industrialized so that more and more people sit in assembly lines or behind computers rather than working in the fields.

Unfortunately, though many countries are developing fast economically, their healthcare systems are not up to speed in meeting the health challenges that progress bring. Awareness and prevention programs, as well as and emergency treatment are inadequate.

From lessons learned in North America and Europe, it is expected that this trend in cardiovascular diseases in many fast developing countries will worsen before it gets better.


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Birth weight and cardiovascular health – where is the connection?

August 20, 2008 by  

How much did you weigh at birth? Your baby/babies? Does it matter?

A new study by British researchers published in the European Heart Journal shows that there is a link between low birth weight and predisposition to hypertension later in life.

Increasing evidence suggests that adverse prenatal environments, as indicated by low birth weight, cause long-term changes in cardiovascular physiology that predispose to circulatory disease.

The study followed up 140 healthy children aged 7 to 9 years old who were born at full-term, had a wide-range of birth weights though still considered normal. Blood pressure and heart rate (by ECG) were regularly monitored. In addition, the children were also subjected to psychological stress tests (e.g. speaking in public, mental arithmetic task) and the response in the form of cardiac impedance was measured.

The results show that there birth weight is linked to certain cardiovascular response to stress. However, the relationship is different depending on gender. Boys with low birth weights are more like to have higher vascular resistance and higher blood pressure during the stress test. In girls, this link is not evident. However girls with low birth weight tended to have higher activity of the sympathetic nervous system in response to stress. This is the part of the nervous system usually located in the spinal cord and is responsible for regulation of many processes in the body, including stress response. Both responses translate to a predisposition to cardiovascular problems later in life.

The study concludes

Smaller size at birth is associated with sex-specific alterations in cardiac physiology; boys had higher systemic vascular resistance and girls had increased cardiac sympathetic activation.

The results of this study are based on children with birth weights considered to be low, nevertheless still within a range considered normal.

Can you imagine what possible health problems premature babies with below normal birth weights can have? A baby is considered premature when born before the 37th week of gestation. Premature babies – preemies for short – tend to be smaller and weigh less than full-term babies. Several studies have shown that preemies are more likely to have health problems ranging from respiratory problems to autism

This doesn’t mean that preemies are doomed to be ill for the rest of their lives. My twins were born 5 weeks early but I didn’t resign myself to the fact that they will be just as healthy as their peers just because they were small babies. I strongly believe in the power of prevention through a healthy lifestyle. Exercise, proper nutrition, and the right attitude can make a lot of difference and I can to attest this when I look at how my boys can outrun and outcycle other kids of their age.

Still, now that the health consequences of low birth weight are known, pregnant and wanna-be pregnant women should pay closer attention to factors that can affect a fetus’ growth in the womb – and these include maternal nutrition, smoking, and alcohol consumption.

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Hysterectomy: keeping the ovaries keeps the heart healthy

August 5, 2008 by  

Cervical cancer is a cancer that affects the tissue of the cervix, the funnel-shaped organ located between the uterus and the vagina. According to estimates by the National Cancer Institute, about 11,000 new cases of cervical cancer have been diagnosed in the US in 2008, and 3,870 cases have resulted in death.

One of the most common forms of intervention for cervical cancer is hysterectomy which is the surgical removal of a woman’s uterus. According to MedicineNet, about 600,000 hysterectomies are performed in the US each year and about 50% of these also include bilateral oophorectomy, which is the removal of the 2 ovaries. The reason for removing the ovaries is to prevent the development of ovarian cancer.

The removal of a woman’s ovaries has drastic consequences, namely:

  • A woman without ovaries, even at a young age, goes into premature menopause because the organs that produce the female hormones – the ovaries – are gone.
  • A premenopausal woman will have to undergo hormone replacement therapy (HRT) to counteract menopausal symptoms. In recent years, HRT has been linked to many health problems in women, including cardiovascular disorder and breast cancer.
  • A young woman without ovaries can no longer ovulate and produce eggs, thus ending the chances of a woman to produce an offspring. There have been many cases of women who had hysterectomy but with intact ovaries to have biological children through surrogate motherhood.


A recent study reviewed the database of clinical studies on hysterectomy and oophorectomy to answer the question whether performing an oophorectomy is necessary, especially in premenopausal women. The authors analysed data from studies conducted up to 2007. The results of the analysis were not conclusive but there is a tendency to point to the fact that oophorectomy may not be beneficial in the long run.

Leaving the ovaries in will mean a woman’s body can continue to produce female hormones that provide protection from a lot of age-related diseases including heart diseases, stroke osteoporosis and dementia.

There are of course, women who are at very high risk for developing cancer of the ovaries and in such cases, oophorectomy may be necessary, However, in many cases, especially when involving women of premenopausal age, the risk/benefit ratio of such an intervention should be carefully considered.

According to lead author Leonardo Orozco

“Until more data becomes available, [ovary removal during hysterectomy] should be approached with great caution…Currently, the existing evidence does not support the high number of ovary removals in clinical practice.”




Cochrane Database Syst Rev. 2008 Jul 16;(3):CD005638

MedicineNet.com, 18 July 2008


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Your cat may be good for your heart!

July 23, 2008 by  

Had a bad day at the office? What about getting a cat to de-stress? Owning a cat may even benefit your heart, according to a 20-year “feline lifeline” study by researchers at the University of Minnesota Stroke Center.

Examining data on 4,435 adults, the researchers found that the relative risk of death from heart attack was 40 percent higher for those who had never owned a cat. Specifically, 3.4 percent of cat owners died from a heart attack during the course of the study versus 5.8 percent of non-owners.

Many cat owners would certainly agree to these findings. And many vets aren’t that surprised either. As many pet owners would testify, pets help ease stress and anxiety. They can provide comfort and security and distract people’s minds away from their worries. And in cardiovascular health, the social risk factors such as stress and worries are often underestimated, even overlooked.

However, it is not clear whether it is the cat itself that gives the health benefits or it is because cat owners have certain personality traits and lifestyles that lower their risk for cardiovascular disorders. This is the question that future studies have to address.

According to an animal behaviour expert, a cat owner would tend to be a “nurturing, low-stress individual.”

“If this relationship is real, then, unlike other preventive measures such as angioplasty or medications, this seems to be very low risk and may not need to be evaluated like other medical interventions,”

according to lead researcher Adnan Qureshi, a cat owner himself.

But many heart experts are skeptical. For one thing, cats can cause more allergies which can weaken the immune system. Immune response plays an important role in heart attacks, according to one cardiologist.

Now what about having a dog?

A previous study on the benefits of pet ownership reported that dog owners have better chances of survival after a heart attack than cat owners.

Advocates of the cat theory believe that a cat can reduce stress better because it is a lap animal. “When being petted, the stress level of the pet and owner goes down, as well as heart rate and blood pressure in most cases” according to Lawrence McGill, technical vice-president and veterinary pathologist at ARUP Laboratories in Salt Lake City. Besides, cats require less hands-on attention than dogs and make less noise that can add to the stress levels.

However, dog owners have the benefit of being obliged to do a daily walk, thus avoiding a sedentary life.

Pet owners don’t really care much about what the experts say. They have firsthand experience of the benefits of having pets, whether it is physical, emotional, or psychological.

Recommended reading:

The Healing Power of Pets by Marty Becker, cat lover and vet


abc news

University of Minnesota News

American Journal of Cardiology

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Sleepless nights are hard on women’s hearts

June 24, 2008 by  

Poor sleep is associated with increased risk for having type 2 diabetes and heart disease. And when it comes to lack of sleep, women’s cardiovascular health suffer the most. A recent study by researchers at Duke University Medical Center shows that women’s hearts and vascular systems are more sensitive to sleep deprivation than men’s.

The results of the study were based on data gathered from 210 healthy middle-aged women and men. All participants had no history of diagnosed sleep disorders. They were all non-smokers, and were not on daily medications.

The participants were categorized as good sleepers and poor sleepers. Poor sleepers are those having problems falling asleep and having frequent disruptions in sleep. 40% of the participants were poor sleepers and these have a much higher risk for cardiovascular disease than the good sleepers. However, poor sleepers who are females exhibited higher levels of C-reactive protein and interleukin-6 and higher levels of insulin then male poor sleepers. C-reactive protein and interleukin-6 are biomarkers for inflammation which are linked to increased risk of heart disease. Insulin levels are biomarkers for type 2 diabetes.

The time it takes to fall asleep seems to be a big factor. Female participants who take a half hour or more to fall asleep had the highest risk.

In a survey by the National Sleep Foundation, 60 % of the female respondents report that they only get a good night’s sleep a few nights a week. 43 % report sleepiness during daytime and this can interfere with their normal daily activities.

There are many reasons why people have sleep shortage. For many women, having children is the main reason for sleep deprivation. As mom of twins, I knew how sleep deprivation sapped me of energy and pushed me into a prolonged postpartum depression. Although that was 5 years ago and my sleeping patterns have since improved, I still suffer from sleep disruptions each time my children awake at night to go to the bathroom. I guess it’s one of the hazards of motherhood.

“We found that for women, poor sleep is strongly associated with high levels of psychological distress, and greater feelings of hostility, depression and anger. In contrast, these feelings were not associated with the same degree of sleep disruption in men.”

according to head researcher Edward Suarez.

Other causes of sleeplessness in women may be also biological and mainly hormonal in nature. They may include menstrual cramps, hot flashes and irregular menstrual cycles.

In another post, I will be tackling the topic of “sleep hygiene habits.” So if you can’t sleep, stay tuned!

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NOTE: The contents in this blog are for informational purposes only, and should not be construed as medical advice, diagnosis, treatment or a substitute for professional care. Always seek the advice of your physician or other qualified health professional before making changes to any existing treatment or program. Some of the information presented in this blog may already be out of date.