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It's not the cholesterol - it's the inflammation

Do the Math

It didn’t quite add up the way it was supposed to.

In the e-Alert “I Won’t Dance. Don’t Ask Me.” (1/17/08), I told you about a recent clinical trial that revealed something unexpected: When Zetia (a drug that impedes the body’s absorption of cholesterol) was combined with Zocor (a cholesterol-lowering statin drug), arterial plaque actually accumulated nearly twice as much as it did in subjects who took Zocor alone.

So how in the world could Vytorin (the brand name of this double-whammy of cholesterol medications) make the plaque problem even worse?

The short answer: They messed with Mother Nature. And they lost.

And the slightly longer answer

It’s a simple equation: a + b = c

a) Accumulation of fatty deposits (cholesterol) on artery walls narrows the arteries and increases risk of heart disease and heart attack.

b) Cholesterol-lowering drugs lower cholesterol.

c) Sotake cholesterol-lowering drugs and you reduce heart disease and heart attack risk, right?

Well, it looks good on paper.

After I sent you “I Won’t Dance. Don’t Ask Me,” a member named Joe sent an e-mail with his take on the process.

Joe: “Why do Zetia and Zocor increase arterial plaque? Well, why does the body store fat when you fast? The body needs cholesterol to repair cells. The body needs cholesterol to repair arterial damage caused by inflammation. When you remove that material unnaturally, the body reacts by trying to make more and then quickly using what it does have, just in case it can’t get more. Since artery plaque is a repair response from the body, it has priority over all else. Once the medical pundits realize that “It’s the inflammation, stupid!”, we’ll all be better off.”

Good angle, Joe. But no need to wait for the pundits to come around – we already know how to handle inflammation.

Low flame

Inflammation plays a key role in the development of heart disease and other chronic diseases, and once a disease is underway, inflammation helps keep it going.

Dietary choices that evenly balance omega-3 fatty acid intake with omega-6 intake may offer the best first step in managing inflammation. In the average western diet, omega-6 intake is typically quite a bit higher than omega-3. This imbalance increases enzymes that promote the production of inflammatory agents. But when processed foods are kept to a minimum (along with omega-6-laden oils such as corn, canola, sunflower, safflower, and soy), and good sources of omega-3 (such as salmon, tuna, mackerel, and other fatty fish) are increased, the desired 1:1 ratio of omega-3 to omega-6 can help bring inflammation in line.

Vitamin C might also help the effort.

In a 2006 report in the American Journal of Clinical Nutrition, UK researchers recruited more than 3,250 healthy men over the age of 60. Food frequency questionnaires were used to determine fruit and vegetable intake, and blood samples were taken to measure vitamin C and C-reactive protein (CRP – a marker that signals risk of heart disease and other chronic illnesses).

Researchers found high fruit consumption to be linked with a 25 percent reduced risk of inflammation, while inflammation risk was nearly cut in half among those who had high blood levels of vitamin C.

And a few weeks ago I told you about research from Tufts University that reveals another inflammation tamer: vitamin K.

When the Tufts team examined dietary and medical records of more than 1,380 middle- aged subjects, they found that a high intake of foods that contain vitamin K was linked to lower levels of 14 inflammatory markers, including CRP.

Vitamin K can be found in leafy green vegetables, broccoli, asparagus, tomatoes, avocados, olive oil, whole wheat, butter, meat, liver, egg yolk, and fermented products such as yogurt and cheese.

You can read more about vitamin K in the e-Alert “The K Connection” (3/12/07), at this link: