February is National Heart Month from the UK charity the British Heart Foundation and we all know how important a sensible diet and exercise is in supporting our heart health.
Appropriately we are going to take a closer look at certain nutrients such as vitamins, minerals and natural nutrients that all specifically play an important role in supporting cardiovascular health – in our diet or in a supplement form. In this article we look at Vitamins D, C and K, Omega 3 Fatty Acids (EPA & DHA) and C0-Enzyme Q10 (CoQ10).
Vitamin D is mostly made in our skin by exposure to sunlight. Hence Vitamin D is termed ‘the sunshine vitamin’ and not enough sunshine, not enough Vitamin D.
Most of the foods we eat contain very little vitamin D, though more recently some makes of processed foods are fortified with added vitamin D. The following foods are natural sources of Vitamin D: salmon, mackerel, tuna, sardines, milk, eggs, beef, liver and Swiss cheese.
Vitamin D is most commonly associated with assisting with the maintenance of strong bones and teeth, helping support the functions of the immune system and contributing toward normal muscle functions and normal blood calcium levels.
Vitamin D is considered to have a role in regulating blood pressure and a deficiency in vitamin D has been linked to hypertension. Vitamin D deficiency is also linked to an increased cardiovascular risk.
Many precursor states of heart failure, such as hypertension, atherosclerosis, and diabetes are more prevalent in subjects with low vitamin D levels. Epidemiological data and mechanistic studies have provided strong support for a potentially cardio-protective effect of vitamin D.
Vitamin D3 is the most bioavailable form of this nutrient and far preferable to Vitamin D2 to supplement with. As we age our body does not convert vitamin D from sunlight as easily and current UK Government advice recommends that all pregnant and breastfeeding women, children aged six months to five-years-old, people aged 65 years and over and people not exposed to much sun should also take daily vitamin D supplements. Children and pregnant and breast-feeding women all need extra vitamin D because it is a vitamin required for growth.
Vitamin D receptors have a broad tissue distribution including the vascular smooth muscle, endothelium and cardio-myocytes. Vitamin D is considered to have a role in regulating blood pressure with deficiency activating the ‘angiotensin-aldosterone’ system predisposing to hypertension. Deficiency is also linked to an elevation in parathyroid hormone thus increasing insulin resistance and hence associated with diabetes, hypertension, inflammation and increased cardiovascular risk.
Many precursor states of heart failure such as hypertension, atherosclerosis and diabetes are more prevalent in subjects with low vitamin D levels. Recent experimental data has provided clues as to how vitamin D might exert cardio-protective effects. The steroid hormone vitamin D regulates gene expression of many genes that play a prominent role in the progression of heart failure, such as cytokines and hormones. Specifically, vitamin D is a negative regulator of the hormone renin, the pivotal hormone of the rennin-angiotensin system. Epidemiological data and mechanistic studies have provided strong support for a potentially cardio-protective effect of vitamin D.
There is ongoing debate on what levels of Vitamin D to supplement with – recent studies suggest higher levels than the current UK RDA (Recommended Daily Allowance) are optimally beneficial.
Omega 3 Fatty Acids EPA & DHA
In suitable quantities the fatty acid content of Omega 3 bestows a wide range of health benefits and this includes supporting the normal function of the heart (subject to a daily intake of 250mg of EPA and DHA).
The primary food source of Omega 3 is fish and especially oily fish such as mackerel and sardines. Unfortunately the substantial fall in our consumption of fish over recent decades has led to a dramatic lowering of good omega 3 fatty acid levels in our body. This has conversely seen a substantial rise in sales of Omega 3 supplements comprising fish oils and krill oils.
The health benefits of oily fish can be mainly attributed to its fatty acid content. There are 2 types of fatty acid: Omega 3 and Omega 6. When we ingest Omega 3 our body breaks the fatty acids down to 2 other fatty acids – ‘EPA’ (Eicosapentaenoic acid) and ‘DHA’ (Docosahexaenoic acid).
These are the components our body uses for many essential activities such as the maintenance of cardiac function, eye health, cell membrane integrity, skin health, joint mobility, and normal liver function. That is why they are now added to baby foods and formulas, and why the Government recommends we eat fish at least twice a week, one of which should be oily fish (recommendations vary for pregnant women).
In respect of heart health Omega 3 essential fatty acids help maintain the elasticity of artery walls, prevent blood clotting, reduce blood pressure and stabilise heart rhythm. EPA and DHA seem to have anti-inflammatory and membrane-stabilising effects. Many diseases, such as heart disease and arthritis, are related to an inflammatory process, and it may be this ability to “tune down” such inflammation that helps EPA and DHA prevent certain chronic diseases or positively affects other conditions.
There has been a substantial growth in Omega 3 supplements as a result of the awareness of the importance of this essential fatty acid and for those who would rather take supplements than eat fish. The most popular supplements are typically fish oils and Krill oil supplements too.
When it comes to fish or krill oil supplements you should look for a product that provides high levels of Omega 3 EPA/DHA, and that is pure, and pollution free. Fish oil supplements are either made from fish livers, body fish, or a combination of both – so you have a choice here. The fish liver oils are much richer in vitamin A (and vitamin D) however pollution in fish is concentrated in the liver so you need to ensure the product is pollutant free. Some population groups should avoid excessive vitamin A intake especially pregnant women.
Eating plenty of fish or taking Omega 3 supplements will not cause one to put on weight. For example 2 grams of Omega 3 would only contain 18 calories and almost all Omega 3 ingested is used for essential body processes.
For vegetarians and vegans who do not eat fish a good supplement option for rich Omega 3 is flaxseed oil. For flaxseed oil supplements you will again look for a pure oil rich in ALA (alpha-linolenic acid), organic so it is free from herbicides, and cold-pressed, which means that it is unprocessed and that the fatty acid content will remain unharmed in the extraction.
Scientists were first alerted to the many benefits of EPA and DHA in the early 1970s, when Danish physicians observed that Greenland Eskimos had an exceptionally low incidence of heart disease and arthritis despite the fact that they consumed a high-fat diet.
Intensive research soon discovered that two of the fats (oils) they consumed in large quantities, EPA and DHA, were actually highly beneficial. More recent research has established that fish oils (EPA and DHA) play a crucial role in the prevention of atherosclerosis (where arteries become clogged up by fatty substances, such as cholesterol) and heart attacks.
Doctors and nutritionists are noticing that some people are unable to efficiently break down Omega 3 into the useful DHA and EPA components, which is why many people are now advised to supplement with clean, stable, whole body fish oils and krill oils.
Finally it is important to note that the human body needs not only sufficient amounts of both Omega 3 and Omega 6 but also a suitable ratio between the two. Oily fish are rich in Omega 3 fatty acids, whilst Grains are a rich source of Omega 6.
With the fall in our consumption of fish and the wide availability of convenience foods which feature grain and seed oils, the ratio of these two fatty acids in the diet has swung dramatically in favour of Omega 6 and reduced the amount of Omega 3. We therefore need to increase our intake of Omega 3 fatty acids to regain the beneficial balance of oils in our diet and reap the health benefits they can give.
CoQ10 (C0-Enzyme Q10)
The nutrient CoQ10 is used as an integral part of energy metabolism inside our cells. Coenzyme Q10 is a chemical cofactor which is required by every cell in the body to produce the energy we need to live. It has been shown to increase the level of energy to all muscles and is especially important to cardiac function as it increases energy production at an optimal rate.
CoQ10 is found in small quantities in foods such as red meats and fish; it is high in red organ meat and fish, in soy oil and canola and also in most fruit and vegetables, albeit at lower but nevertheless healthy levels. However our production of CoQ10 decreases as we age so it may be beneficial to supplement with the correct form of this enzyme to achieve the potential health benefits.
CoQ10 is part of the energy metabolic cycle in the body and heart muscle has a huge requirement for it. As we age our heart muscle needs more and our production wanes, hence the potential need for supplementation.
CoQ10 protects the oxidisation of lipids including LDL cholesterol and is essential for the production of energy in the mitochondria and the elasticity of blood vessels. Those taking the cholesterol reducing statins are particularly at risk of lowered CoQ10 levels due to the ability of the statins to block the natural production of CoQ10 by the liver.
Those people who have suffered cardiovascular problems need to be aware that the heart muscle gets damaged in heart attacks and rarely if ever recovers to the same level of function as it had before the attack. So suitable CoQ10 supplementation will help optimise the function of such muscles post attack or post damage.
‘Ubiquinol’ is the best supplement form of CoQ10 and the one to look for. Ubiquinol is the reduced form of CoQ10 and immediately bioavailable and bioeffective.
CoQ10 is used ‘intracellularly’ and hence needs to be in a fatty substrate to cross the cell membrane. The ‘Ubiquinone’ form of CoQ10 is water soluble not fat soluble whilst the reduced form (Ubiquinol) is fat soluble and crosses the cell membrane.
Vitamin K is an important vitamin for the maintenance of normal bones, the cardiovascular system, necessary for blood clotting and essential for the prevention of calcification of the arteries. Destruction of Vitamin K takes place due to oxidation in inflamed arterial walls.
Inadequate levels of vitamin K2 can lead to hardening of the arteries (arteriosclerosis) and osteoporosis. Vitamin K2 is an excellent calcium regulator – Excess calcium in the arteries results in coronary heart disease (CHD) and other degenerative conditions.
Vitamin K2 is able to move excessive arterial calcium into bone tissue where it belongs and is needed, while removing it from arteries where it can cause arteriosclerosis or hardening of the arteries.
Vitamin K is most commonly found in two forms – K1 and K2. K1 is found in green vegetables and excellent sources are ‘greens’ like spinach, kale, broccoli and brussel sprouts. Vitamin K1 has been recognised as being important in maintaining a healthy blood clotting system. Vitamin K1 is now coming toward the fore in terms of fighting Osteoporosis.
Vitamin K2 content in food is more ‘elusive’; the best source is ‘natto’ a popular Japanese dish. Fermented foods such as natto, cheese and sauerkraut are considered the better food sources of K2. Vitamin K2 is recognised as beneficial towards osteoporosis and more specifically cardiovascular diseases including arterial calcification prevention.
By all means try the ‘natto’ for the important Vitamin K2. However if you don’t like the taste of natto or want to supplement anyway choose a vitamin K2 supplement or vitamin K2 as part of a suitable multi-formula.
Without doubt the best known of all the vitamins with its presence in a host of healthy foods and specifically oranges, lemons and other fruits. We all recognise the important health bestowing qualities of Vitamin C.
However Vitamin C is an essential water-soluble vitamin that cannot be stored in the body and therefore needs to be adequately replaced daily from food or supplementation.
There are many valid benefits for good levels of Vitamin C including contributing to immune system support, the maintenance of normal blood cholesterol levels, the reduction of tiredness and fatigue and the normal function of the nervous system. Vitamin C also provides important antioxidant activity with the protection of DNA, proteins & lipids from oxidative damage.
Vigorous exercise will deplete Vitamin C levels as will a hectic lifestyle and more than minimal alcohol consumption. So maintain a diet rich in natural Vitamin C foods and if looking for a supplement form select one that is food based e.g. from oranges. Alternately choose a multivitamin appropriate to your age, gender and medical history that contains a food based Vitamin C.
Vitamin C is unstable and is easily destroyed by heat and light and the process of storing, peeling, freezing and cooking can deplete much of the food content in our foods. Vitamin C occurs naturally in many foods, primarily citrus fruits and leafy vegetables, tomatoes, potatoes and sweet potatoes.
The British Heart Foundation
If you have any questions regarding this article, any of the health topics raised, or any other health matters please do contact me (Amanda) by phone or email at any time.