The Risk and Benefit Matrix


Living a heart healthy lifestyle means looking at human behavior as it relates to nutrition and the manageable risk factors for heart disease.  We are all human. This subjects us to being vulnerable to physical and emotional needs. It seems so simple, doesn’t it?  Eat right, exercise and control those urges that you know are ” just not right”. Over eating, drinking alcohol in excess and other behaviors, increase our risk of not only heart disease, but also other body ailments.  Why is it we do what we do?   Most behaviors are learned early in life and are ingrained into our psyche of what we justify as enough gratification. Also some of us just hate to work out.

Successfully managing any of the major risk factors greatly improves our chances of avoiding the consequence of heart disease. The problem is risk factors “ganging up” on you. Rendering an individual with multiple factors at extremely high risk. All the factors are interrelated. Obesity, high sodium diets, high solid fat diets and high blood cholesterol, all contribute to the development of high blood pressure and diabetes. Exercise, reduced sodium and saturated fat diets, controlling cholesterol and blood pressure, all contribute to maintaining a healthy body weight.  Stress management, eliminating situations that cause increased risk and using Vitamin/Mineral supplements* further help lower the incidence of heart related risk factors.

It’s a package deal!

Modifying our behaviors to help manage the risks will only work if we put all the key components to work at the same time. For maximum effect, we must change multiple unhealthy life activities to ones that favor a healthy heart. By living those behaviors every day, we are setting an example for our children and those around us, as we help ourselves.  A Heart Healthy Lifestyle is living behaviors that promote health. Only then can the matrix of behavior, nutrition and risk factor control, work at its full potential.

*Heart Healthy Nutrients:
Minerals; calcium, copper, cobalt, magnesium, selenium, iron, iodine, zinc
Vitamins; B-12, B6, B1, B5, B9, A, D3, E, K and C.
Amino Acids; lysine, methionine, leucine, valine.
Co-Factors; Co-enzyme Q10, L-carnitine, flavonoids, inositol, choline.

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Increased levels of Homocysteine causes increase risk of heart disease.
Homocysteine is an intermediate in the production of methionine and cystine, two amino acids.  It is naturally present in our bodies, but having to much is associated with increase risk of CVD, including atherosclerosis, high blood pressure, coronary heart disease, and stroke. Research indicates that plasma homocysteine level less than 10 µmol/L is associated with lower risk. Micronutrients involved in metabolism of homocysteine include folate, vitamin B-12, vitamin B6, riboflavin, and choline. Homocysteine lowering strategies are being investigated for their abilities to reduce the risk of heart disease.

Our bodies are capable of synthesizing this co-factor, but not enough to meet the demands.  Diet or supplementation must provide this essential nutrient. Choline functions as a bilateral structural component of cell membranes and some proteins. It is a precursor to betaine, a compound participating in a reaction that converts homocysteine to methionine.  It has been shown that choline supplementation can reduce blood homocysteine levels, but not enough evidence to say it lowers risk of heart disease.

Deficiencies are associated with increased risk of heart disease.
Dietary folate and Supplementation (folic acid or L-5MTHF) reduces the risk of cardiovascular disease, including coronary artery disease, heart attack, and stroke. Involved with vitamin B6, B12 and riboflavin in the reduction of Homocysteine plasma levels.

B vitamins catalyze several metabolic antioxidant enzyme systems involved in converting food to usable energy.  They control the enzymatic, chemical activation of folate to L-5TH-Folate. Working in combination with vitamin B12, B1, they assist in lowering Homocysteine.

Vitamin B6
Essential nutrient involved in many metabolic functions including conversion of energy, formation of neurotransmitters and DNA synthesis. In combination with other B vitamins, it works to maintain the normal concentrations of homocysteine. Supplementation with a combination of B6 and B12 and folic acid lowers homocysteine levels, but has not been associated with lower risk of heart disease.

Vitamin B12
Deficiencies are associated with increased risk of heart disease.
Vital nutrient in prenatal diet. It acts to convert food to usable energy, make red blood cells and it is required for proper nerve function.  It assists in the maintenance of normal concentrations of homocysteine. People over 60 years of age are commonly deficient in vitamin B12, which may contribute to the high homocysteine levels and elevated heart risk. Combinations of other B vitamins (B6, B1, Riboflavin, folate) show the capability of reducing homocysteine levels.  The addition of vitamin B12 supplementation lowers these levels even further.

We all love it.   A complex mixture of chemicals including: caffeine, several phytochemicals and xanthines. High intakes (4 cups) result in higher blood homocysteine concentrations.  Luckily!  There appears to be no significant association between moderate coffee consumption (3 to 4 cups a day) and the risk of coronary heart disease.

Consult your healthcare provider before starting any exercise, diet, or supplement program. He or she is the best person to take into account the many variables involved in your health. Your doctor can keep you up to date as new strategies come on the scene (homocysteine metabolism, folate genetic deficiencies, and supplementation with methyl folate).

NEXT WEEK . . . What good nutrition and heart healthy lifestyle mean at different ages.