Lisa Nelson RD #9: Vitamin D Deficiency Symptoms – Is there a connection between vitamin D and heart disease? What level vitamin D should individuals maintain to prevent heart problems?

Dr. Shelby-Lane: It is a known and documented fact that too little Vitamin D puts the heart at risk. Yet many patients are not routinely tested, and if so, they do not take the proper steps to reach optimal Vitamin D levels between 50 to 100 ng/dL. Most lab tests give 30 as a low normal, yet this is not optimal. This can by done by diet, sun exposure (in most cases) or adequate supplementation. But most of all, people are not tested. Research suggests Vitamin D deficiency may be an unrecognized heart disease risk factor.

Researchers say a growing body of evidence suggests that vitamin D deficiency increases the risk of heart disease and is linked to other, well-known heart disease risk factors such as high blood pressure, obesity, and diabetes.

For example, several large studies have shown that people with low vitamin D levels were twice as likely to have a heart attack, stroke, or other heart-related event during follow-up, compared with those with higher vitamin D levels.

“Vitamin D deficiency is an unrecognized, emerging cardiovascular risk factor, which should be screened for and treated,” says researcher James H. O’Keefe, MD, director of preventive cardiology at the Mid America Heart Institute in Kansas City, Mo., in a news release. “Vitamin D is easy to assess and supplementation is simple, safe and inexpensive.”

Most of the body’s vitamin D requirements are met by the skin in response to sun exposure. Other less potent sources of vitamin D include foods such as salmon, sardines, cod liver oil, and vitamin D-fortified foods like milk and some cereals. Vitamin D can also be obtained through supplements.

Vitamin D deficiency is on the rise. Vitamin D deficiency symptoms are traditionally associated with bone and muscle weakness, but in recent years a number of studies have shown that low levels of the vitamin may predispose the body to high blood pressure, congestive heart failure, and chronic blood vessel inflammation (associated with hardening of the arteries). It also alters hormone levels to increase insulin resistance, which raises the risk of diabetes.

In a review article published in the Journal of the American College of Cardiology, researchers surveyed recent studies on the link between vitamin D deficiency and heart disease to come up with practical advice on screening and treatment.

They concluded that vitamin D deficiency is much more common than previously thought, affecting up to half of adults and apparently healthy children in the U.S.

Researchers say higher rates of vitamin D deficiency may be due in part to people spending more time indoors and efforts to minimize sun exposure through the use of sunscreens. Sunscreen with a sun protection factor (SPF) of 15 blocks approximately 99% of vitamin D synthesis by the skin.

“We are outside less than we used to be, and older adults and people who are overweight or obese are less efficient at making vitamin D in response to sunlight,” says O’Keefe. “A little bit of sunshine is a good thing, but the use of sunscreen to guard against skin cancer is important if you plan to be outside for more than 15 to 30 minutes of intense sunlight exposure.”

Testing for Vitamin D Deficiency

Vitamin D levels can be measured with a blood test for a specific form of vitamin D called 25-hydroxy vitamin D (25(OH)D). Vitamin D deficiency is defined as a blood 25(OH)D level below 20 ng/dL. Normal levels are considered to be above 30 ng/dL.

Again, criteria for optimal levels is between 50 to 100 ng/dl.

All the best,
Lisa Nelson RD
Heart Healthy Tips

If you strive for optimal health, consider adding a whole food supplement to your daily regimen. However, you must be a savvy shopper to make sure you select a supplement that lives up to its claims. . .many are a waste of money! Things to look for:

1. Independent research – This means the company selling the product did not conduct the research.

2. Double blind, placebo controlled studies – This means neither the “patient” nor the doctor knew if they were taking the supplement or a sugar pill. Provides more reliable results.

3. Research that shows results – If the product claims to raise antioxidant levels and reduce high blood pressure then research studies need to back this up.

4. Publication in peer reviewed journals, such as The Journal of the American College of Cardiology or the Journal of Human Nutrition and Dietetics.

All the best,
Lisa Nelson RD
Juice Plus

The link between calcium and blood pressure was noticed years ago when researchers realized people drinking hard water had less high blood pressure than those drinking soft water. Hard water contains more minerals, including calcium.

Individuals receiving more than 800 mg of calcium daily have a 23 percent decreased risk of high blood pressure versus those consuming less than 400 mg of calcium per day.

Back in 1996, scientists compiled all the research to date on calcium and high blood pressure. The results showed calcium supplements given to individuals with high blood pressure lowered systolic blood pressure (top number) an average of 4.3 mm Hg and diastolic blood pressure (bottom number) 1.5 mm Hg.

Some people respond better to supplemental calcium than others. Those with the best results include African-Americans, elderly, pregnant women, menopausal women, people with salt-sensitivity, individuals with a high sodium intake, and those with Type II diabetes.

For the best results, don’t rely on a supplement alone. Work to increase your intake of calcium containing foods – dairy. To promote heart health, select low fat dairy products, such as low fat milk, cheeses, and yogurts.

Additional calcium sources:

Leafy greens (i.e. kale, collard, turnip, mustard greens)
Broccoli
Sardines
Canned Salmon
Calcium fortified Orange Juice
Tofu (if made with calcium carbonate)

For even better results, supplement calcium along with vitamin D. One study supplemented women 1200 mg of calcium to reduce blood pressure. When they added 800 IU of vitamin D, systolic blood pressure decreased an average of 9.3 percent.

Don’t forget three other minerals affect how effective calcium – potassium, magnesium, and sodium. For calcium to have the greatest positive effect on blood pressure, your levels of these three nutrients need to be adequate as well.

For additional steps to lower blood pressure, check out the free e-course 7 Naturals Ways to Lower Blood Pressure.

All the best,
Lisa Nelson RD
Be Heart Healthy and Lose Weight

Fish oil supplements are a great alternative for people that do not eat fish often to boost their omega 3 intake and promote heart health.

There’s been some media speculation about possible contaminants, such as mercury, within fish oil supplements. However, good news if you supplement fish oil, there are minimal contaminants within the supplements!

There have been several studies, specifically a report by ConsumerLab.com and Harvard Medical School, finding no mercury or PCBs within over 40 popular fish oil supplements. Fish oil is typically taken from fish, such as cod and sardines, that do not contain high levels of mercury. Also, many manufacturers distill the fish oil to remove contaminants.

February is American Heart Month. In recognition of American Heart Month you can access Heart Health Made Easy at a 25% savings. Learn more about this take action guide to lower cholesterol and blood pressure at http://www.hearthealthmadeeasy.com.

All the best,
Lisa Nelson RD
Be Heart Healthy and Lose Weight

Here’s another question I asked Dr. Cynthia Shelby-Lane and her answer.

Lisa Nelson RD: Is it safe for individuals taking medication for heart disease, such as Lipitor, to eat grapefruit or drink grapefruit juice?

Dr. Shelby-Lane: I am including information that may help answer your question about grapefruit and a variety of nutritionals that affect statin drugs for the lowering of cholesterol.

Zocor (Simvastatin), for example, is a Statin drug, used to lower high cholesterol levels, and also known as HMG-CoA reductase inhibitor. Zocor may affect the absorption or utilization of vitamins E and coenzyme Q10. Tests showed the average concentration of coenzyme Q10 in blood plasma decreased by approximately 50% after statins were used for 30 days. Supplementation is considered beneficial.

Grapefruit and grapefruit juice may increase the effects of HMG-CoA reductase inhibitors and should not be consumed at the same time. It is suggested that these medications be taken with water. Grapefruit contains substances that may inhibit the body’s ability to break down statin drugs increasing the toxicity of the drug. Muscle pain, tenderness, or muscle weakness may be a result. If you begin to notice these symptoms, contact your doctor.

Niacin is the form of vitamin B3 used to lower cholesterol. Large amounts of niacin taken with a statin drug may cause serious muscle disorders (myopathy). Reasonable levels of niacin combined with statin drugs have been shown to enhance the cholesterol lowering effect. For proper dosage, consult your physician before taking niacin.

Pomegranate juice has been shown to inhibit the same enzyme inhibited by grapefruit juice. This may cause reactions similar to grapefruit juice when it is used with statin drug treatments.

A study of 37 people with high cholesterol treated with diet and statin drugs found vitamin A increased in the blood over two years of therapy. People taking statin drugs and vitamin A supplements should have blood levels of vitamin A monitored.

Magnesium and aluminum containing antacids were reported to interfere with statin drug absorption. To avoid this interaction, take statin drugs two hours before or after any aluminum/magnesium containing antacids. Some magnesium supplements such as magnesium hydroxide are also antacids.

It should be noted that doctors often recommend supplementing with 100 mg of coenzyme Q10 per day for maintaining healthy levels. However, those on statin drugs may have a greater need for a higher dose. It further should be noted that the symptoms associated with the combination of grapefruit juice and statin drugs (muscle weakness and discomfort) are commonly reported as symptoms associated with CoQ10 depletions. Supplementation with coenzyme Q10 is strongly recommended.

The herbs Artichoke plant, Garlic and Plantain may decrease blood cholesterol levels, and therefore enhance the effects of Zocor. Consult with your pharmacist or physician before taking them.

All the best,
Lisa Nelson RD
Be Heart Healthy and Lose Weight