Keeps Heart and Blood Vessels Healthy
Weekly exercise four to five times keeps heart young
Weekly exercise two to three times keeps our blood vessels young; from four to five sessions, the heart stays youthful as well, new research shows. This knowledge helps develop exercise programs that combat aging.
As people age, the arteries that carry blood in and out of the heart can become stiffer, increasing the risk of heart disease. It has long been a pressing question: how much exercise is optimal to slow this aging of cardiovascular systems?
While any form of exercise reduces the risk of death from heart problems, this new research shows that it matters to arteries how often a person moves each week: exercising for 30 minutes two to three times a week may be enough to counteract the stiffening of medium-sized arteries, while training four to five times a week is required to keep even the larger central arteries youthful. The research was published in The Journal of Physiology [1].
Movement history under the microscope
To arrive at this result, the researchers conducted a cross-sectional study* among 102 people over 60 years old whose exercise history was known. Detailed information on the degree of arterial stiffness was collected from all participants.
Participants were then divided into four groups:
- Those with sedentary lifestyles: exercise less than twice a week.
- Relaxed exercisers: two to three workouts per week.
- Serious exercisers: four to five workouts weekly.
- Athletes: exercise six to seven times each week.
The duration of a training session was at least thirty minutes.
Exercising four to five times helps heart rate
The research team found that two to three sessions a week resulted in younger, less stiff medium-sized arteries, which are the arteries that carry oxygen-rich blood to the head and neck. However, people who exercised four to five times a week additionally had more younger, larger central arteries as well. These are the arteries that supply oxygen to the abdomen and chest (including the heart).
The researchers also mentioned the limitations of their study: the individuals had been classified according to the number of training sessions in the past, and not according to intensity, length (other than a minimum of 30 minutes per session) or mode of exercise, all of which can greatly affect cardiovascular adaptation. Furthermore, they also had not included the participants' dietary habits and social background.
Developing exercise programs
The researchers are betting on a follow-up to this study: "The results give us the opportunity to develop exercise programs to keep the heart young and even turn back time for older cardiovascular patients." [2] A new study focuses on a two-year exercise program for middle-aged men and women, with and without risk factors for cardiovascular disease.
A cross-sectional study means that a cross-section of the total population is sampled.
Orthomolecular lifestyle tips for good cholesterol
Recently, there has been a lot of buzz about treating elevated cholesterol with statins. But what exactly is cholesterol? Is there such a thing as "good" and "bad" cholesterol? How bad is high cholesterol anyway? And can we get by without statins? We have listed our most important lifestyle tips for you.
Cholesterol is a lipid, more specifically a sterol compound. It is an extremely important substance for the body: it is the building block for all steroid hormones and for vitamin D. In addition, it plays a role in the integrity and fluidity of cell membranes. In addition, the body uses cholesterol to produce bile acid salts, which are important for fat digestion in the small intestine.
Also, research shows that cholesterol can be a repair agent in case of damage and that it can neutralize bacteria, viruses and toxins and along this way reduce endotoxemia in the blood (Ravnskov, 2003). Endotoxemia is a source of inflammation, and it is becoming increasingly clear that inflammation is at the root of numerous diseases of affluence, including cardiovascular disease (Muskiet, 2011). In our evolutionary past, we had more to contend with inflammation and infection; in resolving these, cholesterol had an important role to play.
If we look at our current living conditions, we see that while the risk of infection due to bacteria and viruses has greatly decreased, diet, exercise and stress have also changed significantly. That we suffer from cholesterol problems today does not make cholesterol the culprit so much as the evolutionary mismatch that has occurred as a result of our changed lifestyle. Therefore, it would be wiser to identify the current lifestyle as the culprit and take appropriate action on it.
Different types of cholesterol
Cholesterol is mainly produced in the liver and we get it through our diet. Rich sources of cholesterol include eggs, cheese, full-fat yogurt, shrimp and (organ) meat. In recent decades, there has been a lot of controversy about foods high in cholesterol and saturated fats. But what exactly is cholesterol?
In the blood, one finds cholesterol mainly bound to protein fraction (lipoprotein): the HDL, IDL, LDL and VLDL cholesterol. The first letters in these compositions stand for, respectively, High, Intermediate, Low and Very Low. The D stands for "density," and this says something about the ratio of protein to lipid in the lipoprotein. The less protein, the lower the density. So the different lipoproteins are all slightly different and therefore all have slightly different functions.
Below we discuss two much-discussed types of cholesterol: HDL and LDL cholesterol, which have quickly come to be called 'good' and 'bad' cholesterol in popular and media parlance. This is a simplification that is only partially illuminating; in fact, under normal circumstances, both forms of cholesterol are essential for normal function of our physiology and therefore neither "good" nor "bad. It is true, however, that the ratio of total cholesterol/HDL says something about the risk of cardiovascular disease and that LDL can oxidize under certain conditions. Overproduction of oxidized cholesterol can trigger an inflammatory response. It is this inflammatory reaction (and not the cholesterol itself) that we might call "bad," as it is associated with cardiovascular disease.
Functions HDL and LDL
HDL and LDL are lipoproteins that transport cholesterol and triglycerides through the blood. LDL is high in cholesterol and low in protein and transports cholesterol from the liver to the tissues. In contrast, the protein-rich HDL transports cholesterol back to the liver. In the liver, the remaining cholesterol is used to produce bile acid salts. The body controls cholesterol levels itself through biological feedback mechanisms. If a lot of cholesterol comes in through the diet, the body's own production goes down. If little is ingested, production rises again.
An excess is excreted under physiological conditions because it cannot be converted into energy. Thus, cholesterol levels have a homeostatic balance; production goes down or up under normal conditions until the body can meet its needs as economically as possible. In this way, the body can put the released energy into other important processes.
Elevated values and atherosclerosis
Elevated LDL levels may occur because the cells and tissues need extra cholesterol, for example, because of a situation with (a lot of) stress and/or endotoxemia in the bloodstream. An elevated LDL is then a physiological response of our body, to produce more cortisol, or address the endotoxemia. LDL contains relatively high levels of fat and therefore easily sticks to the edge of blood vessels. In principle, if blood vessels are smooth (comparable to the inside of a garden hose), LDL cannot stick. When do problems arise, especially atherosclerosis?
Damage to the vessel wall can occur, for example, from increased homocysteine levels in the blood, as well as from low-grade inflammation. To these ragged blood vessels, LDL can easily stick and then oxidize. This leads to an inflammatory reaction in which monocytes produce foam cells. In this way, the vessel wall thickens, eventually leading to atherosclerosis.
Association with cardiovascular disease
Especially since 1985, consumption of saturated fat, cholesterol and of "dietary fat" in general has been associated with cardiovascular disease (Keys, 1953). This is still the predominant view. For example, the Nutrition Center indicates on its website that saturated fat increases the "bad" LDL cholesterol in the blood, and that this is not good for blood vessels. They therefore recommend replacing saturated fat with polyunsaturated fatty acids as much as possible (Voedingscentrum).
Of course: polyunsaturated fatty acids have a beneficial effect on the heart and blood vessels. However, the question is whether saturated fat and elevated cholesterol levels lead to cardiovascular disease. For example, a large-scale review shows that elevated LDL cholesterol levels do not shorten the lifespan of the elderly. On the contrary, elevated LDL is often associated with a longer lifespan (Ravnskov, 2016). In addition, much research shows that dietary cholesterol has little effect on cholesterol levels in the body. For example, population studies show that there is no relationship between dietary cholesterol and heart disease in the population (Lecerf et al., 2011). In fact, two-thirds of those surveyed see little to no increase in cholesterol levels after consuming cholesterol-rich foods, even in very large amounts (Blesso et al., 2018). There is even research showing that dietary cholesterol actually has a beneficial effect on the LDL-HDL ratio in the blood. This ratio is considered the best indicator of cardiovascular disease risk (Ali et al., 2012).
Also, research from Kuopio University in Finland, among 1,000 men and with a duration of 21 years, showed that consuming large amounts of cholesterol is not related to the risk of cardiovascular disease (Virtanen et al., 2016). This outcome applies at least up to an intake of 520 mg of cholesterol per day. Even when egg consumption was looked at specifically, it was not found to be associated with an increased risk of cardiovascular disease. This outcome applies at least up to an intake of seven eggs per week, the highest number eaten on average within the group. Also, there appeared to be no relationship between dietary cholesterol and thickening of the carotid artery. The thickness of the wall in this vein is a marker for subclinical atherosclerosis. Thus, eggs also do not increase the risk of arteriosclerosis.
Statins or red yeast rice?
Statins lower LDL cholesterol and are therefore widely used for elevated cholesterol levels, with the goal of treating cardiovascular disease. However, statins have unpleasant side effects. Our lecturer Remko Kuipers, a cardiologist at the OLVG, therefore argued in the past for more independent research on statins. A possible short-term alternative is red yeast rice. Red yeast rice, thanks to monacolin K, contributes to the maintenance of normal cholesterol levels in the blood. It has similar effects to statins but is of natural origin. In addition to regulation of LDL cholesterol, lowering homocysteine levels and reducing short-term oxidation of LDL are also indicated, as they contribute to the development of inflammation and atherosclerosis. Vitamin B6, B12 and folic acid are beneficial for homocysteine metabolism. For the long term, however, lifestyle changes are always necessary.
Ultimate solution of cholesterol problems
Major causes of increased cholesterol production are stress and insulin resistance. Insulin resistance results in less glucose being absorbed into cells and consequently more glucose being converted into fat. Fat is the building material of cholesterol. Increased fat storage in the body means increased production of cholesterol. Excessively growing adipose tissue is more easily damaged, and as a result of this damage, inflammation occurs in the adipose tissue. As the adipose tissue continues to grow, these inflammations increase and spread throughout the body. In response, cholesterol production goes up further; after all, one of the functions of cholesterol is to fight infections. Reducing insulin resistance has a beneficial effect on cholesterol production.
Eating fewer carbohydrates results in less glucose entering the blood, reducing the need to produce insulin and decreasing insulin resistance. In addition, less glucose is converted into fat, which can reduce adipose tissue. Eating unprocessed foods has the added benefit of reducing the amount of substances that are unfavorable to our bodies, which can reduce inflammation and reduce pressure on the liver's detoxification capacity. As a result, the liver can better perform its role in regulating cholesterol. In addition to dietary modification, reducing meal frequency and sober exercise also has a beneficial effect on insulin resistance.
Stress leads to the release of the hormone cortisol. This is a steroid hormone: its basis is cholesterol. With increased stress, there is an increased demand for cortisol and more cholesterol is needed to meet the production of cortisol. So this leads to increased cholesterol levels. Stress reduction by seeking more relaxation and applying relaxation techniques such as mindfulness or yoga reduces the production of cholesterol. Of course, the ultimate solution to stress problems is to eliminate or deal with the stressor differently. The text/context meta-model gives you guidance in this regard.
Thus, the ultimate solution to cholesterol problems lies in addressing the major causes of cholesterol elevation, insulin resistance and stress, using lifestyle interventions. The quick win, employing red yeast rice (or statins if necessary), is an aid in achieving the ultimate solution. Thus, you have a total intervention that allows you to contribute to the health of your clients and thus to a healthier world.
Resources
[1] (Ravnskov, 2003) U. Ravnskov, High cholesterol may protect against infections and atherosclerosis. QJM: An International Journal of Medicine, Volume 96, Issue 12, December 1, 2003, Pages 927-934.
[2] (Muskiet, 2011) F.A.J. Muskiet (2011). The evolutionary background, cause and consequences of chronic systemic low grade inflammation; significance for clinical chemistry. Ned Tijdschr Klin Chem Labgeneesk 2011, vol. 36, no. 4.
[3] (Keys, 1953) Keys A. Atherosclerosis: a problem in newer public health. J Mt Sinai Hosp N Y 1953; 20; 1: 18-39. More information: https://www.sevencountriesstudy.com
[4] (Nutrition Center, coconut fat) https://www.voedingscentrum.nl/encyclopedie/verzadigd-vet.aspx and https://www.voedingscentrum.nl/encyclopedie/kokos-en-kokosvet.aspx
[5] (Ravnskov, 2016) Uffe Ravnskov, David M Diamond, Rokura Hama, Tomohito Hamazaki, Björn Hammarskjöld, Niamh Hynes, Malcolm Kendrick, Peter H Langsjoen, Aseem Malhotra, Luca Mascitelli, Kilmer S McCully, Yoichi Ogushi, Harumi Okuyama, Paul J Rosch, Tore Schersten, Sherif Sultan, Ralf Sundberg, Lack of an association or an inverse association between low-density-lipoprotein cholesterol and mortality in the elderly: a systematic review, BMJ Open, 2016;6:e010401
[6] (Lecerf et al., 2011) Lecerf JM, de Lorgeril M., Dietary cholesterol: from physiology to cardiovascular risk, Br J Nutr. 2011 Jul;106(1):6-14. doi: 10.1017/S0007114511000237. Epub 2011 Mar 9.
[7] (Blesso et al., 2018) Christopher N. Blesso and Maria Luz Fernandez, Dietary Cholesterol, Serum Lipids, and Heart Disease: Are Eggs Working for or Against You? Nutrients. 2018 Apr; 10(4): 426.
[8] (Ali et al., 2012) K Mahdy Ali, A Wonnerth, K Huber, and J Wojta, Cardiovascular disease risk reduction by raising HDL cholesterol - current therapies and future opportunities, Br J Pharmacol. 2012 Nov; 167(6): 1177-1194.
[9] (Virtanen et al., 2016) Jyrki K Virtanen, Jaakko Mursu, Heli EK Virtanen, Mikael Fogelholm, Jukka T Salonen, Timo T Koskinen, Sari Voutilainen, and Tomi-Pekka Tuomainen,Associations of egg and cholesterol intakes with carotid intima-media thickness and risk of incident coronary heart disease according to apolipoprotein E phenotype in men: The Kuopio Ischaemic Heart Disease Risk Factor Study, Am J Clin Nutr, March 2016, vol. 103, no. 3 895-901
[1] Shigeki Shibata et al, The effect of lifelong exercise frequency on arterial stiffness, The Journal of Physiology (2018). DOI: 10.1113/JP275301
[2] https://medicalxpress.com/news/2018-05-young-days-week-heart.html