By Astrid Derfler Kessler
An Interview with Dr. Steven MasleySteven Masley, MD, a practicing physician from St. Petersburg, Florida, is a fellow with the American Heart Association, the American Academy of Family Physicians, and the American College of Nutrition.
He wrote The 30-Day Heart Tune-Up because he was becoming increasingly frustrated with the current state of affairs when it comes to America’s number one killer, cardiovascular disease. His goal, and the purpose of the book, he says, is to prevent heart disease and stroke by making treatment options available to patients long before they develop the disease. The book provides the tools that are needed—as well as 60 heart-healthy recipes—to accomplish this goal. Following this plan for one month will help prevent plaque from forming, reduce plaque if it already exists, and potentially save your life, says Dr. Masley.
LE: What makes your approach to heart disease different from other plans?
SM: Most doctors focus on lowering cholesterol and blood pressure to prevent heart disease. Their approach relies on drug therapy and laboratory testing, which have been a tremendous boon to the pharmaceutical and medical laboratory industry, but not necessarily to patients. Statins…still have an appropriate use in some patients, yet they increase the risk of diabetes and unfortunately, their testosterone-lowering effect may cause weight gain, reduce sexual enjoyment, and lower a person’s drive to stay fit. Managing cholesterol and blood pressure have helped reduce the rate of heart attacks and strokes, but they don’t do enough. That’s because we’re focusing on the wrong issue.
The 30-day heart tune-up is about shrinking arterial plaque, improving circulation, and strengthening your heartbeat. I recommend neither an extreme vegan diet, which few people can maintain for more than a week or two, nor deprivation, nor expensive medications that merely treat symptoms rather than the cause (although I agree that some medications, when indicated, do help make the transition to optimal health).
So how can you accomplish this goal in such a short time? Here are your tools:
LE: What is the number-one risk factor people face when it comes to cardiovascular disease?
SM: We used to believe that high cholesterol was the number-one risk factor. But we must look at the whole picture. Having metabolic syndrome, appropriately called “diabesity” by Dr. Mark Hyman in his book The Blood Sugar Solution and also known as prediabetes, is a greater risk factor than having high cholesterol. In fact, it’s the number one risk factor of cardiovascular disease. (To read an interview with Dr. Hyman, see the May 2013 issue of Life Extension Magazine®.)
More than 30% of adults (50% of baby boomers) have this condition. The bad news is metabolic syndrome can kill you before you ever develop diabetes. Because it changes your cholesterol profile, increases inflammation, and raises your blood pressure levels in ways that are similar to those of diabetes, it can cause a heart attack or stroke.
LE: Your book offers the tools people need to, as you put it, “make a U-turn on the road to heart disease in just 30 days.” Can you elaborate on your 30-day plan?
SM: It’s about shrinking arterial plaque, improving circulation, and strengthening your heartbeat. You will be using four important tools: heart-healing foods, exercise that strengthens your heart and arteries, stress management, and a customized heart-friendly supplement plan. The [plan is] based on my life’s work. I’ve devoted every hour of every day striving to make my patients’ lives and hearts better without their having to resort to surgery or other invasive procedures. The losses we suffer due to cardiovascular disease are great—personal pain, decreased income, reduced productivity, physical suffering, and even premature death. So much of this anguish is unnecessary. Instead of muddling through as a helpless, hopeless victim of heart disease, with this plan, you will have all the tools you need to attack and defeat this scourge. It is possible to reverse cardiovascular disease and certainly to prevent it.
Tune Up Your Heart with SupplementsLE: Feeding the heart the nutrients it needs for total health isn’t easy to do from diet alone. Supplements are key to good health. What supplements do you recommend for total heart health?
SM: Everyone needs a personalized eating plan to meet their key nutrient needs because no one eats well all the time. Just bear in mind that…vitamins, minerals, herbals, and other valuable treatments…can only enhance a healthy eating plan and an optimal lifestyle. They can’t replace it. They will never make up for snacking on junk food or being stressed or inactive.
Nevertheless, supplements can benefit your heart health substantially even if you eat well, exercise regularly, and manage stress. They can also provide some nutrients you may otherwise be lacking. At least 80% of Americans are nutrient deficient. Yes, we get plenty of calories, but we don’t consume enough vitamins and minerals. Nutrient content has been dropping in our highly processed food supply. That’s why supplements are an integral part of your 30-day heart tune-up. And, they may boost your heart health in ways that food alone cannot.
LE: What should a high-quality multivitamin contain?
SM: A multivitamin is a good place to start. Keep in mind that a multivitamin won’t supply fiber, fish oil, magnesium, and potassium in a significant way. These are critical heart nutrients.
To begin with [you need at least] 1,500 to 2,000 IUs of vitamin D. You’ll also want a pill that has mixed carotenoids, not just beta-carotene, as well as mixed forms of folate, especially 5-MTHF (5-methyltetrahydrofolate), not just folic acid. If you’re over 50, you’ll need adequate B12—at least 100 mcg daily, but if you take an acid blocker, a minimum of 500 mcg is recommended. Vitamin K should come as a mixture of vitamin K1 and K2, as I’ll discuss later. And finally, you should take 75 to 150 mcg of iodine.
LE: Vitamin D is critical to so many aspects of overall good health, from diabetes and bone health to cancer and cognitive health, but how does it relate to heart health?
SM: Vitamin D is called a fat-soluble vitamin, but once converted to its active form, it functions like a hormone. Every cell in the body appears to have vitamin D receptors, so having adequate amounts in your bloodstream is absolutely critical to your health. Studies show that people with higher blood levels of vitamin D have lower rates of heart attacks and strokes and better blood pressure and weight control. Clearly, vitamin D is essential for optimal heart and general health. As a hormone, vitamin D communicates directly with your genes, influencing how they function, and tells the cells which protein to produce.
How much vitamin D you need would depend on your current blood levels. For most people, optimal dosages vary from 1,500 to 3,000 IU daily, with the goal to achieve a blood level of 40 to 70 ng/mL. (Life Extension®recommends a blood level of 50 to 80 ng/mL.) Less than 32 ng/mL is deficient. If your level is very low, then taking 5,000 IU daily for two to three months will probably bring you back to normal. (Life Extension recommends that healthy adults supplement each day with at least 5,000 IU of vitamin D.)
LE: Vitamin K, in the form of vitamin K1 and vitamin K2, is critical to cardiovascular health, as well as offering protection against arterial calcification, bone loss, cancer, metabolic syndrome, and aging. You call it an essential supplement.
SM: Vitamin K is essential for cardiovascular health because it prevents calcium from shifting from your bones to your arteries. Not surprisingly, then, vitamin K is essential to keeping bones strong. With increasing vitamin K deficiency, artery walls calcify, blood pressure increases, and the lining of your arteries grows more plaque. The minimum dietary intake of vitamin K for proper clotting is around 100 mcg per day— 90 mcg for women and 120 mcg for men. Yet bones and arteries function much better with 250 mcg and preferably 1,000 mcg of vitamin K daily. (Life Extension recommends 2,700 mcg of vitamins K1 and K2 together.)
There are two primary forms of vitamin K—K1 and K2. K1 comes from leafy green vegetables and provides most of the dietary intake in the US. K2 comes from fermented soy products and most Americans [don’t] consume enough. Keep in mind that calcium supplements may already provide some of the K your body needs. Calculate how much vitamin K you get from your diet and other vitamins, and supplement accordingly.
LE: Several large studies have shown benefits of vitamin E intake in reducing cardiovascular disease and death from heart attacks. What do you recommend regarding vitamin E for cardiovascular health?
SM: Vitamin E is made up of several molecules—four tocopherols (alpha, beta, gamma, delta) and four tocotrienols (alpha, beta, gamma, delta). Gamma and delta tocopherols and tocotrienols improve the advanced lipid profile, so if you’re taking…a vitamin E supplement, make sure it has mixed forms of vitamin E—in particular, delta and gamma tocopherols.
For Those With Congestive Heart Failure and Heart DiseaseLE: Your book is focused on the prevention of heart disease and keeping the heart healthy. But what if someone has congestive heart failure or heart disease—what do you recommend as far as supplements are concerned?
SM: With heart failure, the heart is starved for energy. Without it, your heart can’t pump efficiently, and the fluid from your blood backs up into your lungs. One of the many keys to restoring function, then, is restoring heart cell energy.
Mitochondria produce most of the energy your cells use. Your heart cells have more mitochondria than any others in the body. Dr. Stephen Sinatra, a nationally known integrative cardiologist, was one of the pioneers in advocating therapy to enhance heart cell mitochondrial function—something he called metabolic cardiology.
He focused on three key supplements: CoQ10, ribose, and carnitine.
Clinical experience using these agents has shown they’re excellent in improving the quality of life for some people who have heart failure.
LE: What other supplements do you recommend for those who currently have heart disease?
SM: Two other agents have great promise to enhance mitochondrial function and energy production. These are curcumin and resveratrol. [These] compounds are essential to controlling artery inflammation and oxidative stress, but are required in such large amounts that it is unrealistic to get an adequate dosage from food (or red wine, in the case of resveratrol).
Curcumin is such an outstanding anti-inflammatory that I even prescribe it to my patients with arthritis, those who want to limit cognitive decline, and for cancer prevention. Curcumin absorption is highly variable, so it is critical to take a high-quality form with proven absorption rates.
As [stated] earlier, vitamin K prevents artery calcification. If you have advanced heart disease/failure, ask about adding extra vitamin K. Increase magnesium to 300 to 500 mg twice daily. It will help relax blood vessels and enhance blood pressure control, making pumping easier for the heart. At some point on this dosage, ask your doctor to measure your blood cell magnesium levels to confirm you’re in the normal range.
Arginine is also an excellent nutrient to enhance artery function and improve blood pressure control. It is the building block that the body uses to make nitric oxide, which is essential to arterial health and wellness. Nitric oxide induces the arteries to dilate… [I suggest] a supplement with 1,000 mg twice daily.
If You’re On a Cholesterol-Lowering Medication
LE: Statin medications are taken by millions of Americans. You recommend additional supplements for those on statins.
SM: Statin medications decrease not only cholesterol but also compounds in the body derived from cholesterol, such as testosterone, CoQ10, and other substances that repair muscle. Yes, cholesterol-lowering medications help reduce heart attacks and strokes in people with known heart disease and for those at high risk, but they can produce a variety of symptoms. Most people assume the benefit from taking a statin is related to its cholesterol-lowering effects, but other important benefits are due to the fact that statins also decrease artery inflammation and make your blood less sticky, so it’s less likely to clot.
CoQ10 is essential for energy production, especially for heart cells. Every cell has energy-generating organelles called mitochondria…which require CoQ10 to produce energy. Studies show that the ability to produce CoQ10 drops by 20% in people who take a statin…and a big concern is that it might decrease your energy and mental sharpness and interfere with quality of life. Most holistic and integrative physicians recommend that patients on a statin should take CoQ10 with it…to bring the body back to its normal, pre-statin state. I find 50 to 100 mg of high-quality and well-absorbed product will bring the CoQ10 level back to pre-statin levels.
SummaryLE: You’ve integrated the 30-day heart tune-up in many of your patients. What do they tell you after that one-month mark?
SM: The combination of eating heart-friendly foods, building your fitness level, managing your stress, and meeting your heart’s nutritional needs will not only help you dramatically reduce your risk for heart disease and stroke, but it will also turn back the clock on aging—allowing you to regain energy and vitality you haven’t known in years. The greatest thanks I get from my patients have been their frequent observation after the first 30 days [when they tell me] “I forgot how much better I could feel.”
Steven Masley, MD, is a Fellow with the American Heart Association, the American Academy of Family Physicians, and with the American College of Nutrition. He has devoted his medical career to the study of heart disease and aging, and has published significant research on these subjects in leading medical journals. Currently he is the president of the Masley Optimal Health Center in St. Petersburg, Florida, and has a clinical appointment with the University of South Florida.
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