Title: The Burden of Common Preventable Chronic Diseases
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2Scientists couldn't believe it at first, but now
they've been forced to admit1. Inflammation
causes hardening of the arteries. It makes
cholesterol stick to your artery walls in thick
deposits called plaque, and then...2.
Inflammation causes heart attacks! It tears off
pieces of artery plaque and sends them hurtling
toward your heart, or worse...3. Inflammation
causes strokes when those chunks of plaque reach
your brain and...4. Inflammation may even cause
9 out of 10 cases of high blood pressure!
3The Burden of Common Preventable Chronic Diseases
70 to 90 of deaths from chronic illnesses in
the U.S. are believed to be caused by poor
nutrition, sedentary living, and tobacco use.
In addition to hypertension, manifestations of
the lifestyle syndrome include the metabolic
syndrome, obesity, dyslipidemia, CVD, cancer,
osteoarthritis, depression, sexual dysfunction,
and type 2 diabetes mellitus.6
4According to a case-controlled study of 52
countries (INTER-HEART), optimization of 9 easily
measured and potentially modifiable risk factors
could result in a 90 percent reduction in risk of
an initial acute myocardial infarction. The
effect of these risk factors is consistent in men
and women across different geographic regions by
ethnic group, which makes study applicable
worldwide.These 9 risk factors included
Cigarette smoking,Abnormal blood lipid
levels,Hypertension,Diabetes, Abdominal
obesity,a Lack of physical activity,Low daily
fruit and vegetable consumption,Alcohol over
consumptionand STRESS.Rosamond W, Flegal K,
Furie K, et al. Heart disease and stroke
statistics 2008 update a report from the
American Heart Association Statistics Committee
and Stroke Statistics Subcommittee. Circulation
2008 Jan 29117(4)e25-146.
All nine of the risk factors have 1 common
denominator INFLAMMATION!!!
5Researchers indicate systemic inflammation
promotes insulin resistance leading to Metabolic
Syndrome. Evidence at present favors chronic
inflammation as a trigger for chronic insulin
insensitivity, rather than the reverse
situation. Grimble RF. Inflammatory status and
insulin resistance. Currr Opin Clin NutrMetab
Care 20025(5)551-9.
6From AHA / NHLBI Scientific
Statement Diagnosis and Management of the
Metabolic Syndrome An American Heart Association
/ National Heart, Lung, Blood Institute
Scientific Statement
- The NCEP (National Cholesterol Education
Program) ATP (Adult Rx Panel) III proposed a
simple set of diagnostic criteria - Waist circumference
- Triglycerides
- HDL-Cholesterol
- Blood pressure
- Fasting glucose level
- Abnormalities in any 3 of these 5 measures
constitutes a diagnosis of metabolic syndrome.
Circulation 2005112000-000 _at_www.circulationaha.o
rg
7From AHA / NHLBI Scientific
Statement Diagnosis and Management of the
Metabolic Syndrome An American Heart Association
/ National Heart, Lung, Blood Institute
Scientific Statement
Metabolic Syndrome confers
- A 2-fold increase in relative risk for ASCVD
events. - A 5-fold increase in risk for developing DM-II in
individuals without established diabetes.
This finding implies that the metabolic syndrome
imparts a relatively high long-term risk for
both ASCVD and diabetes.
Circulation 2005112000-000 _at_www.circulationaha.o
rg
8Belly Fat causes Excess Estrogen in
Men!!!Abdominal Fat increases risk of Stroke,
Cancer, CVDCorrelation between Estradiol and
InflammationHow Excess Estrogen Levels Occur in
Aging MenIn males, the main biologically active
estrogen is estradiol. The primary source of
estradiol in men is from the conversion
(aromatization) of testosterone. As men age, the
production of androgens from the adrenals and
gonads is decreased. The aromatization of
testosterone to estradiol is often maintained,
but due to a variety of factors, more
testosterone is aromatized in fatty tissues,
causing a further imbalance of the ratio of
testosterone to estrogen, i.e. too much estradiol
and not enough testosterone. The result is a
deficiency of beneficial testosterone and an
excess amount of estradiol.34As men age, the
amount of testosterone produced in the testes
diminishes greatly. Yet estradiol levels remain
persistently high. The reason for this is
increasing aromatase activity along with
age-associated fat mass, especially in the
belly.5 Estradiol levels correlate significantly
to body fat mass and more specifically to
subcutaneous abdominal fat. The epidemic of
abdominal obesity observed in aging men is
associated with a constellation of degenerative
disorders, including heart disease, diabetes, and
cancer.9,35-38Subcutaneous abdominal fat acts as
a secretory gland, often producing and emitting
excessive levels of estradiol into an aging mans
blood.39 Ones waist circumference is a highly
accurate prognostic measurement of future disease
risk, with excess estradiol secretion being at
least one of the deadly mechanisms associated
with the difficult-to-resolve problem of having
too much abdominal fat.5,40Symptoms of excess
estrogen in aging men include the development of
breasts, having too much abdominal weight,
feeling tired, suffering loss of muscle mass, and
having emotional disturbances. Many of these
symptoms correspond to testosterone deficiency as
well.41Double the Stroke RiskStroke is the
third leading cause of death and the leading
cause of age-related disability. Abnormal blood
clotting in the cerebral blood vessels is the
most common cause of stroke. Excess estrogen
promotes abnormal blood clots.1In a study
published just last year, blood levels of
estradiol (a potent estrogen) were measured in a
group of 2,197 men aged 71 to 93 years of age.
Adjustment for age, hypertension, diabetes,
adiposity, cholesterol, atrial fibrillation, and
other characteristics were made. During the
course of follow-up, men with the highest blood
levels of estradiol had a 2.2-fold greater risk
of stroke compared with those whose estradiol
levels were lower
The epidemic of abdominal obesity observed in
aging men is associated with a constellation of
degenerative disorders, including heart disease,
diabetes, and cancer.
Ones waist circumference is a highly accurate
prognostic measurement of future disease risk,
with excess estradiol secretion being at least
one of the deadly mechanisms associated with the
difficult-to-resolve problem of having too much
abdominal fat
Protecting Against Toxic Estrogen Metabolites It
is not just excess estradiol that poses health
risks. Specific estrogen metabolites may also
initiate and promote hormone-related cancers.
Daily consumption of cruciferous vegetables
(broccoli, cauliflower, cabbage, Brussels
sprouts),54-59 along with isoflavone-rich soy
foods60-64 converts these dangerous estrogen
metabolites (such as 16-alpha-hydroxyestrone) to
safe ones (2-hydroxyestrone) that may protect
against prostate cancer. For those who dont eat
these cancer-protective foods on a daily basis,
low-cost supplements can supply the most active
constituents of cruciferous vegetables (such as
indole-3-carbinol and sulphoraphane)65-70 and soy
(genistein and daidzein).
9A normal body mass index(BMI) does not
necessarily mean the absence of Metabolic
Syndrome. A person of normal weight can still
suffer from the effects of Metabolic Syndrome.
11.1 percent to 21.3 percent of individuals with
a BMI 23.0 to 26.9 have metabolic syndrome.
10Pro-inflammatoryHigh Omega 63 Ratio
Anti-inflammatory Balanced omega 63 ratio
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12Researchers followed 208 apparently healthy,
non-obese subjects for four to 11 years after
baseline measurements of insulin resistance. The
purpose was to correlate insulin resistance at
baseline to the development of various clinical
events including hypertension, coronary heart
disease, stroke, cancer and type 2 diabetes.7 The
subjects were divided into tertiles (groups
divided by3) of insulin resistance at baseline
the most insulin-resistant tertile, intermediate
insulin resistance, and no insulin resistance.
During the follow-up period, 40 clinical events
occurred among 37 subjects, including 12
hypertension, three hypertension and type 2
diabetes, nine cancer, seven coronary heart
disease, four stroke, and two type 2 diabetes.
Twenty-eight of the 40 diseases occurred in 25
individuals who were part of the most
insulin-resistant tertile. Facchini FS, Hua N,
Abbasi F, Reaven GM. Insulin resistance as a
predictor of age-related disease. J Clin
Endocrinol Metab 2001863574-8.
No diseases developed in the subjects with normal
insulin sensitivity, which was (according to the
authors) seems to be truly remarkable.
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15Grains and bread contain excessive amounts of
pro-inflammatory omega-6 fatty acids, gluten (to
which many are sensitive) and lectins that
inflame the gut and promote systemic disease.
They are deficient in such key nutrients as
vitamins C, A, B12 and beta-carotene.1 The pH of
grains is acidic. Lowering body pH can promote
inflammation, pain and osteoporosis. David
Seaman, author of Clinical Nutrition for Pain,
Inflammation, and Tissue Healing.
16We are genetically accustomed to a 11 ratio of
omega-6 (n6) to omega-3 (n3) fatty acids. Under
41 is an acceptable ratio, however, as the ratio
increases, so does inflammation. The average
American's ratio range is from 101 to 301,
reflecting an extreme aberration that creates a
pro-inflammatory state, which is thought to
promote pain inflammation cancer heart
disease Alzheimer's disease inflammatory gut
disease depression osteoporosis and most of
the other chronic diseases from which we suffer
David Seaman, author of Clinical Nutrition for
Pain, Inflammation, and Tissue Healing.
17Consider oatmeal, a very common breakfast food,
for example. In one quarter of a cup of rolled
oats, we are treated to .44 mg of linoleic acid
(n6) and .02 mg of linolenic acid (n3), which
reflects a 211 ratio of n6 to n3.3 White bread
provides a 211 ratio, while whole wheat contains
a 271 ratio.3 Potato chips boast a 601 ratio,
and corn chips provide a 121 ratio
David Seaman, author of Clinical Nutrition for
Pain, Inflammation, and Tissue Healing.
18Vegetables such as kale broccoli cauliflower
spinach collard and mustard greens arugala
Swiss chard and chicory are excellent sources.
The spring green mix, also called field greens,
California greens or Mesclun greens, is a great
source. These make an excellent salad and should
replace iceberg lettuce. Most fresh fish is rich
in n-3s, as is wild game. Today, people can even
buy n-3-rich eggs, such as Eggland's Best, found
in most supermarkets. Health food stores
typically carry the Country Hen or Gold Circle
Farms brands. Flaxseed can be sprinkled on salads
and fruits, and flaxseed oil can be used in salad
dressings. David Seaman, author of Clinical
Nutrition for Pain, Inflammation, and Tissue
Healing.
19Broccoli Provides an Impressive 13 Ratio of N6
to N3, and Kale Offers a 11.3 Ratio, While Most
Lettuces Give a 12 Ratio.3 Fish Ranges From 11
to 17
The ratio of n6 to n3 in fruits generally ranges
from 21 to 11. For example, blueberries are
noted for their heavy concentration of
bioflavonoids they produce a 43 ratio of n6n3.
Cherries are also rich in flavonoids and provide
a 11 ratio. The banana, one of the more commonly
eaten fruits, possesses a 21 ratio
David Seaman, author of Clinical Nutrition for
Pain, Inflammation, and Tissue Healing.
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21Most degenerative diseases are caused by chronic
inflammation, so our supplemental approach should
be supportive of reducing inflammation. Nicklas
BJ, You T, Pahor M. Behavioral treatments for
chronic systemic inflammation effects of dietary
weight loss and exercise training. Can Med Assoc
J 20051721199-1209.
22Omega-3 Supplements At This Point, It Should Be
Clear That We Gorge Ourselves With N6 Fatty Acids
and Create a Pro-inflammatory State That Drives
Inflammation, Pain and Chronic Disease.
Regretfully, It Is Nearly Impossible to Ensure a
Proper Ratio of N6n3 If You Plan to Do Anything
but Shop and Prepare Meals. I Strongly Suggest
That You Immediately Begin a Lifelong
Supplementation Program Involving N3 Fatty Acids,
Particularly eicosapentaenoic Acid (EPA) and
docosahexanoic Acid (DHA). We Find These in Fresh
Fish and Wild Game to Varying Degrees. However,
They Are Most Commonly Associated With Fish, So
EPA and DHA Supplements Are Typically Referred to
As Fish Oil.
David Seaman, author of Clinical Nutrition for
Pain, Inflammation, and Tissue Healing.
23EPA-DHA 720 provides 720 mg of omega-3 essential
fatty acids from cold water fish per
softgeleicosapentaenoic acid (EPA) and
docosahexaenoic acid (DHA)to help deliver
greater support in fewer softgels.Supplies high
levels of EPA and DHA, which have been shown to
support healthy function in body systems
including cardiovascular, immune,
gastrointestinal, and musculoskeletal. Omega-3
fatty acids such as EPA and DHA are vital for
healthy nervous system function. Features a
unique antioxidant blend of vitamin E, ascorbyl
palmitate, and rosemary to stabilize the oil for
maximum freshness.
24Kaprex provides a safer option for effective
joint relief. This proprietary combination of
selected plant components influences kinase
signaling and the formation of certain substances
that are associated with minor pain. Clinical
testing suggests that Kaprex may offer a high
degree of predicted cardiovascular, gastric,
renal, and liver safety. Provides effective
joint relief that is worry-free. Modulates
prostaglandin E2 (PGE2) production at specific
target cells. Features SKRMs in the form of
THIAA to modulate kinase activity in favor of
good health. The ingredient synergy of
Tetrase, oleanolic acid, and rosemary provide
efficacy at a low dose for a maximum
cost-effectiveness. Developed through the
ExpresSyn Process, which combines cell proteomic
research, safety evaluations, human ex vivo
research, and clinical testing for maximum safety
and effectiveness. EACH SOFTGEL SUPPLIESA
proprietary blend of  350 mgTetrase,
(Tetrahydro-iso-alpha acids complex, from hops)
(Humulus lupulus L.), Oleanolic Acid (from olive
leaf extract, Olea europaea), Rosemary Leaf
Extract (Rosmarinus officinalis)
25Inflavonoid is expertly formulated to provide
relief from minor pain and support healthy muscle
tissue. It is the perfect choice for patients
whose muscles are impacted by physical stressors,
poor posture, and even inactivity. Supports
healthy eicosanoid synthesis such as
prostaglandins, thromboxanes, and leukotrienes
that can affect muscle and connective tissue.
Provides Ayurvedic herbs traditionally used to
support healthy muscle tissue. Provides lemon
bioflavonoids and vitamin C, which help to
protect connective tissues from damaging free
radicals.
26UltraInflamX Plus 360 is a medical food
formulated to provide specialized nutritional
supportincluding reduced iso-alpha acids (RIAA,
from hops), L-glutamine, and easily digestible
rice proteinfor patients experiencing
inflammation and pain associated with
inflammatory bowel disease (IBD), such as Crohn's
disease and ulcerative colitis.
                    Features selective kinase
response modulators (SKRMs) in the form of RIAA,
which has been shown to beneficially influence
the function of enzymes involved in inflammatory
processes. Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â RIAA has
demonstrated potent antioxidant activity and
research suggests that it may help improve
overall redox status through influencing
inflammation signaling molecules such as NF-?B,
COX-2, and PGE2 Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Includes
ginger and rosemary, which may help support
healthy eicosanoid and cytokine metabolism
                    Provides turmeric extract,
which has been shown in research to inhibit the
activities of a wide variety of enzymes,
cytokines, eicosanoids, and reactive species
implicated in pain and inflammation
                    Supplies a low-allergenic
potential protein base in the form of rice
protein concentrate Â
27HOW TO AGE RAPIDLY OR NOT!by Pauline N. Harding,
MD, who is residency trained in Internal
Medicine, Board Certified in Family Practice, and
licensed as a Nutrition Counselor. She is an
instructor in the Department of Family Practice
at the University of Illinois College of Medicine
in Chicago. She has been on the speakers' forum
for the Rush Presbyterian St. Luke's Medical
Center Conference for Body-Mind Healing and the
Wilson Foundation Conference on Ethics for High
School Science Teachers, and she has acted as
panel discussant for the American Psychological
Association. Dr. Harding is Medical Director at
Prairie Trail Family Medicine in Winfield,
Illinois. Her medical practice embraces a
potpourri of natural healing techniques,
especially as they apply to problems associated
with environmental sensitivity and other
allergies, fibromyalgia, chronic fatigue,
colitis, sleep disturbances, and menopause.
. . . the "chin forward" posture also invites
rapid aging, especially of cognitive functions.
28The inflammatory propensity survey   Please
check any of the boxes that may apply to you. Â Â
- ? I have or had been diagnosed with any of the
following arthritis, fibromyalgia, chronic
fatigue syndrome, sinusitis, allergies, acne,
asthma, digestive conditions, flu symptoms,
dysmenorrhea, endometriosis, Alzheimers disease,
Parkinsons disease, multiple sclerosis, cancer,
heart disease, osteoporosis, hypertension,
depression, the insulin resistance syndrome
(pre-diabetes), or diabetes. - ? I seem to wake up with lots of joint stiffness.
- ? I take anti-inflammatory meds at least once per
week. - ? I regularly eat cheese in more than condiment
size portions. - ? I have an unhealthy BMI or I need to lose
weight - ? I have a waiste to hip ratio of greater 11
- ? I have neck or back pain and or stiffness
- ? I feel mentally drained most days of the week
and have feelings of depression. - ? I feel older that what I should for my age.
- I am chronically tired.
- I consume breads and cereals daily
- I consume refined sugar and or baked goods
several times per week - ? I consume fried foods and other foods that may
have trans fats - ? I consume commercially salad dressings and or
mayonnaise as well as foods cooked with vegetable
oils like corn and safflower - ? I consume processed daily products.
- ? I consume meats and other animal products that
are grain fed. - ? I find it hard to exercise regularly.
- ? My skin seems to be dry and lacks resiliency
- ? I have allergy symptoms and seem to be prone to
seasonal changes
If you have checked any of the boxes above, there
is a strong likelihood that you have at lease a
mild if not a significant inflammatory condition.
29Inflammation, Heart Disease and Stroke The Role
of C-Reactive ProteinHow does inflammation
relate to heart disease and stroke
risk?Inflammation is the process by which the
body responds to injury or an infection.
Laboratory evidence and findings from clinical
and population studies suggest that inflammation
is important in atherosclerosis
(ather-o-skleh-ROsis). This is the process in
which fatty deposits build up in the inner lining
of arteries.C-reactive protein (CRP) is one of
the acute phase proteins that increase during
systemic inflammation. Its been suggested that
testing CRP levels in the blood may be an
additional way to assess cardiovascular disease
risk. A more sensitive CRP test, called a highly
sensitive C-reactive protein (hs-CRP) assay, is
available to determine heart disease risk. The
American Heart Association and the Centers for
Disease Control and Prevention published a joint
scientific statement in 2003 on the use of
inflammatory markers in clinical and public
health practice. This statement was developed
after systematically reviewing the evidence of
association between inflammatory markers (mainly
CRP) and coronary heart disease and
stroke.Whats the role of CRP in predicting
recurrent cardiovascular and stroke events?A
growing number of studies have examined whether
hs-CRP can predict recurrent cardiovascular
disease, stroke and death in different settings.
High levels of hs-CRP consistently
predict recurrent coronary events in patients
with unstable angina and acute myocardial
infarction (heart attack). Higher hs-CRP levels
also are associated with lower survival rates in
these patients. Many studies have suggested that
after adjusting for other prognostic factors,
hs-CRP is useful as a risk predictor.Studies
also suggest that higher levels of hs-CRP may
increase the risk that an artery will reclose
after its been opened by balloon
angioplasty. High levels of hs-CRP in the blood
also seem to predict prognosis and recurrent
events in patients with stroke or peripheral
arterial disease.Whats the role of hs-CRP in
predicting new cardiovascular events?Scientific s
tudies have found that the higher the hs-CRP
levels, the higher the risk of having a heart
attack. In fact, the risk for heart attack in
people in the upper third of hs-CRP levels has
been determined to be twice that of those whose
hs-CRP level is in the lower third. These
prospective studies include men, women and the
elderly. Studies have also found an association
between sudden cardiac death, peripheral arterial
disease and hs-CRP. However not all of the
established cardiovascular risk factors were
controlled for when the association was examined.
The true independent association between hs-CRP
and new cardiovascular events hasnt yet been
established.What causes low-grade
inflammation?The major injurious factors that
promote atherogenesis cigarette smoking,
hypertension, atherogenic lipoproteins, and
hyperglycemia are well established. These risk
factors give rise to a variety of noxious stimuli
that cause the release of chemicals and the
activation of cells involved in the inflammatory
process. These events are thought to contribute
not only to the formation of plaque but may also
contribute to its disruption resulting in the
formation of a blood clot. Thus, virtually every
step in atherogenesis is believed to involve
substances involved in the inflammatory response
and cells that are characteristic of
inflammation.In addition, there is also research
that indicates an infection possibly one caused
by a bacteria or a virus might contribute to or
even cause atherosclerosis. The infectious
bacteria, Chlamydia pneumoniae (klah-MID'e-ah
nu-MO'ne-i), has been shown to have a significant
association to atherosclerotic plaque. The herpes
simplex virus has also been proposed as an
initial inflammatory infectious agent in
atherosclerosis.The notion that chronic
infection can lead to unsuspected disease isn't
foreign to most doctors. For example, bacterial
infection with Helicobacter pylori is now known
to be the major cause of stomach ulcers. The
treatment for this condition now routinely
includes antibiotic therapy.  Should I have my
CRP level measured?If a persons cardiovascular
risk score judged by global risk assessment
is low (the possibility of developing
cardiovascular disease is less than 10 percent in
10 years), no test is immediately warranted. If
the risk score is in the intermediate range
(1020 percent in 10 years), such a test can help
predict a cardiovascular or stroke event and help
direct further evaluation and therapy. However,
the benefits of such therapy based on this
strategy remain uncertain. A person with a high
risk score (greater than 20 percent in 10 years)
or established heart disease or stroke should be
treated intensively regardless of hs-CRP
levels.What is the normal range of hs-CRP
level?If hs-CRP level is lower than 1.0 mg/L, a
person has a low risk of developing
cardiovascular disease.If hs-CRP is between 1.0
and 3.0 mg/L, a person has an average risk.If
hs-CRP is higher than 3.0 mg/L, a person is at
high risk.If, after repeated testing, patients
have persistently unexplained, markedly elevated
hs-CRP (greater than 10.0 mg/L), they should be
evaluated to exclude noncardiovascular causes.
Patients with autoimmune diseases or cancer, as
well as other infectious diseases, may also have
elevated CRP levels.Â
The American Heart Association and the Centers
for Disease Control and Prevention published a
joint scientific statement in 2003 on the use of
inflammatory markers in clinical and public
health practice.
30researchers found that vitamin D deficiency is
associated withincreased inflammation in
otherwise healthy people. Increased inflammation
inthe body can increase the risk of chronic
inflammatory conditions, includingcoronary heart
disease (CHD) and diabetes. Further, the
researchers found thatinflammation was lowered
by simple vitamin D (supplementation)Vitamin D
Lowers InflammationContributed by John Jacob
Cannell, MD, executive director of The Vitamin D
Council
31Recommended Inflammatory Markers Indicating the
Relative Risk of Chronic Degenerative diseases
- hs CRP
- Vitamin D3 levels
- Insulin Resistance (2 hr)
- Sed rate