This St. Patty’s Day: Hoist a Pint for Your Health?

We’re not suggesting that you overdo it this St. Patrick’s Day—but if you do enjoy a drink with your corned beef and cabbage, we want to share some heartening news: Moderate alcohol consumption might actually be good for your health.

We spoke to URMC investigator Dr. John Cullen, whose research found that moderate drinking decreased atherosclerosis, or hardening of the arteries, in mice. This narrowing and stiffening of blood vessels is a serious condition that can pave the path to a heart attack or stroke. With St. Patrick’s Day nearing, we thought it was timely to present facts on the link between alcohol and heart health. We met with Dr. Cullen to learn more.

Scripts: Your research is good news for folks who enjoy drinking.

Cullen: It is, but we must be clear. In our study, we found that moderate, daily alcohol consumption was cardioprotective. By moderate, we mean two drinks per day for a total of 14 per week. How you pace yourself clearly matters, because we also found that binge drinking—say, those same 14 drinks per week, only over a two-day period—actually increased the development of the disease.

Scripts: Can you explain what you mean by “cardioprotective?”

Cullen: We observed three groups of mice that were all put on diets mimicking high-fat Western fare, to encourage the development of fatty deposits – also known as plaque – in the arteries. In the daily, moderate-drinking mice, LDL (or bad cholesterol) plummeted 40 percent. Surprisingly, levels of HDL (or good cholesterol) went up in both the moderate and binge-drinking groups. The volume of plaque also decreased in the moderate-drinking mice, compared to the no-alcohol mice group.

Scripts: So naturally, we wonder: What might we drink, and how often? There’s a lot of information in the news about the health benefits of red wine. Is that better than a martini?

Cullen: The resveratrol ingredient in red wine is a polyphenol, with antioxidant properties that are inherently good for you; there are published studies showing the cardioprotective effects of resveratrol.  However, our recent study results are based on the ethanol (the alcohol itself) present in these drinks. That’s the substance we found (again, in the right amounts) protects arteries. So if you want to help your heart, Irish whiskey works just as well as wine. Just keep it in moderation.

The National Institute on Alcohol Abuse and Alcoholism has a great program called Rethinking Drinking, which explains low- and high-risk drinking, and suggests appropriate amounts to consume. Based on their data they recommend no more than four drinks in any one day and for a total of no more than 14 drinks per week for men. Recommendations for non-pregnant women are no more than three drinks per day and seven drinks per week.

Dr. John Patrick Cullen received a Ph.D. in Cardiovascular Pharmacology from the Queen’s University of Belfast, Ireland. He is currently a Research Associate Professor in the Department of Surgery’s Basic and Translational Research Division. His research interests, among other things, include the effects of alcohol consumption patterns on the development of atherosclerosis.

A Heart-to-Heart on Cardiac Health

February is overrun with the hearts and flowers fanfare of Valentine’s Day. But long after bouquets have wilted and chocolate boxes have been picked over, our hearts should continue a steady beat.

The statistics about heart disease are staggering – it causes more deaths each year than all forms of cancer combined, even though it’s preventable for some people.  Doctors use American Heart Month to remind us to be good to our hearts, so we’ve asked cardiologist Dr. Jeffrey Alexis for some tips.

Scripts:  What’s the best ways we can help prevent problems with our heart?

Alexis:  We can all work to keep our hearts healthy by avoiding tobacco, eating right and getting more exercise.  Smoking damages so many parts of our body; if you’re addicted to tobacco, do whatever it takes to quit.  Miraculously, your body can reverse the damage caused by smoking.   Check out New York State Smokers Quitline for tips and access to resources.

Obesity also contributes to a variety of diseases that can hinder heart functioning. Stay trim, eat a nutritious, plant-based diet – with low-salt and low-calorie foods. Don’t drink too much alcohol.  Make sure you get enough exercise – 30 to 60 minutes per day. This protects against heart disease by:

• helping the heart work more efficiently;
• reducing blood pressure;
• decreasing the tendency of blood to form life-threatening clots;
• moderating stress;
• helping your body use insulin; and,
• helping you maintain a healthy weight.

Scripts:  How do we know if cardiovascular problems are beginning? Are there warning signs?

Alexis:  Pay attention to your blood pressure and cholesterol levels; it’s really important that you know these numbers. 

Regular blood pressure screenings start in childhood. Adults should have their blood pressure checked at least every two years. You may need more-frequent checks if your numbers aren’t ideal, or if you have other risk factors for heart disease. Optimal blood pressure is less than 120/80 millimeters of mercury. There are many inexpensive medications that doctors prescribe to help manage blood pressure or hypertension, and stave off heart disease, if your numbers are high.

Adults should have their cholesterol measured every five years. You may need more frequent testing if your levels are off, or if you have other risk factors for heart disease.  Doctors sometimes even check children’s cholesterol levels if there’s a strong family history of heart disease.  An ounce of prevention goes a long way.

Dr. Jeffrey Alexis is a member of the URMC Program in Heart Failure and Transplantation team, which cares for people with advanced heart disease. 

For more information about heart care, visit URMC’s Heart and Vascular Center or call 275-2877.

Does ‘Good’ Cholesterol Still Deserve its Halo?

For years, cardiologists have revered high-density lipoproteins – the so-called “good cholesterol” – for their work ferrying fats along the bloodstream and out through the liver. Having high levels of these fat-moving molecules has been long considered key for a smooth-humming heart and blood vessel network.

Until recently, at least.

New research published in last week’s The Lancet is “compelling and disturbing,” according to a number of high-profile clinician-scientists cited by the New York Times. The research findings, which looked at the DNA from tens of thousands of Americans, show that “good genes” known to raise HDL levels actually had no bearing on an individual’s risk for heart disease.

Could the recent trial’s results shake up cholesterol science as we know it? We spoke to preventive cardiologist Dr. Robert Block to find out.

Scripts: Can you back up and explain, briefly, the difference between HDL and LDL?

Block: Happily. HDL, as you’ve noted, is the high-density lipoprotein (historically dubbed “good” cholesterol); LDL is low-density lipoprotein (or “bad” cholesterol). Here’s a simple analogy: We often refer to LDL as the “garbage” that clogs up arteries, and HDL as the “garbage trucks” that collect it. In other words, LDL causes blood vessel disease, heart attacks and strokes, whereas HDL actively helps avert it by keeping the circulatory system free and clear.

Besides being “good,” HDL also has been considered “smart”; it has many characteristics that help to regulate overall cholesterol metabolism. Remember, cholesterol is an essential ingredient in building cell membranes, human hormones, and more.

Scripts: For many years we’ve accepted, almost as fact, that high HDL levels are protective. What’s propped up this theory?

Block: The Framingham Heart Study, for starters. It’s a landmark, longitudinal heart-health research project. Initially launched in 1948, it continues to follow participants in an effort to better understand heart disease risk factors. Repeatedly, the Framingham study has shown HDL levels to be better predictors of heart attacks than LDL levels, or other types of cholesterol levels (triglycerides, etc.)

You could also look at the gender argument. As a group, women tend to have higher HDL levels than men, and also a lower risk of cardiovascular disease events to boot. So the two appear connected. Other studies, such as the 1990s Veterans Affairs High-Density Lipoprotein Intervention Trial (VA-HIT), showed that an increase in HDL (thanks to gemfibrozil, a medication that boosts HDL levels) was tied to a significant risk reduction for cardiovascular disease.

On the other hand, as the Times recently pointed out, another prominent HDL project – the AIM-HIGH study – showed little promise and was halted early.

AIM-HIGH set out to test whether a double-punch – raising HDL levels and lowering triglycerides – could reduce the likelihood of repeat heart and vascular problems in people with well-controlled LDL levels. On a cursory glance, the mere fact that the study closed early might seem to deflate the “high-HDL-helps” theory a bit, but it’s worth looking at the study design. In AIM-HIGH participants, the LDL (“bad” cholesterol) levels already were rather low. Going back to our garbage analogy, you can think of it this way: If you have little in the way of trash, amping up your fleet of garbage removal trucks won’t matter much. This goes to show that all findings need to be taken in context of the trial’s design, its inherent limits, and of course, other parallel studies.

Scripts: Well said. Still, researchers say that this may be a perfect example of two factors having an associative, but not causative, relationship. Can you explain this idea to us?

Block: Certainly. And it’s a very good point. “Associative,” in this case, means that having a high or low level of a given molecule correlates with either high or low risk for a linked disease. “Causative,” just like it sounds, would go a step further, attributing credit (or blame!) and implying that the molecule actually causes the disease.

For the HDL saga, if only an association exists between HDL levels and heart disease risk, then raising or lowering HDL blood content would have little power to fend off heart disease and stroke. And that’s not impossible; it’s at least conceivable that HDL is merely a marker (associated and predictive, but not actually causative) of heart disease risk. Current data from many studies, however, have strongly suggested that HDL actually is protective (causative) in preventing the arterial hardening that leads to heart attacks and strokes. That’s why I’m taking the Lancet study’s results with a grain of salt. In large part, it’s a step removed from the real issue: Genetics is just one of a whole host of factors that shape a person’s overall blood HDL level. So to jump right from genes to heart disease risk is a bit of an oversimplification. So many other things work together to influence HDL levels.

Scripts: Even so, the Lancet study seems to have shaken up some big players in the field of HDL research. Do you think this will have major implications for current investigations and clinical care?

Block: I doubt this one study will change the game much. It certainly will (and should) stimulate more research regarding HDL function and metabolism.

It’s interesting to note that a less-talked-about measure, known as the “non-HDL” cholesterol level (this is, simply subtracting HDL from total cholesterol), has been shown in some very large, reputable studies to be a far better predictor of cardiovascular disease risk than LDL and some other blood cholesterol molecules. This is important, as it nods to HDL as an important part of the equation. Another perk of this “non-HDL” measure is that it’s highly practical – it’s valid in the fasting and non-fasting states.

Dr. Block specializes in the care of patients with high blood cholesterol levels. If you’ve been diagnosed with unhealthy cholesterol levels, and are you looking for help getting them under control, call URMC’s Lipid Clinic at URMC at (585) 341-7700.

The Latest Claim: Some ‘Fried Foods’ OK for the Heart

No, it’s not carte blanche to toss aside the carrot sticks and gleefully chow down on drive-thru fare.

Rather, new research from Spain (which followed 40,000-some Spaniards for 12 years), suggests that not all “fried foods” deserve to be demonized. Researchers found that, so long as the cooking involves healthier fats, like olive and canola oils, the occasional indulgence might not significantly increase risk for heart disease. What’s more, it may even be a smart part of a balanced diet.

“Like so much nutrition advice, this all boils down to moderation,” said registered dietitian Tracy Cherry, a clinical nutrition specialist with URMC’s Cardiac Rehabilitation program. “Integrating a reasonable amount of heart-healthy oil into our cooking can go a long way toward keeping our diet interesting – and maintainable.”

In the interview below, Cherry talks about the rightful place for some “fried fare” on our daily plate.

Scripts: There seems to be a bit of a disconnect, here. In the U.S., the term “fried” is usually a dead giveaway that a food item is chocked full of fat, salt, and other unsavory ingredients – but this study is almost putting a halo on some fried foods. Can you expound?

Cherry: Here in the U.S., the notion of “frying” foods conjures up thoughts of battered fish fries and greasy, sugared donuts (which almost act like sponges to soak up fats!). But this study took place in Spain, where residents eat a more traditional Mediterranean diet; they’re rarely breading and deep-frying salty, sugary foods in Crisco-like fats – but rather, they’re stir-frying veggies or pan-frying undressed fish, using just a couple of teaspoons of olive oil. There’s a world of difference between these two concepts of what it means to “fry.”

Scripts: Tell us more about heart-healthy oils.

Cherry: Really, oils in general – especially olive and canola oils (though peanut, grape seed, and sunflower oils aren’t a bad second choice) – are more heart-healthy than solid, saturated fats, which tend to raise “bad” cholesterol levels in the blood, upping one’s risk for heart disease. 

But portion size matters, too. Oils and solid fats pack the same calorie content, tablespoon for tablespoon, so it’s smart to budget just a teaspoon of oil per serving when you’re cooking. That’s why stir-frying, sauteing and pan-frying are far better options; you can cook a really flavorful meal without having to douse it in a bath of bubbling fat. For an even leaner option, you can supplement the pan oil with a few splashes of water, or a cooking spray; it can help with the cost, too, and no one will be the wiser.

Scripts: You touched on this earlier, but does breading really make a big difference?

Cherry: You’d be surprised, but yes, it does. Again, it almost mops up oils – and the U.S. dietary guidelines recommend just one or two tablespoons of fats per person per day. (Remember, there are plenty of other sources that can supply fat – mayonnaise, peanut butter, olives, and walnuts – so there’s no need to “spend” all of your allowance in one place.)

Scripts: You talk about fats very matter-of-factly – as if they’re not necessarily bad. Why is that?

Cherry: It’s the truth! Back in the 80s and 90s, the party line was that all fats were evil; diet foods touted “no-fat” labels with pride, as Americans ruthlessly ridded the full-fat versions from their cupboards.

Now, we’re much savvier; we realize that small amounts of fat are beneficial, even essential, to our diet. Brain-building omega-3 fatty acids, found in foods like walnuts and fish, promote vigorous neurodevelopment in infants (even in-utero). Omega-3’s are also thought to help pull down triglycerides (bad fats in the bloodstream), help patients with arrhythmias (irregular heartbeats), and lower overall blood pressure.

Scripts: So, what’s the takeaway?

Cherry: I might sounds like a broken record, but it’s important: Moderation. Using modest amounts of healthy oils while cooking can go a long way toward creating a flavorful, heart-healthy meals that won’t derail your diet.

To learn more about heart care at URMC – including our cardiac rehabilitation programs – click here.

Men: What’s in Your Six Pack?

Men often neglect their health until something starts to go wrong – usually around middle age. And after all those years of not paying attention to their bodies, men in their 50s and 60s can feel overwhelmed by the chore of making health changes, asking themselves “How do I even get started?”

Aging expert Dr. Roger Oskvig has a quick and easy checklist of six things – what he calls the “six pack” – that every man needs to know to get started on the road to fitness. In the clip below, he also throws in a few extra handy tips about exercise and eating well, too.

Eighth Annual Men’s Health Day is Sept. 23

When it comes to your health, being a little proactive can go a long way; that’s why the University of Rochester Medical Center is inviting men to its eighth annual Men’s Health Day on Sept. 23. Geared toward men ages 45 and older, the day-long festivities will present a unique (non-nagging) opportunity to learn about health topics ranging from cardiovascular wellness and prostate health to cataract surgery and sleep disorders.

Want to register for this year’s Men’s Health Day event? Act fast! In 2010, Men’s Health Day sold out, attracting more than 400 men.

In addition to terrific speakers, the day will also include health screenings, hands-on demonstrations, giveaways, healthy snacks, breakfast and lunch, and deluxe raffle prizes. New this year, attendees also can receive an individual analysis of their “gait,” since the way you walk can predict the likelihood of a fall. A flu shot clinic also will be available.

Tickets are on sale now and can be reserved by calling (585) 275-2838. Admission is $15 and includes everything: breakfast, lunch, giveaways, prizes, and free parking at the Hyatt Regency Rochester (125 Main Street).

For more information, visit www.menshealth.urmc.edu.