We caught up with Dr. Comilla Sasson, the American Heart Association’s VP for science and innovation. She’s an emergency physician who teaches at the University of Colorado. She’d traveled to New York City to “help with the response,” and she talked with us from a field hospital that had been set up on a tennis court in Central Park.
She had lots to say about what’s driving patients away from emergency departments these days and what’s likely to happen in medicine (hello, telemedicine!) once the pandemic abates.
Running time: 15 minutes
From a BMJ Open Heart online study (March 8, 2020):
Overall, the evidence in the literature suggests that spirulina improves several well-established CVD risk factors including hyperlipidaemia and seems to provide benefits around weight loss.
Although caloric restriction and exercise are the mainstay treatments for obesity, spirulina has shown significant benefits in aiding weight loss. The phycocyanin in spirulina contains a light-harvesting chromophore called phycocyanobilin, which is capable of inhibiting nicotinamide adenine dinucleotide phosphate hydrogen (NADPH) oxidase, a significant source of oxidative stress in adipocytes playing a key role in inducing insulin resistance and shifting adipokine and cytokine production in hypertrophied adipocytes. Thus, by suppressing adipocyte oxidative stress, spirulina may lead to systemic anti-inflammatory and insulin-sensitising effects.
Spirulina is both a salt and fresh water blue-green algae, which is being increasingly studied recently. Spirulina was initially classified under the plant kingdom due to its rich plant pigments and its ability to photosynthesize, but was later placed into bacterial kingdom (cyanobacteria) due to its genetic, physiological and biochemical makeup. Spirulina grows naturally in high salt alkaline water reservoirs in subtropical and tropical areas of America, Mexico, Asia and Central Africa.
From a BMJ Research study (March 4, 2020):
Habitual fish oil supplementation is associated with a 13% lower risk of all cause mortality, a 16% lower risk of CVD mortality, and a 7% lower risk of CVD events among the general population
Fish oil is a rich source of long chain omega 3 fatty acids, a group of polyunsaturated fats that primarily include eicosapentaenoic acid and docosahexaenoic acid. Initially, these compounds were recommended for daily omega 3 fatty acid supplementation for the prevention of cardiovascular disease (CVD). Consequently, the use of fish oil supplements is widespread in the United Kingdom and other developed countries.
Several mechanisms could explain the benefits for clinical outcome derived from fish oil supplementation. Firstly, the results of several studies have indicated that supplementation with omega 3 fatty acids has beneficial effects on blood pressure, plasma triglycerides, and heart rate, all of which would exert a protective effect against the development of CVD. Secondly, several trials have shown that omega 3 fatty acids can improve flow mediated arterial dilatation, which is a measure of endothelial function and health. Thirdly, omega 3 fatty acids have been shown to possess antiarrhythmic properties that could be clinically beneficial. Finally, studies have reported that fish oil can reduce thrombosis. Additionally, studies have reported that the anti-inflammatory properties of fish oil could have a preventive role in the pathophysiology of CVD outcomes. Other mechanisms could also be involved to explain the effect of fish oil on CVD outcomes.
Hazen and colleagues find that gut bacteria play a central role in the conversion of dietary proteins into a compound, phenylacetylglutamine ( PAGln), which not only is associated with future cardiovascular disease risk in humans but also promotes platelet responsiveness and blood clotting potentially via adrenergic receptors, according to mouse models.
From a BMJ Research online study (March 4, 2020):
We found no association between egg consumption and risk of cardiovascular disease in three large US cohorts. Results from the updated meta-analysis lend further support to the overall lack of an association between moderate egg consumption (up to one egg per day) and cardiovascular disease risk.
Eggs are a major source of dietary cholesterol, but they are also an affordable source of high quality protein, iron, unsaturated fatty acids, phospholipids, and carotenoids.
Introduction: In the United States, cardiovascular disease is the leading cause of death in men and women. Diet and lifestyle undisputedly play a major part in the development of cardiovascular disease. In the past, limiting dietary cholesterol intake to 300 mg per day was widely recommended to prevent cardiovascular disease. However, because of the weak association between dietary cholesterol and blood cholesterol, and considering that dietary cholesterol is no longer a nutrient of concern for overconsumption, the most recent 2015 dietary guidelines for Americans did not carry forward this recommendation.
From a MedPageToday.com online article (March 2, 2020):
“Dysfunctional sleep likely is by far the most prevalent comorbidity in CVD. This makes it essential to explore the nature of sleep, but this is reliant on the enthusiasm of clinician scientists,” according to the editorialists.
“In modern society, both the quantity and quality of sleep are negatively influenced by factors such as longer hours of work, more shift work, artificial light and cell phones, all leading to self-reported daytime symptoms such as fatigue, tiredness, and sleepiness,”
A larger range in individual sleep duration and sleep timing across 7 days of wrist actigraphy was associated with significantly more CVD events over a median 4.9 years of follow-up (P=0.002 for both trends).
On the Mayo Clinic Radio program, Dr. Todd Miller, a Mayo Clinic cardiologist, explains how exercise affects the heart. This interview originally aired Feb. 22, 2020. Learn more about exercise and the heart: https://www.mayoclinic.org/healthy-li…
From a Journal of Epidemiology & Community Health online release:
The 10 year CVD (cardiovascular disease) incidence increased significantly across the baseline SMI (skeletal muscle mass index) tertiles (p<0.001). Baseline SMM (Skeletal muscle mass) showed a significant inverse association with the 10 year CVD incidence (HR 0.06, 95% CI 0.005 to 0.78), even after adjusting for various confounders. Additionally, participants in the highest SMM tertile had 81% (95% CI 0.04 to 0.85) lower risk for a CVD event as compared with those in the lowest SMM tertile.
Background Skeletal muscle mass (SMM) is inversely associated with cardiometabolic health and the ageing process. The aim of the present work was to evaluate the relation between SMM and 10 year cardiovascular disease (CVD) incidence, among CVD-free adults 45+ years old.
Methods ATTICA is a prospective, population-based study that recruited 3042 adults without pre-existing CVD from the Greek general population (Caucasians; age ≥18 years; 1514 men). The 10 year study follow-up (2011–2012) captured the fatal/non-fatal CVD incidence in 2020 participants (50% men). The working sample consisted of 1019 participants, 45+ years old (men: n=534; women: n=485). A skeletal muscle mass index (SMI) was created to reflect SMM, using appendicular skeletal muscle mass (ASM) standardised by body mass index (BMI). ASM and SMI were calculated with specific indirect population formulas.
The global population is ageing at an unprecedented speed, especially in Europe. As a concept, ageing is considered a continuous process starting from birth and is accompanied by various physiological changes and a number of comorbidities1 2 that affect health and quality of life.3 4 Skeletal muscle mass (SMM)4 alterations are among these physiological changes.
SMM tissue decline, as a part of these physiological changes, starts in middle age (or even earlier, in the 30s) and progresses in more advanced age.5 It has been shown that SMM declines with a rate of more than 3% per decade starting from the age of 30+.6 Half of the human body’s mass is actually SMM and it has an active role in numerous metabolic pathways.5 7 SMM decline is related, among others, to various disability patterns, poor mental health and increased mortality.5 7 8 In addition, well documented studies have shown that SMM alterations are related to cardiovascular health,9 10 even different muscle morphology.11 Recently, Srikanthan et al 12 reported the importance of muscle tissue in relation to cardiovascular disease (CVD) and total mortality in stable CVD patients.