Being regular is dangerous to your health

25. September 2011 William Davis (21)
No, I'm not referring to your daily morning ritual in the bathroom. I'm talking about heart rate.

Counterintuitively, a perfectly regular heart rate is a marker of poor health. People with perfect regularity of heart rate have more heart attacks, for instance.

Regularity of heart rate occurs more commonly in people with hypertension and other metabolic derangements, and it signals increased risk for both heart attack and death. A perfectly regular heart rate, i.e., no variation in the time interval from beat to beat, suggests that the parasympathetic nervous system, the component of automatic ("autonomic") nervous system control that is associated with the relaxation response, feelings of well-being, quiet, and relaxation, is weak. It also means that the opposing sympathetic nervous sytem that regulates the "fight or flight," adrenaline-like response is allowed to be dominant. Dominance of the sympathetic over the parasympathetic system generates regularity of heart rate. Heart rate also tends to be faster, e.g., 85 beats per minutes rather than 55 or 60 beats per minute. So perfect regularity, as well as increased rate, is undesirable.

What we want is irregularity of heart rate. But not irregularity that occurs chaotically with no rhyme or reason. More precisely, we want variability in heart rate. And we want variability to occur in synchrony with breathing, i.e., the respiratory cycle.

The ideal response is:

1) increase in heart rate with inspiration

2) decrease in heart rate with expiration.

Heart rate in healthy people typically varies 15-20 beats per minute within the respiratory cycle, e.g., 60 bpm at end-exhalation, 80 bpm at end-inspiration.

Restoration of increased heart rate variability is associated with reduced blood pressure, reduced blood sugars (HbA1c), reduced inflammatory markers and cortisol (associated with stress), even an increase in DHEA levels. Feelings of well-being and calm also develop.

Among the strategies to consider to restore heightened heart rate variability and slowed heart rate include:

--Omega-3 fatty acid supplementation
--Exercise
--Weight loss
--Deep breathing exercises
--Meditation, prayer, and biofeedback

For our Track Your Plaque purposes, we are folding in the HeartMath strategies, i.e., use of a heart rate monitor that calculates heart rate variability in the context of respiratory cycle. If you've not already done so, take a look at the two Special Reports devoted to this topic on the Track Your Plaque website.
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Comments (21) -

  • Tim Huntley

    9/25/2011 2:06:58 PM |

    Dr. Davis,

    I have spent about 6 months taking daily HRV measurements using a Suunto t6d watch and analyzing the output with a software tool from Kubios.  From my n=1 experience, the most meaningful long-term impact to improved HRV has been regular exercise.  A lot of the research studies I looked at are in agreement with the other factors you mentioned above; however some of the factors tend to be more transitory (breathing, meditation, etc. ) and create a change during the time that you are working on them vs. the more lasting effects from exercise.

    I would be happy to share more specifics from my experience if you are interested.

    ...Tim

  • me@me.com

    9/25/2011 3:20:56 PM |

    Dear "Dr. Davis"

    i'd love to read more !

    warmly
    interested one Smile

  • Geoffrey Levens, L.Ac.

    9/25/2011 4:20:46 PM |

    The folks at Heart Math have had this mastered for years.  Books, classes, seminars, and they sell a portable and a computer based biofeedback device for training "coherence".  I am not affiliated with them in any way and do not sell their products but I do think it is a pretty good way to get into the whole arena of meditation and of very directly training HRV.

  • Diana

    9/25/2011 8:01:23 PM |

    This is really interesting, because it goes along exactly with what I learned in studying midwifery - that hearing an absolutely regular/non-variable heartbeat on a fetoscope is a sign of a seriously compromised baby. Interesting that that carries on into the adult world!

  • LINDA

    9/25/2011 9:19:57 PM |

    (The FASEB Journal. 2011;25:971.10)
    © 2011 FASEB
    ________________________________________
    971.10
    Daily apple consumption promotes cardiovascular health in postmenopausal women
    Sheau C Chai, Shirin Hooshmand, Raz L Saadat and Bahram H Arjmandi
    Nutrition, Food & Exercise Sciences, Florida State University, Tallahassee, FL
    Animal findings suggest that apple and its components, e.g. apple pectin and polyphenols improve lipid metabolism and lower the production of proinflammatory molecules. To our knowledge, the present study is the first that evaluated the cardioprotective effects of daily consumption of apple for one year in postmenopausal women. Qualified women (160) were randomly assigned to one of the two dietary intervention groups: dried apple (75g/day) or comparative control dried fruit. Fasting blood samples were collected at baseline, 3-, 6-, and 12-month to measure various parameters. Our findings indicate that the additional daily caloric intake of ~240 from dried apple not only do not increase body weight but rather lower it by 1.5 kg without altering habitual dietary intake. In this study, apple consumption significantly reduced serum levels of TC and LDL by 14% and 23%, respectively. The daily apple consumption also profoundly improved atherogenic risk ratios in addition to lowering serum levels of lipid hydroperoxide (33%) and C-reactive protein (32%). In conclusion, incorporation of apple into regular diet is encouraged because of its highly favorable effects in reducing the risk factors for cardiovascular disease.
    Grant Funding Source: Partly supported by USDA
    Table of Contents
    This Article
    1.  FASEB J. April 2011 25 (Meeting Abstract Supplement) 971.10
    1.  Â» Meeting Abstract

  • LINDA

    9/25/2011 10:27:18 PM |

    Effects on Thyroid
    The National Institutes of Health (NIH) note that although little scientific data is available about the effects of flax on the thyroid, some experts in natural medicine advise that patients avoid flaxseed in cases of hypothyroidism. (See Resource 2) The Univeristy of Maryland Medical Center also suggests that patients with thyroid disorders stay away from flaxseed and other foods that may interfere with thyroid function. (See Reference 3)
    Goitrogens
    Thiocyanite, a substance found in flax products and other foods, such as apricots, rye, millet and broccoli, might act as a goitrogen-that is, it may block the uptake of iodine in the thyroid gland. When your diet is too rich in goitrogens and too low in iodine, it can cause the thyroid gland to swell and form a lump, or goiter. However, the typical diet in the United States contains enough iodine that problems like goiter have been practically eliminated, so goitrogens should not be a concern for the average American. (See Reference 2, pages 100-101)
    Read more: Flaxseed and Thyroid Disease | eHow.com http://www.ehow.com/facts_5629982_flaxseed-thyroid-disease.html#ixzz1Z0N1SV8j

  • Dr. William Davis

    9/26/2011 12:37:25 PM |

    I didn't know that, Diana!

    That's very interesting, a phenomenon consistent in widely variable situations.

  • Dr. William Davis

    9/26/2011 12:38:51 PM |

    Hi, Geoffrey--

    My experience with HeartMath goes back around 15 years, long ago that I still remember using Holter monitors, shipping the tape to LA, and waiting for the analysis to come back--long delay, no real-time feedback.

    The new do-it-yourself device really changes the entire equation: real-time feedback, much faster results.

  • Dr. William Davis

    9/26/2011 12:41:32 PM |

    Hi, Tim--

    I'd love to hear more! Specifically, what is the heart rate feedback like on your watch? Is it a visible signal?

    You are absolutely correct: Many effects are transitory. However, the more you do it, the more you habituate the response, the more likely it becomes "coherence" occurs spontaneously.

  • Teresa

    9/26/2011 4:14:34 PM |

    HeartMath exercises are more than regular breathing.  They advocate activating a positive feeling, such as gratitude or appreciation, during the breathing exercises.  This helps maintain the increased heart rate variability.  Here is a link to one of their techniques.  

    http://www.heartmath.com/personal-use/quick-coherence-technique.html

    This is a summary of some of the scientific concepts of HeartMath.  It is an older publication, but still interesting to read.

    http://www.heartmath.org/research/science-of-the-heart/introduction.html

    More research studies are listed here.

    http://www.heartmath.org/research/research-library/research-library.html#educational-research

    While the computer programs and gadgets are helpful, they are not essential to learning and being successful with the techniques.

    Teresa

    P.S.  I am not affiliated with HeartMath in any way except that I have a relative who works for them.  I don't make any money off of them.

  • Bill

    9/26/2011 8:03:36 PM |

    With regard to your play on "being regular", apart from being grain free with not one lapse for 4 years, I have been squatting for 5 years and believe it's natural and very beneficial. Strongly recommend!

  • Dr. William Davis

    9/27/2011 2:53:40 AM |

    Hi, Teresa--

    Yes, there are many ways to achieve enhanced parasympathetic tone, HeartMath coherence being one of them.

    You could meditate for months to years, you could perform thermal biofeedback. What I like about HeartMath is its immediate accessibiity.

  • Rita

    9/27/2011 10:44:58 AM |

    This is just a housekeeping issue. I used to get your posts via email but not for months now. When I try to re-subscribe, Feedburner says I am already subscribed, but still no posts come to email. Can you get this fixed? Thanks.

  • Makro

    9/28/2011 12:21:30 PM |

    Dr. Davis - OT question:

    When is WB showing up in the Kindle store? Looking forward to giving it a read.

  • MaryB

    9/28/2011 1:11:31 PM |

    This is very interesting information.  It parallels the test they do for Diabetic Neuropathy.  

    If the heartbeats are the same on inhale and exhale you have it pretty bad.  The closer they are to the same, the worse the Neuropathy is found to be.  They use an EKG test and compare the peaks... If I understand correctly.  This sounds like it relates to what you are discussing Dr. Davis... am I correct

  • MaryB

    9/28/2011 1:14:19 PM |

    hmmm did you read the article?  LOL  This is not about constipation but heartbeats.

  • Lance Strish

    9/28/2011 11:41:33 PM |

    DrGreger talked about heart rate variability in 2009 once
    http://www.youtube.com/watch?v=sK0PHQLpw4U&feature=BFa&list=PL53AA35449C7DD652&lf=PlayList#t=4m
    -
    http://tinyurl.com/drgregerPDF

  • Dr. William Davis

    9/29/2011 1:02:36 AM |

    Yes, indeed, MaryB: Absolutely correct.

    Diabetes, in particular, can lead to a marked lack of heart rate variability and its health consequences.

  • Dr. William Davis

    9/29/2011 1:03:11 AM |

    Hi, Makro--

    It should already be there. Are you outside the U.S.?

  • Dr. William Davis

    9/29/2011 1:04:56 AM |

    Hi, Rita--

    Sorry. Thought this was fixed.

    I'll have it looked into.

  • Ginger

    1/1/2013 4:16:09 AM |

    Any info on stopping PVC's? I don't do caffiene, very little sugar, i do deep breathing and meditation. I'm dairy free and don't eat gluten.

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Watch your weight plummet:Be a super vegetarian

14. January 2007 William Davis (0)
Here's a neat trick for losing weight: Become a strict vegetarian for 3 days.

Before you yawn or say "Yecchhhh!", let me elaborate.

Pick some time period. It doesn't have to be 3 days. It could be 2 days, or 5 days, or two weeks. But, for the period you choose, eat only vegetables. No meat, cereals, breads, milk, cookies, etc.

Vegetables alone could get monotonous, so make them interesting. Possibilities include:


--Hummus--add a little bit of olive-oil, chopped garlic, paprika, red pepper.

--Tabouleh--I get mine from Trader Joe's and it's delicious.

--Salsa--Low in calories, rich in lycopene and other flavonoids, with no nutritional downside. Also, pico de gallo--chopped tomatoes, onions, jalapeno chiles, cilantro, cucumbers.

--Mustards--hot, yellow, brown, spicy, gourmet, horseradish, etc.

--Cocktail sauce--i.e., ketchup and horseradish. Use the low-carb ketchup made without high fructose corn syrup.

--Tapenades--e.g., olive tapenade made with chopped olives, capers, and olive oil.
--Pesto-made with basil, garlic, and olive oil.

--Spices and herbs--basil, arugula, peppers, mustard powder, garlic, cilantro, ginger, etc.

--Vinegars--wine, Balsamic, rice, apple cider.

--Infused olive oils--infused with garlic is especially delicious,e.g., added to hummus.

--Bean dips--white bean dip, roasted bean dip, etc.





With the varieties of ways to jazz up your vegetables, you couldn't possibly be bored.

For example, for breakfast on day 1, eat sliced cucumbers and green peppers dipped in garlic-infused olive oil hummus and a handful of almonds. For a snack, some walnuts, sunflower seeds, sliced zucchini dipped in salsa. For lunch, a salad with an olive oil and balsamic vinegar dressing. For dinner, tablouleh, a cucumber and tomato salad, celery sticks dipped in pico de gallo.

All vegetables can be eaten without restricting portion size, since calorie content of vegetables are so low compared to other calorie-dense foods. (See The Heart Scan Blog from a few days back, "One bit or many mouthfuls?" at http://heartscanblog.blogspot.com/2007/01/one-bite-or-many-mouthfuls.html.)

This approach works nearly as well as fasting. A half-pound per day weight loss or more is common and painless. You'll also feel great living on low glycemic index foods.

(Photos courtesy Wikipedia.)

Dr. Agatston to the rescue

12. January 2007 William Davis (0)

Dr. Arthur Agatston, author of wildly successful South Beach Diet, has just released a new book titled The South Beach Heart Program. Dr. Agatston has started on a media speaking circuit to promote his book and concepts.


A reporter from Time, who interviewed Dr. Agatston, commented:

". . .not enough doctors prescribe niacin for their heart patients, even though the medicine is a proven treatment for raising 'good' cholesterol. Physicians are reluctant, Agatston suggests, because niacin requires diligent follow-up to watch for side effects, taking time that most primary-care practices cannot afford. On the other hand, he says, too many doctors are performing heart operations that represent a financial windfall for hospitals. Bottom line: there isn't as much money to be made in prevention as in treatment."

Amen.

Dr. Agatston echoes many of the concepts that the Track Your Plaque program advocates. His notoriety is going to help disseminate the idea that 1) CT heart scans are the #1 method to identify hidden atherosclerotic coronary plaque, 2) taking control of your heart scan score is the best way to seize hold of your future, and 3) the present-day popularity of heart procedures like stents and bypass is intolerable, inexcusable, and needs to be reined back.

Agatston also brings great credibility and fairness to the conversation and his comments will gain tremendous attention in the press and with the public.

When is a vitamin not a vitamin?

12. January 2007 William Davis (0)
When it's a hormone.

That's the stand that several researchers in vitamin D have taken and I think they're right. Dr. John Cannell has made a fuss over this in his www.vitamindcouncil.com website.

Structurally, vitamin D is most closely related to testosterone, estrogen, and cortisol. You wouldn't call testosterone vitamin T, would you?

Vitamins are also meant to be obtained from food. Yes, vitamin D is in milk but only because humans are required to put it there to prevent childhood rickets. Otherwise, the only substantial food source of vitamin D is in oily fish like salmon and then only a modest quantity.

Vitamin D is cholecalciferol, a hormone. Deficiencies of hormones can have catastrophic consequences. Imagine that every winter your thyroid gland shuts down and produced no thyroid hormone. You'd get very ill, gain 30 lbs, lose your hair, feel awful.

That's what happens when you're sun deprived and thereby deficient in cholecalciferol--you're deficient in a hormone. And it happens to most of us every year for many months.

I continue to witness spectacular effects by bringing 25-OH-vitamin D3 blood levels to 50 ng/ml with supplementation, including an apparent surge in success dropping heart scan scores.

An epidemic of heart disease reversal

10. January 2007 William Davis (3)
Heart disease reversal is nothing new in my office. However, I have to admit that it's not something that generally happens each and every day.

As our approach is refined, we are witnessing an unprecedented frequency of plaque reversal. Since Monday (today is Tuesday), I've seen four people who have regressed their coronary plaque and dropped their heart scan score.

Pat was the most recent addition to this list. At age 53, I was honestly surprised at the ease of dropping her heart scan score from 128 to 42 in the space of a year. I was surprised because among her lipoprotein patterns was the dreaded combination of lipoprotein(a) and small LDL, probably the most aggressive risk for heart disease I know of and also among the most difficult to gain control over. She also suffered a deep personal tragedy in her family, an emotional convulsion that can sometimes wipe out any hope of plaque reversal.

I'm hopeful that this virtual epidemic of heart disease reversal continues. And I hope that you participate in it.

Second heart scan and heart attack risk

9. January 2007 William Davis (0)
At first, Joe felt disappointed, defeated, and frightened. After his heart scan, a radiologist at the center told him that his score of 264 was moderately high. He told Joe that he was at moderate risk for heart attack and that a nuclear stress test was going to be required.

This left Joe feeling confused. After all he'd had a heart scan 18 months earlier and his score was 278, 5% higher.

I reassured Joe that the radiologist had not been aware that Joe had a prior heart scan. The radiologist didn't know that Joe's heart scan score had actually been reduced.

In fact, Joe's risk for heart attack was not moderate--it is now very low, since his score was 5% lower. While growing plaque is active plaque, shrinking plaque is inactive plaque and thereby at far less risk for heart attack.

I wrote about this phemonenon in a previous Blog: When is a heart scan score of 400 better than 200? at http://heartscanblog.blogspot.com/2006_09_01_archive.html. When you've had more than one scan, the risk for heart attack suggested by the score takes a back seat to the rate of change of your score. In other words, even though Joe's score of 264 represented a moderate risk (of approximately 3% per year, roughly 30% over 10 years), this no longer held true, since it actually represented a 5% decrease over a previous score.

Joe's risk for heart attack is probably close to zero. ALWAYS view your second (or any subsequent) heart scan score in the context of your previous score, not in isolation.

Track Your Plaque newsletter subscribers: We will detail more of Joe's story in the coming January 2007 newsletter. If you'd like to read or subscribe to the newsletter, go to http://www.cureality.com/f_scanshow.asp.

Heart scan curiosities #5

8. January 2007 William Davis (1)
Despite the controversy over drug-coated stents, I maintain that the best stent is no stent at all.

Yes, there are indeed times when such things are necessary, but not with the frequency that they are implanted nowadays.

Another reason why stents are an undesirable phenemenon is that they muck up your heart scan. Take a look:





The long white object in the center is a stent in the left anterior descending artery of this 60 year old man. Just beyond the stent (at about 1 o'clock from the stent) is a plaque that could be scored. However, you can see that, with the presence of the stent, the bulk of this artery is no longer "scorable". If this man wishes to "track his plaque", he will have to be content with tracking only the circumflex and right coronary arteries, the other two arteries without stents.

The stainless steel or similar metallic materials of current stents simply prevent us from seeing through them for plaque scoring purposes. It's best if you can simply avoid getting one for this and other reasons.

Track Your Plaque Members: Watch for the upcoming editorial by our Heart Hawk on drug-eluting stents.

One bite or many mouthfuls

6. January 2007 William Davis (0)
A reader brought this beautiful series of food photos to my attention:

http://www.wisegeek.com/what-does-200-calories-look-like.htm

It's simply a graphic display of what 200 calories of various foods look like. You'll note that vegetables and fruits permit large servings to yield 200 calories. Processed foods, on the other hand, require very little to tally up the same calorie load. In particularly, look how little in the way of wheat products are required to match that amount.

Heart scan curiosities #4

5. January 2007 William Davis (2)
Here's an interesting example of a 63-year old man with a heart scan score of 112. However, his aortic valve was also severely calcified (loaded with calcium). In other words, the normally flexible and mobile "leaflets" of the aortic valve were coated with calcium and other tissues that interfere with its free motion. The aortic valve is the starburst white in the center of the heart.








This is what the aortic valve should look like on a CT heart scan--you shouldn't see it at all.

The first man with the calcified valve will unfortunately require a new prosthetic aortic valve sometime in his future. This is usually determined with the help of an ultrasound, or echocardiogram, a better test for assessment of the aortic valve (though useless for detection of coronary plaque).

It's my suspicion that chronic and longstanding deficiency of vitamin D is among the factors that contribute to the abnormal deposition of calcium on the aortic valve. We desperately need more data on this. Nonetheless, perhaps this adds yet another reason to 1)get a CT heart scan, and 2) bring your vitamin D blood level to normal. (We aim for 50 ng/ml year round.)

Fish oil and the perverse logic of hospitals

4. January 2007 William Davis (6)
Hospitals are now starting to carry prescription fish oil, known as Omacor, on their formularies. It's used by some thoracic surgeons after bypass surgery, since fish oil has been shown to reduce the likelihood of atrial fibrillation (a common rhythm after heart surgery).

Why now? The data confirming the benefits of fish oil on atrial fibrillation has been available for several years.

It's now available in hospitals because it's FDA-approved. In other words, when fish oil was just a supplement, it was not available in most hospitals. Whenever I've tried to get fish oil for my patients while in hospital, you'd think I was trying to smuggle Osama Bin Laden into the place. The resistance was incredible.

Now that FDA-approved Omacor is available, costing $130 dollars per month for two capsules, $195 for the three capsule per day dose for after surgery, all of a sudden it becomes available. Why would this irrational state of affairs occur in hospitals?

Several reasons, most of which revolve around the great suspicion my colleagues have towards nutritional supplements. In addition, there's the litigation risk: If something has been approved by the FDA, their stamp of endorsement provides some layer of legal protection.

However, I regard those as pretty weak reasons. I am, indeed, grateful that fish oil is gaining a wider audience. But I think it's absurd that it requires a prescription to get it in many hospitals. Imagine, as the drug companies would love, vitamin C became a prescription agent. Instead of $3, it would cost far more. Does that make it better, safer, more effective?

Of course, no drug sales representative is promoting the nutritional supplement fish oil to physicians nor to hospitals. I now see people adding the extraordinary expense of prescription fish oil to their presription bills.

In my view, it's unnecessary, irrational, and driven more by politics and greed than actual need. Take a look at the website for Omacor (www.omacorrx.com). Among the claims:

"OMACOR is the only omega-3 that, along with diet, has been proven and approved to dramatically reduce very high triglycerides..."

This is a bald lie. Dozens of studies have used nutritional supplement fish oil and shown spectacular triglyceride-reducing effects.

Their argument against fish oil supplements:

"Dietary supplements are not FDA-approved for the treatment of any specific disease or medical condition. Get the Facts: nonprescription, dietary supplement omega-3 is not a substitute for prescription OMACOR."

Does that make any sense to you? Should you buy a GM car because only GM makes genuine GM cars? This is the silly logic being offered by these people to justify their ridiculous pricing.

How about: "The unique manufacturing process for OMACOR helps to eliminate worries about mercury and other pollution from the environment."

Funny...mercury in fish tends to be sequestered in the meat, not the oil. Independent reports by both Consumer Reports and Consumer Lab found no mercury, nor PCB's, in nutritional supplement fish oil. But just suggesting a difference without proving it may be enough to scare some people.

Just because something is used by a hospital does not make it better. The adoption of fish oil is hospitals is a good thing. Too bad it has to add to already bloated health care costs to enrich some drug manufacturer.

Repent for past sins

2. January 2007 William Davis (0)
If the food temptations of the holidays got the best of you, and you're now 5, 10, 15 lbs or more over your pre-holiday weight (our record is 18lbs!), then it's time for serious action.

One easy method to regain the control you may have lost is to pick some period, say, 3 days. During those three days, eat nothing but vegetables--no breads, meats, dairy products, certainly no cookies, cakes, pasta, etc., not even fruit. Follow this routine and weight drops rapidly. Vegetables are wonderful but sometimes boring, so use healthy condiments to spice them up: mustards (hot, brown, yellow, horseradish); healthy salad dressings, which are olive or canola oil-based; salsas, a fabulous garnish with no nutritional downside whatsoever; pesto; tapenades; horseradish added to other condiments or even by itself (wasabi).

Of course, fasting in one of its several variations is another rapid method to regain control. My favorite is to use soy milk in a modified fast, usually 4-6 glasses of a low-fat, low-sugar soy milk per day, along with plenty of water. (Please refer to the precautions detailed in the recent Track Your Plaque Special Report, Fasting: Fast Track to Control Plaque , particularly if you fast 5 days or longer or take blood pressure or diabetic medication.)

Of course, yo-yoing your weight--up during the holidays, down after their conclusion--is not good for you. It does raise the likelihood of diabetes, not to mention cultivate the patterns that contribute to coronary plaque growth, especially small LDL. But if temptation got out of control and you need to regain lost ground, these two strategies work fabulously well for most people.

If you've gained, say, 10 lbs during the holidays, but simply resume your usual habits, chances are you won't lose the weight. Year after year, this can add up to an enormous weight gain. The time to act is now. It's easier to lose the 10 lbs of weight you gained recently, rather than the 50 lbs you've stacked up over the past 5 years.