By Alex Ryan
Cardiovascular diseases can be roughly defined as those that affect the heart, blood vessels or both. Heart disease alone is the leading cause of death in the US, with 600,000 people dying annually. The most common causes of cardiovascular disease are atherosclerosis and hypertension, and risk factors include diabetes, obesity, excessive alcohol intake, poor diet and sedentary lifestyle. This month being January – a month of fresh, New Year’s resolve – what resolutions can you make to improve your health and reduce your chance of cardiovascular disease?
Last year you may have seen this article, recommending a 15 minute walk for every 3 hours of sitting. Prolonged sitting leads to impaired circulation, and endothelial function. The endothelial cells line blood vessels, and dysfunction is commonly associated with cardiovascular disease (more on this below). Taking a slow, five-minute walk every hour prevents the endothelial damage; and when I say slow, I’m talking about two miles an hour; that’s the equivalent of “running” 100 meters in a little under two minutes.
Another reason to get walking is that recent evidence suggests that skeletal muscle can secrete molecules called myokines. These are thought to have endocrine roles, meaning that they can affect other organs and tissues. During contraction (exercise) the secretion of these myokines changes, and this is thought to have several beneficial roles.
As controversial as it is to suggest eating chocolate as a New Year’s resolution, I will anyway. A flavanol called epicatechin is found in cocoa products, particularly dark chocolate. This has been shown to have beneficial effects on the insulin resistance (a precursor to Type 2 Diabetes) and yields cardioprotection. Epicatechin leads to improved cardiac angiogenesis, to a similar rate as exercise. Importantly, the effect is additive, meaning that carrying out exercise as well as epicatechin treatment improves angiogenesis even more. Furthermore, epicatechin improves skeletal muscle mitochondrial function; a risk factor for Type 2 Diabetes and heart failure.
You can buy epicatechin tablets online if you don’t like the taste of chocolate, but otherwise dark chocolate can provide it; the more bitter the better. However, unfortunately you can’t just eat all the chocolate you want, one or two pieces (of dark chocolate only!) in the morning is ideal. Epicatechin functions on a bell curve, meaning that a fairly low concentration hits the, ahem, sweet spot…
In another one of life’s annoying little ironies, inadequate sleep appears to be both a cause and symptom of cardiovascular disease. Although the mechanism is not fully understood, several aspects are thought to play a role.
A lack of sleep, or insomnia, leads to an increase in circulatory pro-inflammatory molecules. An inflammatory state is associated with atherosclerosis and Type 2 Diabetes. Interrupted sleep has also been shown to cause endothelial damage, in otherwise healthy individuals. As mentioned above endothelial dysfunction is associated with cardiovascular disease. Endothelial dysfunction exacerbates these pro-inflammatory conditions by preventing eNOS (endothelial cell nitric oxide synthase) from generating nitric oxide, a potent anti-oxidant. eNOS dysfunction is thought to play a role in causing sleep apnea; a phenomenon characterized shallow or infrequent breathing whilst sleeping. Sleep apnea is associated with an increased risk of several cardiovascular diseases and diabetes.
If you’re reading this I think it’s safe to assume you’re a grown up, and should know better when it comes to brushing your teeth. As the hugely realistic Saw VI pointed out, gum disease is associated with an increased risk of cardiovascular disease. This is actually true: Poor dental hygiene can lead to increased inflammation, which, as mentioned in the section on sleep above, can lead to an increased risk of cardiovascular problems. Overwhelming epidemiological evidence supports this (the two links provided here are just scratching the surface), so brush, swill and floss your way to a healthier cardiovascular system in 2015.
So there you have it, four resolutions to start 2015 with: eat a small amount of dark chocolate, go for a walk, brush your teeth, and then get to bed! That doesn't sound so hard now