Food Antioxidants, Stroke, & Heart Disease

Food Antioxidants, Stroke, & Heart Disease
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The oxidation of high-fat and cholesterol-rich foods in our stomachs may help explain why eating antioxidant packed foods appears to reduce heart attack and stroke risk.

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Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

The total antioxidant capacity of our diet may also be protective against stroke, in contradiction to all the pill studies that failed to show benefit. But, what they did in this study was take into account “all antioxidants present [in actual food] in the diet, including thousands of compounds, in doses obtained from a usual diet,” not one or two in high doses in pill form. Stroke is the world’s leading cause of death, after heart disease.

The buildup of oxidized fat is considered “the hallmark of fatty streak formation,” the earliest manifestation of atherosclerotic plaques. Yes, the oxidation of fat can happen outside the body, every time we cook it, but oxidized fats “are not only formed in foods, but may also be generated during digestion,” especially in stomach acid. Our stomach may be like “a bioreactor” for “the oxidation of high-fat, cholesterol-rich foods.” See, “[m]uscle foods contain large amounts of endogenous catalysts,…which accelerate [fat oxidation].” As poultry sits in our stomach, the oxidation may build up, minute by minute.

See, chickens are bled of only about half their blood, and the remaining residual can be a powerful promoter of fat oxidation. So, there are those in the industry advocating an additional decapitation step to reduce all that oxidation. But, if oxidation is the problem, antioxidants may be part of the solution.

“Total antioxidant capacity from diet and risk of [heart attack].” Well, we know antioxidant pills don’t work. While “[e]xtensive experimental data have revealed a central role for oxidative stress  in [the stiffening of our arteries] and suggested a potential role for ‘antioxidant’ treatment in cardiovascular disease…[,] [e]xperimental data [has] not translated into clinical benefit. “[M]ost antioxidant vitamin trials have failed to reduce” heart disease and death, “and may, in fact, [even] be detrimental.” As a result, some have even “questioned…the [supposed] central role of oxidative stress” in the disease process, described as a “critical blow to the [whole] free radical theory of aging”—the fact that pills didn’t work.

But, “high-dose single-antioxidant supplements are not a good substitute for the very complex antioxidant network of thousands of compounds in foods, present at concentrations far below those used” in those pill trials. No one had ever looked at “the overall effect of the complex antioxidant network in our diet in relation to [our leading killer,] coronary heart disease,” until now.

“The total antioxidant capacity measures, in one single value, the free-radical-reducing capacity of all antioxidants present in foods” and all the synergistic effects. And, “[i]n this large prospective population-based cohort study,” they “observed that higher total antioxidant capacity of diet was…associated with lower risk of incident [heart attack] in a dose-response manner”—meaning, potentially, the more high-antioxidant plant foods in our diet, the better.

Please consider volunteering to help out on the site.

Images thanks to Andrea.k.e and gliageek via flickr

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

The total antioxidant capacity of our diet may also be protective against stroke, in contradiction to all the pill studies that failed to show benefit. But, what they did in this study was take into account “all antioxidants present [in actual food] in the diet, including thousands of compounds, in doses obtained from a usual diet,” not one or two in high doses in pill form. Stroke is the world’s leading cause of death, after heart disease.

The buildup of oxidized fat is considered “the hallmark of fatty streak formation,” the earliest manifestation of atherosclerotic plaques. Yes, the oxidation of fat can happen outside the body, every time we cook it, but oxidized fats “are not only formed in foods, but may also be generated during digestion,” especially in stomach acid. Our stomach may be like “a bioreactor” for “the oxidation of high-fat, cholesterol-rich foods.” See, “[m]uscle foods contain large amounts of endogenous catalysts,…which accelerate [fat oxidation].” As poultry sits in our stomach, the oxidation may build up, minute by minute.

See, chickens are bled of only about half their blood, and the remaining residual can be a powerful promoter of fat oxidation. So, there are those in the industry advocating an additional decapitation step to reduce all that oxidation. But, if oxidation is the problem, antioxidants may be part of the solution.

“Total antioxidant capacity from diet and risk of [heart attack].” Well, we know antioxidant pills don’t work. While “[e]xtensive experimental data have revealed a central role for oxidative stress  in [the stiffening of our arteries] and suggested a potential role for ‘antioxidant’ treatment in cardiovascular disease…[,] [e]xperimental data [has] not translated into clinical benefit. “[M]ost antioxidant vitamin trials have failed to reduce” heart disease and death, “and may, in fact, [even] be detrimental.” As a result, some have even “questioned…the [supposed] central role of oxidative stress” in the disease process, described as a “critical blow to the [whole] free radical theory of aging”—the fact that pills didn’t work.

But, “high-dose single-antioxidant supplements are not a good substitute for the very complex antioxidant network of thousands of compounds in foods, present at concentrations far below those used” in those pill trials. No one had ever looked at “the overall effect of the complex antioxidant network in our diet in relation to [our leading killer,] coronary heart disease,” until now.

“The total antioxidant capacity measures, in one single value, the free-radical-reducing capacity of all antioxidants present in foods” and all the synergistic effects. And, “[i]n this large prospective population-based cohort study,” they “observed that higher total antioxidant capacity of diet was…associated with lower risk of incident [heart attack] in a dose-response manner”—meaning, potentially, the more high-antioxidant plant foods in our diet, the better.

Please consider volunteering to help out on the site.

Images thanks to Andrea.k.e and gliageek via flickr

Doctor's Note

What about antioxidants and cancer? That was the subject of my last video, Food Antioxidants & Cancer.

Which foods have the highest antioxidant content? See:

It’s the heme iron in chicken blood that’s implicated in fat oxidation in the stomach. That’s one of the targets of the Meat Additives to Diminish Toxicity.

More on reducing stroke risk can be found in my videos Preventing Strokes with Diet and Whole Grains May Work As Well As Drugs.

I have dozens of other videos on heart disease. Check out Heart Disease Starts in Childhood and One in a Thousand: Ending the Heart Disease Epidemic for two of the more recent.

If you haven’t yet, you can subscribe to my videos for free by clicking here.

23 responses to “Food Antioxidants, Stroke, & Heart Disease

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  1. I read an article the other day about a group of natives who in spite of being older than the comparison group and eating way more salt, don’t get high blood pressure, have a ninth the amount of heart disease and one-fifteenth the amount of cancer. These guys do eat fish but mostly have a vegan diet. It seems that their good health is due to drinking 4 to 5 cups each day of a drink they make from boiled ground raw cocoa beans and banana which they strain before drinking. I compared it the organic cocoa powder I use and found that mine has no more than one-sixth the flavonol (antioxidant) content of theirs. And of course I don’t use nearly as much or even use it daily. I’d love to hear more about this!

    http://voices.yahoo.com/kuna-cocoa-optimal-way-decrease-blood-pressure-11583580.html?cat=70




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    1. How do we know that it’s the Kuna cocoa drink that extends their longevity? Surely there are so many other factors at play – their communal/tribal structure, their low levels of mental illness, their constant exposure to sunlight, their living near a semi-aquatic environment, other dietary factors, physical exercise, childrearing practices, genetics. To say it’s all got to do with this one drink that they consume….




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      1. Good Questions, DGH! We certainly should ask this sort of thing whenever a study comes out for a particular indigenous culture. Digging a bit deeper, I found numerous studies which support this effect in cultures other than in the Kuna, both epidemiological and clinical. Pubmed for example lists too many studies to mention. Some of the benefits of cocoa in them include prevention of preeclampsia, of cardiometabolic disorders, of insulin resistance, obesity, vascular dysfunction, depression, gingivitis, Alzheimers, diabetes, glaucoma, cataracts, inflammation. It increased good cholesterol, antioxidants in the blood and protected the skin from sunburn. Plus there was confirmation of its protective effects I mentioned above, against heart disease,high blood pressure and the big C. But cocoa isn’t the only food with flavanols, although it may be one of the best:

        Source
        Flavanol Content, mg/kg or mg/L

        Chocolate
        460–610

        Beans
        350–550

        Apricots
        100–250

        Cherries
        50–220

        Peaches
        50–140

        Blackberries
        130

        Apples
        20–120

        Green tea
        100–800

        Black tea
        60–500

        Red wine
        80–300

        Cider
        40

        Finally, I want to comment that we can do even better than the Kuna by following Dr. Greger’s recommendations. We can avoid their consumption of salt, eat the 5 servings of fruits that they consume daily, but include berries, citrus and apples; each day have some mushrooms or nutritional yeast, cruciferous vegetables, greens, tea, beans, garlic and onions, flax, vitamin D and B-12 and of course, avoid the mercury and toxin-laced fish flesh.




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  2. Not directly related to this, idk where to ask this. Does drinking high antioxidant drinks (like green tea or hibiscus tea) out of metal (stainless steel or aluminum) affect the amount of antioxidants and other phytochemicals that are available as opposed to drinking from glass or ceramic. Also the same for drinking cold beverages out of plastic (bpa free, never hot drinks of course). Thank you.




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  3. I have been reading about cooking oils harming the endothelial layer and leading to oxidative stress etc. What do you think of cooking with oil, Dr. Greger?




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      1. I eat these oils in moderation, mainly in the form of whole nuts/seeds, a little bit of canola oil in some hummus, and a tablespoon of tahini per day in a salad, but I don’t cook or oxidize any cooking oils in my diet. I think the harms of cooking oils are somewhat overblown, but I remain conservative and cautious about their use.




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      1. You need fat to help absorb carotenoids. Maybe, DHG has got the right idea, eating them in a natural unprocessed form. But I’d avoid the canola and substitute fresh avocado instead.




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        1. Most plant foods contain sufficient quanitites of fat to be absorbed. From Jeff Novick:

          Absorbing more doesn’t automatically equate to better health outcomes.

          Speaking of health outcomes, which is what really matters, lets put all of this into proper perspective.

          From

          “‘Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids’, Food and Nutrition Board. Institute of Medicine. National Academy Press, Washington D.C. Pp. 343-344 (2000)”

          http://www.nap.edu/openbook.php?record_id=9810&page=353

          “These data, although in varying populations, suggest that 3 to 6 mg/day of β-carotene from food sources is prudent to maintain plasma β-carotene concentrations in the range associated with a lower risk of various chronic disease outcomes (see Table 3).”

          Table 3:

          http://www.nap.edu/openbook.php?record_id=9810&page=341

          As just detailed, plasma and tissue concentrations of carotenoids have been associated with a variety of health outcomes; that is, higher concentrations are associated with a lower risk of cancer, coronary heart disease, and all-cause mortality. This could be used as a possible indicator for establishing requirements for carotenoids. However, the limitation of this approach is that it is not clear whether observed health benefits are due to carotenoids per se or to other substances found in carotenoid-rich foods.

          Thus, these data are suggestive of prudent intake levels, not required levels of intake. Recommendations have been made by a number of federal agencies and other organizations with regard to fruit and vegetable intake. Nutrient analysis of menus adhering to the U.S. Dietary Guidelines and the National Cancer Institute’s Five-a-Day for Better Health Program, for example, indicates that persons following these diets would be consuming approximately 5.2 to 6.0 mg/day provitamin A carotenes on average if a variety of fruits and vegetables were consumed (Lachance, 1997). Similar levels would be obtained by following Canada’s Food Guide for Healthy Eating which specifies a minimum of five servings of vegetables and fruit (Health Canada, 1997). Other food-based dietary patterns recommended for the prevention of cancer and other chronic diseases would provide approximately 9 to 18 mg/day of carotenoids (WCRF/AICR, 1997).

          NOTE: this is 3-6x the amount recognized as being enough to lower disease risk

          It is also based on the WCRF/AICR report from 1997. In many other discussions here, I have quoted the WCRF/AICR newest report from 2007 saying that they now more than ever, recommend dietary “patterns” over recommending specific “individual foods”.

          So, in other words, if Americans would just get in the recommended amounts of fruits and veggies, it would not only provide carotenoids, but more than enough of all of them to produce the beneficial health outcomes, including reduced risks of cancer. And anyone following a Whole Food plant based diet, as recommended here, would already be consuming WAY more than enough.

          Of course, the real issue is why do you have to increase the absorption of raw veggies (which are very low) when you can just eat tubers, which have almost the highest absorption rate, as is.

          http://www.nap.edu/openbook.php?record_id=9810&page=354




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  4. Dr. Greger, I have been reading a bit about the negative effects of saponins on increasing the permeability of the intestines. This really concerns me since I have lots of food intolerances and I do eat grains and beans, and these seems to be known to contain saponins. I am 100% vegan and have been for many years. But my diet seems to consist of lots of foods that even many vegans out there seem to avoid for just this issue I have inquired about here. Thank in advance for any comments on the merits of this study, and whether you feel that the saponins in plants and grains and beans can, when eaten as a large part of the diet, make the gut “leaky”/permeable.

    http://www.ncbi.nlm.nih.gov/pubmed/3794833




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    1. Dr Greger, should antioxidants be evenly distributed in meals: instead of my adding frozen berries, amla and Goji berries to my morning oatmeal, should the amla be added to lunchtime kidney beans instead? If there is a high nominal antioxidant level in any given meal, will the last incremental antioxidants be less efficacious?




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  5. Does a high fruit-sugar diet cause the liver to dump fat into the blood? I am considering reducing excessive fruit consumption based on some Doctors claiming that high fructose containing whole fruits can actually contribute to fat in the blood. Such a weird concept for me to get my mind around but apparently it has to do with the liver converting glucose to fat, then pumping it out into the body. One ends up getting heart disease even on an extremely low-fat diet. So odd but apparently true. What do you think?




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    1. Anectdotal: I now eat lots of fruit compared to my prior veg-junk-tarian diet. My triglycerides (fat in the blood) are down to 62 from nearly 400.

      As long as one is not gaining weight from eating an excess of calories, sugar in fruit is not generally a problem for non-diabetics.




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  6. When you talk about strokes and preventing strokes are you talking about both hemorrhagic (bleeding) AND ischemic (blockage) strokes? I understand the vast majority of strokes are ischemic, but I wonder whether someone who has had a hemorrhagic stroke is equally well served by a plant based diet.




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  7. Interesting: for mouse strain with two characteristics of human metabolism–

    the lack of endogenous ascorbate (vitamin C) production and the expression of Lp(a),

    the latter a leading risk factor for cardiovascular disease–

    vitamin C in drinking water sufficient to raise blood levels to normal (wild mouse) levels

    inhibited chronic hypoascorbemia and complete depletion of ascorbate (scurvy),

    which lead to Lp(a) accumulation in the vascular wall (atherosclerotic lesion development)

    in mice that didn’t receive C-laced drinking water.

    “…study design mimics important events during the evolution of man. After the loss of endogenous ascorbate synthesis, the survival of our ancestors was repeatedly threatened through epidemics of scurvy. Individuals expressing Lp(a) may have had an evolutionary advantage by effectively counteracting hemorrhagic blood loss through a scurvy-impaired vascular
    wall.”

    Cha et al, 2015. Hypoascorbemia induces atherosclerosis and vascular deposition of lipoprotein(a) in transgenic miceAm J Cardiovasc Dis. 2015; 5(1): 53–62. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4447075/




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