Fighter of Heart Disease and
Diabetes
Heart
disease, including heart
attack, is the number one
killer in the western world,
accounting for 48% of all
deaths in the U.S. Related
conditions to heart disease,
including stroke, account
for an additional 10% of
deaths. That means heart
disease in one form or another
contributes to almost 60%
of all deaths(166)! And
diabetics are more prone
than non-diabetics to develop
cardiovascular complications,
which, as will be discussed
later, may have a Vitamin
C connection(123,167,223).
What contributes
most to heart disease are
clogged arteries or arteriosclerosis.
And what causes clogged,
plaque-filled arteries are
high lipid and cholesterol
levels. And what causes
high cholesterol levels
is eating too much saturated
fat. And the way to reduce
cholesterol levels is to
reduce dietary intake of
animal fats and dairy products,
sources of saturated fat.
And so the fable of the
last 30 years or so goes
on. Right? NOT NECESSARILY!!!!
Are you
aware that a long term,
large scale epidemiological
study of the population
of Framingham, Massachusetts,
conducted by the National
Institute of Health showed
NO significant correlation
between dietary cholesterol
intake and blood cholesterol
levels, and that at least
8 clinical trials conducted
in the US, the UK and Scandinavia
between 1965 and 1972 also
showed that changing the
amount of dietary cholesterol
had NO significant effect
upon heart disease(3,45,166,240)?
Eminent
and erudite nutritional
physicians such as Dr. George
V. Mann of Vanderbilt University
School of Medicine have
added their voice, through
such distinguished journals
as the New England Journal
of Medicine -"Foundations,
scientists and the media....have
promoted low fat, low cholesterol,
polyunsaturated diets, and
yet the epidemic continues
unabated....the oil and
spread industry advertises
its products.....promises
that make these foods seem
like drugs...(166)"
Are you
aware that in fact, according
to published evidence by
Professor John Yudkin, even
as long ago as 1957, more
than 30 years ago, there
is a direct and highly significant
correlation between the
intake of sugar and heart
disease in 15 countries.
Clinical and epidemiological
studies conducted by Yudkin
confirmed that men eating
high quantities of sugar
were significantly at greater
risk of developing heart
disease than those with
low sugar intakes(243-4).
When has this been advertised
in the media?
Several
anomalies in the high fat-heart
disease story also indicate
that sugar, not fat is the
main culprit(80), those
including peoples such as
Yemenite Jews(57), East
African Masai and Sumburu
tribes, all of whom ate
a high-fat, low sugar diet
and who didn't suffer from
heart disease until sugar
intake increased(166).
And are
you aware that way back
in the 1930's, that's 50
years ago, a link between
Vitamin C and arteriosclerosis
and heart disease had already
been established(151,174,205)?
Are you also aware that
by 1953, 35 years ago, an
intimate relationship between
Vitamin C, cholesterol synthesis
and atherosclerosis had
already been documented(18,163,235),
and that by 1957, it had
been shown that atherosclerosis
is reversible by Vitamin
C(149, 236-9)? Even as early
as 1947 it was suggested
in a clinical article(211)
that Vitamin C be used for
treatment of heart disease.
Furthermore, Vitamin C also
possesses significant therapeutic
impact upon diabetes and
hypoglycemia. But is Vitamin
C being widely dispensed
by cardiovascular specialists
and hospitals(76)?
Read today's newspapers.
Page 1, Sept. 3, 1989, of
the London Sunday Times
"Poly Fats Bad for
You". New Scientist,
Sept. 9, 1989 "Media
saturation fuels debate
about fats in the diet".
Full-page ad in London Observer,
Sept. 10, 1989 "Polyunsaturates
are Essential for Health",
sponsored by the Flora Project
(Flora is a brand of margarine).
What is
going on here? Is it any
wonder that everyone, including
the public, is thoroughly
confused about what is or
isn't good for you. And
while we are all bending
over backwards to attempt
to reduce cholesterol levels
by not eating animal and
dairy derived fats, is it
really to no avail to our
improved health. What are
the facts, and how can we,
as discriminating health-conscious
individuals, cut through
this massive gobbledy-goop
of scientific and medical
red tape? And, furthermore,
who can we believe, with
so many "experts"
lining up on different sides
of the heart disease question?
Having
surveyed the historical
literature concerning heart
disease, cholesterol and
Vitamin C, the author is
appalled at this scandalous
outrage of re-enforced ignorance
and misinformation. Fifty
years ago is a long time;
even 30 years is long ago.
But even today in 1989,
the public is still being
barraged by the media about
fat and high cholesterol
levels. Something has got
to change. And that seems
to point to a more highly
critical and discerning
consumer who is willing
to question and doubt even
their doctors. In actuality,
sober reading of the clinical
information about cholesterol,
heart disease, and the impact
of Vitamin C, is lucid,
highly revealing, and offers
food for thought and helpful
suggestions for sufferers
of heart-related conditions.
The Cholesterol Story
_____________________
Consider cholesterol,the
lipid substance, formula
C27H46O. It is found in
all bodily tissues, particularly
in the brain, spinal chord,
liver and bile. The liver
manufactures cholesterol,
quite a lot of it, about
3-4 g per day, from a variety
of sources, including acetate,
an organic salt generated
during normal metabolism,
dietary cholesterol, and
bile acids reabsorbed from
the intestines(166). There
is actually a cholesterol
cycle:
1. Cholesterol
is synthesized in the liver;
2. Cholesterol,
associated with a lipoprotein
called "low-density
lipoprotein (LDL)",
is transported through the
body's bloodstream. This
is the stage of the cycle
where cholesterol can attach
to and be deposited in the
linings of arteries.
3. Cholesterol,
associated with another
lipoprotein called "high-density
lipoprotein (HDL)",
is transported to the gall
bladder where it is converted
to bile acids, which are
then eliminated via the
intestines.
4. Some
of the bile acids are reabsorbed
from the intestines, reconverted
to cholesterol and hence
carry on with the cholesterol
cycle.
The cholesterol
that we consume in our diet
obviously does constitute
part of the cholesterol
"pool" in the
body; the recommended dietary
levels of 250-300 mg would
therefore constitute less
than 10% of the total cholesterol
amount made by the liver.
Moreover, there is a feedback
mechanism which will decrease
the amount of newly synthesized
cholesterol if we consume
more cholesterol than normal(166).
In the above-mentioned Framingham
study, there was no difference
in the total serum cholesterol
levels of the men and women
who consumed higher or lower
amounts of cholesterol in
their diet(166). Actually,
the total amount of cholesterol
in the blood is determined
by the interaction of 4
factors:
1. The rate of cholesterol
liver synthesis from acetate.
2. The
rate of cholesterol obtained
from food.
3. The
rate of cholesterol converted
to bile acids and excreted
via the intestines.
4. The
rate of bile acids reabsorbed
and reconverted to cholesterol.
What becomes
crucial in the cholesterol
story is the BIOCHEMISTRY
AND PROCESSING of cholesterol
in our bodies. High serum
cholesterol levels are dangerous,
and ARE correlated with
increased risk of heart
disease. In a study conducted
by the National Heart Institute,
in which blood cholesterol
levels were reduced by 8.5%,
the death rate from heart
disease was reduced by 25%(166).
However, DIETARY source
of cholesterol are not necessarily
the principle contributors
to total cholesterol levels,
and altering DIETARY cholesterol
intake alone does not necessarily
produce lower cholesterol
levels.
The biochemistry
and function of the two
lipoproteins, LDL and HDL
are crucial in understanding
the cholesterol cycle. LDL's,
low-density lipoproteins,
carry cholesterol throughout
the bloodstream, enabling
cholesterol to "stick"
to cell linings. LDL's are
"bad guys". HDL's,
on the other hand, transport
cholesterol back to the
gall bladder, where it is
converted to bile acid and
excreted via the intestines.
HDL's are therefore "good
guys", because they
are helping to eliminate
cholesterol. A growing body
of evidence now indicates
that total cholesterol,
LDL and HDL measurements
are actually a more reliable
index of our cholesterol
"status" than
simply total cholesterol
measurements alone. High
levels of cholesterol and
LDL correlate with high
risk of heart disease; high
levels of HDL correlate
with low risk of heart disease.
This is
not to deny that the amount
and type of fat consumed,
whether saturated or polyunsaturated,
is not an important parameter
in the heart disease equation.
The essentiality and benefit
to health of certain types
of polyunsaturated fats
have received considerable
attention in recent years
as has the potentially increased
rate of free radical formation
with the use of polyunsaturated
fats found in margarines.
For a more detailed coverage
of the fats and oils story,
which is beyond the scope
of this volume, the reader
is enthusiastically referred
to "Fats and Oils"
by Udo Erasmus(74). For
the sugar connection, Yudkin's
"Sweet and Dangerous"(244)
is highly recommended.
Thus far,
the majority of health investigators
have concentrated upon the
dietary cholesterol factor
in the heart disease equation(206).
However, research into other
aspects, such as increasing
HDL levels and thus the
elimination of cholesterol,
increasing the synthesis
of collagen, a major structural
component of blood, and
inhibiting the degradation
of the lining of arteries,
have yielded valuable information
which has documented and
corroborated the 1930's
research which implicated
Vitamin C deficiencies with
heart valve and muscle lesions,
and heart disease. In fact,
there is now a considerable
volume of clinical, biochemical
and epidemiological evidence
which attests to Vitamin
C's important role in preventing,
controlling and even reversing
the number one killer -
heart disease (5,15,18,29,31-2,58,69,76-8,81,131,189,190,195,209,216,223,230).
The Vitamin
C Heart Disease Connection
______________________________________
Clinical
and epidemiological studies
demonstrate that Vitamin
C plays a vital role in
the prevention, control
and even reversibility of
atherosclerosis, the "deposition
of hard yellow plaques of
lipoid material in the intimal
layer of the arteries, resulting
in arterial degeneration
and thickening".
Historically, during the
1930's and 1940's, researchers
noted that Vitamin C deficiencies
in guinea pigs led to heart
valve and muscle lesions,
myocardial degeneration,
arteriosclerosis, inflamed
heart valves, myocarditis,
pericarditis and coronary
thrombosis(151,163,174,205,211);
in other words, Vitamin
C was linked to atherosclerosis.
During the 1950's, the Vitamin
C was shown to be related
to cholesterol metabolism
- Vitamin C deficiency led
to increased cholesterol
synthesis, feeding animals
an increased cholesterol
diet reduced Vitamin C levels
and Vitamin C supplementation
decreased cholesterol levels(149,235-8).
In 1957, it was discovered
(with guinea pigs) that
Vitamin C could even reverse
atherosclerosis(239)!
Now, more
than 30 years later, our
understanding at the biochemical
level, of how Vitamin C
protects against heart disease
has advanced, along with
a concomitant array of epidemiological
evidence. Vitamin C has
been shown tomodulate cholesterol
metabolism in the following
ways(83-8,157-9,193-6,215):
1. Vitamin
C increases the rate at
which cholesterol is removed
by its conversion to bile
acids and excretion via
the intestines;
2. Vitamin
C increases HDL levels.
High HDL levels are correlated
with low risk of heart disease;
3. Vitamin
C, through its laxative
effect, accelerates elimination
of waste, thereby acting
to decrease the re-absorption
of bile acids and thence
their reconversion to cholesterol.
Clinical
studies have shown that
Vitamin C reduces serum
cholesterol and triglyceride
levels in individuals with
high levels. Ginter(85)
showed that 1 g/day Vitamin
C led, after 3 months, to
a decline in plasma cholesterol
levels by 10% and triglycerides
by 40%. Another study(78)
showed that 3 g/day Vitamin
C decreased cholesterol
by 18% and triglycerides
by 12% after 3 weeks. Vitamin
C does not reduce cholesterol
or triglycerides levels
in individuals who are within
"normal" values(118),
suggesting that Vitamin
C acts in a homeostatic
way to promote equilibrium.
It has
been known for over 50 years
that Vitamin C is essential
for the synthesis of collagen(166).
Collagen, a superhelical
protein, composed of amino
acids glycine and hydroxyproline,
is one of the most important
buttresses to the body's
architectural integrity.
Collagen is fibrous and
strong, forming the connective
tissue essential to strong
bones, teeth, skin, muscle,
blood vessels, indeed all
body parts(177). Extensive
biochemical research has
revealed that Vitamin C
is required for almost every
step involved in the complex
synthesis of collagen. Deficiencies
of Vitamin C lead to a weakening
of the structural foundation
of all body parts, including
blood vessels, the heart
and heart muscle(14). The
intimate involvement of
Vitamin C with collagen
synthesis is certainly a
factor in C's positive effect
in protecting against heart
disease(201,203).
At the
molecular level, Dr. Anthony
Verlangieri, director of
the Atherosclerosis Research
Laboratories at the University
of Mississippi and co-workers
have been researching, for
twenty years, the mechanisms
behind Vitamin C's therapeutic
effect upon atherosclerosis(219).
Dr. Verlangieri has shown
that Vitamins C and E is
required for the synthesis
of a substance called glycosaminoglycan
(GAG), a crucial ingredient
for the "cement"
which holds arterial cells
in place(224). Deficiencies
of Vitamins C lead to deterioration
of the cell lining, resulting
in arterial lesions, which
then can fill up with cholesterol,
causing atherosclerosis(223).
The mechanisms of Vitamin
C's role in GAG synthesis
have been elucidated by
Verlangieri's group.
It turns
out that sulfate groups
play a critical role in
supporting the strength
of the GAG matrix(10,157).
High sulfate levels are
correlated with low cholesterol
levels; low sulfate levels
with high cholesterol(220).
Removal of sulfate groups
by an enzyme called Aryl
Sulfatase B leads to degradation
of the GAG matrix. Vitamin
C has been shown to inhibit
this enzyme and thence prevents
the removal of sulfate group
of the GAG matrix(223).
These methodical and rigorous
studies at the molecular
level support the theory
that one of the key elements
in preventing and controlling
atherosclerosis is the maintenance
of structural integrity
of cell and arterial linings.
Vitamin C, involved directly
in collagen synthesis and
in the inhibition of Aryl
Sulfatase B, obviously is
an important factor in supporting
the structural integrity
of the body tissues. Additional
elegant studies, initially
with rabbits(224) and more
recently using non-invasive
ultrasound techniques in
monkeys(222), have also
demonstrated that arteries
with high Vitamin C levels
have lower cholesterol levels
and that Vitamins C and
E can actually reverse the
disease process of atherosclerosis(230)!
(Fig. 4)
Fig. 4. Effect of Vitamins
C and E Upon Arterial Stenosis
(narrowing)(230)
Vitamin C Prolongs Life
- Epidemiological Evidence
__________________________________________________
Epidemiological studies
provide the nitty gritty
proof of which factors are
statistically correlated
with the hypothesis in question.
Several epidemiological
studies performed with Vitamin
C, in America, the UK and
throughout Europe, provide
evidence that Vitamin C
has an important protective
effect against heart disease.
In fact, one study by Chope
& Breslow(55) revealed
that Vitamin C supplementation
was the most important factor
in decreasing the death
rate.
A study
by Gey et al(82), recently
presented at the Third Conference
on Vitamin C, surveyed the
plasma levels of Vitamin
C of populations at different
risks from heart disease
throughout Europe, including
Southern Italy, Switzerland,
Northern Ireland, Scotland
and two regions in Finland.
The results, shown in Fig.
5, were highly revealing
and demonstrated the important
protective factor that Vitamin
C represents against ischemic
heart disease (IHD). In
South Italy and Switzerland,
where Vitamin C levels were
adequate, the heart disease
mortality was low. In Northern
Ireland, where Vitamin C
levels were on the borderline
between adequate and marginally
deficient, the heart disease
mortality was medium. In
Scotland, where heart disease
mortality was high, Vitamin
C levels actually delved
into the region of being
at risk at overt scurvy.
This study also showed the
protective effect of Vitamin
E against heart disease.
Fig. 5. Vitamin C and Heart
Disease Mortality in European
Countries(82)
Vitamin
C to Replace Triple Bypass
Surgery?
___________________________________________
The research
data has certainly been
accumulating in favour of
Vitamin C's powerful effects
in reducing cholesterol
and LDL, increasing HDL
levels, actually reversing
the atherosclerotic process,
and in decreasing mortality
from heart disease in a
variety of populations from
western countries. Will
we be seeing the day when
safe, inexpensive Vitamin
C may replace dangerous,
and expensive surgical treatments
such as open heart surgery
arising from arteries clogged
up with cholesterol? In
this instance, surely the
saying "an ounce of
prevention is worth a pound
of cure" is more than
apt when it comes to Vitamin
C and heart disease.
The Diabetes Connection
_______________________
Diabetics
are at greater risk of suffering
the complications of heart
disease and atherosclerosis.
Despite the life-saving
effects of insulin in preventing
diabetic coma, diabetics
suffer secondary complications
such as blindness and atherosclerosis.
These complications include
a 25-fold greater incidence
of retinal artery disease,
a 7-fold greater incidence
of kidney and a high incidence
of coronary arterial conditions(221,223).
One explanation
for this high incidence
of cardiovascular disease
amongst diabetics invokes
the molecular similarity
of glucose and Vitamin C,
discussed in Chapter 2.
It is recalled that in diabetes,
there is an insufficient
level of the hormone insulin
to uptake glucose from the
blood into cells. Therefore,
although the diabetic may
have extremely high glucose
levels in the blood and
urine, his or her cells
may actually be starved
for glucose, which need
insulin to transport glucose
into the cell.
Since Vitamin
C is structurally very similar
to glucose, one of the transport
mechanisms of Vitamin C
into the cells has been
suggested to be via the
insulin transport mechanism.
If, as in diabetes, glucose
concentrations are very
high, then Vitamin C will
be "out-competed"
by glucose and will simply
not get into the cells.
As stated by Pecoraro &
Chen(167) who were investigating
competition for membrane
transport between glucose
and ascorbic acid at the
most recent Vitamin C International
Conference: "these
results are consistent with
the hypothesis that chronic
hyperglycemia may be associated
with intracellular deficits
of leukocyte AA, an impaired
acute inflammatory response,
and altered susceptibility
to infection and faulty
wound repair in patients
with diabetes". This
cellular deficiency in Vitamin
C, with its concomitant
effects - increased cholesterol
levels, increased atherosclerosis,
degeneration of heart and
arterial tissues - contribute
to the above-named complications
experienced by diabetics(191).
Vitamin
C is said to be a potentizer
of insulin, in that less
insulin is needed to control
blood sugar when Vitamin
C is given in combination(180,198).
If it is true that the complications
of diabetes are the result
of cellular Vitamin C deficiency,
then treatment aimed at
increasing Vitamin C levels
in diabetics ought to yield
beneficial therapeutic effects.
There has already accumulated
a considerable clinical
literature linking Vitamin
C with insulin action(11-13,95,169,171,200).
Continued research into
the interactions of Vitamin
C and insulin may yield
a safe and inexpensive way
to control diabetes and
to prevent the development
of the tragic cardiovascular
complications suffered by
millions of diabetics.
