2013 AHA/ACC Cardiovascular Risk Reduction Guidelines - Drug Companies Win Again

Last week the American Heart Association (AHA) and the American College of Cardiology (ACC) published new updated guidelines in the journal Circulation for reducing the risk of cardiovascular disease in individuals [1]. Their goals aim to "prevent cardiovascular (CV) diseases, improve the management of people who have these diseases through professional education and research, and develop guidelines, standards and policies that promote optimal patient care and cardiovascular health".

To accomplish these commendable goals, AHA/ACC targets better management of blood cholesterol levels, overweight and obesity in adults, and provides information on lifestyle modifications [2]. They also provide extensive guidelines on the use of cholesterol-lowering medications, mainly the statins [1].

After reading through the updated guidelines it is clear to me that the state of cardiovascular health, as it stands currently in the United States today, will remain dismal at best. The chance of heart disease and strokes being displaced as the number one and number four leading causes of death in the U.S. [3] are slim to none. Here's why...

The Incredible, Edible Egg or Not?

Eggs have long been part of the traditional American diet especially when it comes to a hearty breakfast. Gym junkies also swear by eggs, highlighting the egg whites as a perfect low-fat, low-calorie source of protein. Others say eggs are an essential food for good health citing the fact they are an excellent source of vitamin A, B-complex vitamins (specifically choline), and two carotenoids (lutein and zeaxanthin) which are important for healthy vision. Along with these health claims proponents also often say you should limit egg consumption. The Mayo Clinic states to consume no more than 4 eggs per week to avoid increasing cholesterol levels.

So are eggs really the perfect food? Are there any downsides to eating eggs? Should you eat eggs or not eat eggs? What does the science say about eating eggs?

Eggs - The Evidence vs. What They "Say"

Egg advocates often highlight a few vitamins and antioxidants contained in the egg to help boost the case of them being a health food.  The cholesterol and fat content is usually downplayed as a source of concern when it comes to egg's overall effect on health by these same proponents. I believe it's important to look at the actual evidence when contemplating whether or not to eat eggs before making your decision. Relying on hearsay is of little benefit when it comes to your individual health.

Below is a look at the evidence (not funded by the egg industry) on egg consumption and health:

Benefits of a Plant-Based Diet

When you hear the words "vegan" or "vegetarian", you may think of trendy people who disavow T-bone steaks and leather jackets and are ardent supporters of PETA. You may think of activists who throw red paint on people wearing fur. You may even think of yoga-practicing, granola-crunching hippies flashing peace signs. But what you might not realize is that a plant-based diet has many health advantages, and can benefit anyone regardless of age, gender or personal philosophy.

The Cure

A plant-based diet can reduce the risk of developing a number of diseases and serious conditions. Loma Linda University found that vegetarians are 36 percent less likely to develop metabolic syndrome, which is characterized by a large waist circumference and high cholesterol, glucose, blood pressure and triglyceride levels, and can lead to serious health problems such as diabetes, heart disease and stroke. This condition can drastically affect your life, making you less able to perform your daily activities. If not treated properly, these illnesses can lead to physical incapacitation to the point where you rely on wheelchairs and wheelchair accessible vans to stay mobile.

A vegetable-rich diet can lower your risk of obesity and certain types of cancer, as well as your cholesterol and blood pressure. This is because a plant-based diet includes more nutrients the body needs like vitamins, minerals and phytonutrients, as well as fewer of the elements that should be limited like cholesterol and saturated fat. Additionally, vegetarians tend to eat fewer calories and keep a healthy weight.

Our Taxes - Are They Making Us Sick?

When it comes to spending money, you're making a conscious decision on whether or not the goods and services you're purchasing are worth your hard earned dollars.  You want to feel like you've made a smart decision that contains some sort of value.

I'm sure you would find this same concept true when it comes to your overall health.  In essence, you want to make good decisions and investments which help you feel better, live longer, and avoid the chronic diseases that plague most of our society.  And the most important investment you can make, when it comes to determining how healthy you are, is in the form of the foods that you purchase and consume on a regular basis.  So how are the prices of various foods determined?

You may or may not realize that this is largely determined by how our tax dollars are spent with respect to the different subsidies paid to the food and agriculture industries.  Common sense would tell us that we would want our government to subsidize the foods that increase and promote overall health the most.  However, in reality the exact opposite is true.  In fact, the rise in obesity and decline in public health is directly correlated to the increasing availability of low-nutrient, inexpensive food that is high in fat, sugar, and refined grains [1].  On the contrary, foods found to have the highest amount of nutrients per calorie (fruits and vegetables) cost much more per calorie than their lower nutrient counterparts [2] even though they play a vital role in promoting health and wellness.

So how exactly does this all fit together?  And what does the breakdown look like when it comes to our tax dollars being divvied up to their respective recipients in the food and ag industries?  Let's find out as we take a deeper look into these very issues.

PQQ - A Biological MultiTasker That Helps You Thrive

You've probably never heard of it and I would venture to guess that many of those serving in the medical field haven't either but pyrroloquinolone quinone (PQQ) is the life force behind what makes so many different living species thrive including human beings.  It was discovered way back in the 1960's as a bacterial cofacter [1].  But as the years have gone by scientists have uncovered just how important this micronutrient is to both the plant and animal kingdom.  Much has been discovered about it's role to the overall health of human beings in the past couple of decades so let's take a look at what this is all about.

How does PQQ benefit humans?

There's several important functions that PQQ carries out that are vital to our health and longevity.  The most important of these has to do with the growth of new mitochondria otherwise known as mitochondrial biogenesis [2].  If you can remember way back from biology class in high school mitochondria serve as little powerhouses in all of our living cells whether they be muscle cells, fats cells, skin cells, or any other living cell in our body.  Mitochondria turn the food that we eat into usable energy.  They're also responsible for many other functions such as cell signaling, cellular differentiation, cell growth, and cell death.  We literally could not function as living beings without our mitochondria.  Because PQQ is so vital to the growth and development process it is thought to increase our durability and longevity.  The more healthy and functioning mitochondria we have in our cells the healthier and longer we live [3,4].

Powerful antioxidant effects have also been shown as yet another benefit of PQQ.  Antioxidants are extremely important to a person's overall health because they act to neutralize the effects of free radicals in the body.  Free radicals can cause oxidative damage to our cells, tissues, organs, and overall system leading to a number of chronic diseases including cancer, heart disease, diabetes, autoimmune diseases, and more.  PQQ helps keep this process in check by limiting free radical damage to our body by carrying out processes known as redox cycling reactions [5].  In fact, PQQ may even be considered a super antioxidant because it is far more stable than most other antioxidants and can carry out more redox cycling reactions as a result of this.  It's been found to be 175 times more efficient than epicatechin (antioxidant found in chocolate), 200 times more efficient than quercetin (antioxidant found in green tea & various fruits & vegetables), and 5,000 times more efficient than vitamin C [14].

PQQ has some profound benefits in relation to cardiovascular health as well [6].  In a study in 2006 using animal models, PQQ was actually shown to be superior to a well known beta-blocker (metoprolol) in reducing oxidative damage after a heart attack and resulted in reduced area of cardiac tissue death and improved overall cardiac function [7].  Another study using animal models found that PQQ "appears to act as a free radical scavenger in ischemic myocardium & is a highly effective cardioprotective agent" [15].  While large scale studies are needed to assess the direct impact on cardiovascular health in humans it goes without saying that the data so far clearly points to beneficial affects that PQQ has on the heart.

The benefits go beyond heart health though.  PQQ has been studied for it's neurological protection especially in cases following a stroke or spinal cord injury.  One study showed that when PQQ was given within 3 hours of a stroke in animal models there was reduction in tissue damage due to a return of blood flow to the damaged area in the brain [8].  Another mechanism by which PQQ provides neurological protection is by reducing the damage from a substance called inducible nitric oxide synthase (iONs) which plays a crucial role following a spinal cord injury [9].  Inducible nitric oxide synthase (iONs) forms reactive nitrogen species and these have been shown to damage N-methyl-d-aspartic acid (NMDA) receptors [10].  NMDA receptors are important because they allow your nerves cells to communicate to one another so that they can carry out the everyday functions of your nervous system.  In addition to reducing damage due to strokes and spinal cord injuries PQQ has also been shown to help in the treatment of Parkinson's disease[11] and Alzheimer's disease [12].

PQQ has also had a positive affect on memory function in humans.  A randomized, double-blind study released in 2009 looked at the the effect of PQQ and CoQ10 supplementation over a 3 month period on 71 middle aged individuals.  What they found is that memory, attention, and cognition improved in individuals supplementing with PQQ and this affect was enhanced even more when taking both PQQ and CoQ10 together [13].

The last benefit I'll mention is the ability of PQQ to enhance the cell growth and development of human fibroblasts [16].  Why is this important to you?  Well, I'm sure all of you females out there will like this because human fibroblasts are the cells that form connective tissue in the body.  The constant regeneration of new connective tissue keeps your skin from wrinkling.  So when you take in adequate amounts of PQQ you are keeping those wrinkles at bay and retaining your youthful appearance.

How much PQQ do I need?

The recommended daily intake of PQQ has not been determined thus far by either the USDA or the World Health Organization.  Research is just beginning in humans in regards to this topic and until more studies come out we just don't know.  However, an article written in 2009 in the Alternative Medicine Review journal mentions that typical exposure to PQQ in humans tends to be 100-400 mcg/daily in the free form and 1-2 mg/day in the form of PQQ derivatives [14].

Remember the study mentioned above about PQQ increasing memory function in humans?  Well, that study involved individuals taking a dose of 20 mg/day of PQQ to achieve those beneficial results [13].  PQQ has been studied in humans in dosages up to 60 mg/day with no observed side effects or toxicities [14].  With all this in mind, I think it's safe to say that the jury is still out when it comes to determining what dose of PQQ is considered optimal for overall human health.

Where can I get PQQ?

It has been shown that humans and other animals cannot currently synthesize their own PQQ [17,18] so it must be obtained through diet or supplementation.  Therefore, PQQ is considered an essential micronutrient.  PQQ is available in supplement form but I believe the best way to get this micronutrient is from nutrient dense, plant-based foods.  I have always been of the philosophy that if you can get the nutrients you need through health promoting foods then this is a much better option over taking supplements.  The reason that this is the case is because when you consume health promoting foods (i.e. nutrient dense, plant-based foods) for any one particular nutrient you are also getting many other added benefits including increased fiber intake in addition to consuming a myriad of other important vitamins, minerals, antioxidants, and phytochemicals contained within these foods.

With this being said you can find PQQ in many different foods.  However, it is found in the highest quantities in plant-based foods as seen in the chart below.

To sum it all up

PQQ is new on the research front and it's exciting to see the initial benefits coming to light with this very important micronutrient.  As time goes on we'll get a better idea of just how much we need for optimal health.  Until then I think it's fair to say that it would be wise to do what's long been proven to improve the overall health and well being of human beings and that is - consume nutrient dense, whole foods that are from the plant-based spectrum (fruits, vegetables, whole grains, nuts/seeds, and legumes) and limit or avoid foods that are highly processed or are from animal-based sources (meat, dairy, eggs).  Science has proven that you just can't go wrong with this approach.

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by Dustin Rudolph, PharmD
Clinical Pharmacist

Check out Dustin Rudolph's book The Empty Medicine Cabinet to start your journey towards better health. This step-by-step guide leads you through many of today's common chronic diseases (heart disease, obesity, diabetes, cancer, and more), giving you the facts on foods versus medications in treating these medical conditions. The book also contains an easy-to-follow guide on how to adopt a whole foods, plant-based diet as a part of an overall lifestyle change, producing the best possible health outcomes for you and your family. Hurry and get your copy today!

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References:

1 Hauge JG. Glucose dehydrogenase of Bacterium anitratum: an enzyme with a novel prosthetic group. J Biol Chem 1964;239:3630-3639.

2 Chowanadisai W, Bauerly KA, Tchaparian E, Wong A, Cortopassi GA, Rucker RB. Pyrroloquinoline quinone stimulates mitochondrial biogenesis through cAMP response element-binding protein phosphorylation and increased PGC-1 alpha expression. J Biol Chem. 2010 Jan 1;285:142-52.

3 Lanza IR, Nair KS. Mitochondrial function as a determinant of life span. Pflugers Arch. 2010 Jan;459(2):277-89.

4 Robb EL, Page MM, Stuart JA. Mitochondria, cellular stress resistance, somatic cell depletion, and life span. Curr Aging Sci. 2009 Mar;2(1):12-27.

5 Stites TE, Mitchell AE, Rucker RB. Physiological importance of quinoenzymes and the O-quinone family of cofactors. J Nutr 2000;130:719-727.

6 Tao R, Karliner JS, Simonis U, et al. Pyrroloquinoline quinone preserves mitochondrial function and prevents oxidative injury in adult rat cardiac myocytes. Biochem Biophys Res Commun 2007;363:257-262.

7 Zhu BQ, Simonis U, Cecchini G, et al. Comparison of pyrroloquinoline quinone and/or metoprolol on myocardial infarct size and mitochondrial damage in a rat model of ischemia/reperfusion injury. J Cardiovasc Pharmacol Ther. 2006 Jun;11(2):119-28.

8 Zhang Y, Feustel PJ, Kimelberg HK. Neuroprotection by pyrroloquinoline quinone (PQQ) in reversible middle cerebral artery occlusion in the adult rat. Brain Res 2006;1094:200-206.

9 Hirakawa A, Shimizu K, Fukumitsu H, Furukawa S. Pyrroloquinoline quinone attenuates iNOS gene expression in the injured spinal cord. Biochem Biophys Res Commun 2009;378:308-312.

10 Zhang Y, Rosenberg PA. The essential nutrient pyrroloquinoline quinone may act as a neuroprotectant by suppressing peroxynitrite formation. Eur J Neurosci 2002;16:1015-1024.

11 Jihoon K, Ryuichi H, Masaki K, Natsuki K, Koji S. The inhibitory effect of pyrroloquinoline quinone on the amyloid formation and cytotoxicity of truncated alpha-synuclein. Mol Neurodegener. 2010 May; 5: 20.

12 Zhang JJ, Zhang RF, Meng XK. Protective effect of pyrroloquinoline quinone against Abeta-induced neurotoxicity in human neuroblastoma SH-SY5Y cells. Neurosci Lett. 2009 Oct 30;464(3):165-9.

13 Nakano M, Ubukata K, Yamamoto T, Yamaguchi H. Effect of pyrroloquinoline quinone (PQQ) on mental status of middle-aged and elderly persons. FOOD Style. 2009;21:13(7):50-3.

14 Rucker R, Chowanadisai W, Nakano M. Potential physiological importance of pyrroloquinoline quinone. Altern Med Rev. 2009 Sep;14(3):268-77.

15 Zhu BQ, Zhou HZ, Teerlink JR, Karliner JS. Pyrroloquinoline quinone (PQQ) decreases myocardial infarct size and improves cardiac function in rat models of ischemia and ischemia/reperfusion. Cardiovasc Drugs Ther 2004;18:421-431.

16 Naito Y, Kumazawa T, Kino I, Suzuki O. Effects of pyrroloquinoline quinone (PQQ) and PQQ-oxazole

on DNA synthesis of cultured human fibroblasts. Life Sci 1993;52:1909-1915.

17 Smidt CR, Bean-Knudsen D, Kirsch DG, Rucker RB. Does the intestinal microflora synthesize pyrroloquinoline quinone? Biofactors.1991 Jan;3(1):53-9.

18 Matsushita K, Arents JC, Bader R, et al. Escherichia coli is unable to produce pyrroloquinoline quinone (PQQ). Microbiology 1997;143:3149-3156.

19 Kumazawa T, Sato K, Seno H, Ishii A, Suzuki O. Levels of pyrroloquinoline quinone in various foods. Biochem J. 1995 April 15; 307(Pt 2): 331–333.

20 Kumazawa T, Seno H, Suzuki O. Failure to verify high levels of pyrroloquinoline quinone in eggs and skim milk. Biochem Biophys Res Commun. 1993 May 28;193(1):1-5.