Nutrition-savvy cardiologist maps clear route to better heart health via diet, lifestyle, and mind-body measures
by Craig Weatherby and Randy Hartnell
We’ve known Dr. Stephen Sinatra since 1998, when his name had just begun to become widely known via the bestseller he published that year: “Optimum Health: A Natural Lifesaving Prescription for your Body and Mind”.
Board certified in internal medicine and cardiology, Dr. Sinatra also undertook more than 10 years of postgraduate training in the crucial role that behavior and emotion play in heart disease.
For 20 years, he’s helped patients prevent and reverse heart disease via conventional and complementary nutritional and psychological therapies.
His first book established Dr. Sinatra as a physician with an unusual knowledge of, and passion for, nutrition and lifestyle approaches to heart health.
He’s written several other popular books since, and his latest work, Reverse Heart Disease Now, brings readers up to date on the latest findings in cardiovascular
disease and the nutritional and lifestyle factors that can alleviate or even reverse it.
The book starts with two chapters that outline the mechanisms underlying heart disease. And Dr. Sinatra and his co-author – cardiologist James C. Roberts, M.D – do a superior job of explaining the process.
The first chapter – “Death by Inflammation” -- explains why inflammation is the engine driving development of arterial plaque, and exactly how American’s imbalanced, nutrient-poor diets cause the problem.
The second chapter – “The Cholesterol Obsession” – deconstructs the misconceptions that have mistakenly pinned the blame for cardiovascular diseases on this essential molecule.
As Drs. Sinatra and Roberts explain in detail, high cholesterol levels aren’t the problem. Instead, oxidation of LDL cholesterol and creation of sticky blood -- which have little to do with “high cholesterol”, per se -- are the key threats.
Nutritional interventions: fish oil first
Following some clear, concise chapters in which they review the risk factors, tests, and drugs associated with heart disease, the authors turn their attention to diet, supplements, exercise, and stress relief.
Unsurprisingly, given the strength of the evidence in its favor, the very first supplement Drs. Sinatra and Roberts discuss is fish oil. And they rest their case for its importance on the major studies we’ve covered in Vital Choices.
They also review in detail the cardiovascular benefits of CoQ10, l-carnitine, magnesium, l-arginine (a nitric oxide precursor), phosphatidyl choline, vitamin C, B vitamins, garlic, pomegranate juice, d-ribose, and vitamin K-2.
Our only quibble is with their advice to choose only high-potency, “pharmaceutical grade” fish oils, by which they mean molecularly distilled oils, which come largely from menhaden and farmed salmon.
We’ll address this subject in more depth, below (see “Whole salmon oil versus distilled fish oil”).
In chapter nine, Drs. Sinatra and Roberts outline the ideal, anti-inflammatory eating plan for heart-health, which they call the Pan-Asian Mediterranean (PAM) diet.
The results of studies showing that people in rural Mediterranean and East Asian regions live longer, healthier lives than do people in most industrialized Western countries, and they used this data to outline a diet based on these cultures’ traditional eating habits. Their PAM diet breaks down as follows:
- Low-glycemic (non-starchy/sugary) fruits, vegetables, and whole grains (40 percent of calories)
- Healthful proteins: fish, soy, foods and pasture-fed meats and poultry (25 to 30 percent of calories)
- Healthful omega-3 and monounsaturated fats: fish, olive oil, nuts, and avocado (30 to 35 percent of calories).
They cite several key benefits/attributes of a PAM-style diet:
- High in antioxidants
- High levels of healthy omega-3 fatty acids
- More fish, less beef and dairy
- High in olive oil
- Weight loss
Last, but not least, Chapter 12 – titled “Putting it all Together” -- does just that for readers.
In this chapter, Drs. Sinatra and Roberts provide a detailed “therapeutic” supplement program, a lower-budget “bare bones” version, a list of the medical tests you should have done, what the results mean, and the nutritional steps you should take in case of unhealthful outcomes.
Even admitting our bias toward a truly wonderful doctor and human being, we think that Dr. Sinatra’s latest book is a must-have for everyone concerned about heart disease … in other words, just about everybody.
Whole salmon oil versus distilled fish oil
The good doctors’ recommendation to take high-potency, “pharmaceutical grade” fish oils -- by which they mean molecularly distilled oils -- is understandable, given that virtually all of the clinical trials of fish oil have used molecularly distilled oils with artificially high concentrations of omega-3s (EPA and DHA).
We think that our Salmon Oil offers a reasonable, possibly preferable alternative. Here’s why:
Higher-dose, distilled fish oils are used in clinical trials primarily because most such studies last only a few weeks, so researchers need to ensure that participants’ tissues become saturated with omega-3s rapidly enough to show clear results.
However, it only takes a few weeks for the lower, naturally occurring doses of omega-3s in Sockeye Salmon oil to boost red blood cell levels to optimal levels.
For example, blood tests done in some Vital Choice folks who take two to four capsules per day – regimens that deliver 320 to 640 mg of EPA + DHA, respectively -- show very high concentrations of omega-3s in their red blood cells.
Standard fish oils, like those used in most clinical trials, must be distilled because of the uncertain purity of the mixed fish species used, and because of the potentially un-hygienic nature of the large-scale rendering processes used to extract the oils from the fish.
In terms of purity, our Sockeye Salmon Oil is not significantly different from distilled “pharmaceutical grade” oils, thanks to the pristine nature of wild Alaskan Sockeye Salmon: a vegetarian fish that does not bioaccumulate toxins from eating other fish, and lives in very clean waters. (For more information and test results, click here.)
And there may be a downside to distilled fish oils. Temperatures above 350 degrees F can adversely impact the structural integrity of the omega-3 fatty acid molecules in fish oil. Regardless of this risk, standard fish oils are heated to temperatures in excess of 450 degrees F as part of the distillation process.
In contrast, Vital Choice Salmon Oil is extracted from the heads of fresh wild Alaskan Sockeye, just a few steps from the fishing boats at temperatures below 225 degrees F. It is then cold-filtered and encapsulated in its whole, balanced form -- a rich matrix that includes dozens of other naturally occurring fatty acids and phospholipids.
And unlike distilled oils, Vital Choice Salmon Oil contains naturally occurring vitamin D (53 IU per 1,000 mg capsule).
Our Salmon Oil also contains the extremely potent, naturally occurring antioxidant astaxanthin, which the doctors recommend taking two milligrams of every day.
While a 1,000 mg capsule of our Sockeye Salmon Oil contains only 0.024 mg of astaxanthin, this is a significant amount given its unequalled potency as an anti-inflammatory, antioxidant agent. And a 3.5 oz serving of Sockeye Salmon contains a hefty three milligrams of astaxanthin.