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Heart health news

Heart health news

Two recent studies related to heart health deserve attention, for different reasons. One study involves a nutrient; one involves what could be described as environmental exposures.

Niacin and your arteries

Niacin (sometimes called B3) is one of the B vitamins, and is essential for health. Adult females should get 14 mg per day. It’s widely available in food, particularly chicken, turkey, beef, pork, fish, whole grains and nuts. Niacin is also found in multiple vitamin supplements and is added to some foods. Deficiency is unusual in developed countries; it’s associated with poverty and limited, low protein diets.

Years ago, medical professionals discovered that very high dose niacin could lower blood cholesterol and triglycerides, which would presumably improve heart health. The one significant and unpleasant side effect was facial flushing. After much research, comparing high dose niacin to statins, data showed that the niacin wasn’t any more effective than statins at lowering cholesterol, and didn’t improve heart attack risk.

Meanwhile the link between niacin and lowered cholesterol became public knowledge. Some consumers may have been inspired to start high dose niacin on their own.

Fast forward to 2024. A new study links metabolites of excess niacin to inflammation in blood vessels and increased heart disease risk. Key word: excess. The study measured blood levels of two niacin metabolites from almost 1200 heart disease patients exposed to niacin doses of 500-2000 mg/day. Higher levels of these 2 metabolites were associated with increased heart disease risk.

What’s the message here? First, research has shown that high dose niacin isn’t preferable to statin therapy for lowering cholesterol, and does not improve heart health. Not to mention, it causes unpleasant facial flushing. Second, those high doses might actually be contributing to increased heart disease risks due to vascular inflammation.

These are very high doses, not something you’d find in the average multiple vitamin supplement, certainly not found in food, even fortified food. But some B-vitamin supplements have very high doses, not just of niacin but of all the common B vitamins. I never recommend those for any reason. Who needs 100 mg of every B vitamin every day? No one.

Microplastics and heart disease

Plastic pollution and microplastics are a hot topic right now. Micro- and nanoplastics are extremely tiny bits of plastic released as the multiple plastic items in our environment deteriorate. They’re being blamed for obesity and hormone abnormalities, among other things. A new study hints that these residues might be contributing to heart disease.

This very small study from Italy examined plaque removed from arteries of people with arterial disease. Of the 257 subjects who had surgery, 150 showed signs of various nanoplastics in their plaque. After follow up of almost 3 years, the patients who had evidence of nanoplastics were at higher risk for heart attack, and showed more signs of arterial inflammation.

So conclusion: microplastics cause heart attacks? Not So Fast. Certainly finding this stuff in plaque in arteries is alarming. How did it get there? Where did it come from? But it’s too soon to draw sweeping conclusions. Here’s why:

  • This was a very small study.
  • The study subjects had existing heart disease.
  • Some of the samples could have been contaminated during the surgical procedures.
  • Samples could have been contaminated during the lab analysis process.

Nevertheless…

It’s very unusual to have nanoplastics in your blood, lodging in the plaque in your arteries. The “how did it get there” question needs to be answered. If from lab or surgical contamination, then this is less alarming. If these plastics enter from the environment (from breathing, from something you eat or drink, from something you rub on your skin), we need to learn how that happens and prevent it. We also need to know where else those particles are hanging out in the body.

Food could be a source, mainly from packaging: plastic water bottles, plastic beverage and food containers, plastic food wraps. Do plastics migrate into food when food is heated in the microwave? Do plastics migrate into food during processing and packaging? This is all very new stuff.

Plastics have been in our environment for a long time. The first version was invented in 1869. Now it’s hard to imagine life without them, and not just in food and beverage packaging. Plastic is used for medical devices and supplies, containers for household products, parts for appliances and building construction, cars, planes and other transportation, and of course computers and electronic devices.

Tracing the source of nanoplastics in carotid plaque would be helpful. If these particles come from food and beverages, we can hopefully design packaging that doesn’t contribute to that. Can you do anything now to minimize dietary exposure? Buy less processed whole foods, that aren’t packaged in plastic. Avoid using plastic containers in the microwave. This advice ties into the definition of a less processed diet, which is what we should be eating anyway.

Bonus third study!

Here’s a third thing about heart health, nothing to do with diet. There’s a popular myth linking Daylight Savings Time change to increased heart attacks. A study that tracked 36 million people over 5 years of daylight savings time changes found no significant increase in heart attacks. So go ahead, set those clocks ahead and enjoy daylight in the evenings. You can take a walk, which is good for heart and health.