Programs

Cardio-Nutrition Concepts

Cardio-nutrition, simply put, is the diet, exercise, emotional support(stress reduction), and nutritional therapies for specific cardiovascular related problems.

The definition and treatment program evolved over the years through my management of cardiovascular disease. This is not a new concept. Many years ago, the New York Academy of Sciences sponsored a meeting "BEYOND DEFICIENCY." Basically, this program reported on the use of nutrients as therapeutic modalities. As the title indicated, the use of nutrients beyond their ability to prevent deficiency diseases. Deficiency diseases are unknown now in this country because of the minimal requirement for preventing diseases such as scurvy, beriberi and other nutritional deficiency diseases. However, they did point out that nutrients can be used as a therapy in doses beyond that recommended by minimal daily requirement. Such examples are the use of vitamin C to prevent cold, enhance immunity and now perhaps there has been some indication that high doses of vitamin C may have anticancer actions, and they also are useful in asthma and allergy. Another excellent example is the use of Niacin in high doses. This is now very well accepted as part of a cholesterol management program especially for its ability to increase HDL or good cholesterol. With regards to my practice over the years, I found and as I studied nutrition, that the management of disease states require a combination therapy of lifestyle changes, drug therapy, and nutritional supplements. Therefore, the problems that I was seeing on a daily basis required the development of a nutraceutical program. The cardio-nutrition program can also fall into the category of nutri-pharmacology or the use of nutrients and diet as a therapeutic agent. The problems that I found needed the most attention were hyperlipidemia, hypertension, coronary artery disease, arrhythmias, congestive heart failure, obesity and diabetes. Presently, there is an epidemic of obesity/diabetes in this country and as a matter of fact a new term has been developed ?diabesity.? Through the years, I studied the use of pharmacologic agents and the ability of nutrients to replace drug therapy in some conditions or the ability of nutrients to work syngerstically with drug therapy for better effect.

With regards to the application of the program, my entire practice dealing with heart disease, diabetes, obesity, cardiovascular disease, coronary artery disease, hypertension, hyperlipidemia, metabolic syndrome have all through the years, been found to have been helped by certain nutrients. As mentioned above, the use of Niacin for hyperlipidemia, but beyond that there are many nutrients possibly seven to eight nutrients per each specific cardiovascular entity. With regards to the need for the program and the need for this publication, there are many. There is a great deal of concern about the complication and side effects of drugs. People are now becoming weary of drug therapy because of the side effects. There are number of drugs that have been considered safe and now been taken off the market as the so called COX-2 inhibitors such as Vioxx have been shown to be very lethal, diabetic drugs have a problem such as the drug Rezulin, statin drugs have been taken off the market, specifically the drugs Baycol and more recently an antibiotic (Tequin) has been discontinued because of its profound blood glucose lowering effect in diabetic patients. The general public also is looking for natural therapies as evidenced by the fact that the vitamin and health industry is now a multibillion-dollar industry. There has been public demand for natural products. There is a large group of patients that want natural therapies. There is also a great deal of misinformation, both in the press and on the internet both for and against nutrients. Many false claims have been made and as new research is published, much of it is contradictory. In my own practice, I have found that most physicians are afraid to use nutrients. However, the public continues to hear about the use of nutrients and there has to be some information disseminated concerning the safety of nutrients with specific pharmacologic therapy such as antihypertensive drugs, cholesterol lowering drugs, diabetic drugs and others.

My practice and a recent reported literature, has now found that lifestyle changes can be aggressive and very successful in managing and preventing degenerative diseases. New research is now showing that lifestyle changes and even certain drugs can prevent diabetes. Certain antihypertensive drugs as reported in the Heart Outcomes, Prevention Evaluation study, or HOPE study have shown that the use of certain ACE inhibitors can prevent heart disease, diabetes and cardiovascular complications. So the drug therapy is necessary, which can be used in conjunction with nutritional therapies. Diet still remains an area where there is a great deal of uncertainty. The public has been made insensitive to dietary claims because of the rapid, so called, changes with regards to dietary fats, sugars and carbohydrates. The proper diet has been shown to be very effective in managing many disease states, both in the form of prevention and management. Additionally, exercise is very under utilized and is an important part of my cardio-nutrition program as is stress reduction, and now I am also finding out that as part of lifestyle program, it is obvious that there is an overwhelming number of sleep disorders that are effecting general cardiovascular health and well being. Recent studies have shown that poor sleep habits can lead to weight gain, diabetes and fatigue.

With regards to future considerations, new products and drugs are now becoming available and they will have to be discussed as they relate to nutritional therapies. The management of cardiovascular disease is ever changing and the needs for literature such as this dealing with nutrition, vitamins, diet, exercise, stress reduction as it relates to specific problems in cardiovascular disease. A basic example of how the program works, as I look into features of cardiovascular disease, such as coronary artery disease, there are several therapies that have to be targeted, both from the area of drug and nutritional therapies. Cardiovascular disease requires risk factor reduction, and therefore drugs, specific diets, nutritional programs, and exercise management must be gearing towards control of hypertension, lipid management, reduction of inflammation, management of hormone levels, control of insulin levels, and there are therapeutic agents both in the drug and nutritional program that can be very effective in preventing and managing cardiovascular and other degenerative diseases.

Frederic J. Vagnini, M.D., FACS