On February 16th preventive cardiologist Steven Devries, MD, of The Healthy Heart Center, University of Illinois at Chicago, gave an inspiring NOHA lecture on prevention of heart disease and stroke. He explained to us that major problems that would result in possibly fatal heart attacks or strokes and that are often COMPLETELY HIDDEN in people who are seemingly perfectly healthy can be revealed by new sophisticated blood tests, which are almost always covered by medical insurance. After this careful, complicated testing, the treatment that Dr. Devries prefers and that addresses the underlying causes of the patient's problem involves NO pharmaceutical drugs but actually simply lifestyle changes, including diet and particular vitamins. Sometimes a patient is not willing to change. In that case, Dr. Devries will prescribe the usual medications and explain to the patient that the underlying problems are NOT being addressed.

Dr. Devries told us that the usual surgeries, like angioplasty and bypass surgery do not cure anything. The underlying problems remain and often the surgeries have to be repeated-just at a different spot in the patient's cardiovascular system.
The tests, recommended by Dr. Devries are for:

• Homocysteine, a natural biochemical that occurs as an intermediate in the metabolism of the amino acids methionine and cysteine. When homocysteine accumulates it is extremely toxic. This metabolic problem arises when sufficient amounts of the vitamins B6, B12, and folic acid are lacking and can be fixed by adding them to the diet.
• Lipoprotein (a ), which is a "toxic sandwich of fat wrapped in clot marker." The treatment is the vitamin niacin. Following the test, this treatment needs to be carefully monitored to be sure that enough niacin is administered and not too much, which could be toxic.
• LDL (Low Density Lipoprotein) particle size. LDL is the "bad" cholesterol. However, it seems that particle size is important. The larger particles are "safer." Small particles penetrate the artery walls more easily and are more easily oxidized. This easy penetration Dr. Devries portrayed as the difference between throwing darts or softballs at a cracked wall. Some of the darts would stick in the cracks, while all the softballs would bounce back from the wall. We know that oxidized cholesterol is the really dangerous kind. We need adequate antioxidants in the diet.
• C Reactive Protein, which indicates inflammation in the body. A test result of 0.6 is normal. Dr. Devries' patients sometimes show far higher numbers. Fiber in the diet can be helpful-especially soluble fiber.

We see that these tests go far beyond the standard cholesterol tests, which do not reveal the patient's underlying metabolic problems.

Dr. Devries was eloquent on the importance of oils. Unfortunately, many doctors are ignorant on this vital subject. He pointed out sadly that in his excellent medical training, he received "zero" instruction in nutrition. Quite recently a doctor friend inquired, "What are 'trans' fatty acids?" That ignorance is really shocking! For many years, we, in NOHA, have known the deleterious effects from the trans fatty acids, which are ubiquitous in processed foods.

. . . major problems [can] result in possibly fatal heart attacks or strokes and . . . are often COMPLETELY HIDDEN in people who are seemingly perfectly healthy . . .

Dr. Devries pointed out that there is excellent scientific evidence showing the virtues for the heart of monosaturated oils, which are found in foods like avocados and, of course, in olive oil, which is basic in the healthy Mediterranean diet (See the NOHA tapes of Artemis Simopoulos, MD). In spite of this evidence, he often finds that patients are shocked when he suggests these foods. They exclaim, "Oh, but they are full of fat!" He has to explain the healthy fats. Dr. Devries also told us about the virtues of nuts. He mentioned with a smile that he often munches a handful of nuts-almonds or walnuts-between patients. Nuts have fine protein as well as healthy fats.

Prestigious scientific evidence has shown the importance of the omega-3 fatty acids for the cardiovascular system. Specifically, they lower triglycerides, calm irregular heart beats, thin blood, and reduce inflammation, which can affect the heart-no matter where the inflammation occurs-even periodontal disease. Dr. Devries recommends twice a week wild-caught (NOT farm-raised) fish, for example salmon, that are high in the long-chain omega-3 fatty acids; or, one can take capsules put out by companies that are careful to test for the toxic heavy metals, which can accumulate in fish, because of worldwide pollution. Of the long-chain omega-3 fatty acids, Dr. Devries points out that EPA (eicosapentaenoic acid) is especially good for the heart and DHA (docosahexaenoic acid) for the brain. He recommends one to two grams per day. (See also the tape of Professor Michael A. Crawford, "Essential Fatty Acids for the Brain and Heart," April, 1997, for NOHA's Twenty-fifth Anniversary)

Dr. Devries emphasized healthy aspects of soy bean consumption and recommended 25 grams per day. In the questions afterward, genetic engineering and pesticides were mentioned as problems with many soy products. However, there is another aspect. Raw soybeans contain certain anti-nutrients, which are not completely eliminated by cooking or sprouting, only by traditional fermentation. (See NOHA NEWS, Fall 2001, "The Downside of Soybean Consumption.")

. . . the treatment that Dr. Devries prefers and that addresses the underlying causes of the patient's problem involves NO pharmaceutical drugs but actually simply lifestyle changes, including diet and particular vitamins.

Dr. Devries emphasizes the genetic component of heart disease. Often his patients will look healthy but will have close relatives who died early from heart disease. In these cases it is especially helpful to get the tests for hidden metabolic problems. Often, they have discovered results that are spectacularly abnormal and that can be corrected by diet and appropriate supplements.

Many patients have no conception that consumption of white flour products (or sugar) in their diet can result in increased fat. The body just converts the extra carbohydrates-not needed for immediate energy-into stored fat. His patients are often amazed when he points out that these starches and sugars are just as deleterious as any saturated fat, which they may be actually trying to avoid. In other words, their "low fat" and high carbohydrate diet can make them obese and more subject to heart failure. The glycemic index is an important aspect of diet that is often overlooked. For a healthy heart, Dr. Devries recommends eating lower on the glycemic index. He gave us two interesting examples:

GLYCEMIC INDEX

HIGH	baked potatoes	white rice
LOWER	new potatoes	brown rice

Besides diet, in Dr. Devries overall program for his patients' healthy hearts, he emphasizes exercise, stress reduction, and, of course, cessation of smoking as additional required lifestyle changes.

Dr. Devries' background is fascinating. He received superb medical training with his MD degree and his Board Certification in Internal Medicine from the University of Michigan Medical School and his Board Certification in Cardiovascular Diseases from Washington University in Saint Louis. On his own, he has learned about nutrition and about simple preventive measures that patients can take to greatly reduce their risk of heart disease or stroke. He has just completed a course in Integrative Medicine with Andrew Weil, MD, and plans to take a second course. It was exciting having him speak to us in NOHA!

Article from NOHA NEWS, Vol. XXX, No. 2,Spring 2005, pages 1-2.