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magazine presents

HEART HEALTH
by

KAROLYN A. GAZELLA

Copyright 2010 by Karolyn A. Gazella and Active Interest Media, Inc.

All rights reserved. No part of this booklet may be reproduced, stored in an electronic
retrieval system, or transcribed in any form or by any means, electronic or mechanical,
including photocopying and recording, without the prior written permission of the
publisher, except for the inclusion of quotations in a review.
Published by:
Active Interest Media, Inc.
300 N. Continental Blvd., Suite 650
El Segundo, CA 90245
This booklet is part of the Better Nutrition Healthy Living Guide series. For more information,
visit www.betternutrition.com. Better Nutrition magazine is available at fine natural health
stores throughout the United States. Design by Aline Design: Bellingham, Wash.
The information in this booklet is for educational purposes only and is not recommended
as a means of diagnosing or treating an illness. All health matters should be supervised by
a qualified healthcare professional. The publisher and the author(s) are not responsible for
individuals who choose to self-diagnose and/or self-treat.

HEART HEALTH
CONTENTS
Introduction: Feel The Beat .........................................................6
Chapter One: Conventional Wisdom? ...................................7
Chapter Two: Top Six Heart Pumping Polyphenols ..... 12
Chapter Three: Six More Heart Healthy Ingredients... 20
Chapter Four: Heart-Healthy Diet And Lifestyle .......... 25
Selected References ........................................................................ 31

Introduction

Feel The Beat

ake a fist and then take a good long look at it. Just imagine
thats the size of your heart. Weighing in at about nine ounces
for women and 11 ounces for men, the operation of the human
heart is pretty simple. One side of the heart pumps fresh oxygenated
blood out to the body, while the other side receives oxygen-deficient
blood. When you feel your heart beating, you are experiencing the resting
and contracting of the heart muscle pushing blood to where it is needed.
Although it may seem simple enough, the beating of your heart is what
keeps you alive, and there is nothing simple about that.

Out of Rhythm
The rhythmic pumping of the heart sends around five quarts of blood in
your body on about 500 roundtrips a day. Depending on whether you are
relaxed or excited, your heart can beat 60 to 120 times a minute. Sometimes when the heart is not healthy, the heart will beat too fast, too slow,
or it will stop altogether. When this occurs, a number of conditions can
result and they are all lumped into the same category of heart disease.
Heart disease is the general term given to a group of illnesses including:
Myocardial infarction = heart attack
Atherosclerosis = narrowing and hardening of the arteries
Cardiomyopathy = thickening or enlarging of the heart
Angina = chest pain
Stroke = interruption of blood supply to the brain
Arrhythmias = heart rhythm problems
Congenital heart disease = heart conditions you are born with
Heart disease is the number one cause of death in the United States.
According to the Center for Disease Control and Prevention, each year
about 785,000 Americans have a first heart attack and an additional
470,000 who already experienced one or more heart attacks have still
another attack. One in four Americans has some form of heart disease.
In fact, the American Heart Association reports that every 34 seconds
someone dies of heart disease and every three to four minutes someone
dies of a stroke.
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Controlling risk factors can go a long way in helping to prevent heart disease.

Its frightening to think that the operation of this small, hand-sized muscle
can stop in an instant. The best way to prevent heart disease is to be proactive.
And that proactive approach begins with an understanding of risk.

Risky Business
There are several factors that can increase your risk of developing heart
disease. These include:

Tobacco use. Cigarette smokers are two to four times more likely

Excess alcohol. Drinking too much alcohol can raise cholesterol

and blood pressure and may cause heart failure or stroke. Drinking
more than one drink a day for women and two drinks a day for
men is considered excessive.

to have some form of heart disease than nonsmokers. People

who are exposed to second-hand smoke are also at higher risk of
developing heart disease. For more information about smoking,
refer to the side bar on page 26.

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Stress. In some individuals, stress can contribute to heart disease.

Physical inactivity. Being inactive significantly increases your risk

of developing heart disease, as well as other conditions that can
lead to heart disease including obesity and diabetes.

Diabetes. Individuals who are diagnosed with diabetes have

Obesity. Studies have clearly shown that people who are overweight
and specifically if they carry extra weight around their waistline, are at
higher risk of developing heart disease. In addition to putting more
pressure on the heart, excess weight can lead to high blood pressure or
high cholesterol, which are also risk factors for heart disease.

High blood pressure. When a person has high blood pressure, the
heart thickens and becomes stiff. The continually increased pressure
of the blood flowing through the arteries can damage the lining of the
arteries and can cause them to weaken and enlarge. When combined
with high cholesterol or other risk factors, high blood pressure can
significantly increase the risk of developing heart disease.

High cholesterol. Too much cholesterol can encourage plaque

buildup in the arteries. The higher the cholesterol, the higher the
risk of developing heart disease.

Stress is also believed to lead to other risk factors such as excess

alcohol consumption, smoking, or overeating.

a higher chance of developing heart disease. According to the

American Heart Association, about 75 percent of people with
diabetes will likely die of some form of heart disease.

When multiple risk factors exist, the risk of heart disease increases dramatically. For example, author Michael Murray, ND, points out in his
book, What the Drug Companies Wont Tell You and Your Doctor Doesnt
Know, that if you have one major risk factor (listed previously), your risk
of heart disease is 30 percent higher. But if you have high cholesterol and
you smoke, for example, your risk skyrockets to 350 percent. If you smoke,
have high blood pressure and high cholesterol, your risk increases to a
whopping 720 percent. Its obvious that controlling risk factors can go a
long way in helping to prevent heart disease.
The next chapter features more detail about high blood pressure and
high cholesterol and the last chapter discusses diet and lifestyle factors
that you can proactively incorporate into your daily routine. But first, lets
take a closer look at how conventional medicine treats the two most commonly diagnosed risk factors of heart disease.

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Chapter One

Conventional Wisdom?

ver-the-counter and prescription drugs have saved countless lives.

Unfortunately, in the desire to find a magic bullet that will fix the
problem, we sometimes lose sight of the underlying causes of disease. As a result, medication may actually do more harm than good. This
is often the case with cholesterol-lowering drugs.

Unclogging Cholesterol
We often think of cholesterol as being bad. Actually, just the opposite
is true. The body, specifically the liver, makes cholesterol for many important reasons. Cholesterol helps with the production of vitamin D, a nutrient critical to good health. It also helps form sex hormones, produces bile
acids so we can digest food, and assists with the formation of cell membranes, specifically in the brain and nervous system.
Too much cholesterol can cause problems. When cholesterol accumulates in the arteries it becomes a part of plaque buildup. As plaque
increases, it can cause the artery to narrow and harden. This can eventually become atherosclerosis or hardening of the arteries. As we are learning more about cholesterol, we are discovering that even when cholesterol
is high, it still doesnt develop into heart disease until there is damage to
the arterial wall. This damage can occur as a result of inflammation or
oxidation. High homocysteine levels can also be the catalyst that causes
high cholesterol to become dangerous.
A poor diet, featuring lots of unhealthy fats, and lack of exercise are the
biggest culprits to the development of high cholesterol. A poor diet can
also contribute to inflammation and oxidationmore on that later. Cholesterol has become a huge health issue.
A cholesterol reading of 240 mg/dL or higher is considered high risk.
Levels from 200 to 239 mg/dL are borderline-high. According to the
American Heart Association, more than 102 million Americans have total
cholesterol levels of 200 mg/dL or higher. Remember, however, that total
cholesterol is not the only number thats important. Its critical to know
your numbers for LDL (bad) cholesterol versus HDL (good ) cholesterol.
Even low levels (less than 40 mg/dL for men and 50 mg/dL for women)
of HDL cholesterol can increase your risk of heart disease. According to
the American Heart Association, an HDL of 60 mg/dL or higher actually
protects you from heart disease and an LDL of less than 100 mg/dL is also
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We sometimes
lose sight of the
underlying causes of
disease. As a result,
medication may
actually do more
harm than good.
This is often the case
with cholesterollowering drugs.

optimal. The ideal total cholesterol to HDL ratio is about 3.5:1 so if your
total cholesterol is 210 and your HDL is 60, you are in the ideal range.
Conventional medicine uses cholesterol-lowering drugs known as statins
to keep cholesterol in check. These drugs (Lipitor, Crestor, Zocor, Mevacor)
block a substance that the body uses to make cholesterol. Some of these
drugs also help the body reabsorb accumulated cholesterol. Studies show
that these drugs are most effective in people with existing heart disease or
people diagnosed with diabetes. However, these drugs are being used in a
much broader patient population. The scientific literature is not clear that
people without existing heart disease or those with diabetes will even get
any benefit from these drugs. Dr. Murray carefully reviewed data from eight
published studies featuring participants who did not have evidence of heart
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disease but were on statins. He found that there were no significant differences in mortality from cardiovascular disease between people who took
cholesterol-lowering agents and those who took a placebo [fake pill].
These drugs are not without serious side effects, which can cause some
patients to stop taking them. One of the biggest side effects of statins is
severe muscle weakness. A recent March 2010 report issued by the FDA
warned that higher doses (80 mg) of the cholesterol-lowering drug Zocor
carries an increased risk of muscle injury including the serious complication known as rhabdomyolysis which can result in fatal kidney damage. The FDA referred to the SEARCH study that demonstrated fewer cases
of muscle damage on patients taking 20 mg of Zocor per day versus 80
mg. The study also found that when Zocor at the higher dose was combined with other heart drugs, specifically those to treat heart arrhythmias,
angina, and blood pressure, it was even more dangerous.
In addition to muscle and joint pain, statins can cause liver damage, nausea, diarrhea, constipation, and a deficiency of coenzyme Q10
(CoQ10). Deficiency of CoQ10 is a significant concern because CoQ10
is especially important to optimal heart function. CoQ10 is described in
more detail in Chapter Three.
In 2007, CBS News reported that annual sales of just one statin, specifically
Lipitor, exceeded $12 billion a year. While these drugs have saved many
lives, such widespread use may not be necessary, says Matthew Budoff, MD,
associate professor of medicine at the David Geffen School of Medicine at
UCLA. Dr. Budoff says a targeted approach that assesses all individual risk
factors is the best approach to preventing and treating heart disease.
Because cardiovascular disease is a multifactorial issue, any attempt to
simplify it by addressing only one risk factor is doomed to fail, concludes
Dr. Murray.
High blood pressure medications have also become big business. But
just how effective and safe are those medications?

Please note: You should never discontinue

taking a prescription medication without
first talking to your doctor. Also, inform your
doctor of all dietary supplements that you
are taking. Self-diagnosis and self-treatment
of any serious illness is not advised.
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Knowing Your Numbers

Blood Pressure Reading

Category of Risk

Below 120/80

Normal

120-139/80-89

Prehypertension

140-159/90-99

Stage 1 Hypertension

160/100+

Stage 2 Hypertension

180/110+

Hypertensive Crisis

Note: Unusually low blood pressure readings should be evaluated by your doctor.
Source: http://www.americanheart.org/presenter.jhtml?identifier=2112

Easing The Pressure

According to the American Heart Association, one in three Americans
has high blood pressure. In 2006, high blood pressure, also known as
hypertension, killed well over 56,000 people in the United States. In a
ten-year period from 1996 to 2006, high blood pressure rates increased by
nearly 20 percent, with the number of deaths associated with high blood
pressure increasing by more than 48 percent. Obviously high blood pressure is a serious illness.
If your blood pressure measures 140 mmHg over 80 mmHg or higher,
you have high blood pressure. If your pressure is between 120/80 and
139/89, you have pre-hypertension and your doctor may wish to monitor
you more frequently.
Although not as widely prescribed as cholesterol-lowering medications,
blood pressure drugs continue to rank among the top-selling pharmaceuticals. Newer pharmaceuticals for high blood pressure such as calcium
channel blockers and angiotensin-converting enzyme (ACE) inhibitors
are safer than previously used drugs such as diuretics and beta-blockers;
however, these new drugs are not without their side effects. For example,
calcium channel blockers can cause constipation, allergic reactions, headache, dizziness, fatigue, fluid retention, and, in about 20 percent of the
users, erectile dysfunction. Some individuals can experience heart failure
while on calcium channel blockers.
ACE inhibitors appear to be better tolerated but they can still cause
side effects such as headache, dizziness, and a dry nighttime cough. ACE
inhibitors can also cause potassium to build up so kidney function must
be monitored closely in individuals taking these drugs.
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More than 80 percent of patients with high blood pressure are in the
borderline-to-moderate range, explained Dr. Murray. Because most of
these cases can be brought under control through changes in diet and
lifestyle, it can be concluded that 80 percent of the prescriptions for high
blood pressure are ill-advised.

First do no Harm
All doctors take an oath to first do no harm. This directs them to
find the path to healing that features not only the most effective plan, but
also the plan with the least amount of side effects. The plan that gets to
the underlying cause rather than merely treats the symptom. Heart disease
requires this approach. While the operation of the heart may seem simple,
the vast array of conditions that can negatively affect its operation are complex and require a multi-factorial, individualized treatment plan. Exploring the integration of diet, lifestyle, and dietary supplements is an essential
part of this comprehensive heart disease prevention and treatment plan.
One of the myths associated with nutraceutical ingredients found in quality dietary supplements is that there are no good scientific clinical studies
that back up their effectiveness. In the next two chapters, I will identify and
review some of the most studied heart-healthy natural substances. While
there are many that fit into this category, Ive narrowed the list down to the
top 12 most remarkable heart healthy nutrients. Lets start with my favorite,
the widely studied category of polyphenols found in food.

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11

Chapter Two

Top Six Heart

Pumping Polyphenols

hen it comes to polyphenols, terminology can be confusing.

Some people use the following terms interchangeably: polyphenols, flavonoids, and anthocyanins. But the fact is, polyphenols
is the broad category name given to a group of chemical substances found
in plants (which includes fruits, berries, tea, etc). Flavonoids are a sub category of polyphenols which includes thousands of compounds. Anthocyanins are a subcategory of flavonoids and these substances give plants and
fruits their vibrant color. Other common names include flavonols, bioflavonols, bioflavonoids, anthocyanidins, proanthocyanins, proanthocyanidins,
etc. For the purpose of this discussion, well stick to polyphenols.
Numerous studies have shown that polyphenols, including specific flavonoids and anthocyanins, have tremendous antioxidant capacity. Antioxidants are important because they quench free radicals. Free radicals
are highly reactive molecules that can damage healthy cells. We breathe in
free radicals every dayeven the very act of breathing causes free radicals
to form. Our body also forms free radicals during digestion, muscle contraction (more specifically, exercise), and other processes.
Excess free radical damage has been linked to many serious illnesses
including heart disease, cancer, diabetes, and even accelerated aging. For
this reason, it is absolutely critical that we keep free radicals in check.
Given how many free radicals are created in the body, it is no wonder that our body has evolved ways to control or neutralize reactive compounds, explains author and naturopathic doctor Lise Alschuler, ND.
In his book Immunotics, Robert Roundtree, MD, describes free radicals as
sparks in a forest. Antioxidants are the important first buckets of water
that we use to keep the fire at bay. If our body does not have enough antioxidants available, the sparks will soon spread and cause damage. While
antioxidants are vital to free radical control, they also stimulate a positive
immune response.
Our bodies do not make antioxidants. We can only get them from food
and dietary supplements. The heart-healthy diet in Chapter Four focuses
on antioxidants that come from food. In this chapter and the next, we will
focus on the antioxidant capacity of food-based nutraceutical ingredients.
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The antioxidant potential in foods and ingredients is measured using the

Oxygen Radical Absorbance Capacity (ORAC) assay that was developed by
USDA researcher Guohua (Howard) Cao. Keep in mind, however, that even
if a fruit or vegetable has a lower ORAC value, it can still be very healthy for
you. For example, mango has a lower ORAC value than many other fruits
and yet they are still good for you. For more information on ORAC, see the
side bar on page 15.
In addition to their important antioxidant properties, many polyphenols are also anti-inflammatory. This is critical with heart health because,
as I mentioned earlier, inflammation is one explanation as to why the
plaque sticks in the arteries in the first place. Chronic internal inflammation has been linked to many serious illnesses, including heart disease.
So you see, the heart-pumping potential of these polyphenols is very
powerful. Lets take a look at the top six polyphenols that I have chosen.
So as not to play favorites, they are listed in alphabetical order beginning
with the berry known as Acai (pronounced ah sigh ee).

Acai (Euterpe oleracea)

This reddish purple berry comes from a distinctive Amazon palm tree
and is in the same berry family as the blueberry, cranberry, and other
dark berries. In addition to potent polyphenols, this little berry contains
other health-promoting compounds such as oleic acid (a healthy fat),
essential amino acids, important trace minerals, and other health-promoting nutrients.
Several studies have confirmed that acai has high ORAC levels and can
improve antioxidant status. Some studies have shown that acai has more
antioxidant capacity than any other berry, and far more than red grapes. A
2009 animal study featured in the journal Nutrition showed that those eating
the acai pulp had lower cholesterol levels. In 2006, researchers at the University of Florida demonstrated that acai berries killed cancer cells in test tube
studies. I expect we will see more clinical human trials done in the near future
using acai for a wide variety of health conditions, including heart disease.

Beet (Beta vulgaris)

A glass of beet juice a day can help keep the doctor away. At least thats
what researchers at the Barts and London School of Medicine found when
they gave healthy volunteers just over 16 ounces of beet juice. Within one
hour of drinking the beet juice, blood pressure dropped, with the most
significant drop occurring about three hours after drinking the juice.
The predominant polyphenol contained in beets is known as betacyanin.
Beets also contain other heart healthy nutrients such as folate, manganese,
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13

A glass of beet
juice a day can help
keep the doctor away.

magnesium, and potassium. Whats more, beets have been shown to be

anti-inflammatory and stimulate a positive immune response. Beets also
contain betalains, which are naturally-occurring nitrates. These nitrates
are converted into nitrites and then into nitric oxide which assists with
vasodilation (i.e. lower blood pressure).
An animal study conducted in Korea showed that red beet leaf fed to
animals eating a high fat high cholesterol diet increased antioxidant status.
The researchers concluded that the beet leaf could help prevent lipid peroxidation (free radical damage) and improve antioxidant defense systems.
I happen to like beets but not everyone does. In addition, beets are high
in sugar so this is a case where I think a dietary supplement complex that
contains beets is a good idea. In addition to beet juice, its always a good
idea to make sure your salad greens contain beet green leaves as well. That
will give you a little extra beet boost in your diet.

Chocolate (Theobroma cacaoYes, cocoa!)

When most people hear they are not only allowed to eat chocolate but
that it will actually benefit their health, a cat-like grin usually appears on
their faces. The flavonols found in cocoa have been shown to be especially
beneficial to the heart.
The research regarding the heart benefits of cocoa is quite compelling. In 2008, researchers from the University of Illinois reviewed previously published clinical trials
and found important scientific evidence that
the daily consumption of cocoa, specifically dark chocolate, significantly reduced
blood pressure and may help reduce the
risk of heart disease in general.
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The Scientific Facts Are Clear

When I have a question about something
health related, I like to go to the source
the actual scientist who is performing the
studies. When it comes to the antioxidant
capacity of natural compounds, Ronald L.
Prior, PhD, who is a nutritionist and senior
researcher with the USDA, has been on the
front lines of this exciting area of research
for the past 20 years.
Part of Dr. Priors research is testing
antioxidant levels in people after theyve
eaten a meal. In these human studies, hes Ronald L. Prior, PhD
found that when he gives a meal of just
protein, carbohydrates, and fats, the antioxidant levels in the
blood actual decline. But then when he adds high polyphenol
foods such as berries, grapes, or spinach to the meal, the antioxidant levels increase. That is proof positive that the foods we
eat directly impact our health.
Dr. Prior uses the ORAC assay, as well as other tests, to determine antioxidant capacity of a specific food. ORAC measures the
total of all the compounds that have antioxidant activity. The
ORAC assay is being used far more than I ever envisioned and
it has even become well established internationally, explained
Dr. Prior in a recent telephone interview I had with him. ORAC
gives us a starting point but its not the only measurement.
As Dr. Prior points out, ORAC is just one tool used to determine if a food or ingredient has therapeutic value. He believes
that measuring the flavonoid compounds in foods may help
define the dietary conditions needed to prevent tissue damage that leads to heart disease and other illnesses. Presently, Dr.
Priors work involves understanding how flavonoids may help
prevent the development of metabolic syndrome and insulin
resistance. Both of these are risk factors for heart disease.
Theres no question that these compounds have tremendous
impact on health, so its important to know how much we are
consuming of these compounds, he notes.

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15

The Darker The Better

If you are going to eat chocolate, its best to eat the darker chocolate. Dark chocolate has fewer carbohydrates and more polyphenols
than milk chocolate. The higher the percentage, the less sugar is
added. Unsweetened or bitter chocolate is around 100 percent. For
optimum health benefits, eat chocolate that is at least 70 percent
cacao content.
Look for certified organic 100 percent naturally-processed cocoa,
not Dutch or alkalized cocoa. Dutch or alkalized cocoa may taste
better but the process reduces polyphenol levels. Bitter is better!
Chocolate has now been elevated to the connoisseur level. Choosing the percentage and type of chocolate is like picking a fine wine.
Although both red wine and chocolate are now considered beneficial
to consume, remember moderation is key. Never overindulge in either.

Another recent 2010 study from Australia set out to determine if the
amount of cocoa affected the outcome regarding blood pressure reduction. The study featured 32 men and 20 postmenopausal women with
mild hypertension that were randomly assigned to receive one of four
doses of a cocoa flavonol-rich beverage for a period of six weeks. Upon
completion of the study, the researchers found that the group receiving
the highest level of cocoa flavonols, 1,052 mg daily, had the most significant reduction in blood pressure. The researchers concluded that the
polyphenol content of the cocoa is the most important aspect to consider
when taking it for heart health.
Those same Australian researchers studied the effects of cocoa on obese
individuals after exercise. Of the 21 people recruited, one group drank a
high-flavonol cocoa beverage and the other drank a low-flavonol beverage. Not only did this improve FMD [flow-mediated dilation], blood
pressure increases after working out were 68 percent lower in the group
drinking the high flavonol beverage compared to those getting fewer flavonols. The researchers concluded, These improvements in FMD and
blood pressure response to exercise add to the growing evidence that
high flavonol cocoa consumption may benefit individuals with cardiovascular risk factors.
Still another study in 2010, published in the European Heart Journal,
found that people who ate more chocolate had lower blood pressure. The
researchers of that study explained that the polyphenols in cocoa appear
to improve the bioavailability of nitric oxide, which is a gas that causes
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blood vessels to relax and widen. Nitric oxide also makes blood less sticky
and makes white blood cells less likely to attach to the arterial lining,
which is a sign of inflammation.
One product I recommend is CocoCardio made by Madre Labs because
the organic cocoa is 100 percent natural, non-alkalized and has naturallyoccurring polyphenols. CocoCardio also contains other important polyphenols from other natural sources.

Grape Seed And Grape Vine Extracts

(Specifically Resveratrol)
I have been known on occasion to drink a glass of red wine or two. So
I was tickled when I heard that red wine in moderation is actually good
for your health. First chocolate, now red wine! Before you get too excited
though, remember that drinking more than one drink a day for women
and two drinks a day for men can be dangerous to your health. Too much
alcohol can raise blood pressure and cause other heart problems. In addition, you would have to drink multiple bottles of wine each day to get the
health-promoting polyphenols found in resveratrol supplementsand
that is definitely not recommended.
Its best to get your red wine polyphenols from grape seed and grape
vine extracts, specifically resveratrol. Resveratrol is a polyphenol found
in the skin, seeds and vines of grapes. For that reason, red wine contains
naturally-occurring polyphenols. Resveratrol made headlines several years
ago as the anti-aging nutrient. In 2005, there was a human clinical trial
involving 30 men with heart disease that demonstrated that red grape
polyphenols significantly improved tissue function in the heart.
A 2010 animal study published in the American Journal of Hypertension
demonstrated that resveratrol protected the heart by reducing oxidative
stress. The researchers concluded, Resveratrol may have potential in preventing cardiac impairment in patients with essential hypertension.
The powerful effects of resveratrol go beyond the heart. Some studies
show that it can actually extend life expectancy. It has also been shown
to increase athletic performance and slow brain degeneration. All in all,
I would say that grape seed and grape vine extracts are a great source of
polyphenols and should be added to your overall wellness program.

Hibiscus (Hibiscus sabdariffa)

I am a tea drinker; however, the tart taste of pure hibiscus tea makes
it difficult for me to get enough of the important polyphenols from tea
alone. Fortunately, it can be found as a supplement in several forms.
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17

Over the past year or so I have been reading the research involving
hibiscus for heart health. Its exciting to see this natural ingredient get so
much attention in the scientific literature. The most recent study was done
by researchers at Tufts University and published in the Journal of Nutrition in February 2010. This was a randomized, double-blind, placebocontrolled clinical trial involving 65 adults diagnosed with pre- and mild
high blood pressure. This style of research (randomized, double-blind,
placebo-controlled) is considered the gold standard. The results of this
study confirmed previous clinical trials that demonstrated that hibiscus
lowers blood pressure.
That information in and of itself is impressive. However, other
studies have demonstrated that hibiscus also lowers cholesterol. This is the one-two punch of heart healthhealthy
blood pressure and cholesterol levels. A 2007 study
published in Nutrition Research showed that
taking hibiscus extract for one month significantly lowered cholesterol levels. The
benefits started after just two weeks.
In order to get the benefits of
hibiscus, youd have to drink a lot
of tea. One of the studies had participants drink
16 ounces of tea in the morning before breakfast.
This may not be feasible for many people. I recommend a heart-healthy powder that contains hibiscus
that can be simply added to water.

Pomegranate (Punica granatum)

Pomegranates are one of the most unique looking, beautiful fruits you
can find. When you crack open a pomegranate and find all of those luscious little red seeds (arils), its almost like winning the lottery. Pomegranate is actually an ancient fruit. It has even been featured in Greek mythology. And yet, pomegranates are just now catching on in North America.
Given the vibrant red color of the arils, its no wonder pomegranates are
packed with polyphenols for the heart.
A 2004 study featured in Clinical Nutrition demonstrated that pomegranate juice not only helped reduce blood pressure, it helped unclog arteries in
people with atherosclerosis. A more recent study done by researchers from
the University of Chicago studied the progression of artery thickening in
people at moderate risk of developing heart disease. They found that pomegranate juice slowed the progression of artery thickening in the patients
with high cholesterol. The researchers concluded that pomegranate juice
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Pomegranate is packed with

health-promoting polyphenols.

can help slow the progression of heart disease in people with increased
oxidative stress as indicated by high cholesterol levels.
According to a 2009 review written by researchers from Oklahoma State
University, Evidence to date suggests it may be prudent to include this
fruit juice in a heart-healthy diet. I agree. And if you dont drink the
juice every day, be sure this ingredient is a part of the whole foods dietary
supplement you are taking for your heart.

Whole Food Complexes

Putting polyphenols to work for you may seem overwhelming if you
think that you have to drink glasses and glasses of pomegranate, hibiscus,
beet, grape, and acai juice every day. Thats a lot of juice. And you may
think its easy to add cocoa to your diet but remember, the active compounds reside in the bitterness of the cocoa bean, not the typical sweet
stuff thats actually not as good for us.
I agree with most health experts that you should get as many therapeutic
nutrients as you can from your diet. But in the case of these potent polyphenols, taking a dietary supplement is best. I prefer to focus on whole food
complex supplements that provide me with the full spectrum of benefits
from the originating food source. That way, Im sure to get all of the benefits that the fruit or plant offers. I recommend two products, Acai Heart
and CocoaCardio, that provide the full spectrum whole food complexes.
When you are looking for a dietary supplement for your heart, try to get
as many of these important polyphenols as you can. In addition, there are
six more heart healthy ingredients that you will want to consider.
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Chapter Three

Six More Heart

Healthy Ingredients

he first six remarkable nutrients for heart health are pretty impressive, but the list continues. Because heart disease is the number one
killer in North America, researchers are searching for effective ways
to reduce the statistics. In this chapter, there are six more natural, effective substances that have been scientifically proven to significantly benefit
heart health. These are also listed in alphabetical order. Lets begin with
Allium sativum, aka aged garlic extract.

Aged Garlic Extract (Allium sativum)

Ive had the pleasure of working with and interviewing UCLA researcher
and cardiologist Matthew Budoff, MD. Dr. Budoffs main area of research
is identifying and then reducing the risks of heart disease, including high
cholesterol and high blood pressure. A natural substance that Dr. Budoff
has used in his studies is aged garlic extract, specifically Kyolic.
Amazingly, there are presently well over 600 published scientific studies
in peer-reviewed scientific journals featuring aged garlic extract, explains
Dr. Budoff. My colleagues at the Los Angeles Biomedical
Research Institute at Harbor-UCLA Medical Center and
I demonstrated that aged garlic extract enhances blood
flow, clears arteries of deposits and reduces multiple risk
factors for heart disease. In two successive randomized trials,
we have shown conclusively that aged garlic extract has cardiovascular benefit.
Thats a pretty strong endorsement. Dr. Budoffs
research confirms results from numerous other studies
that show aged garlic extract can enhance heart health
on many levels, including:

improved circulation;
reduced plaque build up;
less calcified plaque progression;
normalized cholesterol levels; and
reduced high blood pressure.
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Adding raw garlic to the diet or including a garlic dietary supplement to

your regimen is a wise choice if you have a history of heart disease or are
trying to prevent heart problems in the future.

Coenzyme Q10 (Ubiquinone, Ubiquinol)

Coenzyme Q10 (CoQ10) is a nutrient involved in energy production at
the cellular level. It is often referred to as the spark of life. According to
author and naturopathic physician Michael Murray, ND, CoQ10 is like the
spark plug in your car. Just as a car cannot function without that initial
spark, the human body cannot function without CoQ10, he explains.
The simple fact is, without that constant spark of energy, our heart would
stop pumping. Thats why much of the research involving CoQ10 has been
done on heart disease. However, it has also been studied extensively regarding its influence on immune and brain function.
In 2008, a study featured in the Journal of the American College of Cardiology evaluated blood samples from 236 patients admitted to the hospital
with chronic heart failure. The researchers found that low levels of CoQ10
is an independent predictor of mortality. In other words, levels of CoQ10
in the blood could indicate if the patient would die of heart failure in the
future. Thats why its so troubling that statin drugs used to treat high cholesterol deplete CoQ10 to dangerous levels.
A 2004 study conducted by Columbia University concluded that even
brief exposure to statin drugs can cause marked decreases in CoQ10 levels
in the blood. The researchers concluded that the CoQ10 depletion may
also explain some of the more commonly reported side effects of statins,
including exercise intolerance and muscle pain. Individuals taking statin
drugs should also take supplemental CoQ10. Please note that you should
always inform your doctor of the dietary supplements you are taking and
you should never discontinue a prescription medication without first talking it over with your doctor.
The scientific literature has shown that CoQ10 can help a wide range of
heart conditions including arrhythmia, high blood pressure, high cholesterol, heart toxicity caused by some chemotherapy drugs, congestive heart
failure, mitral valve prolapse, and angina. The link between CoQ10 and
peak heart-pumping capacity is clear, says author and holistic pharmacist
Sherry Torkos. When it comes to heart-healthy supplements, CoQ10 is at
the top of my list.
Its important to choose a CoQ10 you trust. The largest CoQ10 supplier in
the United States is Kaneka. They provide the only CoQ10 made from fermented yeast that is bio-identical to the CoQ10 produced in the body. The
Kaneka CoQ10 has been used in many clinical trials for the past three decades.
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Essential Fatty Acids From Fish or Plant Oils

(Omega-3s, specifically EPA and DHA)
Im often asked if I had to limit my dietary supplements to just three,
which three would I choose. This is difficult because as a cancer survivor and someone diligently trying to prevent a cancer recurrence, I take
a good number of dietary supplements each day. One supplement that
always makes it to my top three list is an essential fatty acid supplement.
I have used both fish oil supplements and supplements that have a plant
oil base and I have found each to be effective. Why are essential fatty acids
so important? Because they truly are essential to our health, especially
heart health.
There are several different types of fats. The ones we hear most about
are the bad fats. These are known as trans fats and saturated fats. Food
labels will tell you how much trans fats and saturated fats are in that particular food. Trans fats should be avoided completely and saturated fats
should be extremely limited. Saturated fats are found in meat, cheese,
whole milk, cream, and butter. Trans fats are found in prepackaged foods,
as well as restaurants that cook with trans fat oils. Fast food restaurants are
notorious for using these bad fats.
At the opposite end of the spectrum are essential fatty acids. Omega-3,
Omega-6, and Omega-9 are essential fatty acids. The average American
diet is severely deficient in Omega-3 fatty acids. These are found in plant
oils (flax, olive, avocado), nuts and seeds, fruits, and vegetables. The best
plant source of Omega-3 is flaxseed and the best food source is fatty fish.
When it comes to heart health, EPA (Eicosapentaenoic acid) and DHA
(Docosahexaenoic acid) are the two most important types of Omega-3
essential fatty acids. A 2010 study published in Clinical Nutrition showed
that when participants ate a meal that was supplemented with both EPA
and DHA, their arteries were less stiff. The researchers noted that improvement in arterial flexibility is directly linked to long-term heart health and
heart disease prevention. Numerous other studies have demonstrated
Omega-3 essential fatty acids can help reduce the risk of heart disease,
lower cholesterol and high blood pressure, reduce the tendency of thrombosis (blood clots), and improve heart rate.
In addition to nourishing the heart, essential fatty acids also enhance
immunity, help regulate blood sugar levels, and reduce chronic inflammation. You can see why this dietary supplement consistently makes it onto
my top three. Keep in mind that, in addition to taking an essential fatty
acid supplement, its important to incorporate more EFAs into your diet
by eating more fruits, vegetables, healthy oils (specifically olive), and fatty
fish such as salmon and trout.
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Hawthorn (Crataegus
oxyacantha)
Hawthorn is a botanical in the
rose family. It has thorns like a
rose bush, as well as attractive
flowers. However, the hawthorn
shrub or tree also has red berries.
The fruit has been used for years
as a heart tonic. More recently, however, the leaves and flowers have been used as
extracts to treat a wide variety of heart conditions including angina (chest pain) and heart failure.
A 2008 review of 10 clinical trials revealed that hawthorn can be an effective complementary treatment for chronic heart failure. Symptoms such
as shortness of breath and fatigue were significantly improved in patients
who took hawthorn. Exercise tolerance was also significantly increased in
those taking hawthorn. The authors reported that side effects of hawthorn
were infrequent, mild, and transient. After analyzing all of the data, the
researchers concluded there is a significant benefit in symptom control
and physiologic outcomes from hawthorn extract as an adjunctive treatment for chronic heart failure. For this reason, it is prudent to look for
hawthorn as an ingredient in the heart-healthy formula you choose.

L-Carnitine
L-carnitine is an antioxidant nutrient that helps convert fat into energy.
It is primarily used as a dietary supplement for fatigue and to improve
exercise performance. While L-carnitine deficiency is not that common,
the heart is especially vulnerable to low L-carnitine levels because of its
high-energy needs. The forms of L-carnitine taken specifically for heart
conditions are known as L-carnitine Fumarate, L-carnitine Tartrate, and
more recently Propionyl-L-carnitine.
Several small studies have shown that L-carnitine supplementation can
help patients who have experienced heart disease. A study published in
2007 combined L-carnitine with CoQ10 and demonstrated that the combination significantly reduced impaired inflammatory markers in patients
with heart failure. The researchers concluded that there was a marked
improvement in the quality of life in those taking the L-carnitine-CoQ10
combo and that there was a decrease in heart failure.
There is also scientific evidence showing that L-carnitine can protect the
heart in patients taking doxorubicin. Doxorubicin is a chemotherapy drug
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typically used to treat a wide variety of cancers including breast, ovarian,

bladder, stomach, and others.
Its important to note that some studies did not demonstrate that
L-carnitine influences mortality in heart patients. More research involving larger numbers of study participants should be conducted to confirm
the exact benefit that L-carnitine has on the heart. Preliminary evidence is
very promising.

Nattokinase
Natto is a Japanese food that looks like cheese but is made from fermented soybeans. An enzyme extracted from this food is called nattokinase. Several studies have shown that the nattokinase enzyme can help
reduce blood pressure. Researchers believe this enzyme helps dissolve
fibrin (fibers) that can hold blood clots together. By dissolving these fibers,
nattokinase thins the blood so it can move through the arteries more
freely. In addition, nattokinase can help reduce water and salt retention.
A randomized, double-blind, placebo-controlled 2008 study featuring
73 patients with high blood pressure showed that nattokinase can reduce
both systolic and diastolic blood pressure. The researchers concluded
These findings suggest that increased intake of nattokinase may play an
important role in preventing and treating hypertension.
The problem with the food known as natto is that it has a fairly strong,
salty taste. Not everyone cares for natto and therefore, most Americans
are not getting nattokinase in their diet. In Japan, it is a dietary staple and
some researchers believe this is one reason why Japan has a lower incidence of heart disease than North America. Fortunately, nattokinase is an
ingredient in many heart-healthy dietary supplements.

Nourishment From Nature

As you can see, Nature provides us with many options when it comes
to nourishing a healthy heart. The top 12 most remarkable nutrients
described here are simple, effective, and natural ways to keep your heart
pumping strong. Through a combination of diet and dietary supplements,
you should try to incorporate as many (if not all) of these heart-healthy
nutrients into your daily routine. But we all know that there is no such
thing as a magic bullet in the form of either a drug or a dietary supplement.
To have a strong heart for a lifetime, you need to build a strong foundation with diet and lifestyle. As you will discover in the next chapter, your
heart is influenced (positively or negatively) by a variety of factors. The
key is to find ways to consistently and positively influence the health of
your heart every day.
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Chapter Four

Heart-Healthy Diet
And Lifestyle

y grandfather had four major heart attacks before he died. My

father has diabetes and has had peripheral artery disease, which
is a narrowing of vessels outside the heartboth of these factors put him at high risk of heart disease. At the age of 33, I was operated
on for ovarian cancer and had a complete hysterectomy, which increases
my chances of developing heart disease. You can see why this is an important topic for me personally.
I would love nothing more than to take one (or all) of these remarkable nutrients Ive just described and be assured that I will not develop
heart disease. But that just isnt possible. I have learned over the years that
optimum health requires a comprehensive strategy that must begin with
diet and lifestyle, and then incorporates dietary supplements as added
insurance. While there is much controversy about what is the best diet
for your heart, I have found that the scientific literature clearly points us
in the direction of the Mediterranean Diet.

Plant-Based Diet
A plant-based diet focuses on vegetables, fruits, beans, nuts, healthy
fats, and whole grains. The most widely studied plant-based diet is the
Mediterranean Diet, which originates primarily from Greece and Italy. A

Eat Organic
Whenever possible, choose organic.
Organic foods are not only better for
your health because they are free
of pesticide residue, hormones,
preservatives, and other toxic
compounds, they are also better
for our environment.

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landmark study published way back in 1970 found that men in seven
nations who consumed the highest amount of animal products and saturated fat had the highest incidence of heart disease. The United States and
Finland had the worst statistics, while Greece, Italy, and Japan had the
least amount of heart disease. Its no wonder, because in Greece the average resident eats nine servings of vegetables and fruit each day, while the
typical American eats about four servings of fruits and vegetables daily.
Numerous studies since that one in 1970 have confirmed the benefits of the Mediterranean plant-based diet. The key components of this
diet include:

less red meat and more fish;

more vegetables and fruits;
extra virgin olive oil is the primary fat source;
fewer processed foods;
more whole grains and nuts; and
red wine in moderation.

Stop Smoking!
You probably already know that if you smoke, you should quit. We
often make the connection between smoking and lung cancer, but
you may not have been told exactly how cigarette smoke (including
secondary smoke) harms your heart. There are four key ways that
cigarette smoke negatively influences heart function:
1 It causes an adrenalin release that speeds up your heart rate

and can put extra strain on your heart.

2 Carbon monoxide inhaled from cigarettes reduces oxygen intake

and increases oxidation.

3 The vast amounts of chemicals in cigarette smoke cause hard-

ening of the arteries because the blood vessels are less able
to relax.
4 Smoking can lead to inflamed arteries which means plaque is

more likely to stick to the walls, causing clogging.

But dont just take my word for it. The statistics dont lie. Smoking
causes heart disease. According to the American Heart Association,
smoking causes 30 percent of all heart disease deaths each year. If
you smoke, quit. If someone you loves smokes, help them quit.
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Optimum health requires

a comprehensive
strategy that must begin
with diet and lifestyle.
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27

This diet is high in antioxidants, which is critical to killing off those

dangerous free radicals. This diet also is high in fiber, vitamins, minerals, essential fats, and polyphenolsall are very important to heart
health. A plant-based diet can help you achieve healthy cholesterol and
blood pressure levels, as well as keep your blood flowing freely through
relaxed arteries.
Because I often cant get the fruits and vegetables I need each day, I
supplement my diet with two powdered supplements, one that includes
a variety of important greens and the other that includes super fruits and
berries. The green drink product I use is called Midori Greens and the berries product I use is called Eureka! Berries.
In addition to diet, there are other things you can do on a daily basis to
ensure your heart is healthy.

Move it!
Your heart is a muscle, and muscles need to move to stay healthy and
vibrant. If Im not working out on a consistent basis, even the simple task
of carrying a couple bags of groceries can seem like a chore. But when Im
working out, those groceries seem light as a feather. Exercise actually helps
keep my heart trained to pump more efficiently, so taking the stairs versus
the elevator doesnt seem like a big deal.
Being physically active on a consistent basis is the most important thing
you can do for your heart. And the most important thing about being

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Exercise Tips to Remember

To get the most benefit from your exercise program, keep this
inmind:

Make physical activity a part of your daily routine.

As you get more comfortable with exercise, increase the duration and the intensity.

The best exercise program focuses on frequency rather than

duration. In other words, its much better to exercise four
times a week for 30 minutes than it is to exercise twice a week
for an hour.

Have fun!

Be sure to warm up and cool down with simple stretching.

Participate in physical activity for at least 30 minutes, four
times a week.

Please note that if you have not been active for a while, talk to
your doctor before embarking on a new exercise program.

physically active is to choose activities that you enjoy. Some people like
going to the gym, while others prefer to garden, go for walks, ride their
bike to work, take the dog for a walk at lunchtime, play golf several times
a week, or all of the above. Its important to vary your physical activity so
you dont become bored or give up. Your body will also appreciate the
variety because it requires three different types of physical activity in order
to stay healthy:

Aerobic (brisk walking, swimming, biking, etc.)

Strength training (weight lifting, Pilates, etc.)
Stretching (simple stretches, yoga, or tai chi)
When we are physically active, we look and feel better. Numerous studies demonstrate that exercise not only helps your heart, it will also make
your bones stronger, increase oxygen and blood flow to the brain, stimulate a positive immune response, give you more energy, and help relieve
depression and anxiety. And who wouldnt want all that?

What Else?
The best heart-healthy program begins and ends with a healthy diet and
active lifestyle. But there is even more that you can do to help ensure your
heart stays pumping properly for a lifetime.
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Sleep. Sleep deprivation has been linked to heart disease and other agerelated illnesses, including diabetes, obesity, and memory loss. Be sure to
get at least seven hours of quality sleep each night. Several dietary supplements have been shown to promote sleep and induce relaxation. One
supplement known as L-theanine (brand name Suntheanine) is a common ingredient in many sleep and stress reducing formulas.
Relax. The link between stress and heart disease has been confirmed. In
fact, in a 2008 study published in the Archives of General Psychiatry, Americans who said they became stressed after the 9/11 terrorist attack (even
those not directly involved who watched the horrifying event unfold on
television) reported higher rates of heart disease up to three years later. In
addition to exercise, Sherry Torkos recommends massage, acupuncture,
deep breathing, progressive muscle relaxation, visualization, or meditation as effective techniques that can help you relax.
Love. It may sound corny, but the heart needs to give and receive love
it is, after all, the universal symbol of love. This has been scientifically
proven by many researchers, but none have so eloquently confirmed the
benefits of love to the human heart than Dean Ornish, MD. Our survival
depends on the healing power of love, intimacy, and relationships, Dr.
Ornish wrote in his best-selling book Love and Survival. Lise Alschuler,
ND, my co-author of The Definitive Guide to Cancer says Love goes far
beyond romantic love. It is the most powerful health-promoting emotion
of allgiving it, receiving it, and even doing things you love.

Final Thoughts
As you can see, if you have a heart condition or are afraid of having
heart problems in the future, there is a lot you can do. From heart-pumping polyphenols and other heart-healthy ingredients, to diet, exercise, and
even increasing the amount of love you give and receive each day, there
are many resources available to you. The most effective heart health plan
features as many of those resources as possible.

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Selected References
http://www.americanheart.org
http://www.ars.usda.gov/is/AR/archive/feb99/aging0299.htm
Alschuler, Lise and Karolyn Gazella. The Definitive Guide to Cancer, 3rd Edition. Berkeley,
CA: Celestial Arts, 2010.
Aviram M. Pomegranate juice consumption for 3 years by patients with carotid artery
stenosis reduces common carotid intima-media thickness, blood pressure, and LDL
oxidation. Clinical Nutrition. 23(3):423-33, 2004.
Basu A. Pomegranate juice: a heart-healthy fruit juice. Nutrition Review. 67(1):49-56, 2009.
Berry NM. Impact of cocoa flavonol consumption on blood pressure responsiveness to
exercise. British Journal of Nutrition. 19:1-5, 2010.
Budoff MJ. Garlic therapy retards coronary artery calcification. Presented at the
Experimental Biology 2008 Conference held in San Diego, CA, April 2008.
Budoff MJ. Inhibiting progression of coronary calcification using aged garlic extract in
patients receiving statin therapy: a preliminary study. Preventive Medicine. 39(5):985-91,
2004.
Buijsse B. Chocolate consumption in relation to blood pressure and risk of cardiovascular
disease in German adults. European Heart Journal, 2010.
Chong MF. Long chain n-3 PUFA-rich meal reduced postprandial measures of arterial
stiffness. Clinical Nutrition, Mar 1, 2010.
Davidson MH. Effects of consumption of pomegranate juice on carotid intima-media
thickness in men and women at moderate risk for coronary heart disease. American Journal
of Cardiology. 104(7):936-42, 2009.
Davison K. Dose-related effects of flavonol-rich cocoa on blood pressure. Journal of Human
Hypertension, Jan 21, 2010.
Erdman JW Jr. Effects of cocoa flavonols on risk factors for cardiovascular disease. Asia
Pacific Journal of Clinical Nutrition. 17 Suppl 1:284-7, 2008.
Holman EA. Terrorism, acute stress, and cardiovascular health: A 3-year national study
following the September 11th attacks. Archives of General Psychiatry. 65(1):73-80, 2008.
Kim JY. Effects of nattokinase on blood pressure: A randomized, controlled trial.
Hypertension Review. 31:1583-1588, 2008.
Kumar A. Effect of carni Q-gel (ubiquinol and carnitine) on cytokines in patients with
heart failure in the Tishcon study. Acta Cardiologica. 62(4):349-54, 2007.
Lekakis J. Polyphenolic compounds from red grapes acutely improve endothelial function
in patients with coronary heart disease. European Journal of Cardiovascular Prevention and
Rehabilitation. 12(6):596-600, 2005.
Lee JH. Red beet (Beta vulgaris L.) leaf supplementation improves antioxidant status in
C57BL/6J mice fed high fat high cholesterol diet. Nutrition Research and Practice. 3(2):14421, 2009.

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McKay DL. Hibiscus sabdariffa L. tea (tisane) lowers blood pressure in prehypertensive and
mildly hypertensive adults. Journal of Nutrition. 140(2):298-303, 2010.
Molyneux SL. Coenzyme Q10: an independent predictor of mortality in chronic heart
failure. Journal of the American College of Cardiology. 52(18):1435-41, 2008.
Murray, Michael T. What The Drug Companies Wont Tell You and Your Doctor Doesnt Know.
New York: Atria Books, 2009.
Oliveira de Souza M. Diet supplementation with acai (Euterpe oleracea Mart.) pulp improves
biomarkers of oxidative stress and the serum lipid profile in rats. Nutrition. Dec 17, 2009.
Pittler MH. Hawthorn extract for treating chronic heart failure. Cochrane Database Systematic
Reviews. (1):CD005312, Jan 2008.
Rundek T. Atrovastatin decreases the coenzyme Q10 level in the blood of patients at risk
for cardiovascular disease and stroke. Archives of Neurology. 61(6):889-92, 2004.
Thandapilly SJ. Resveratrol prevents the development of pathological cardiac hypertrophy
and contractile dysfunction in the SHR without lowering blood pressure. American Journal
of Hypertension. 23(2):192-6, 2010.
Tzu-Li L. Hibiscus sabdariffa extract reduces serum cholesterol in men and women. Nutrition
Research 27: 140145, 2007.
Webb AJ. Acute blood pressure lowering, vasoprotective, and antiplatelet properties of
dietary nitrate via bioconversion to nitrite. Hypertension. 51(3):784-90, 2008.

For more information about the products featured in this booklet, visit:
www.iherb.com or www.madrelabs.com
For more information about the author of this booklet, visit:
www.karolyngazella.com

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CHECk ouT ANoTHER BETTER NuTRiTioN

HEALTHy LiviNg guidE TodAy!

This booklet is a part of the Better Nutrition Healthy

LivingGuide series. For more information about other
topics in this series, visit your local independent
health food store or visit usonline.

betternutrition.com

magazine presents

HEART HEALTH
pREvENT HeArt DIseAse NATuRALLy

very 34 seconds someone dies of heart disease. According

to the American Heart Association, one in four Americans
has some form of heart disease. In this booklet, veteran
health writer Karolyn A. Gazella provides important details about
heart disease risk factors including high cholesterol and blood
pressure. In addition to diet and lifestyle, she provides exciting
information about the 12 most remarkable heart-healthy herbs
and nutrients. Gazella interviews several experts and scours the
scientific literature to provide the most trusted information about
a natural approach to heart disease prevention.

ABouT THE AuTHoR of THis BookLET

karolyn A. gazella is a veteran publisher in the field of
integrative medicine with 18 years of experience. She is
the founding publisher of the Natural Medicine Journal
(www.naturalmedicinejournal.com) and has written
hundreds of articles for both consumers and healthcare
professionals on the topic of natural health. She is the
co-author of the Definitive Guide to Cancer, Boost Your
Health With Bacteria, and Return to Beautiful Skin. She
is the creator and managing editor of the Healthy Living
Guide series of booklets and books available through
Better Nutrition magazine. For more information visit
www.karolyngazella.com.

Number 32
betternutrition.com