Preventing inflammation in the arteries is critical to your health
I often tell people I have the most intelligent-thinking readers in the entire blogosphere as it relates to nutrition and health because you are inquisitive, insightful, and constantly in search of discovering the truth about how our bodies and metabolisms work the way they do. If topics like weight loss and disease control were simple, then there’d be nothing to talk about. Thank goodness for you and me it’s NOT that easy and there are certain nuances that are worthy of further investigation. And these often make for outstanding conversations to begin right here in this forum.
One such subject came up recently in an e-mail from a very dedicated reader of my columns. She wanted to know about the role of acid in the blood being a leading cause of the arterial inflammation which more and more cardiologists are properly educating their patients is leading directly to atherosclerosis. Here’s her lengthy but logical theory with the crux of her question highlighted in bold for my emphasis on what I want you to focus on:
I have thought quite a bit about something for the last couple years and that is the “arterial inflammation” problem. I have suspected for some time that the real problem is not the cholesterol, but inflammation of the interior of the artery walls. I have come across the idea that when the artery walls get inflamed, the body uses cholesterol to “patch” the inflamed areas, as a protection to the artery.
Why do they get inflamed? Some say due to an acid condition in the body. If the blood becomes a little too acidic, then it begins to inflame and erode at the interior of the artery walls. The body uses the cholesterol and fatty substances to patch the inflamed areas, knowing that it is better to have the unnatural patch inside the artery than to allow the acid to eat a hole in the artery.
I came across the importance of maintaining an alkaline condition in the body 30 years ago when studying the Asian macrobiotic diet. It is interesting that only recently has the Western medical profession discovered this inflammation factor that is so closely associated with cardiovascular disease (or at least I only started hearing of it recently). But, it is my understanding that the medical profession wants to treat the inflammation with anti-inflammatory drugs, which possibly doesn’t get at the root of the problem.
So, for some time now I have believed that it is very important to maintain an alkaline condition in the body, and there are many websites that give lists of “alkaline-producing” foods. I had a doctor tell me that your body must naturally maintain a very strict slightly-alkaline condition (I don’t remember the actual ph range), implying that there is no reason to try and maintain it yourself. But, I think the factor not mentioned is a discussion of what your body has to go through to maintain that alkaline condition when our diet is continually producing an acid condition.
I have read that our body must rob calcium from the bones and place it in the blood to counteract the acid condition. It seems likely that this reaction of the body may be why so many elderly now have bone density issues. This may not be medically accurate, but it is what I have gathered from the little research that I’ve done, and I haven’t heard an explanation that makes any more sense to me. It makes sense that if the body has no reason to patch the arteries, then the cholesterol can pass through them without being deposited on the interior walls. Even if all this is right, and it may not be, the kicker is having the knowledge of how to maintain an alkaline condition and then having the discipline to do it.
My big question now: Is it accurate to say that if we eat an improper (acid-producing) diet, that our blood actually can become acid enough to inflame the interior of the artery walls? If this is true, then the rest of the scenario makes complete sense to me.
Any thoughts on this are greatly appreciated. THANK YOU!
Awesome topic, huh? We already know that cutting down on inflammation is why you and I are eating a carbohydrate-restricted diet, but what about some of the low-carb foods we consume that make our blood more acidic? Are these actually sabotaging our efforts by undermining the positive benefits of livin’ la vida low-carb due to my reader’s theory about acidic blood leading to arterial inflammation that causes heart health problems down the road? I’m privileged to have instant access to some of the best and brightest health low-carb experts in the entire world and I decided to pose this reader’s question to some of them for a response. Here’s what they said:
If we are not talking about supportive research and diet per se, here are the things I know. Although blood acid levels do go up with low-carb, they only rise to a small degree and then homeostasis occurs shortly thereafter. Additionally, blood acid levels return to normal and eating green leafy vegetables as you do on a good low-carb diet helps to maintain normal pH levels. Although much of what she says has truth to it, I think what she is doing is taking one element (i.e. low blood pH) and trying to assign it the “now I’ve discovered why people get heart attacks, lose bone density, etc. and it’s all because of this one thing phenomenon.” Typically we only scratch the surface on knowing why people get sick when it is usually multi-factorial. That being said I do think there are symptoms that people will experience of which many practitioners will not put together as blood pH imbalance. My big question now: Is it accurate to say that if we eat an improper (acid-producing) diet that our blood actually can become acid enough to
inflame the interior of the artery walls? If this is true, then the rest of the theory your reader proposes makes complete sense to me.
To my knowledge, the data supporting this notion exist, but are indirect. We know that lower serum bicarbonate levels (an alkaline substance) are associated with higher inflammatory markers, such as C-reactive protein, white blood cell count and activity. Pathologic acidification, potentially an exaggeration of more “pedestrian” acidification due to poor food choices, leads to diffuse and aggressive atherosclerosis. This occurs in kidney disease, since the kidney is responsible for disposal of acidic byproducts of metabolism. Alkalinizing foods (i.e. vegetables, fruits, nuts) have all been associated with reduced cardiovascular risk. Acidifying foods (i.e. meats) have been associated with increased all-cause mortality (but especially cancer). However, the precise means by which acidification leads to atherosclerosis has not, to my knowledge, been mapped out. It is likely that it is not a simple “injury and repair” mechanism, but a multi-faceted response that involves variation in calcium metabolism and deposition, modulation of local arterial factors such as endothelin and nitric oxide, modification of oxidation state of LDL. It is a fascinating issue, but I don’t anybody knows enough to connect all the dots just yet. One final thought: Interestingly, the easiest and fastest way to increase the alkaline state of the blood is to breathe deeply. Deep breathing results in lower carbon dioxide in the blood, resulting in net alkalinization. Wouldn’t it be neat if we could study and quantify this response over time and its effects on atherosclerotic disease?
Oh sheesh–this whole “acid/alkaline” thing (better known as the cult of “acid/alkaline”). Although I do think there’s certainly something to the whole acid/alkaline thing, it isn’t the bottom line in something like this (much less everything else). I would look to other things before I lumped this into that general category. Two VERY common causes of arterial inflammation can include 1) excess levels of something referred to as lipoprotein (a), which is a very small and dense form of cholesterol-carrying lipoprotein that can plug up nutrient channels in arterial walls and set up an inflammatory response. Most physicians don’t talk about this form of cholesterol (not that ANY lipoprotein carrier is actually cholesterol at all–HDL and LDL only serve as carriers for cholesterol–all cholesterol of which is EXACTLY the same) mainly because statin drugs can’t touch it. Lipoprotein (a) is generated only in the presence of insulin (read: high carbohydrate diets). When you lose the carbs, lipoprotein (a) goes away. 2) Another very common vector for arterial endothelial inflammation is (believe it or not) H. pylori. If digestion and HCL is impaired long enough (which is extremely common) this can result in H. pylori overgrowth which preferentially seeks endothelial tissue as a growth medium–ANY
endothelial tissue. The GI tract lining is one place it sets up shop and arterial endothelium is the other place. There are many, many papers on this in the literature. There are some natural remedies that can serve to eradicate excess H. pylori somewhat easily and relatively quickly (usually inside of a month). A history of digestive issues and HCL insufficiency/symptoms are often good indicators of the problem. There is a breath test and a stool antigen test for H. pylori overgrowth that are quite accurate (in that order). I’ve written about all this in my book, by the way. Possible other causes could include some form of free radical activity, elevated uric acid levels, EFA deficiencies or disproportionately high omega-6 levels, trans-fats, etc. Just my two bits.
Actually I’m currently writing an e-book on this very subject which I’m hoping it will do very well since this is such an important issue. The short version is that your reader is definitely on to something. The long version is the 100 or so pages I’ve written that I’m now trying to cut down to a manageable e-book! But basically shes right although the acid diet is only part of the problem. Be looking for it coming soon.
The acidic theory has been known for several years. I consider it totally unlikely because the kidneys regulate the pH in the blood effectively within a very narrow range (7.35-7.45). Excess acidic or alkaline compounds are excreted rapidly into the urine. It is correct that inflamed arterial tissue is a little more acid than normally, but this is a secondary phenomenon most likely due to obstruction of the capillaries that bring nutrients and oxygen to the arterial wall (the so-called vasa vasorum) and lack of oxygen leads to acidosis. On page 193 in my new book I have given more details about this.
Our body’s pH is tightly regulated whether we eat acidic foods or alkaline foods and we have an excellent buffering system. If we get too much acid, then all we have to do is breathe a little deeper and/or faster transiently and the problem is immediately corrected when we are in a healthy state. So the body does not have to go through much to accomplish tweaks in the pH. The calcium thing alluded to by your reader is more of a long-term compensation that often simply does not occur unless we have significant kidney and/or lung problems. So I think the premise that acidic blood causes arterial inflammation is wrong. Of course inflammation is the key element here and certain phytonutrients (i.e. resveratrol, quercitin, catechin, and others) have anti-inflammatory properties. It appears fish oil may have this as well as the statin drug Lipitor. Fat cells secrete pro-inflammatory factors when engorged, but when they are small they secrete some anti-inflammatory factors that also improve insulin resistance. The calcium overlay in arterial plaque is part of the body’s repair system and would happen no matter what you eat.
As you can see from these varied responses, it’s quite a fascinating discussion my reader has brought up and I’m glad she did. Anyone else who wants to chime in on this, feel free to do so in the comments section below. Do you think there’s anything to this whole acid/alkaline debate as it relates to arterial health? Tell us what YOU think and let’s learn from each other. Feel free to send your inquisitive questions for me to ask my low-carb expert friends anytime by e-mailing me at email@example.com.
Dear Jimmy, I have recently posted 2 articles in our blog "New Evidences: Acidity Theory of Atherosclerosis", that may of interest for your readers on the present discussion. The first published in February 22, 2010 was entitled "Sympathetic predominance: a primary factor in the cascade of events leading to the atherogenic spiralling?". The last article published in April 15, 2010 is entitled "Fermentable carbohydrates: a link between periodontal disease and cardiovascular disease?". As you may know we defend that an altered autonomic nervous system, sympathetic bias, increased lactic acid and acidic environment may propitiate atherogenesis. Our proposal may extend to any respiratory or metabolic disturbances resulting in acidosis.“ Our blog is at http://aciditytheory.blogspot.com/