For people on the path to diabetes, there are two equally frightening endpoints to try to avoid at all costs: full-blown diabetes, with complications such as blindness or amputation, and deadly heart disease. We’ve just reviewed in detail the extra help you can get from nutritional supplements that may give you the edge you need in controlling your blood sugar. Now let’s look at supplements that can improve your heart health.
Most of these supplements are the same ones Dr. Atkins recommended for helping to balance your blood sugar. Remember, these are recommended in addition to a good-quality, iron-free multivitamin/mineral supplement. The combination can help you lower your blood pressure and improve your blood lipids—the two vital steps in improving your heart health.
We suggest that when planning a supplement program for improving your risk factors for heart disease, you work with a nutritionally oriented physician who understands and supports the application of the Atkins Blood Sugar Control Program (ABSCP).He or she will help you to decide which supplements—and dosages—are best for you. If you take medications, this is particularly important because certain supplements can react with or magnify the effects of certain drugs.
Important note: By making diet and lifestyle changes and adding supplements, you may be able to cut back on or even discontinue medications for high blood pressure and abnormal blood lipids.Some supplements could have an effect on medications you may be taking for other conditions. Before taking these or any supplements, discuss them with your doctor and plan ahead about how you will reduce or change your medications as your blood pressure and other values improve. As one example of many, Dorothy W. (see page 89), who had hypertension as a result of her underlying metabolic imbalance, was able to taper down to only a small dose of blood pressure medication once she made the lifestyle changes that are part of the ABSCP.
ANTIOXIDANTS FOR HEART HEALTH
For people who are at risk of heart disease—which includes anyone with the metabolic syndrome, prediabetes, or diabetes—Dr. Atkins recommended supplementing with several important antioxidant vitamins and minerals as well as some other nutrients. (Review Chapter 20 for an introduction to antioxidants.) Here are the supplements and dosages he recommended for boosting heart health.
Vitamin C
High levels of vitamin C help keep your blood vessels relaxed so that blood flows smoothly through them. And if you have the high blood pressure that usually accompanies blood sugar abnormalities, extra vitamin C can help bring it down.1 The usual dosage is 1,000 mg to 2,000 mg a day in divided doses.
Vitamin E
The most valuable use of vitamin E for people with blood sugar abnormalities and diabetes may be in helping to protect your LDL cholesterol from oxidization by free radicals. According to one study, the large, buoyant LDL particles received more protection from oxidative stress than did the small dense, more dangerous LDL particles.2 Remember, when an individual follows the Atkins approach, both HDL and LDL particle size shifts to predominantly larger, more buoyant particles.3, 4 What all of this means is that it may decrease your tendency toward clogged arteries. Vitamin E makes your blood less “sticky,”which helps prevent clots that cause heart attacks.5 Dr.Atkins generally suggested 400 IU to 800 IU daily.
Important note: It has been observed in clinical practice that a few individuals experience elevated blood pressure while taking vitaminE. If your blood pressure goes up while taking a high dose, cut back.
B VITAMINS
Although you need all the B vitamins to keep your heart healthy, three of them are particularly important for heart health, especially for people with blood sugar problems. The first is folic acid, also known as fo- late. Folic acid could save your life.
The reason is a little complex. One of the normal by-products of metabolizing the amino acid methionine is a substance called homo- cysteine. Statistically speaking, a high level of homocysteine in your blood is associated with an increased risk of heart disease from clogged arteries. That can automatically raise the risk of death from heart disease for those individuals who have a tendency toward high homocysteine levels. If you have high homocysteine levels and diabetes, your risk is about 2.5 times greater.6
People with diabetes and elevated homocysteine are more likely to have complications such as kidney disease and eye problems.7 Another study showed that lowering homocysteine improves blood sugar control.8 The commonly used diabetes drug metformin (Glucophage), in some instances, may also raise your homocysteine level.9
Fortunately,you can take positive steps to bring your homocysteine level down if it’s too high.(Your doctor can do a blood test to find out.) First, getting your blood sugar down almost always also brings down your homocysteine.10 Second, folic acid supplements, along with vita- min B6 (pyridoxine) and vitamin B12 (cobalamin),contribute to lowering homocysteine levels by helping your body form the enzymes that break it down.11 To lower homocysteine, Dr. Atkins used 2,000 mcg to 4,000 mcg (2 mg to 4 mg) a day of folic acid, along with 50 mg of vitamin B6 and 500 mcg to 1,000 mcg of vitamin B12. To get your homocysteine under control with such doses, however, work with your doctor because follow-up blood monitoring for homocysteine will be needed until the optimum level is reached. Dr. Atkins’ goal was a homocysteine blood level of 8 µmol/L or below. Another important reason to review this with your physician is that, in some women, additional folic acid can have a mild estrogenic effect, which may need to be monitored. These nutrients have been helpful for patients with neuropathies.A good example of the effectiveness of the use of B vita- mins in lowering homocysteine levels was Martha N., who saw Dr. Atkins for weight management and to reduce some of the five medications she was taking, including those for elevated triglycerides—hers had been as high as 700. Interestingly, although she had a number of cardiovascular risk factors, she never had her homocysteine level tested. On her initial visit her homocysteine level was 20.6. After two months with additional supplementation of B6,B12, and folic acid, her level dropped to 8.8.
Another valuable B vitamin for heart health is niacin, also known as vitamin B3. Long before statin drugs appeared on the scene, doctors used large doses of niacin to help bring down LDL cholesterol and triglycerides and to raise HDL cholesterol.12 This treatment was improved by the development of a form of niacin called inositol hexanicotinate (IHN), which works well without the unpleasant flushing side effect that can result from large doses of niacin. If you want to try IHN to improve your lipid profile, you must work with a nutritionally oriented physician to find the right dose, monitor your progress, and check your liver function. Dr. Atkins usually prescribed 500 mg to 1,500 mg per day in divided doses.
One problem with niacin and IHN is that they might raise your blood sugar a bit if you have diabetes.13 For patients with elevated blood sugars, Dr. Atkins usually prescribed a slightly lower dose of IHN and the higher dose range for chromium (check Chapter 20 for more information on this mineral). Blood sugar elevation does not happen to everyone, but be sure to monitor your blood sugar. The combination therapy he used is just as effective as a larger dose of IHN alone for improving cholesterol levels.
Pantethine, a form of the B vitamin pantothenic acid, can also be helpful for improving your lipid profile, particularly total cholesterol and LDL.14 Pantethine can be very effective with minimal side effects. (Some patients get diarrhea, but this usually goes away if the dose is reduced.) Dr. Atkins found that his patients usually benefited most from taking two or three 450 mg capsules of mega-pantethine a day. If that formulation isn’t available, take three to six tablets daily of a standard pantethine complex supplement.
MAGNESIUM
If you have the metabolic syndrome, prediabetes, or diabetes, your magnesium levels are likely to be low, as we explained in Chapter 20. That’s not just bad for your blood sugar, however—it’s also bad for your blood pressure and your heart. Low levels of magnesium can cause heart arrhythmias (irregular heartbeat) and may also make your blood “stickier”and more likely to form clots.15, 16
Magnesium can have a major impact on your blood pressure. When you’re low on magnesium—as many people with hypertension are—the walls of your blood vessels tighten up, which raises your blood pressure. Magnesium helps the blood vessels relax, which brings your blood pressure down.17 For treating high blood pressure, Dr. Atkins used 500 mg a day of magnesium orotate in three or four divided doses. He preferred this form of magnesium, as it is generally well absorbed. Alternatively, use magnesium taurate in doses of three to four a day.
Important note: If you have kidney disease,you must discuss magnesium supplements with your doctor before you try them.
TAURINE
The amino acid taurine is another valuable supplement for treating high blood pressure and helping your heart.18 It acts as a natural diuretic, which helps your body excrete excess fluid.19 That, in turn, lowers your blood pressure and puts less strain on your heart. Taurine has been shown to enhance immunity and protect against oxidative stress.20 It’s usually available in 500 mg tablets. The usual dose range is 1,500 mg to 3,000 mg a day in three divided doses.
Important note: Amino acids such as taurine can have powerful effects, especially in the presence of medications such as diuretics, and should be used only under the supervision of a nutritionally oriented physician. Health care professionals differ in their opinions on the use of individual amino acids for therapeutic effect.
ESSENTIAL FATTY ACIDS
Omega-3 fatty acids are extremely helpful for preventing heart disease (as discussed in Chapter 8) in people with diabetes, mostly by lowering their triglyceride levels and blood pressure. Eating cold-water fish twice a week gives you a lot of the benefits of the omega-3s,in addition to providing high-quality protein and some nice variety in your diet. Taking omega-3 capsules can boost that benefit—especially if you don’t like eating fish. (Flaxseed oil is another source of omega-3.) There is solid evidence to show that supplemental omega-3 helps your blood pressure.21 In addition to its blood-pressure-lowering effect, omega-3 supplementation was found to reduce triglycerides without adverse effects on glucose metabolism.22–25
To obtain all the omega-3 fatty acids, including eicosapentenoic acid (EPA) and docosahexanoic acid (DHA), which are found only in fish oil, we recommend taking a soft gel containing 600 mg total. Dosage can range from two to six soft gels per day. If triglycerides are significantly elevated or inflammation markers are high, the higher dose range may be needed until lab results fall to the optimum level. If you currently take any prescription medications to thin your blood, discuss omega-3 supplements with your doctor first.
It’s important to balance your intake of omega-3 and omega-6 fatty acids. For supplements of omega-6 (also called gamma linolenic acid or GLA),Dr.Atkins used borage oil in 240 mg soft gels; the dose ranges from one to three capsules daily. Atkins Formula Essential Oils combines the essential fatty acids in the optimal balance. A table listing all of the nutrients in Atkins Essential Oils follows.
ESSENTIAL OILS FORMULA
SUPPLEMENT | AMOUNT PER |
SERVING | |
Vitamin E (from mixed tocopherols) | 20 IU |
Alpha linolenic acid (from flaxseed oil) | 440 mg |
Docosahexaenoic acid (from fish oil) | 160 mg |
Eicosapentanoic acid (from fish oil) | 240 mg |
Gamma linolenic acid (GLA) (from borage seed oil) | 192 mg |
Linoleic acid (from borage, flaxseed, and fish oils) | 305 mg |
Oleic acid (from borage, flaxseed, and fish oils) | 405 mg |
COENZYME Q10
One of the worst things about statin drugs, the de rigueur prescription for people with high cholesterol, is that they interfere with your production of coenzyme Q10 (ubiquinone or CoQ10). Because you need CoQ10 to create energy in your mitochondria, the tiny power plants found in all your cells, a shortage of it can lead to fatigue and muscle weakness. That’s more than just a minor side effect—it can be a real problem when it comes to your heart, a powerful muscle that has more mitochondria per cell than any other part of your body. The last thing you want to take is a drug that weakens your heart, yet statin drugs are being liberally prescribed as a way to help your heart.26 Dr. Atkins believed that this self-defeating paradox would soon be recognized, when people who have been taking statin drugs for years start showing the signs of heart failure, cardiomyopathy, arrhythmias, and other problems caused by insufficient amounts of CoQ10. What the medical establishment will say then should be interesting to observe.
Even without statin drugs, your production of CoQ10 naturally drops off a bit as you get older. Dr. Atkins routinely prescribed CoQ10 for all of his patients who were at risk for heart disease. He also found CoQ10 to be effective for lowering high blood pressure. The usual dose is 100 mg three times per day; in some cases he recommended a higher dose.
For ease in designing your supplement regimen,Atkins makes supplements that support the needs of those with blood sugar imbalances and address blood sugar imbalances and cardiovascular health. You have already seen the formulations of Atkins Basic 3 (page 247) and Essential Oils Formula (page 267).For information on specialized formulations, go to www.atkins.com/shop.
You’ve learned about two of the major aspects of the Atkins Blood Sugar Control Program—diet and supplements.Now it’s time to learn about the all-important third leg of the program: exercise.
WHAT’S YOUR HEART HEALTH SUPPLEMENT IQ?
How do different supplements help keep your heart healthy? Check your knowledge with this quiz.
1. Vitamin C helps your heart by:
- preventing scurvy
- improving digestion
- relaxing blood vessels
2. Vitamin E helps your heart by:
- preventing cholesterol oxidation
- building strong bones
- making your heart beat slower
3. Folic acid,vitamin B6,and vitamin B12 are valuable for:
- lowering A1C levels
- lowering homocysteine
- lowering blood pressure
4. Niacin or IHN can help:
- lower cholesterol
- lower blood pressure
- lower blood sugar
5. Magnesium can help:
- lower cholesterol
- lower blood pressure
- manage blood sugar
6. Omega-3 fatty acids help your heart by:
- lowering triglycerides
- lowering blood pressure
- improving blood flow
7. Taurine helps the heart by:
- lowering blood pressure
- increasing loss of excess fluid
- decreasing oxidative stress
Answers1.c.2.a.3.b.4.a.5.b and c.6.a,b,and c.7.a and b.
AN ALTERNATIVE TO DRUGS
When her doctor prescribed diabetes medication, April Greer vowed never to take it. By choosing to follow the Atkins Nutritional Approach instead, she kept her promise to herself—and is living proof that a low-carb lifestyle reaps healthy rewards.
For several months, I had been going to the doctor because of chronic bladder infections. One day he decided to run a urine test. It turned out that the sugar level in my urine was very high, which led him to investigate further. He found that my average blood sugar was 207. When he said, “You are a full-blown diabetic,” his words triggered what would be my personal turning point.
My doctor prescribed diabetes medication, but I did not fill it because I didn’t want to become dependent on pills. I knew that the typical treatment for Type 2 diabetes starts with pills and ends with shots. So I visited the Atkins Web site, and after reading the information, I wanted to start implementing the Atkins program that very minute. Truly, the last thing on my mind was losing weight. My husband liked me the way I was. What I did think about was being able to play football with my sons, who are now six and nine years old. I also feared having organ troubles and maybe losing limbs if I couldn’t get my diabetes under control.
BEFORE AFTER
NAME: April Greer
AGE:34
HEIGHT: 5 feet 3 inches
WEIGHT BEFORE:
237 pounds
WEIGHT NOW:
137 pounds
From the beginning, I was very serious and careful about doing Atkins. I tested my blood sugar every morning and evening. During the first two weeks my blood sugar dropped from 207 to 148. At the end of six months I had lost 100 pounds and my fasting blood sugar stabilized at between 80 and 110. I no longer needed to test my blood sugar every day, which was a real victory.
Looking back, my diet had been a nutritional nightmare. For breakfast, I would have fast-food pancakes or French toast and orange juice; for lunch, takeout burritos or tacos; and pasta with bread was a typical dinner. Now I eat hard-boiled eggs at my desk or pick up some scrambled eggs with bacon or sausage. I still eat a fast-food lunch but I might order a chicken breast with no bun, plus a salad. If I’m pressed for time, I’ll eat an Atkins Advantage bar. For dinner, we have chicken or fish or bunless hamburgers. Sometimes we’ll have breakfast foods like eggs and bacon for dinner. We always have a green veggie. Broccoli has become my vegetable of choice.
I had always been a size 5 in high school, but after my first child I began to gain weight and eat for comfort. It was a very negative cycle: eat, sit, gain, feel tired and depressed, eat, sit, gain….Eventually,I wore asize 22 and had to shop at plus-size stores. My husband really hated those “old lady” clothes. After I had lost about 50 pounds, I no longer wanted to just sit on the couch. I began swimming laps in our pool. At first, four laps left me huffing and puffing but I kept at it and still try to swim every day. Our family also began walking to the park together and playing touch football there regularly. Exercise really gives you an energy boost so the more you exercise, the more you want to exercise. This is important for me because I also have a full-time job as a broker for an international freight service that keeps me sitting at a desk.
A week ago I saw my doctor and he said, “Do you realize because of you I now recommend Atkins to all my diabetic patients?” I feel so proud of what I’ve accomplished and feel blessed to be taking no medication or shots. My kids used to look at old pictures of me and ask,“Mom, when are you going to be skinny again?” It hurt me and I hurt for them. Before,when a man would be ahead of me going into a restaurant or store, he’d look behind him, see me, and let the door slam in my face. Now I have three guys waiting to hold the door open for me. I can’t tell you what that does for your self-esteem. But what really matters most to me is that I have my health and I’ll be around to enjoy it with my kids.
Note: Your individual results may vary from those reported here. As stated previously, Atkins recommends initial laboratory evaluation and subsequent follow-up in conjunction with your health care provider.