Healthy Heart

Happiness and Heart Health

It is common knowledge that stress and worry can make you ill and a new study from researchers at the Johns Hopkins University School of Medicine suggests that the opposite is also true people with cheerful temperaments are less likely to suffer from a coronary event, such as a heart attack.

“If you are by nature a cheerful person and look on the bright side of things, you are more likely to be protected from cardiac events,” says study leader Lisa R. Yanek, M.P.H., an assistant professor in the Division of General Internal Medicine at the Johns Hopkins University School of Medicine. “A happier temperament has an actual effect on disease and you may be healthier as a result.”

For the study, the scientists analysed data spanning 25 years, from 1483 healthy siblings of people who had coronary events before the age of 60. This group of people has twice the average risk of developing coronary artery disease themselves. The study participants completed wellbeing surveys and were given a score that reflected various parameters, including cheerfulness and degree of satisfaction with life. The analysis was corrected to take account of other heart disease risk factors such as age, smoking, diabetes, high cholesterol levels and high blood pressure.

Over the course of the study, participants’ positive outlook was associated with a one-third reduction in coronary events overall; and among people deemed at the highest risk for a coronary event, there was an almost 50 per cent reduction in risk for those who were happy and relaxed. To validate these results, the researchers then looked at similar data from 5992 people in the general population and found that this group also benefitted from a cheerful temperament, which reduced their risk of a coronary event by 13 per cent.

The findings held whether the participants were white or African-American, men or women.

The mechanisms of the protective effects of positive well-being remain unclear. The physiologic patterns associated with positive well-being include improving immune function, reducing damaging stress hormones and increasing beneficial oxytocin (the ‘love hormone’) and endorphins.

Yanek, L., Kral, B., Moy, T., Vaidya, D. & Lazo, M. (2013) Effect of positive well-being on incidence of symptomatic coronary artery disease. American Journal of Cardiology. Article in press.


Hip or Knee pain

 ITB Tightness

At the clinic we see a lot of running related knee pain, most of which are brought on by tightness of the IT Band.

The IT Band or Ilio-tibial Band is a long, non-elastic structure on the outside of the thigh that crosses both the hip and knee. The Tensor Fascia Lata muscle and Gluteal muscles both blend into the IT Band. As the band descends down the thigh, some fibres attach to the femur (thigh bone), the patella (knee cap), and finally, the top of the tibia (shin bone). The band works with the quadriceps to provide stability to the outside of the knee joint during movement, particularly in the swing phase of gait when one leg is taking all the body weight.

IT band syndrome is common in runners who perform unbalanced, repetitive exercise such as running only on one side of a crowned road, or only running one way around a track. Most roads slope off to the sides and running along the edge causes to the outside foot to be lower than the inside foot. This in turn causes the pelvis to tilt to one side and stresses the IT band. Excessive pronation or flattening of the foot, leg length discrepancy and muscle tightness or a lack of flexibility in the gluteal or quadriceps muscles may increase the risk of IT band injuries. Although most common in runners, cyclists are not spared!

Most of the time pain is felt on the outside of the knee, though pain can be felt on the inside, at the top of the shin or even at the hip. Tenderness is also often felt and occasionally there is evident swelling. These symptoms usually present when using stairs or running/walking on a gradient (usually descending) but in more advanced cases any movements can irritate.

It can be incredibly painful and is typically a frustratingly stubborn injury to deal with without the right treatment, remember that as this problem does not come on over night and will not heal overnight. Regular stretching, strengthening and exercise modification are required to gradually get you back to your exercise goal and beyond.


Sun on cloud

Vitamin D

As summer is coming to an end and the sun is disappearing it is important to be aware of what our body is losing out on. Direct sunlight brings with it many benefits, especially Vitamin D which can not be found in great quantities in food but our body needs to look after our bones. Good food sources are oily fish, such as salmon, sardines and mackerel, eggs, fortified fat spreads, fortified breakfast cereals, powdered milk and mushrooms.

Vitamin D is a fat-soluble vitamin that is naturally present in very few foods, added to others, and available as a dietary supplement. It is also produced endogenously when ultraviolet rays from sunlight strike the skin and trigger vitamin D synthesis. Your body doesn’t make too much vitamin D from sun exposure, but always remember to cover up or protect your skin if you are out in the sun for long periods (more that 20 minutes).

Vitamin D promotes calcium absorption in the gut and maintains adequate serum calcium and phosphate concentrations to enable normal mineralization of bone. It is also needed for bone growth and bone remodelling by osteoblasts and osteoclasts. Without sufficient vitamin D, bones can become thin, brittle, or misshapen. Vitamin D sufficiency prevents rickets in children and osteomalacia in adults. Together with calcium, vitamin D also helps protect older adults from osteoporosis.

Vitamin D Deficiency

Vitamin D deficiency is most often caused by insufficient exposure to sunlight and nutritional deficiency but can be secondary to a wide range of other underlying causes, such as disorders of the gut, pancreas, liver and kidney.

The symptoms of vitamin D deficiency are sometimes vague and can include tiredness and general aches and pains. Some people may not have any symptoms at all. If you have a severe vitamin D deficiency you may have pain in your bones and weakness, which may mean you have difficulty getting around. You may also have frequent infections. However, not everyone gets these symptoms.

Supplementing Vitamin D

Research studies have shown Vitamin D can be taken in safe doses of up to 75IU/kg body weight, though tolerable upper intake levels vary from 4000-10000IU/day. Two years ago the UK recommended daily allowance (RDA) was 600IU, currently the UK RDA is 2000IU. In Canada which is approximately the same latitude as the UK the RDA in 2011 was 6000IU. It is considered that the vast majority of populations living in the northern hemisphere are substantially deficient in Vitamin D due to lack of sunlight and scare stories of skin cancer.

If you do take a vitamin D supplement it’s important to keep your blood level monitored, the optimum level is between 80 and 120nmol/L.

Nutri Functional Medicine Conference September 2011