Olive Oil's Role in
Interventional Cardiology, By Antonis Pothoulakis, MD
What
does an interventional cardiologist have to do with olive oil?
The usual day of an interventional
cardiologist in the cath lab is most likely to include cases of coronary artery
disease, either in its acute form (“acute coronary syndromes” that is, heart
attacks or unstable angina) or in its chronic form (chronic stable angina). The
interventional cardiologist uses percutaneous procedures, like balloon
angioplasties and stents, along with a host of medications to open clogged coronary
arteries. In no heart procedures is olive oil used!
Then what is the olive oil connection? The story of diseased heart arteries
starts a few decades before the interventional cardiologist is called upon to
perform any procedures. What starts the artery disease is usually either
smoking or an abnormal metabolism. It is the abnormal metabolism that leads to
heart disease than can be significantly affected by olive oil.
Olive
oil can reduce the risk of heart attacks and stroke.
Antonis Pothoulaki
In our
thirties and forties many of us, exposed to the western lifestyle (limited
physical activity, processed and fast food loaded with salt and saturated and
trans fats, and high-glycemic index snacks such as cookies, desserts, candies)
harbor shallow cholesterol plaques in our coronary arteries. The slow time line
of “atherosclerosis” (cholesterol plaque buildup in the wall of the arteries)
can be suddenly and unpredictably punctuated by a “crisis” caused by an
instability of the plaque. Either a “crack” or “fissure” forms on its
surface or a small “bleed” takes place inside the plaque. The unstable plaque
then prompts the flowing blood to form a clot at the plaque site because the
blood interprets the unstable plaque situation as “bleeding” and it responds
the way it is programmed to: by forming a clot.
What is truly dramatic is the time line of clot formation (“thrombosis”): it takes
between
one and four minutes for a clot to form inside the artery and transform a
previously stable plaque that was causing little or no narrowing of the artery
lumen to now become 100% occlusive. This stops the flow of blood and the
nourishment of the heart or brain cells that depend on that artery abruptly
ceases. The cells, then, start dying fast, resulting in a heart attack, a
stroke, or sudden death.
Prime
risk factors for both plaque development (atherosclerosis) and plaque
instability with clot formation (atherothrombosis) are:
• Smoking
• Metabolic Syndrome
• Genetic profile
• Aging process
While we can do nothing
to counteract our heredity or our age we can do a lot to stop the other two
“killers”: smoking and metabolic syndrome. Whereas olive oil (and the other
features of the so called “Mediterranean diet” or “Mediterranean lifestyle”) is strongly
connected with the health of our metabolism it has no smoking cessation
properties, to my knowledge.
The Metabolic Syndrome is a combination of abdominal obesity (also called
“visceral obesity”, “central obesity”, “apple-shape” body, or “beer belly”)
along with abnormal cholesterol, abnormal sugar metabolism (pre-diabetes or
type 2 diabetes), and high blood pressure (“hypertension”). It is sedentary
lifestyle and an unhealthy diet that lead to metabolic syndrome.
A diet
is unhealthy if it contains:
• Too many calories
• Too much salt
• Unhealthy fats (saturated and trans-fats)
• High-glycemic index carbohydrates
healthy diet, on the
other hand, along with regular and adequate exercise, helps prevent or, at
least, attenuate, the metabolic syndrome and atherothrombosis (heart attacks
and strokes). A healthy diet is not only about what not to contain (the four
categories listed above) but also about what should be included every day:
• At least five portions of fruits and vegetables
• Whole
grains
• Omega-three
PUFAs (polyunsaturated fatty acids found in oily fish salmon, sardines,
mackerel)
• MUFAs
(mono-unsaturated fatty acids found in olive oil, olives, avocado, nuts, dark
chocolate)
Three quarters of olive oil consists of MUFAs (mainly oleic acid) with the rest
almost equally divided between PUFAs and saturated fats. MUFAs are very beneficial
for our health because they:
• reduce LDL-the “bad”-cholesterol levels in the blood
• “displace”
saturated fats from the diet
•
contribute to satiety (make us feel full with less amount of food)
• delay
the absorption of the rest of our food, preventing fast absorption of
high-glycemic index carbohydrates and, thus, prevents insulin spikes and
premature hunger
•
increase adiponectin, a hormone that promotes the “burning” of body fat for
energy production
•
contain additional beneficial substances (antioxidants and phytochemicals)
In
particular, olive oil has:
• the highest content of MUFAs, as compared to other vegetable oils or nuts
• the
higher oxidation threshold, so when used in deep-frying is less likely than any
other vegetable oil to become partially hydrogenated (transformed to the
“poisonous” trans-fats), and it
•
contains a host of antioxidant phytochemicals like polyphenols (tyrosol), squalene,
carotenoids, and vitamin E
Olive oil contains almost no sodium (salt) and carries about 9 calories per
gram.
Metabolic syndrome and atherothrombosis (heart attacks, strokes, or sudden
death) are more likely to occur when our body balance is shifted towards
inflammation (proinflammatory) and clot formation (prothrombotic). Olive oil
helps counteract both morbid states by virtue of its MUFAs and antioxidant
content. Furthermore, antioxidants and oleocanthal counteract the neurotoxic
effect of the ADDL proteins involved in Alzheimer’s disease. Olive oil also
appears to have an anti-aging effect and reduce the risk of certain cancers
including breast, pancreatic, stomach, laryngeal, and urinary tract cancer.
Health benefits of olive
oil in specific diseases
Hypertension
A diet high in unsaturated fatty acids reduces blood pressure as compared to a
diet rich in saturated fat. Among unsaturated fats it appears that both
monounsaturated fatty acids (like those contained in olive oil) and
polyunsaturated fatty acids (found in fish and other vegetable oils) lower
blood pressure. An Italian research in patients with known hypertension has
shown that consumptions of 40 gm of olive oil a day reduces blood pressure by
about 50% (almost half of the patients were able to reduce the dose or stop
taking altogether their blood pressure medications). The beneficial effect of
olive oil (especially the extra virgin olive oil) is attributed mainly to its polyphenols.
Cardiovascular
disease (atherosclerosis and atherothrombosis)
High
LDL cholesterol contributes to atherosclerosis and atherothrombosis, depositing
cholesterol in the artery wall and clogging the arteries of vital organs (like
the heart, brain, and kidneys). HDL cholesterol is the “good” cholesterol and
acts as a scavenger, removing cholesterol from plaques in the artery wall.
Reducing LDL cholesterol and raising HDL cholesterol has significant health
benefits and protects against heart attacks, strokes, and sudden death.
Consumption of about two table spoons of olive oil reduced LDL (the “bad”
cholesterol) and mildly raise HDL (the “good” cholesterol).
Beyond a favorite effect on LDL and HDL levels, olive oil has two more
benefits that reduce heart attacks and stroke:
• It prevents oxidization of LDL which renders it more atherogenic than its
non-oxidized form. This beneficial effect of olive oil on lipids is mediated
through its antioxidant components, especially polyphenols and vitamin E.
• It reduces the chance of “thrombosis”
(clot formation) in arteries by reducing factors that either cause clotting (plasma
factor VII) or inhibit break-down of clots already formed (plasminogen
activating inhibitor)
Type 2
diabetes and metabolic syndrome
Olive
oil reduces the metabolic complications of type 2 diabetes and metabolic
syndrome. With its polyphenols and squalene components it reduces the high level of
inflammatory activity present in both diabetes and metabolic syndrome. Thus,
olive oil helps reduce LDL-the “bad”-cholesterol, lipid oxidation and high
blood pressure. A diet rich in olive oil also facilitates glycemic control by
leaving “less room” for carbohydrates (particularly “simple sugars” that cause
insulin spikes and premature hunger attacks).
Alzheimer’s
disease
Inflammation
and free radicals damage brain cells and impair synaptic function, contributing
to the neurodegenaration and brain cell loss that characterizes Alzheimer’s
disease. The squalene content of olive oils (along with its other antioxidants)
has neuroprotective effects and does not allow oxidation of its monounsaturated
fatty acids (which unfortunately occurs with polyunsaturated fats that may,
thus, contribute to nerve damage). Oleocanthal, another olive oil component has
been shown in scientific research to slow down the progression of Alzheimer’s.
Aging
and longevity
Free
radicals attack and damage cells and its constituents, especially DNA found not
only in the cell nucleus but also in the mitochondria. It is hypothesized that
olive oil with its antioxidant effects inhibit peroxidation and reduces
mitochondrial DNA damage, preserving vitality and youthfulness. It appears that
the oleocanthal component of olive oil significantly contributes to olive oil’s
anti-aging effects. There is a report of a 120-year-old Israeli woman who used
to drink a glass of olive oil every day!
The quality of Balsamic Vinegar of Modena PGI
is determined by 3 main factors: Quality of Ingredients, Quantity of
Ingredients, and Ageing. Within the same category, there may be substantial
differences in quality and the degree of concentration which is a very
important factor in determining the quality of the final product.
A deep study was run by the AIB (The Italian
Association of Balsamic Tasters) along with the CSFA (a well reputed sensory
analysis center) to implement a reliable tool so they are able to grasp the
true meaning and quality of Balsamic Vinegars of Modena and to steer clear of
gimmicks and misrepresentation. This system determines standards of quality in
which 4 basic quality categories were identified and certified, known as the
“Leaf System.” Those classified under the 1 Leaf Categories are the lowest
grade quality with a lighter flavor profile, and those classified under the 4
Leaf Categories are the highest grade quality with a more superb taste and
fuller flavor profile.
The Leaf System: The Only Quality
Certified System in Today’s Market