Fixing Broken Hearts: Louisville Magazine 8.2011

Louisville researchers are using stem cells found in the heart to treat devastating heart failure.  While patients improve after stem cell transplant, no one really knows why. I wrote this story for the August 2011 edition of Louisville Magazine.

No alarm sounds but Dr. Roberto Bolli is awake. Again.

He’d slept fitfully, waking often to fret about the coming day, the thousand things that could go wrong, every possible misstep. Now, at 6 a.m., there was no point staying in bed. By 8, the cardiologist is in the bone marrow transplant laboratory at the James Graham Brown Cancer Center watching the research team prepare precious stem cells. The cells, coddled and multiplied for four months, will now, with a bit of luck, save a life.

Across the street in Jewish Hospital, doctors prepare Mike Jones to receive those cells. Jones, 66, a painting and remodeling contractor, will be awake during the procedure.

It’s good to be awake when you’re making history.

Read the rest of the story.

Food Police Or Criminal Fat

The Louisville Metro Board of Health recommended a ban on trans fats at its Feb. 3 meeting.

So now they want to tell us what we can eat? Oh please!

Is this the case of over-zealous know-it-alls telling us what to do, or is there any evidence that the food police are heading to the scene of an actual crime. I thought I’d take a look at the evidence, dust for fingerprints, scan for stray DNA, extend a metaphor beyond the bounds of the law.

Trans fats are used to extend food shelf life. Although there’s a little bit of naturally occurring trans fats in meat, there is some question this fat behaves the same as the artificial trans fat that appears in many commercial baked goods and commercial fried foods.

I looked at some recent research about trans fat. Most of this data is from a systematic review of studies involving about 140,000 patients. The review was published last year in the Journal of AOAC International. Two of its authors, Dariush Mozaffarian and Walter Willett, have published a great deal about trans fats, including a comprehensive 2006 study in the New England Journal of Medicine. Here’s what the research shows:

  • Trans fats are associated with an increased risk of heart disease.
  • It only takes a little trans fat to do a lot of damage. In one study, each 2 percent increase in trans fat consumption associated with a 23 percent increase in heart disease.
  • Trans fat seems to stimulate more weight gain than other fats, especially around the belly. This is the most dangerous weight gain, linked to a higher risk of heart disease.
  • In recent years, researchers have shown that inflammation — as measured by certain markers in the blood stream — increases your risk of heart disease. That’s why more doctors now recommend you have something called a CRP test in tandem with your cholesterol testing. CRP is the test for C-reactive protein, a marker for inflammation. If it’s high, your risk of a heart attack is high. Trans fat consumption associates with a rise in CRP and other inflammatory markers, including interleukin-6, and tumor necrosis factor.
  • Some studies suggest that increased trans fat consumption could increase insulin resistance, leading to a higher risk of diabetes.
  • One study showed higher infertility rates in women with increased trans fat consumption. Note that it will take more than a single study to confirm this connection.
  • Another single study showed an increased risk of gall stones in men with increased trans fat consumption. Again, no single study is definitive, and more research must test this conclusion.
  • Finally, a study showed an  increased risk of Alzheimer’s disease in the elderly with increased trans fat consumption.

You might conclude the food police have a good line on a killer.  Trans fats are more dangerous than even the saturated fats health experts have been warning us about for years.

Frank Repka, an associate emeritus professor from the University of Toledo Medical Center, explained this to me a few years ago. Repka is a Ph.D. nutritionist. He says trans fats actually reduce the number of cholesterol disposal sites in your liver.

You have special ports or receptors in your liver that capture and remove bad cholesterol — you know, low-density lipoprotein.   Saturated fats inhibit the number of the receptors you make, Repka said. But trans fats shut down those receptors six or seven times more efficiently than saturated fats.

If you take a cholesterol-lowering drug, it increases the number of those LDL receptors in your liver. If you eat trans fats, you’re working against that goal big time.

If trans fats make up as little as 1 percent to 3 percent of your daily diet, they make trouble.  The American Heart Association recommends that trans fats make up no more than 1 percent of your diet. That’s not much: 2 grams a day in a 2,000 calorie diet. Carefully examine food labels.  Even if the label doesn’t include trans fats in its nutrient profile, look at the ingredients. If they include partially hydrogenated oil of any type, you’re consuming trans fats.

There’s probably little chance that Louisville will adopt the trans fat ban. Maybe citizens can establish a neighborhood watch.  Note the suspicious activity down at the Bob Evans restaurant and their servings of Stacked & Stuffed Hotcakes. There is nothing sexy about these, despite the double entendre of the name. Each serving packs 6 to 7 grams of trans fats. Remember that statistic about each 2 percent increase in trans fat increasing heart attack risk by 23 percent?

Happy dining.

Some links to more info:

Here’s our mayor talking to LEO. Scroll down to the question about trans fat. The mayor says people need to be educated to discuss the issue with their representative. Looks like the education needs to start with the mayor. OK, well, the guy can’t know everything.