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John W. Zamarra, MD, FACC 1

•! This presentation is NOT meant to provide medical advice to any specific person in the audience

•! I am NOT recommending anyone start or stop any specific treatment, medication or supplement

•! Please speak to your physician before changing your medical routine

John W. Zamarra, MD, FACC 2

Physician’s Guide toNutrition and Its Effect on HealthOLLI at California State University, FullertonMarch 7, 2015

John W. Zamarra, M.D., F.A.C.C.Natural Medicine and Preventative Health & Heart Group & Associates, Inc.

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What is Nutrition Healthy Eating Key Nutrients in a Healthy Diet Harmony Theory of Health

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“Nutrition is the science that interprets the interaction of nutrients and other substances in food in relation to maintenance, growth, reproduction, health and disease of an organism. It includes food intake, absorption, assimilation, biosynthesis, catabolism and excretion.”

-- National Institutes of Health, Joint Collection Development Policy, Oct 14, 2014

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“Ninety per cent of the diseases known to man are caused by cheap foodstuffs. You are what you eat.”

-- Victor Lindlahr, 1923 Edition of theBridgeport Telegraph

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“Heart disease before age 80 is our fault, not God’s fault, or nature’s will.”

-- Paul Dudley White M.D. “Father of Cardiology” & Founder of the American Heart Association, 1886 -1973

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“Don’t dig your grave with your own knife and fork.”-- Traditional English Proverb

Jared P. Reis PhD et al, Association between duration of overall and abdominal obesity beginning in young adulthood and coronary artery calcification in middle age, Journal of the American Medical Association 310(3):280-288, July, 2013

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•! The digestive tract is a tube that breaks down food and absorbs the nutrients into your body

•! Digestion begins in the eyes and nose•! You see and smell food before eating it•! This triggers the salivary glands so that your

mouth is ready and waiting

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•! Saliva is key to proper digestion•! Food must be properly chewed to start the

digestion process•! Chunks of food are harder to digest and can

cause indigestion and disease•! Chewing strengthens the immune system by

stimulating the parotid gland and thymus to produce T-cells

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“The dependence of the intestinal microbes on food makes it possible to adopt measures to modify the flora in our bodies and to replace the harmful microbes by useful microbes.”

-- Ilya Ilyich “Elie” Mechnikov, Nobel Laureate, Discoverer of the macrophage & founder of using

beneficial ingested microorganisms (probiotics), 1907

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•! The digestive tract is 25-30 feet long and every inch is technically outside the body

•! Bacteria in your gut outnumber the cells in your body 10 to 1

•! Bacteria offer crucial aid in digestion, germ protection and mood regulation

•! Fermented foods nurture friendly bacteria•! Friendly bacteria are called probiotics, and

these microbes perform many tasks that the human body cannot

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Physiology / Biochemistry

Genetics

Environment

Lifestyle

70-90% of Chronic Disease

This is why Natural Medicine focuses on root causes and prevention rather than symptoms

Willis BL et al, Midlife Fitness and the Development of Chronic Conditions in later life, Archives of Internal Medicine 10.1001: 1-8, Aug 27, 2012

What really determines disease for most of us?

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Time of day mattersHealthy, pure foodCalm environmentRegular routine

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“Without proper diet, medicine is of no use. With proper diet, medicine is of no need.”

-- Traditional Ayurvedic Aphorism

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-- Hippocrates, the Father of Medicine460 B.C. – 377 B.C

“Let food be your medicine and medicine be your food.”

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•! An obstacle to healthy eating is conflicting information on what food is healthy

•! Research usually assumes everyone"has the same digestion and needs

•! Nutrigenomics is a new field of research"emphasizing unique genetic profiles for"nutrition and diet

•! Evidence suggests that the food we eat changes how our genes work and what they do – this is called epigenetics

•! This is the science of personalized diets

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Diet and Exercise Can Work, Problem is Compliance

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Mediterranean Diet•! Keeps elders agile•! Fights chronic ailments•! Protects the brain•! Reduces cardiovascular

mortality

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•! Fasting insulin level•! Vitamin D level•! Waist-to-hip ratio•! Body fat percentage•! Cholesterol and HDL ratios•! Blood pressure•! Uric acid level

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•! Soda, diet soda, commercial fruit juice and sports drinks disturb the body’s metabolism

•! Tap water can be contaminated with toxins that are worse than chlorine bleach

•! Filtered tap water is an excellent, inexpensive, and easy source of fluid replacement

•! Bathing also exposes you to these toxins, so a water filter for your shower reduces your toxic load

•! New research is pointing to Structured Water

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•! The goal is to normalize insulin and leptin levels so your body can effectively burn fat as a primary fuel

•! Vegetables and healthy fats in the diet replace processed foods, sugars and grains that contribute to insulin and leptin resistance

•! Potassium and salt ratios are important to heart health

•! Organic and/or locally grown vegetables are best: eat them raw, juiced, fermented or sprouted

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•! To lose weight, WHEN you eat is as important as WHAT you eat

•! Eating only during an eight-to-ten hour window each day will burn fat and improve many markers of good health

•! Breakfast is the most important meal of the day, but not for everyone – for some it might be adding to a weight problem

•! For those people it might be better to skip breakfast and work out while in a fasted state

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•! Just like plants, humans need sunlight to thrive

•! Regular, sensible sun exposure dramatically lowers risk of cancer and heart disease

•! Test blood levels of Vitamin D regularly•! Sunlight is the ideal way to get Vitamin D•! If you cannot get enough sun, a Vitamin D

supplement is necessary

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•! Some whole grains, like brown rice•! Natural sweeteners like agave•! Unfermented soy, including tofu and soy milk•! Vegetable oil•! Many types of fish•! Processed, artificially-sweetened yogurt

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“Currently, the vast majority of dollars is spent treating rather than preventing cardiovascular disease. Instead, through simple, low-cost efforts we could significantly reduce the prevalence and burden of this debilitating disease, and save money and lives.”

-- Valentin Fuster, M.D., Ph.D., Physician-in-Chiefof The Mount Sinai Medical Center

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“It is really possible in every animal species and with every kind of [infectious agent] to achieve a complete cure with one injection, a result which corresponds to what I call therapia sterilisans magna.”

-- Paul Ehrlich, 1908 Nobel Lecture describing the foundations for the Magic Bullet

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Three Primary Categories•! Targeted to specific conditions•! For immediate short-term concerns•! Daily maintenance for overall health

Supplements are not a replacement for a healthy diet and lifestyle, instead they are synergistic

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Nutrients to Prevent Heart Disease•! Vitamin D – Good •! Vitamin K2 – Good •! Magnesium – Good •! L-Arginine – Good •! Vitamin-B Complex – Good •! Resveretrol – Mixed •! CoQ10 – Good

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Nutrients to Prevent Heart Disease•! Omega-3 Fatty Acids / Fish Oil – Good •! Niacin – Good/Bad•! Garlic – Good •! Policosanol – Ugly •! Red Yeast Rice – Good •! Soy – Ugly•! Fermented Soy – Good

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Nutrients to Prevent Heart Disease•! Trans Fats – Ugly •! Monounsaturated Fats –Good •! Flax – Good •! Vitamin E – Bad/Good•! Green Tea Extract –Good •! Citrus Bergamot – Good •! Sugar/High Fructose Corn Syrup – Ugly

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What it Does:•! Improved muscle relaxation (prevents spasms)•! Improves insulin sensitivity•! Reduces hypertension, especially related to

eclampsia•! Required for cellular energy (ATP) in every cell of the

body•! Supports healthy processing of DNA and RNA

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What it Does:•! Reduces serum lipid levels•! Reduces incidents of CHD•! Inhibits cholesterol synthesis via HMG CoA reductase•! Reduces the risk of abdominal aortic aneurysms by

suppressing angiotensin II levels•! Combined with berberine improves insulin resistance,

glucose and lipids in subjects with or without metabolic syndrome

•! Acts as an alternative to Statins in intolerant patients, especially combined with Mediterranean diet

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What it Does:•! Enhances absorption

of calcium, iron, magnesium, phosphate and zinc

•! Critical for maintaining bone density

•! Helps guide and support bone remodeling (repair)

•! Levels should be measured

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What it Does:•! Increases LDL Cholesterol, but changes from small to

the larger, buoyant, less atherogenic forms of LDL•! Reduces blood triglyceride levels•! Stimulates blood circulation•! Increases breakdown of fibrin, compound involved in

clot and scar formation•! May prevent onset of dementia•! May prevent LDL oxidation

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What it Does:•! Helps the mitochondria produce 95% of the body’s

energy in the form of ATP in conjunction with K2•! Powerful antioxidant, especially preventing the

oxidation of lipids and proteins•! Regenerates other antioxidants•! Ensures the heart, liver, and kidneys properly meet

their high energy needs•! Necessary when taking a statin drug

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“One of the first duties of the physician is to educate the masses not to take medicine.”

-- Sir William Osler, Aphorisms from His Bedside Teachings and Writings, 1961

Comparative effectiveness of exercise and drug interventions on mortality outcomes, BMJ 2013;347:f5577 October 01, 2013

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•! Nutrition and nutritional supplements will provide dramatic improvements in serum lipid levels that can compete with drug therapies

•! Combinations of drugs and nutritional supplements are scientifically valid treatments to achieve goal lipid levels and reduce vascular disease

•! In patients that are intolerant to statins, these nondrug approaches are clinically valuable to proper treatment of lipid disorders

Mark Houston, The Role of Nutrition and Nutritional Supplements in Treatment of Dyslipidemia, Clinical Lipidology 2014;9(3):333-354

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20% of both US-manufactured and Indian-manufactured medicines purchased via the internet contained lead, mercury, or arsenic levels exceeding acceptable daily standards

Of these products, 95% were sold by US websites and 75% claimed GMP.

Saper RB et al, Journal of the American Medical Association 300(8):915-923, 2008

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Saper RB et al, Journal of the American Medical Association 300(8):915-923, 2008

Products are commonly adulterated

Heavy metals are primarily a problem with botanicals from Asian and India

All companies had to become compliant with GMPs by June 2010. Hopefully, enhanced inspection of facilities and enforcement the quality will improve, reducing risk of adulteration and contamination

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“A lie can travel half way around the world while the truth is putting on its shoes.”

-- Mark Twain (attributed)1835-1910

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To Harness the Creative Intelligence of Nature•! Effective health plans need to be personalized•! Customize a synergistic supplement plan•! Self-referral systems re-establish order•! It’s not just treatment, it’s a lifestyle•! Health is not merely the absence of disease

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Dr. Joseph Mercola, February 2015

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Follow up Questions:!jzstaff@yahoo.com

(714) 871-5200