by Zonemarcus | Feb 4, 2019 | Today's Information
Picking our poison?
WHITE RICE IS HIGH IS SUGAR. EXCESSIVE SUGAR, A PRIMARY VILLAIN IN THE HEART DISEASE STORY, PROMOTES OBESITY AND HEART DISEASE.
ON THE OTHER HAND, BROWN RICE CONTAINS THE HUSK WHERE DAMAGING LECTINS LURK. LECTINS ARE CARBOHYDRATE-BINDING PROTEINS PRESENT IN MANY PLANTS AND ARE IMPOSSIBLE TO AVOID ENTIRELY IN THE DIET. THEY ARE PARTIALLY NEUTRALIZED BY COOKING.
LECTINS ARE HIGHLY INFLAMMATORY. CHECKING OUR hsCRP LEVEL AND KEEPING IT LOW GIVES OF A MEASURE OF HOW WE ARE DOING IN HEART DISEASE PREVENTION.
LESS THAN 1.0 IS GOOD, LESS THAN 0.5 BETTER AND LESS THAN 0.1 BEST.
DON’T CONFUSE LECTIN (AN INFLAMMATORY FOOD COMPONENT) WITH LEPTIN (A HORMONE IN OUR BODY THAT REGULATES OUR APPETITE AND FAT.)
DISCOVERED IN 1994, LEPTIN IS A HORMONE WHICH IS MADE IN OUR FAT CELLS. IT GOES THE HYPOTHALAMUS PART OF OUR BRAIN AND USES VAGUS NERVE PATHWAYS TO TELL US WHEN WE ARE FULL. ONE EFFECT OF LECTIN IN OUR FOOD IS TO MAKE US RESISTANT TO THE HORMONE LEPTIN’S MESSAGE THAT WE’VE EATEN ENOUGH. ULTIMATELY, LEPTIN CONTROLS OUR APPETITE AND OUR FAT.
SIMPLY IT APPEARS BEST TO US TO CONTINUE WITH WHOLE FOODS AND A PLANT BASED MATRIX WHILE BEING AWARE THAT EXCESSIVE LECTIN CAN BE A CULPRIT IN OBESITY AND CHRONIC DISEASE. SOME COOKED BROWN RICE IS NOT A BAD CHOICE AS PART OF WHOLE FOOD NUTRITION WITH LOTS OF FIBER. LIMITING SUGAR, FOODS THAT GO TO SUGAR, AND PROCESSED FOODS ARE GOOD CHOICES.
DRILL DOWN:
Miyake K, Tanaka T, McNeil PL, 2007 Lectin-Based Food Poisoning: A New Mechanism of Protein Toxicity. PLoS ONE 2(8): e687. doi:10.1371/journal.pone.0000687
“The Plant Paradox” Steven Gundry, MD
by Zonemarcus | Feb 4, 2019 | Today's Information
Written and medically reviewed by Dr. Don Zone, MD, FACC, FAARM — Board-Certified Cardiologist
When patients ask me for the one thing they can do for their circulation, they expect to hear about a pill. What I usually talk about instead is a gas — a molecule so short-lived it survives only a few seconds in the body, yet so central to cardiovascular health that the scientists who worked out what it does were awarded the 1998 Nobel Prize in Medicine. That molecule is nitric oxide, and if you are past 40, you are making meaningfully less of it than you used to.
The good news: nitric oxide responds to what you eat and how you live more directly than almost anything else in cardiovascular medicine. Here is what it does, why it declines, and how to get it back — all backed by science.
The Short Answer
Nitric oxide (NO) is a signaling molecule your blood vessels produce to relax and widen themselves — a process called vasodilation. More nitric oxide means more flexible arteries, healthier blood pressure, and better delivery of oxygen and nutrients to every tissue that needs them: heart, muscles, brain.
Production declines with age, which is one reason blood pressure tends to creep upward in midlife. The most evidence-backed ways to support it are eating nitrate-rich vegetables (leafy greens and beets), regular exercise, and — surprisingly — protecting the bacteria in your mouth that convert dietary nitrate into a form your body can use.
What Is Nitric Oxide?
Nitric oxide is a gas that acts as a messenger inside the body. The inner lining of your blood vessels — the endothelium, a one-cell-thick layer with the surface area of several tennis courts — produces it continuously, releasing tiny puffs that tell the surrounding smooth muscle to relax. When that muscle relaxes, the vessel widens, blood flows more freely, and pressure inside the pipe drops.
Your body makes nitric oxide two different ways, and the distinction matters for everything that follows:
The internal pathway. Endothelial cells build NO from an amino acid called L-arginine, using an enzyme called eNOS (endothelial nitric oxide synthase). This is the workhorse pathway — and it is the one that weakens with age.
The dietary pathway. Nitrate from vegetables is absorbed, concentrated in your saliva, and converted by bacteria on your tongue into nitrite, which your body then converts to nitric oxide. This backup route becomes increasingly important as the internal pathway slows down, and it is the reason food choices move the needle here.
If the name sounds familiar from a pharmacy shelf, there is a reason: nitroglycerin, prescribed for chest pain since the 1800s, works by delivering nitric oxide to the vessels around the heart. Medicine has been borrowing this molecule for over a century.
Nitric Oxide Benefits: What the Research Shows
Healthy blood pressure
This is the best-documented benefit. A meta-analysis of 16 randomized trials in the Journal of Nutrition found that inorganic nitrate and beetroot juice supplementation lowered systolic blood pressure by an average of 4.4 mmHg. That is a meaningful number — population studies associate even a few mmHg of sustained reduction with lower stroke risk.
The reverse experiment is just as telling. When researchers gave healthy volunteers an antiseptic mouthwash for seven days — wiping out the oral bacteria that activate dietary nitrate — plasma nitrite fell by about 25% and blood pressure rose by 2–3.5 mmHg within a day. Blood pressure is a topic I return to often on this site; my deeper guide to understanding and managing blood pressure covers the full picture.
Circulation and oxygen delivery
Wider vessels move more blood at lower cost. That shows up in the research as improved exercise tolerance: dietary nitrate has repeatedly been shown to reduce the oxygen cost of exercise, which is why beetroot juice became a fixture in endurance sport. For my patients, the more relevant translation is everyday energy — climbing stairs, carrying groceries, keeping pace on a walk. Oxygen delivery is energy, and nitric oxide is the traffic controller.
Heart health over the long term
A healthy endothelium that produces nitric oxide freely is one of the strongest markers of cardiovascular resilience. Declining NO bioavailability is an early step in the chain that leads to stiff arteries and atherosclerosis — researchers now describe it as a central mechanism of vascular aging. Protecting nitric oxide production is, in a real sense, protecting the heart you will have in twenty years.
Beyond the heart
Nitric oxide signaling also supports brain blood flow and plays the central role in male sexual function — the entire class of erectile dysfunction medications works by amplifying the nitric oxide pathway. Declining NO is one reason both concerns become more common after 40. The molecule is not a cure for anything; it is infrastructure.
What Happens to Nitric Oxide Production After 40
Nitric oxide production does not fall off a cliff — it erodes, through several compounding mechanisms that a 2025 review in the Journal of Cardiovascular Aging lays out in detail:
The eNOS enzyme becomes less active with age, receiving fewer “on” signals and more “off” signals. Its critical cofactor (BH4) becomes depleted, and without it the enzyme “uncouples” — instead of producing nitric oxide, it starts producing free radicals that destroy nitric oxide. Oxidative stress rises with age, scavenging NO before it can do its job. And levels of ADMA, a natural blocker of the enzyme, climb with age in a way that correlates directly with worsening vascular function.
The practical translation: by midlife, the internal production line is running below capacity while demand stays the same. That is precisely why the dietary pathway — nitrate from food — matters more after 40 than at any other point in life. It is the supply route you still fully control.
Nitric Oxide Foods: What to Eat
A clarification worth making: no food contains nitric oxide. What vegetables contain is nitrate — the raw material your body converts to NO through the salivary pathway described above.
The standard reference on food nitrate content, published in the American Journal of Clinical Nutrition, puts these vegetables in the highest category (more than 250 mg of nitrate per 100 g):
- Arugula (rocket) — the top of the table
- Spinach — sampled as high as 741 mg/100 g
- Beetroot — the most studied source, and the base of most trial protocols
- Celery, lettuce, and cress
One tier down (100–250 mg/100 g): fennel, leek, parsley, endive, and Chinese cabbage.
Two practical notes from the research. First, dose and consistency matter: the beetroot juice trials that moved blood pressure typically delivered 300–500 mg of nitrate daily, with better results after two or more weeks of consistent intake — think a daily salad or beet serving, not an occasional one. Second, young greens punch above their weight nutritionally; I’ve written about why microgreens are one of the easiest upgrades to a midlife diet.
Pomegranate deserves its own mention because it works differently. Rather than supplying nitrate, pomegranate’s polyphenols protect the nitric oxide you already have: research by Nobel laureate Louis Ignarro found that pomegranate juice shields NO from oxidative destruction and enhances its biological action. I cover the fruit’s broader cardiovascular case in my pomegranate guide.
How to Increase Nitric Oxide Naturally
- Eat from the high-nitrate list daily. One generous serving of arugula, spinach, or beets most days is the foundation. This is the single most evidence-backed step on this list.
- Chew your vegetables — or at least keep them in your mouth. The conversion of nitrate to nitrite happens in your mouth, courtesy of your oral bacteria, so contact time matters. This is the science behind what I call the smoothie trick — chewing your drinks to boost nitric oxide — which I’ve written up separately.
- Rethink daily antiseptic mouthwash. The same oral bacteria are collateral damage of twice-daily antiseptic rinses — in the study above, a week of chlorhexidine mouthwash measurably raised blood pressure. Oral hygiene matters; routine antiseptic carpet-bombing may not. If a dentist has prescribed a rinse, follow their guidance — and mention it at your next visit.
- Move, most days. Exercise is the strongest stimulus for your internal eNOS pathway — the friction of blood moving faster across the endothelium directly signals it to produce more NO, and regular training improves vascular responsiveness even when started in midlife. It does not need to be heroic: brisk walking counts.
- Be honest about supplements. Beetroot powders and juices can work — they are simply concentrated delivery of the same nitrate found in food, and most positive trials used exactly that. L-citrulline, an amino acid that feeds the internal pathway, has reasonable supporting evidence. But no capsule replaces the dietary pattern, and anyone taking blood pressure medication or nitrate drugs (like nitroglycerin) should talk to their physician before adding a concentrated NO booster — the effects stack. For patients building a broader cardiovascular routine, my heart health protocols page lays out what I actually recommend and why.
FAQ: Nitric Oxide
What are the symptoms of low nitric oxide?
There is no routine clinical test, and low nitric oxide rarely announces itself directly. The signals are downstream and gradual: blood pressure creeping up over the years, reduced exercise tolerance, slower post-exercise recovery, and erectile difficulties in men. Because these are also signals of broader cardiovascular change, they warrant a conversation with your physician rather than self-diagnosis.
Does nitric oxide lower blood pressure?
The evidence says yes, modestly. Across 16 randomized trials, boosting nitric oxide through dietary nitrate lowered systolic blood pressure by an average of 4.4 mmHg. That is not a substitute for prescribed treatment — but as a dietary layer on top of it, the effect size is meaningful.
What foods are highest in nitric oxide?
Strictly speaking, none — foods supply nitrate, which your body converts to nitric oxide. The richest sources are arugula, spinach, beetroot, celery, lettuce and cress, all above 250 mg of nitrate per 100 g.
Is boosting nitric oxide safe?
Vegetable nitrate at dietary levels has a strong safety record, and the cured-meat nitrite concern is a different context entirely — vegetables come packaged with vitamin C and polyphenols that change the chemistry. The caution zone is concentrated supplements combined with blood pressure medication, PDE5 inhibitors, or prescribed nitrates. Stacking vasodilators can drop blood pressure further than intended, so clear supplements with your physician first.
How long does it take to raise nitric oxide levels?
Faster than almost anything else in nutrition. Blood nitrite peaks within about three hours of a nitrate-rich meal, and single-dose blood pressure effects appear the same day. The trials with the most consistent results, though, ran two weeks or longer — treat this as a daily habit, not a pre-event trick.
Key Takeaways
Nitric oxide is the molecule your blood vessels use to stay wide, flexible, and well-supplied — and production declines through midlife via well-mapped mechanisms. The response is not complicated: a daily serving of high-nitrate vegetables, regular movement, respect for the oral bacteria that run the conversion, and skepticism toward any product that promises more than a 4-mmHg kind of benefit. In cardiology, the interventions that work are usually the boring ones done consistently. This is one of them.
This article is for educational purposes and is not medical advice. Talk to your physician before changing medications, supplements, or your health routine — especially if you take blood pressure medication or prescribed nitrates.
by Zonemarcus | Feb 4, 2019 | Today's Information
2 Tablespoonful’s of Extra Virgin Olive Oil per day can improve our heart health!
It’s simple to keep it handy and use it in or on our food. We have a flavor we like and keep the bottle on the countertop for use on salad, vegetables, and many other foods. It’s amazing how that bottle is gone in a week or two.
The first pressing of olives (extra virgin olive oil or EVOO) produces a liquid rich in beneficial phenols. Refined olive oils do not have this property.
We currently use the commonly available and reasonably priced Olive Ranch brand from Southern California. Different flavors are available and begin to rival the nuances of wine tasting.
Why do we feel this is beneficial to our heart health? Studies have demonstrated that Extra Virgin Olive Oil:
- Decreases Inflammation
- Increases not only the level of beneficial good cholesterol (HDL) in the blood but quite importantly also increases its functionality.
- Lowers blood pressure
- Makes us feel full
- Decreases harmful oxidation
- Lowers blood sugar
- Increases the body’s sensitivity to insulin
What an easy and tremendous way to improve our HeartHealthToday.
Further Reading:
Fits M, Cladellas M, de la Torre R, et al. Antioxidant effect of virgin olive oil in patients with stable coronary heart disease: a randomized, crossover, controlled, clinical trial. Atherosclerosis. 2005;181(1):149-158.
R Madigan C, Ryan M, Owens D, Collins P, Tomkin GH. Dietary unsaturated fatty acids in type 2 diabetes: higher levels of postprandial lipoprotein on a linoleic acid-rich sunflower oil diet compared with an oleic acid-rich olive oil diet. Diabetes Care. 2000;23(10):1472-1477
Bes-Rastrollo M, Sanchez-Villegas A, de la Fuente C, de Irala J, Martinez JA, Martinez-Gonzalez MA. Olive oil consumption and weight change: the SUN prospective cohort study. Lipids. 2006;41(3):249-256
Estruch R, Ros E, Salas-Salvado J, et al. Primary prevention of cardiovascular disease with a Mediterranean diet. N Engl J Med. 2013;368(14):1279-1290.
Babio N, Toledo E, Estruch R, et al. Mediterranean diets and metabolic syndrome status in the PREDIMED randomized trial. CMAJ. 2014;186(17):E649-657.
Salas-Salvado J, Bullo M, Babio N, et al. Reduction in the incidence of type 2 diabetes with the Mediterranean diet: results of the PREDIMED-Reus nutrition intervention randomized trial. Diabetes Care. 2011;34(1):14-19.
by Zonemarcus | Feb 4, 2019 | Today's Information
“You take two bodies and you twirl them into one; their hearts and their bones. And they won’t come undone Hearts and bones” Paul Simon, 1983
Following the direction of Paul Simon’s 1983 album title song, the latest biological science has uncovered still another strong connection between our hearts and our bones.
Mutated stem cells deep in our bone marrow can produce a variety of white blood cells which have a particularly inflammatory effect. As they enter the plaque in our blood vessels in an attempt to do their repair job they may well cause increased plaque growth and rupture. Remember that it is the breaking open of a plaque in our blood vessels that causes the sudden heart attack or stroke.
The practicality of this is that it reinforces our conviction that we must keep unnecessary inflammation to a minimum.
We should strongly consider avoiding foods that produce inflammation. These are not the same for everyone. Some have trouble with dairy, others shellfish,and some others gluten. Excess sugar in its many forms can be inflammatory for most.
Whole food plant based diets are likely one of the most effective ways, but not the only way, to keep inflammation under control.
Certain foods that fight inflammation include blueberries, green tea, beets, the broccoli family, and our favorite, extra virgin olive oil. Ginger and turmeric are well known for their property of decreasing inflammation. The most active ingredient of turmeric in this regard appears to be curcumin.
What causes the mutations of these stem cells in the first place? Toxins such as certain chemicals and smoke are among the likely culprits.
These new discoveries have of course produced yet another acronym (C.H.I.P.) standing for –get ready for this one–Clonal Hematopoiesis of Indeterminate Potential. New CHIP societies and CHIP clinics are already forming and are not to be confused with the kid’s CHIP– Children’s Health Insurance Program.
The studies to date are impressive and may help explain why some of us with few or none of the traditional “risk factors” of high blood pressure, smoking, diabetes and high cholesterol still have heart attacks and strokes.
We continue to advocate the I CAN DO acronym. The I is for reducing unnecessaryInflammation to improve our Heart Health Today.
Further Reading:
- Jaiswal, S., Natarajan, P., Silver, A. J., Gibson, C. J., Bick, A. G., Shvartz, E., et al. (2017). Clonal hematopoiesis and risk of atherosclerotic cardiovascular disease. N. Engl. J. Med. 377, 111–121. doi: 10.1056/NEJMoa1701719
- Jaiswal S, Fontanillas P, Flannick J, et al. Age-related clonal hematopoiesis associated with adverse outcomes. N Engl J Med 2014;371:2488-2498
3. Is Coronary Atherosclerosis One Disease or Many? Circulation. 2017;135:1005–1007. DOI: 10.1161/CIRCULATIONAHA.116.02
by Zonemarcus | Feb 4, 2019 | Today's Information
What is it? Can we measure it?
CORONARY ARTERY CALCIFICATION SCORE – A VALUABLE GUIDE FOR THOSE OF US AT RISK
A simple X-Ray exam that should cost less than $90 is a very accurate measure of the amount of blockage which has developed in our heart arteries. Knowing that number can be an effective motivator for employing an even more effective prevention and reversal program in our lives.
As plaque forms in our arteries, it also becomes calcified, providing a marker that is easily measured by X-Ray. The more calcification, the more plaque, and generally the more serious we must become about managing this health hazard which can result in serious disability or death.
A score of zero is is normal
1 to 99 indicates mild disease
100 to 399 indicates moderate disease
Over 400 indicates severe disease
Extensive guidelines on the use of this test are available from several sources.
The score is not perfect. Plaque can occur without calcification, especially in younger individuals.
The test takes about 15 minutes and no dye is used. The radiation exposure is generally minimal, about equivalent to what we get from our surroundings in one year. The scanners vary widely in the radiation dose, so we pick a good one. Pregnant women or those who may become pregnant should avoid the test. Under age 40, it may not be worth having.
An amazingly comprehensive review of this is contained in the Jan 2018 issue of JACC.
1.Coronary Artery Calcification and its Progression What Does it Really Mean? Hiroyoshi Mori, Sho Torii, Matthew Kutyna, Atsushi Sakamoto, Aloke V. Finn, Renu Virmani
Journal of the American College of Cardiology: Cardiovascular Imaging Jan 2018, 11 (1) 127-142; DOI:10.1016/j.jcmg.2017.10.012
- Coronary Calcium Score and the New Guidelines Javier Sanz
Journal of the American College of Cardiology Oct 2015, 66 (15) 1669-1671; DOI: 10.1016/j.jacc.2015.08.041
