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Good Calcium or Bad Calcium – Myth and Reality

“Got Milk,” has been the fun promotion for the dairy industry for years. We have all read that calcium helps build stronger bones and teeth and we know that milk products are the primary source of calcium in American diets. However, the calcium we will be discussing is a different form and it can be deadly.


Heart Scans and Calcium Scores

So what is a Calcium Score/CT Heart Scan? A non-invasive imaging that provides clear, 3-dimensional pictures of your heart, showing coronary artery calcification (indicating coronary plaque build-up) and other abnormalities of the heart muscle. It’s a totally noninvasive test, which is performed within five minutes.This test is very precise about detecting and quantifying the calcification of the coronary artery disease. The coronary calcification is a direct measure of atherosclerosis or hardening of the artery. It is almost non-existing to have significant plaque formation within the blood vessels if there is no calcification. Therefore, this test is an excellent tool for early detection, quantification, and possible future of progression coronary artery disease.


The problem is how we approach cardiovascular disease in this country. Our healthcare insurance is “sick care” insurance. We are focusing on people coming in with the full-blown heart attack, angina or coronary artery disease. We are not focusing on “prevention.” Thus, we are spending only 3 cents out of every dollar for prevention and 97 cents on chronic disease management. That is why the cost of the healthcare system keeps rising.


Why a Heart Scan May Save Your Life

From my experience as a cardiologist, looking at the EKG stress tests will not tell me if this patient has significant coronary artery disease. The only time I see significant coronary artery disease diagnosed by stress test is when the patient already has 70-80% narrowing in one or two vessels. I routinely see people in the hospital coming in after their normal stress test and then having a heart attack or angina. The prime example is President Bill Clinton, who had a normal stress test three months prior to his coronary artery bypass surgery.


Guess what? The majority of people who have their first heart attack have only 40-50% blockage. They do not have a 90% blockage, and so we are missing anyone who is prone to have a heart attack by not doing the right test to find out who is going to have this heart attack. So I am calling this “heart attack prevention test.”


WebMD argued absence of calcification does not mean there is no coronary artery disease. Yes, that it is true. Some people can have soft plaque even without calcification, but the incidence is less than 1%. This test has such a strong negative predictive value, that if you have 0% calcification, the likelihood of you developing significant coronary artery disease is almost none. If you have any calcification, then it means you are developing atherosclerosis.


What We Know

We know the incremental value of coronary event increases by increased calcium score. The likelihood of having a coronary event is 10 times higher with a score between 100 to 200. It is more than 25 times higher when the score goes beyond 400. So we know that if somebody has a score of 400 with a normal stress test, then this patient is going to have a significant risk, and that is the person we need to identify and complete a strong risk factor modification and follow up very closely. We are missing all of these risk factors because insurance does not pay for these new tests.


In conclusion, “TO STAY YOUNGER AS YOU GROW OLDER, YOU HAVE TO LIVE SMARTER.” And the smart way to maintain health is through preventive medicine. The first step is information. “YOU” and your physician need to know exactly what’s going on inside you, and what to do about it.

YES TO FISH – Very Important In Preventing & Managing Cardiovascular Disease

Salmon, Fish, Omega 3I never thought that fish could be vital to my life. We grew up eating meats like pork and beef. Now we are realizing that we are killing ourselves by our eating habits. As Dr. Bill Roberts from Baylor University Medical Center said, “We kill the cows to eat and eventually they kill us.”

Omega-3 was recently introduced into our lives. In the early 1900s, we discovered that there are certain polyunsaturated fatty acids essential to our life, and the deficiency of those essential fatty acids then led to the development of several diseases, including heart disease. Until the 1980s, we were not sure about the exact role of Omega-3.

 What is Omega-3?

In the early 1900s, scientist discovered essential fatty acids, which would lead them to outside source, since the body cannot synthesize them. The essential fatty acids are an important part of each individual cell and are highly recommended in maintaining the health of the individual cell. Their presence can make cells more stable and resistant. Our diet has both Omega-3 and Omega-6. The Omega-3 has an anti-inflammatory effect, while the Omega-6 has an opposite action. The most important omega-3s are ALA (which is alpha-linolenic acid), DHA, and EPA. DHA and EPA are purely derived from the fish, especially the fish from cold water. Namely salmon, which has the highest content of it, but also other fish like tuna and herring.


ALA is derived from the vegetable source, and it is not as important as the other two. The DHA and EPA are intangible to human health, and depletion leads to several bodily ailments. As I mentioned, Omega-6 has an opposite effect and prone to develop inflammation and thrombosis. Omega-6 is also known to participate in plaque buildup in the heart, brain dysfunctioning, as well as arthritis and skin disorders. Most of Omega-6 that we get is from an animal source, especially from beef and pork.


  Western Diets and Omega-3

Western diet is very deficient in Omega-3. For that reason, the incidence of heart disease and other ailments are very high in the U.S.A. The usual ratio of Omega-3 and Omega-6 should be 1:4, while in most of North America, it is 1:10, and in some cases it is 1:25. This means we should all take a supplement to counterbalance the diseases of modern civilization, i.e. metabolic syndrome, diabetes, hypertension, and cardiovascular diseases.


  Clinical benefits of Omega-3:

  • Lower blood pressure.
  • Reduce triglycerides.
  • Slow the development of plaques in the arteries.
  • Reduce the chance of abnormal heart rhythm.
  • Reduce the likelihood of heart attack and stroke.
  • Lessen the chance of sudden cardiac death in people with heart disease.


It is confusing to the consumer to find the right brand of fish oil and how much to take. Without naming any brand, any fish oil brand has to be a certified brand of IFOS (International Fish Oil Standard). For more information, the consumer should visit (Council for Responsible Nutrition). The FDA states that taking no more than 3 grams of fish oil daily is Generally Recognized as Safe (GRAS). Also, the Omega Association recommends a dose up to 1 gram supplementation.


For people with known disease, as mentioned above, recommendations are from 2 – 3 grams a day. More than 3 grams a day is only recommended for a known history of coronary artery disease and treatment of hypertriglyceridemia. However, under this condition, you should not be taking a higher dose without a physician’s consultation.. Taking more than 3 grams of fish oil daily may increase the risk of bleeding and interaction with several medications and therefore, physician approval is necessary.


Widespread use of Omega-3 needs education of both consumer and physician. Now the American Heart Association is almost making it mandatory to take Omega-3 supplements on a daily basis. Maybe in the future, primary prevention will become one of the priorities of our country instead of trying to manage and treat disease. Say “YES” to fish and Omega-3.