Smoking cessation and regular moderate exercise are key components in any risk reduction programme, but there is more that can be done through dietary intervention and metabolic enhancement.
Now that we have a better understanding of the role of chronic inflammation as a driver of degenerative diseases, and the role of endothelial dysfunction in driving cardiovascular and coronary artery disease in particular, we can assemble rationally designed and highly protective pharmaco-nutritional programmes that can be used both preventatively and in the management of active disease.
If we look downstream from the inflammasome, IL-1b and the formation and release of NF-kappa B, and the mitogen-activated protein kinases, the inflammatory sequence actually causes the progressive destruction of healthy tissue in, for example, the arterioles, leading to ulceration and the start of atheromatous disease.
In the first phase of this biphasic event, the balance between pro- and anti-inflammatory mediators reflects the ratio of omega-3 and -6 fatty acids in the regional cell membranes, which indicates the proportions of those fatty acids in the diet.In the second phase, the synthesis and activation of matrix metalloproteases (MMPs) leads directly to the destruction of healthy tissue.
Here, the polyphenols play a critical role as they both downregulate the genes that express the MMPs and inhibit the enzymes via zinc chelation ... and most likely bind to proline and hydroxyproline residues in or near the enzyme’s active sites.
This begins to explain why purified fish oils have been so ineffective regarding cardioprotection, and why omega-3s combined with polyphenols have been very effective in downregulating inflammation.
It also explains how Indians traditionally have been able to live long and healthy lives — even without consuming long chain omega-3s (there are no cold waters around India).
They have traditionally consumed very high levels of polyphenols and, predominantly, in dietary spices. It explains, too, why the advent of the junk food chains in India has brought havoc.
Unlike the omega-3s, the polyphenols are not stored in the body and must be consumed daily to exert a significant anti-inflammatory effect. For example, when a resident of the subcontinent goes to work for a metropolitan company and abandons traditional foods and starts to consume ultra-processed foods, their polyphenol cover disappears; and, as their omega-3 level is low to begin with, the process of inflammation races away.
You can see the results in India’s lamentable public health statistics.
One way to start to remedy this situation is to enhance the bioavailability of the polyphenols that are still being consumed. Turmeric is a traditional culinary spice and the curcuminoids have an impressive array of anti-inflammatory and other positive pharmacological actions.
However, the low bioavailability of these compounds has restricted their usefulness and lead the scientific consensus to categorise the curcuminoids as an IMP (invalid metabolic panacea).
To combat this claim, there is new development in this area that rewrites the textbooks; it is the marriage of a particle dispersion technology with curcumin.
This technology increases the bioavailability of the curcuminoids and the curcuminoid conjugates significantly.
Specifically, a single dose of 800 mg of HydroCurc containing 90% Curcuma longa extract standardised to 95% curcuminoids, produced peak plasma levels of 800 ng/mL or roughly 2 uM.
To put this in context, a review of curcumin concentrations, shown to exert pharmacological effects in vitro, gave a range between 100 nM and 5 uM.
Therefore, for the first time, we have access to a pharmaco-nutritional intervention — in a single capsule that can logically be used to rectify endothelial dysfunction.
