Dear Reader,

Most doctors dont stress the importance of

having a healthy heart rate variability (HRV), but
they should. Thats because those with disturbed
HRV are more prone to stress-related cardiac
disorders, including arrhythmias, coronary artery
spasm, and even sudden cardiac death. And HRV
has even become a reliable clinical tool for measur-
ing survival potential after a heart attack.
HRV refers to the ultra-subtle variations in the hearts beat-
to-beat interval. A disturbed, rigid HRV means that the heart has
difficulty getting back to a normal beat rhythm after stress and exer-
tionessentially not having the ability to quickly speed up, slow down,
or just go with the flow, so to speak.
Disturbed HRV is ultimately a result of flawed regulation by the
autonomic nervous system (ANS). Excess stress turns on the sympathetic
branch of the ANS and overwhelms the balance with the parasympa-
thetic (calming) branch, which then has a negative impact on your HRV.
HRV-altering stress comes in many different forms: emotional,
spiritual, and physical. Anger, worry, and anxiety can all produce
such stress. So too can air pollution. And as I recently learned from
a new Penn State study, systemic inflammation can even subvert
cardiac function by generating changes in ANS cardiac regulation. The
researchers reached this conclusion after linking elevated C-reactive
protein, a biochemical marker of inflammation, to disturbed daily
patterns of HRV measurements.
The results of this new research dont surprise me. Systemic inflam-
mation is the real underlying cause of so many of the ills of modern man,
including cardiovascular disease, and it is triggered by a multiplicity of
familiar factors, including infections, gum disease, an inflammatory diet,
too much sugar, cigarette smoking, toxic metals, trans fats, insecticides,
pesticides, and even environmental electric fields.
To cultivate a balanced ANS that, in turn, supports a healthy HRV,
you need to take steps to reduce the inflammation in your body and the
stress on your mind. So, take up meditation or yoga, cut down your sugar
intake, and quit smoking for good. Also, discover Earthing, which quickly
helps to restore a calming, HRV-friendly climate in the nervous system.
References
Li X, et al. Systemic inflammation and circadian rhythm of cardiac autonomic modulation. Auton Neurosci.
2011;162(12):7276.
Chevalier G, Sinatra ST. Emotional stress, heart rate variability, grounding, and improved autonomic tone: clini-
cal applications. Integr Med. 2011;10(3):1621.
A Cardiologists Guide to Total Wellness SEPTEMBER 2012
Dr. Stephen Sinatras
STEPHEN SINATRA, MD
Get More of Dr. Sinatra
Stephen Sinatra, MD, FACC, FACN,
CNS is a board-certified cardiologist
and certified bioenergetic analyst with
more than 30 years of experience in
helping patients prevent and reverse
heart disease. Dr. Sinatra integrates the
best conventional medical treatments
with complementary nutritional and
psychological therapies.
Dr. Sinatra is an Assistant Clinical Professor
at the University of Connecticut School of
Medicine and is author of numerous books
including Lower Your Blood Pressure in
Eight Weeks, Heart Sense for Women,
Reverse Heart Disease Now, and Earthing.
He is a Fellow of the American College of
Cardiology; Fellow of the American College
of Nutrition; board certied in internal
medicine and cardiology; and certied in
anti-aging medicine, clinical nutrition, and
bioenergetic analysis.
In Dr. Sinatras Blog
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2 Heart, HealtH & Nutri ti oN September 2012
E
very September, since 1985, the National
Heart, Lung, and Blood Institute promotes
National Cholesterol Education Month to warn the
public about the supposed heart-health horrors of
high cholesterol and saturated fat. My message this
September is quite different, however, because for
many months Ive been hard at work with Jonny
Bowden, Ph.D., a best-selling author and well-
known nutritional/health expert, on a new book
entitled The Great Cholesterol Myth: Why Lowering
Your Cholesterol Wont Prevent Heart Disease and
the Statin-Free Plan That Will (Fair Winds Press).
The title says it all, and the book, packed with
powerful research, expert opinions, and our own
combined clinical experience, constitutes a compre-
hensive defense of cholesterol and saturated fat.
The two of us wrote this book because we believe
strongly that the public has been misinformed and
in some cases directly lied to about cholesterol. We
believe that a combination of faulty information,
scientifically questionable studies, corporate greed,
and deceptive marketing has created one of the most
enduring and damaging myths in medical history:
that cholesterol causes heart disease. Many, many
millions of marketing dollars have perpetuated this
myth and kept the public narrowly focused on a
relatively minor participant in the development of
heart disease, and, in the process, generated nearly
$30 billion per year in sales of cholesterol-lowering
drugs. The real tragedy is that by putting so much
emphasis on the dangers of cholesterol, the actual
causes of heart diseaseinflammation, oxidation,
sugar, and stresshave been largely ignored.
Fat Phobia Falters
In the book, Dr. Bowden explains how, at the begin-
ning of his career, which started as a personal
trainer for a major New York City health club, he
had vigorously promoted the low-fat mantra to his
clients. Yet he soon found that clients did better
on diets with ample fat, similar to my own clinical
experience and research. We both read some of the
same studies that put additional doubts into our
minds and independently led us to believe that
lowering cholesterol and saturated-fat intake has
almost nothing to do with reducing heart disease
and definitely nothing to do with extending life.
Over the years we both learned from Mary Enig,
Ph.D., a leading lipid biochemist, that there was
little to fear from saturated fats in the diet. The real
fat felon in the diet, she correctly identified, is trans
fat, a processed unsaturated fat that may be the
most potent macronutrient for raising heart-disease
risk. Commonly found in fried and snack foods,
baked goods, and frozen dinners, trans fats are
highly inflammatory, and it is inflammation that is
the key cause of heart disease.
Science Sides with Us
Our book is a search for the truth, and I am confi-
dent that we found it. We cite major scientific
research that is routinely ignored by the medical
community, such as a recent study showing that
almost half of nearly 140,000 patients admitted to
hospitals for heart disease had LDL cholesterol levels
under 100mg/dL (the current mainstream therapeu-
tic target for LDL). You would think such a result
would cause some reflection. It didnt. Instead, the
researchers concluded that maybe an even lower
target is needed. Another inconvenient fact supported
by research is that a cholesterol level of 160 mg/dL or
less has been linked to depression, aggression, cere-
bral hemorrhages, and loss of sex drive!
Yet another fact lost on the multitude of mainstream
doctors prescribing cholesterol-lowering drugs is
that only a tiny minority of patients live longer by
taking such medications. We quote one of the worlds
top cholesterol debunkers, Uffe Ravnskov, M.D.,
Ph.D.: People with high cholesterol live the longest.
This statement seems so incredible that it takes a
long time to clear ones brainwashed mind to fully
understand its importance.
CHOLESTEROL EDUCATION OF THE RIGHT KIND
Heart, Health & Nutrition (ISSN# 1554-2467) is
published monthly by Healthy Directions, LLC 7811
Montrose Road, Potomac, MD 20854-3394. Telephone:
(800) 211-7643. Please call or write to P.O. Box 3264,
Lancaster, PA 17604-9915 if you have any questions
regarding your subscription. Postmaster: Send address
changes to Heart, Health & Nutrition, P.O. Box 3264,
Lancaster, PA 17604-9915. Periodicals postage at
Rockville, MD, and at additional mailing offices.
Author: Stephen Sinatra, MD, FACC, FACN, CNS
Managing Editor: Jane Hahn Research Editors: Martin
Zucker and Jan DeMarco-Sinatra, MSN, CNS, APRN.
Annual subscription $69.99. 2012 by Healthy
Directions, LLC. Photocopying, reproduction, or
quotation strictly prohibited without written permission
of the publisher. Bulk rates available upon request.
Heart, Health & Nutrition is dedicated to the
prevention and treatment of disease. Heart, Health
& Nutrition cannot offer medical services; Dr.
Sinatra encourages his readers to seek advice
from competent medical professionals for their
personal health needs. Dr. Sinatra will respond in
the newsletter to questions of general interest, and
urges you to write him at P.O. Box 3264, Lancaster,
PA 17604-9915, or send e-mail to feedback@drsinatra.
com. He maintains a website with additional
information and services at
www.drsinatra.com.
Dr. Sinatra is compensated on the sales of the
supplements he formulates for Healthy Directions.
He is not compensated for other companies products
that he recommends in this newsletter.
Heart, HealtH & Nutri ti oN September 2012 3
In our myth-busting book you will learn many
things that the National Cholesterol Education Pro-
gramor even your doctorwill likely never tell
you, such as:
The theory that fat and cholesterol cause heart
disease became widely accepted despite much
evidence to the contrary.
Todays widely held belief that the best diet for
preventing heart disease is low in saturated fat
and cholesterol is not supported by available
evidence from clinical trials.
The adoption of the cholesterol ideology by
mainstream organizations and the government
had a strong political lobbying component to it.
The concept of good and bad cholesterol
is outdated. It is far more important to know
whether you have a dominating pattern of small,
dense, inflammatory cholesterol particles than
to know your total amount of LDLs. Your total
cholesterol and LDL levels simply dont predict
heart disease very well.
Fat does raise LDL cholesterol, but it increases
the big, fluffy, harmless particles and reduces
the small, dense inflammatory LDLs that
actually contribute to heart disease.
The number one dietary contributor to heart
disease is sugar, a far greater danger to your
heart than fat. But the sugar industry has
suppressed damaging reports for years, similar
to the earlier behavior of Big Tobacco. The fact
is that sugar contributes to inflammation in
the artery walls. Reduce or eliminate sugar and
processed carbs in your diet and you knock down
triglycerides. High triglycerides are far more of a
danger for heart disease than high cholesterol.
The benefits of statin drugs have been widely
exaggerated, and any positive effect of these
drugs has to do with their anti-inflammatory
powers and absolutely nothing to do with their
ability to lower cholesterol. Moreover, their side
effects are grossly underreported. They should
not be prescribed to the elderly, the vast majority
of women, and never to children. The only people
who may benefit from statins are middle-aged
men with coronary artery disease.
Gaining Clarity on Cholesterol
Being a subscriber to this newsletter, youll already
be familiar with some of the books content. But
youll also learn a great deal more from it and get all
the cholesterol, fat, and inflammation facts you need
so that youll truly know what is hurting your heart
and what isnt. In addition, youll discover all the
steps you need to take to protect your heart health.
The book will be out November 1, 2012, but you can
pre-order it through your favorite book vendor. So
I encourage you to get it, share it with your family
and friends, and recommend it to your doctor. Quite
simply, we need to spread the word. Its the only way
to expose the tragic folly so many are making when
they bash fat and cholesterol.
A
t a recent medical conference workshop I gave
on metabolic cardiology, I asked if anybody knew
anything about D-ribose. Only two hands went up...
Clear evidence that D-ribose is the least known sup-
plement in my cherished awesome foursome.
D-ribose is made in the body for the sole purpose of
contributing to the mitochondrial production of ATP
(adenosine triphosphate), the bodys central cellular
fuel. This five-carbon sugar compound is a necessary
compo nent of ATP. Without it, there would be no
ATP. And without ATP, there would be no energy.
While the cells in your body make D-ribose, they
produce less of it as you age. Moreover, in the heart
as well as skeletal muscle tissue and the brain,
production of D-ribose is particularly pokey, only
supplying your day-to-day needs. That means there is
no D-ribose savings account to draw from. So, in the
face of chronic oxygen and blood-flow deficits as occur
in heart disease, the heart isnt able to compensate
and make enough D-ribose and it becomes part of an
overall cardiac muscle energy deficit.
This heart-ribose connection was first discovered
in the 1970s by a German physiologist who demon-
strated that energy-starved, ischemic hearts recov-
ered much quicker when patients received D-ribose.
Two decades later, he showed that D-ribose signifi-
cantly extended exercise tolerance for individuals
with severe coronary artery disease, delayed the
onset of angina, and contributed in a big way to
restoration of normal diastolic cardiac function.
Later, other researchers documented athletic perfor-
mance benefits from D-ribose supplementation.
Ive personally felt the performance benefits of
D-ribose, as adding it to my morning drink has
NUTRIENT SCIENCED-RIBOSE
4 Heart, HealtH & Nutri ti oN September 2012
N
atto is a traditional cheese-like
fermented soy product thats
popular in Japan. Its made by boiling
or steaming soybeans and then ferment-
ing them with the bacterium Bacillus
subtilis natto. While some people are not
fond of the sour aroma and nutty flavor of natto,
its probably one of the worlds healthiest foods.
Thats because it is a great source of two powerful
nutrients: nattokinase and vitamin K2.
Nattokinase helps to address one of the most
overlooked problems in the development of heart
disease and high blood pressure: hyperviscosity.
In plain words, that means thick, sick, sticky, and
inflamed blood that moves slowly through the
circulatory system.
Hyperviscosity feeds the inflammatory process
that damages arteries. The thicker your blood is,
the harder your cardiovascular system has to work
to squeeze the blood through your blood vessels.
Over time, this can cause arteries to become
calcified and less elastic. Sluggish blood flow also
increases the risk of clot formation. But the natto-
kinase in natto reinforces the actions of plasmin,
your bodys own enzyme that breaks down the
clotting agent called fibrin, thereby preventing
abnormal thickening of the blood.
Natto also offers a powerful protective effect
against osteoporosis because of its high vitamin
K2 content. Vitamin K2 helps move calcium into
the bones and, at the same time, protects the
cardiovascular system by helping to keep calcium
out of the arterial walls.
Natto Know-How
Because of nattos direct effect on blood viscosity,
those who are on blood thinners such as Coumadin
(warfarin) should not eat natto. But for others
trying naturally to improve circulation, lower blood
pressure, and build stronger bones, natto is truly
the super food of choice.
Sold at most Asian grocery stores, in some health
food stores, and online, natto is frequently served
with miso, cabbage, eggs, mixed in salads, or mixed
with seaweed. It is also often eaten as a condiment
with raw veggies, crackers, or spread on sandwiches.
Natto tends to be described as an acquired taste.
But one newsletter subscriber shared with me the
recipe below to make natto more palatable. I think
this traditional version of natto is quite delicious!
SINATRAS SUPER FOODS: NATTO
Natto
1 package natto, defrosted
1 free-range organic egg
3 Tbsp. low sodium soy sauce
1 tsp. sesame oil
tsp. mustard
1 scallion, finely chopped
1 cup jasmine rice, prepared according to package
directions
Combine egg (free-range, organic, and as fresh as possible), low sodium soy sauce, sesame oil, mustard,
and scallion. Combine natto with sauce mixture and spoon over hot rice. You can vary the proportions
of soy sauce, sesame, and mustard to suit your taste. Although the raw egg is traditional, you can omit
this if you have any concerns about eating raw eggs. Makes 4 servings.
Nutrition Facts (per serving): Calories 128, Fat 7 g, Sodium 475 mg, Carbohydrate 8 g, Dietary
Fiber 3 g, Protein 10 g
reduced the muscle soreness and cramping I expe-
rienced from my robust exercise program. And Ive
found that D-ribose adds major firepower to CoQ10,
L-carnitine, and magnesium to boost ATP production
in energy-starved cardiac cells. Thus, my awesome
threesome became the awesome foursome.
I recommend 5 g daily of D-ribose prior to activity for
individuals involved in moderate to intense exercise.
You can take it as a powder mixed with water or juice.
For mild heart failure and other forms of ischemic
disease, and peripheral vascular disease, take 10 g per
day. For someone awaiting a heart transplant or with
serious heart failure, dilated cardiomyopathy, frequent
angina, fibromyalgia, or neuromuscular disease, take
up to 15 g daily in divided doses with meals.
Reference
Zimmer HG. Regulation of and intervention into the oxidative pentose phosphate
pathway and adenine nucleotide metabolism in the heart. Mol Cell Biochem.
1996;160161:101109.
For more Sinatras Super Foods go to drsinatra.com
Heart, HealtH & Nutri ti oN September 2012 5
continued on page 6
Addressing the Energy Crisis
ofACS
In a recent report from a European cardiovascular
conference, an Irish psychologist described how a
loss of interest or pleasure in daily activities raises
the risk of death in patients with acute coronary
syndrome (ACS). In the world of psychology, such
a loss of interest and pleasure in life is referred
to as anhedonia. It generates somatic symptoms
such as fatigue and loss of appetite, and differs
from the cognitive symptoms generally associated
with depression, like feelings of worthlessness.
Anhedonia, explained Frank Doyle, Ph.D., of the
Royal College of Surgeons in Dublin, may better
predict long-term outcomes in patients who suffer
from acute chest pain caused by sudden, reduced
blood flow to the heart.
Dr. Doyle, who specializes in depression and psycho-
logical states of cardiovascular patients, came to his
conclusion after an eight-year follow-up with more
than 300 ACS patients. He found that depression
with anhedonia was a better predictor of mortality
than depression and anxiety.
Whats going on here, in my opinion, is an underly-
ing loss of energy. After heart attacks and emer-
gency room scares, I would often see patients exhibit
a physical lack of energy and, consequently, a lack
of interest in life. Patients would sit around and
not want to move. In many cases it went beyond
the depression that develops in people who become
aware that they are facing an increased risk of
death. They just didnt have any energy.
This is yet another area where the awesome four-
some of metabolic cardiology should be consid-
ered. When cardiovascular patients take CoQ10,
L-carnitine, magnesium, and D-ribose (see Nutrient
ScienceD-Ribose on page 3), they dont suffer from
this kind of energy deficit, since these valuable
HEART BEAT: WHATS GOOD, WHATS NOT, IN CARDIOLOGY
P
erhaps theres no more comforting comfort food than a thick slice of savory meatloaf. The problem is
that a lot of meatloaf recipes are high in calories, unhealthy fats, and sodium. But not this one. My
turkey meatloaf comes in at just 220 calories per serving and only 4.5 grams of fat and 170 milligrams
of sodium. On top of that, you get 3 grams of heart-healthy fiber with every serving. And because this
meal is low in carbohydrates, it wont produce a significant insulin response, thereby making it a great
dinner for those with type 2 diabetes, insulin resistance, or anyone bordering on metabolic syndrome.
This meatloaf is simply delicious and offers all the comfort without taking a toll on your heart health.
Preheat oven to 350 F. Spray a 9"x5" loaf pan with nonstick spray. Heat oil in a medium frying pan over
medium heat and saut onion and carrots until tender. In a large bowl, combine all ingredients except
topping. Pat turkey mixture into loaf pan. Mix topping ingredients and spread on turkey mixture. Bake
45 minutes. Makes 4 servings.
Nutrition Facts (per serving): Calories 220, Fat 4.5 g, Sodium 170 mg, Carbs 15 g, Fiber 3 g,
Protein 26 g
FIGHTING HEART DISEASEONE RECIPE AT A TIME
CARDIOLOGIST IN THE KITCHEN
Turkey Meatloaf
1 Tbsp. olive oil
1 medium onion, chopped
2 carrots, finely grated
1
1
/3 lbs. ground turkey breast
cup oatmeal
1 5.5 oz. can of low-sodium V8 juice
1 Tbsp. dried parsley
tsp. black pepper
tsp. garlic powder
1 large free-range organic egg, beaten
1 tsp. honey
2 tsp. Worcestershire sauce
1 Tbsp. Dijon mustard
tsp. dried marjoram
Topping:
cup unsalted tomato sauce
1 tsp. honey
For more heart-healthy recipes go to drsinatra.com
6 Heart, HealtH & Nutri ti oN September 2012
supplements boost the cellular energy of not just
heart cells, but of cells throughout the whole body.
People feel better and more energized. Their hearts
function better and they function better. They have
renewed interest in life.
There are obviously psychological issues such as
fear, anxiety, and depression to deal with after a
cardiovascular event, and they certainly need to be
addressed. Treating an accompanying energy defi-
cit with supplements like my awesome foursome,
however, can go a long way toward extending the
quality and quantity of life.
References
Doyle F, McGee H, et al. Anhedonia, but not other depressive or anxiety symptoms,
predicts 8-year mortality in persons with acute coronary syndrome. Paper pre-
sented at EuroPRevent 2012; May 35, 2012; Dublin, Ireland (No abstract.)
Sinatra DS, Sinatra ST, et al. The effects of coenzyme Q10 on locomotor and behav-
ioral activity in young and aged C57BL/6 mice. Biofactors. 2003;18(14):283287.
Green Light for Nonnutritive
Sweeteners
The American Heart Association (AHA)
and American Diabetes Association (ADA)
recently put together a panel of experts to see
whether existing medical research justifies a
greater utilization of nonnutritive sweeteners
(NNS) in foods and beverages that often use
blends of NNS and common caloric sweeten-
ers such as sugar, corn syrups, and fruit juice
concentrates. Such NNS alternatives include
very low-calorie, artificial, noncaloric, and
intense sweeteners like aspartame (Equal,
NutraSweet), acesulfame-K (Sweet One),
neotame, saccharin (SweetN Low), sucralose
(Splenda), and stevia.
The resulting position statement from this expert
panel offered a somewhat skewed message. It admit-
ted that there is insufficient data to determine
conclusively that using NNS to displace caloric
sweeteners would actually support current nutri-
tional guidelines to reduce added sugars or carbo-
hydrate intake in order to benefit body weight and
cardiometabolic risk factors. Yet, the organization
hedged its bets and concluded that evidence suggests
that when used judiciously, and within struc-
tured diets, NNS could facilitate reductions in
added sugars intake and promote beneficial weight
and health goals. The problem is, we live in an over-
weight society that has an insatiable sweet tooth
and little ability to follow any kind of judicious or
structured diet for long.
With the exception of stevia, which I like for those
who really need a sweet fix, I discourage the use
of sweeteners, nonnutritive or not. I certainly dont
like the idea of using more aspartame, which even
though regarded as safe by the FDA, has been
repeatedly linked to increased health risks, includ-
ing seizures and cancer. Aspartame has excitatory
effects on the nervous system. Over the years
patients have told me they experienced jittery nerves
and headaches after consuming aspartame. My own
mother, who was a diabetic, developed tremors and
weakness when she put aspartame in cereals and
tea. And sucralose, as I reported in September 2009,
has been associated with GI disturbances and, in
laboratory studies, even with weight gain.
I can understand the intent of the AHA and ADA
in striving for clarity and some remedial alterna-
tives for an overweight and over-sugared society. Its
quite a challenge. Yet, why cant they just say that
if you are sick, or dont want to get sick, you should
simply stay away from all kinds of added sweeteners
period? Maybe they are being realistic and I am not,
but I find it troubling that we have to placate a seri-
ously unhealthy lifestyle habit that is doing so much
damage to our health. All I can do is shake my head
and just keep advising you to avoid eating processed
food as much as possible.
Reference
Gardner C, et al. Nonnutritive sweeteners: current use and health perspectives :
a scientific statement from the American Heart Association and the American
Diabetes Association. Circulation. 2012;126(4):509519.
Western Fast Food Hurting
Eastern Health
The West is bringing the East to its knees,
but it has nothing to do with Western military
might. Instead, its the made in the USA fast
food diet that is exerting its unhealthy influence
on millions living in Eastern societies. As an avid
follower of nutritional research, I frequently see
reports about declining health in Asian countries
that are being inundated with Western fast food
chains and local copycat eateries.
The latest report involved a study of more than
50,000 Chinese Singaporean adults 45 to 74, who
had enrolled in a health database from 1993 to
1998. The researchers checked the medical records
of this population at the end of 2009 and found that
those individuals who ate more than two fast food
meals a week had, on average, a 27 percent greater
risk of developing diabetes and a 50 percent greater
risk of dying from coronary heart disease compared
to their peers who ate little or no fast food. Intake
included burgers, fries, pizza, fried chicken, hot dogs,
and the usual array of sodas.
Heart, HealtH & Nutri ti oN September 2012 7
The background to all of this
is that prosperity is on the rise
throughout Asias developing
countries. And along with the
economic boom are rising trends
in obesity, diabetes, high blood
pressure, cardiovascular disease,
and cancer. Growing middle and
wealthy classes, particularly in
the cities, are increasing their
spending on food outside of the
home, eating less healthy tradi-
tional foods, and engaging in less
physical activity.
According to the US-China
Institute at the University of
Southern California, China
today has five times more obese
people than five years ago and
a staggering 380 million have
weight problems, which is more
than the entire U.S. popula-
tion. In addition to having
more cars, city streets are also
now lined with fast food restau-
rants, the ubiquity of which is
one cause of obesity in China,
the Institute wrote in a 2011
report. It is easy to find a
local McDonalds, Pizza Hut, or
Starbucks ready to serve up fast
food to the masses.
Yum! Brands, the parent company
of KFC, Pizza Hut, and Taco Bell,
is doing a sizzling business in the
emerging world, and particularly
in China, which it regards as the
best restaurant growth opportu-
nity of the 21
st
century. It oper-
ates more than several-thousand
of its famous brand restaurants
there, which, the company says,
generates the best unit returns
in its business. Best business
returns, maybe. Best health
returns, hardly.
References
Odegaard AO, et al. Western-style fast food intake
and cardiometabolic risk in an Eastern country.
Circulation. 2012;126(2):182188.
Patterson S. Obesity in China: Waistlines are expand-
ing twice as fast as GDP. US-China Institute, pub-
lished online in 2011.
2011 Yum! Brands, Inc Annual Report.
T
hese days,
doctors
have myriad
diagnostic tools at their dis-
posal to help them quickly and
effectively treat their patients.
But not every medical screen-
ing test is totally worthwhile,
as I reported in this recent
blog post:
The U.S. Preventive Services
Task Force has put an end to
all of the waffling over the
value of the PSA (prostate-
specific antigen) test used
to screen men for prostate
cancer. They gave its accu-
racy a dismal grade of a D
and suggested it should no
longer be used as a routine
screening test in men.
The Task Force cited large
epidemiological stud-
ies showing a combina-
tion of PSA screening and
early treatment of prostate
cancer saves only about
one life for every 1,000 men
screened. For many others,
an elevated PSA score results
in an unnecessary prostate
biopsy and treatments that
can cause impotency and
incontinence.
Additional Thoughts
When all is said and done, Im
not ready to throw the PSA test
under the bus, since a major
spike in PSAsay an annual
reading goes from 1 to 5 or 6
can suggest benign prostate
enlargement, infection, or even
cancer and, therefore, deserves
an evaluation by a urologist.
That said, instead of focusing
so much on screening, I wish
doctors would spend more time
discussing the key nutrients
every man needs to protect pros-
tate health, which include:
Pomegranate: Drink four to
eight ounces of pomegranate
juice daily or take 200 to 300
mg in the form of a pomegran-
ate supplement.
Zinc: Take 20 mg per day.
Vitamin D: Get 1,000 to 2,000
IU every day.
Vitamins B6, B12, and Folic
Acid: Try 20 mg of B6, 100 to
200 mcg of B12, and 400 to 800
mcg of folic acid daily.
Vitamin C: Aim for at least 400
mg every day.
Lycopene: Eat lycopene-rich
foods like tomatoes and water-
melon often and supplement
with 2 to 10 mg per day.
Vitamin E & Selenium: Take
300 IU of vitamin E with mixed
tocopherols and 250 mcg of sele-
nium daily.
Dr. Sinatras
HEALTHY HEART BLOG
Join the Conversation
You and your fellow readers are a never-ending source of inspiration
to me and to each other. I encourage you to read more of my blogs,
ask me a question, or post your thoughts at drsinatra.com.
8 Heart, HealtH & Nutri ti oN September 2012
Keep those questions coming! Send an email to feedback@drsinatra.com,
or write to me at Dr.Sinatra Feedback, P.O. Box 3264, Lancaster,
PA 17604-9915.
In Search of Cooking Tips
Because food selection and preparation seem to be so important for
maintaining a healthy heart, Im interested in finding out more about
heart-healthy cooking and the top foods and meals for cardiovascular
well-being. Where can I find such advice?
Dr. Sinatra replies: Ive always put a lot of emphasis on food selection
and healthy cooking, so I write about these subjects often here in this
newsletter and on my website drsinatra.com, which also offers over
100 of my favorite heart-healthy recipes. In addition, Ive created some
lively cooking videos with one of my sons, who happens to be a chef
and graduate of the Cordon Bleu School of Cooking. I think youll enjoy
viewing them and get a lot of helpful meal preparation tips. Just go to
heartmdinstitute.com.
In particular, I believe the fruit and vegetable antioxidant smoothie that I
blend and drink for breakfast every morning is the single most important
component in my own heart-healthy diet. Its a high-ber, nutrient-rich
powerhouse. You can get the recipe for this smoothie, and for other
foods as well, by going to heartmdinstitute.com/recipes.
Heres your September issue!
Periodicals
postage
paid at
Rockville, MD
and at additional
mailing offices
P.O. Box 3264
Lancaster, PA 17604-9915
Address Service Requested
Dr. Stephen Sinatras
Q & A Session
INSIDE THIS ISSUE:
Dear Reader: The
Importance of HRV . . . . . .1
Cholesterol Education of
the Right Kind . . . . . . . . . . .2
Nutrient Science
D-Ribose . . . . . . . . . . . . . . . .3
Sinatras Super Foods:
Natto . . . . . . . . . . . . . . . . . . . .4
Heart Beat: Energy & ACS;
Sweeteners Debate; Fast
Food Diet Takes Toll . . . . .5
Cardiologist in the Kitchen:
Turkey Meatloaf . . . . . . . . .5
Dr. Sinatras Healthy Heart
Blog: PSA Screening vs.
Prevention . . . . . . . . . . . . . .7
Volume 18, Number 9
T
o array a mans will
against his sickness
is the supreme art of
medicine.
Henry Ward Beecher

See more Q & As online at drsinatra.com

in the Q & A Archive.
See more Q & As online at drsinatra.com