Introduction
Heart disease is the number one Killer in the United States.

Ischemic Heart Disease – Lack of blood to heart muscles.

Myocardial Infarction or "heart Attack" is the sudden closure of the blood vessel supplying a portion of the Heart Muscle.

The Heart is a muscle for pumping blood. There are 4 to 5 major arteries supplying the heart. If an artery is constricted we call it ischemic. If an artery closes off then the muscle supplied by that artery dies. We call this a Myocardial infarction. An Artery is a blood vessel that caries the blood from the Heart.

One half of the people who suffer a Myocardial infarction die before the get medical help.

Causes of Ischemic Heart Disease
1. Smoking
2. High Cholesterol
3. Lack of Estrogen i.e. being male.
4. Excess Homocystine
5. Hypertension
6. Diabetes
7. Obesity
8. Lack of fruit and vegetables
9. Lack of dietary fiber

Physiology
          The Coronary Artery is the area of Concern. These are the blood vessels transporting oxygenated blood from the pumping chamber of the heart to the heart muscle.
          There are muscle in the walls of the arteries. They relax and constrict to regulate a constant pressure and blood supply.

Steps to
1. Inner wall becomes irritated.
     Caused by; 1. Curves,  2. HTN,  3. Sticky blood cell,   4. Free Radical damage
2. Inflammatory cell –Macrophages and other white blood cells invade into the artery wall/ muscular area.
3. Oxygenated Low density Lipoproteins (transporters of Fat) care Cholesterol into the Artery walls.
4. The Inflammatory cells in the Artery wall ingests the Cholesterol causing swelling and constriction of the Artery.
5. The narrowed artery creates more turbulence and pressure causing more irritation of the inner wall.
6. The irregular narrowed artery attracts clotting factors and platelets. This can form a clot causing a MI.

Oxidation and free radicals Explained
Oxidation and reduction reaction are the basis of energy transfer and heat. This is the basis of life. The intermediate forms of the chemical reactions consist of free radicals (molecules with an unpaired electron, which rapidly reacts with other molecules). Life would not exist without these chemical reactions.

When an atom or a molecule combines, or forms a chemical bond, with oxygen, it tends to give up electrons to the oxygen. Oxidation is defined as any reaction involving a loss of electrons

Antioxidant slows oxidation. They stop unwanted chemical reactions. Antioxidants are used as food additives to retard spoilage and color changes.

Intervention
1. Stop Smoking – Causes artery constriction and clotting disorders
2. Lower LDL - Dietary intervention
3. Raise HDL - Exercise, Stop smoking, Lose weight and ?estrogen
4. Prevent oxidation of LDL - plenty 5+ servings of fruits and vegetable daily
5. Control blood sugar and insulin levels;
There is a direct toxic effect of Glucose (at high levels) on the cells it contacts. This in theory may damage the arteries directly. High insulin level raises the cholesterol. And third the excessive Glucose level decrease the immunity to bacterial.
6. Control BP: decrease weight, increase fruit and vegetables, increase water, decrease sugar and salt, stop smoking, stop alcohol, stop harmful stress (anger, resentment)
7. Check and treat homocystine level if elevated. (folate , B-vitamins)
8. Improve General Health- This will improve immunity and decrease likelihood of Clamydia pneumonia bacterial invasion of damage blood vessel.

Cholesterol reviewed
Cholesterol is an odorless, soft, waxy substance. The body needs cholesterol, it is component of cell membranes,  for the production of many hormones, vitamin D, and bile acids (which are important for the absorption of fat). Cholesterol is present in all parts of the body, including the brain and nervous system, muscle, skin, liver, intestines, heart, and skeleton.

Since fats do not dissolve in water, cholesterol (and other fats) travel in the blood in packages of phospholipids and protein called lipoproteins. All lipoproteins are formed in the liver and carry cholesterol through the body. Blood cholesterol packaged in low density lipoproteins (LDLs) is transported from the liver to other parts of the body where it can be used. LDL is sometimes called "bad cholesterol" although it is not bad in proper levels.

Cholesterol is also carried in high density lipoproteins (HDLs). HDLs carry cholesterol back to the liver for processing or removal from the body. HDLs  remove cholesterol from the blood, preventing the accumulation of cholesterol in the walls of the arteries. Thus they are often referred to as "good cholesterol."

The cholesterol panel will include.
  1. LDL-cholesterol level.
  2. HDL cholesterol level.
  3. Triglyceride level.

A ratio of Lipoprotiens is helpful in determining risk of disease. Cholesterol ratio is actually just the total cholesterol or LDL-cholesterol divided by the HDL-cholesterol. For example, if a person's LDL-cholesterol level is 140 mg/dl and his or her HDL-cholesterol level is 35 mg/dl, the individual's cholesterol ratio is 140/35, or 4.

A  person's LDL and HDL levels provide more information on the risk of developing coronary heart disease than just the total blood cholesterol level.

A high LDL-cholesterol level or a low HDL-cholesterol level puts an individual at increased risk.

LDL-Cholesterol Levels: What Do They Mean?
  Desirable: Less than 130 mg/dl
  Borderline: High Risk: 130 mg/dl to 159 mg/dl
  High Risk: 160 mg/dl and above

If an individual's LDL-cholesterol level is in the desirable category, he or she is considered to be at an acceptable level of risk.

HDL-Cholesterol Levels: What Do They Mean?

A HDL-cholesterol level lower than 35 mg/dl is considered too low.  Quitting smoking, losing weight, and becoming physically active may help raise the HDL-cholesterol level.

Diet and Lipid
Avoid Saturated fats- animal fats, butter fats, palm oil, coconut oil.
Avoid hydrogenated Vegetable oil. Same effect as saturated fats.
Unrefined oils are best.  It still contain antioxidents, fat soluble vitamin and other phytochemical. Virgin Olive Oil is the only commonly available unrefined oil.
Avoid Cholesterol – in animal products only
Avocados need not be avoided.
The oil in nut is generally good, peanut is the lest beneficial but still better than animal source
Limit refined carbohydrates i.e sugar deserts white bread.
Include dark green vegetable in diet
Eat freely of fruit and vegetable with few exception i.e. sweet corn can be over used.
Eat freely of whole grains and legumes.

Suggestions to start
Stop Smoking
Begin walking
Be sure and eat 5 servings of fruits and vegetable daily
Drink 8 glasses of water daily.

THERAPEUTIC DIET FOR ELEVATED BLOOD LIPIDS

(CHOLESTEROL AND TRIGLYCERIDES)

BREAKFAST: Choose two (2) foods from the GRAIN category
choose one (1) food from the FAT category
choose two (2) foods from the FRUIT category

LUNCH: Choose two (2) foods from the VEGETABLE category
choose one (1) food from the RAW FOOD category
choose one (1) food from the GRAIN category
choose one (1) food from the FAT category
choose one (1) item from the THERAPEUTIC category (as per order)

DINNER: Choose two (2) foods from the FRUIT category
choose one (1) food from the GRAIN category
choose one (1) food from the FAT category

ADDITIONAL-DIRECTIONS: ____________________________________________________________________________________________

THERAPEUTIC DIET FOR ELEVATED BLOOD LIPIDS

(CHOLESTEROL AND TRIGLYCERIDES)

BEVERAGES (1 C= 1 serv.) EXTRAS

milk (see FATS) non-sugar jam
fruit juice, tomato juice,carrot juice meatless spaghetti sauce
decaf coffee (non-dairy creamer) 3 x/ week: 6 oz. white meat at BR, or LNCH
cereal coffee
herbal tea
decaf tea

 Recipe

NUT CREAM

basic recipe: blend in blender
1 C cashews (raw, unsalted)
3/4 C water (add more as needed)
1/4 tsp. salt

VARIATIONS: (can substitute sunflower seeds for cashews, in all but sweet cream)
for sweet cream, add 1 tsp. vanilla, 1 T honey or maple syrup, or 8 dates chopped
for salad dressing, add 1/4 c lemon juice, salt to taste, 1/4 tsp. garlic powder, 1/4 tsp. onion powder
for gravy, add mushrooms, onion and garlic to taste, salt to taste, soy sauce (opt.)