At the present time we are in the early stages of a growing problem within the athletic community and during the last 20 years there has been an alarming increase in the number of cardiovascular deaths among professional, Olympic, collegiate, high school and serious recreational athletes. When athletes as young as 13 years old are dying from hypertrophic- cardiomyopathy (HCM), we need to get serious about our investigation. As the data continues to accumulate it is becoming obvious that no athlete regardless of their age, gender, size, or level of athletic prowess is immune from the negative impact related to the following five factors.

    1. Nutrient deficient foods that contain chemical additives.

    2. Environmental toxins that permeate our food supply, water and air.

    3. The negative impact on health of electromagnetic pollution.

    4. The stress damage of exercise.

    5. Society’s overuse of prescription drugs and medical technology for treating all
        health and injury related problems for athletes.

    Unfortunately, the recommendations that are emerging from the sports medicine community regarding cardiovascular disease reflect the limited treatment perspective of the American Medical System (AMS), the American Heart Association and their pharmaceutical and medical technology partners. As a result, all serious athletes will continue to be at risk for premature mortality from cardiovascular disease until the five factors presented above are seriously included in this important epidemiological detective story.

    To emphasize the magnitude of this problem, the Orange County Register (CA) newspaper published an article on September 25, 2005 entitled “Heart of the Matter,” that chronicled the death of 14 young athletes who recently died from heart disease and 10 of the 14 deaths were male athletes who were under 21 years of age. The youngest was just 13! Research reports have shown that over 50 percent of the athletes who suffer sudden cardiac death have a condition called hypertrophic cardiomyopathy (HCM), which is the pathological enlargement of the heart. Doctors within the AMS and specifically within the sports medicine community are at a loss to explain what causes this abnormal heart condition beyond a possible hereditary factor, exercise stress and excessive dietary cholesterol. Unfortunately, there is no national data base that collects athlete-specific morbidity and mortality. As a result, the emerging epidemic of cardiac mortality among serious athletes has existed under the radar of medical orthodoxy and this fact will result in increased heart-related deaths in the absence of pro-active healthcare programs based on nutritional science and clinical ecology.

    After the death last year of Jason Collier at age 28, who was the NBA Atlanta Hawks all-star center, a panel discussion on the sports news program ESPN began to address this alarming trend. The sports medicine doctor on this program blamed the development of HCM on genetic factors, stressing family history as an important determinant of this disease. When pressed for recommendations to prevent this increasingly fatal heart deformity, he said better pre-season medical screening programs should be instituted and possibly prescribing cholesterol lowering drugs (Lipitor, Zocor, Crestor, etc.) to all athletes who weigh over 200 pounds. Unfortunately, these recommendations will do little to stop the emerging epidemic of cardiovascular disease and premature death among serious athletes. The reason for this is the lack of attention to the nutritional health of the athlete and the health-negative effects of the five factors presented above. Currently in sports medicine there are three primary protocols for determining an athlete’s fitness to participate in sports and to provide treatment if HCM or other heart related problems are diagnosed. They include;(1) Preparticipation Physical Examinations (PPE), (2) Cardiac and cholesterol lowering drugs, and (3) Implantable Cardioverter Defibrillators (ICD).


1. Preparticipation Physical Examinations (PPE)
    Although preparticipation screening of all athletes is important, many of the serious problems relating to cardiac abnormalities can not be detected by the current testing methods. Katherine Dec, M.D. is a member of the American Medical Society for Sports Medicine’s board of directors who recently addressed this issue; “This is a very touchy subject because we all wish these tragedies could be prevented, but the reality is that even with more comprehensive and costly testing, the small amount of findings they offer aren’t that conclusive.”

    The death of San Francisco 49ers lineman Thomas Herrion emphasizes this point. After Herrion’s death in August of 2005 at age 23, the coroner concluded that he suffered from premature coronary heart disease which was the cause of death. Dr. John DiFlori, an associate professor and chief of the division of sports medicine at UCLA helped to create guidelines for physicians PPE heart exams. Dr. DiFlori commented on Herrion’s death, “The blockage in the player’s heart would have been undetectable under any measure, even under the most extensive screening because Herrion apparently had not complained of heart problems and his fitness as a football player suggested he would have done well in a stress test.”


2. Cardiac and Cholesterol-Lowering Drugs
    Cardiac drugs can be critically important in the management of non-fatal myocardial infarction, serious arrhythmias, resuscitated cardiac arrest, recurrent severe myocardial ischemia, and other acute and chronic heart-related problems. However effective these drugs are in managing crisis situations, they do little to help restore the health of the cardiovascular system or its functional capacity. It has been this author’s experience over the last 25 years working with professional and other classes of athletes that physicians within sports medicine almost never consider the nutritional status of the athlete regarding the pathogenesis of heart disease or other chronic degenerative diseases. In addition, the nutritional constitution of the athlete is disregarded in the treatment of both injury and illness which will negatively impact all athletes facing recovery from injury, surgery or illness.

    An example of this treatment myopia was presented by Sheldon Hendler, M.D., Ph.D., professor at University of California, San Diego School of Medicine and nutrition advisor to the U.S. Olympic Committee. Dr. Hendler cited a study that demonstrated the value of the essential nutrient coenzyme Q10 (CoQ10) in the treatment of heart failure. This study in 1985 involved the Methodist Hospital in Indianapolis and the Institute for Bio-Medical Research at the University of Texas. Heart failure patients were treated with CoQ10 with measurable success and the researchers reported that 91% of these patients showed marked improvement. The benefits of CoQ10 included supporting the pumping capacity of the heart, increased energy production in heart-muscle cells, and a significant reduction in the major side effects associated with conventional heart failure drugs.

    There are literally hundreds of studies in the medical literature that demonstrate the value of essential nutrients (particularly vitamin E, vitamin C, and coenzyme Q10) in supporting cardiovascular health. Vitamin E has also been extensively studied in its multidimensional role as an essential nutrient in facilitating human health. It is a powerful antioxidant which emphasizes its importance in clinical medicine for supporting the health of the cardiovascular system. Vitamin E’s primary role in human biochemistry is to mitigate the destructive effects of free radicals that are implicated in almost all chronic degenerative diseases. It also helps prevent the oxidation of both vitamins A and C, which are nutritional antioxidants that act synergistically with vitamin E.

    In 1996 the Cambridge Heart Anti-Oxidant Study (CHAOS) proved the significant value vitamin E has in lowering some destructive forms of cholesterol which have been implicated in heart disease. This study was published in the British medical journal Lancet. It involved 2002 patients with angiographically proven coronary atherosclerosis and was a double-blind, placebo-controlled trial that covered the median time period of 510 days. The study group was given up to 800 IU of vitamin E (alpha-tocopherol) per day. This study successfully demonstrated the value of vitamin E supplementation. There was a 66 percent reduction of non-fatal heart attacks, and a 36 percent reduction in the combined risks of cardiovascular death and non-fatal heart attack. The primary action of vitamin E, which works synergistically with other nutritional antioxidants like vitamin C, coenzyme Q10, selenium and zinc, is to mitigate free radicals allowing cellular biochemistry to optimize it functions without being damaged by free radicals and other chemicals like reactive oxygen toxic species (ROTS).

    Vitamin C deficiency was shown to be one of the key risk factors in the pathogenesis of cardiovascular disease in the early 1940s. A study published in 1941 by Canadian cardiologist, J.C. Patterson, found that more than 80 percent of heart disease patients had vitamin C deficiency as a major risk factor. Another study published in 1948 by two American doctors, Trimmer and Lundy, found that 70 percent of their patients with coronary artery disease had very low blood vitamin C levels. Dr. Willis, another Canadian physician, conducted a study in 1954 which showed that supplementing the diet with vitamin C could support the integrity of blood vessels which in turn improved the long term prognosis for the patient. The study group received 1,500 milligrams of vitamin C per day and the control group received no supplement. In 1955 American scientists Chope and Bresloe published a study in the Journal of Public Health which showed that vitamin C supplementation was the most important factor in supporting cardiovascular health.

    An epidemiological study published in 1992 by Dr. James Enstrom and a group from UCLA School of Medicine investigated the vitamin intake of more than 11,000 Americans over a ten year period. In this government sponsored study the subjects who took at least 300 milligrams of vitamin C per day from their diet or from nutritional supplements were able to support their heart health. This study also showed that increased vitamin C consumption was associated with an increase in life expectancy of up to six years.

    The current AMS recommendation for the use of cholesterol lowering drugs to help mitigate the emerging epidemic of cardiac mortality among serious athletes is ill advised. Cholesterol is such an important compound that every cell in the human body can make it because it serves critically important functions, including its use as a structural component in tissue and its role in the development of hormones, particularly the sex hormones testosterone and estrogen. During the last ten years cholesterol was also found to be a powerful antioxidant that protects the body from damage caused by free radicals and toxic chemicals. Since most Americans have chronic deficiencies of important dietary antioxidants like vitamins C, vitamin E, coenzyme Q10, zinc and selenium, cholesterol serves as the only endogenous (made within the body) antioxidant that humans can manufacture to protect themselves when dietary antioxidants are deficient. Scientific proof that lowering cholesterol levels in the blood does not reduce heart disease was presented by Dr. Richard Passwater in 1977. He reviewed 17 international clinical trials that started with the Sr. Mary’s Hospital study in 1965 and ranged thought the Honolulu-Japanese Study in 1975. These studies showed that cholesterol was incidental to heart disease and not its primary cause. In addition, Dr. Passwater commented on cholesterol lowering drugs, “The Coronary Drug Project in 1974 showed that drugs that reduced blood cholesterol were of no value in preventing heart disease.”

    MR. FIT was a landmark study that also questioned the direct link of cholesterol with heart disease. The Multiple Risk Factor Intervention Trial, or MR.FIT, ranks as one of the largest and most demanding clinical trials ever performed on a group of human subjects. This study lasted more than 10 years and involved 28 medical centers across the United States. The cost exceeded $115 million and involved the evaluation of 361,662 men just to get 12,866 perfect candidates for this study, which were divided into two groups. They used the risk factor equations developed in the earlier Framingham Study (1970) to limit the experiment to the risk factors they though they could control and would provide the greatest benefit to the American people at the conclusion of the trial if it was successful. The Special Intervention group (6,428 men) had programs designed to reduce three risk factors that were the focus of this study, including; (1) lowering cholesterol levels through dietary modification, (2) controlling high blood pressure with drugs, and (3) stop smoking. The Usual Care group (6,438 men) were on their own and received no special treatment, serving as the control group for the study. The Special Intervention group had impressive results from their dietary modification program and cut their intake of cholesterol by 42 percent, lowering their saturated fat by 28 percent and reduced total calories by 21 percent. Sadly, these significant changes in diet had little effect on cholesterol levels in the blood, reducing it by only 5 percent by one analytical method and 6.7 percent by another.

    The author’s study of mortality data taken from the Major League Baseball Hall of Fame showed that this elite group of athletes born in the modern era of professional baseball (after the year 1900) had a mortality experience between 62 and 72 years. The 12 acknowledged superstars during this era in MLB had the shortest average life of 62 years. The median life lived was 72 years, or about 19 percent below what should be expected for this group. Exercise stress related to frequent vigorous training and competition is responsible for this significant reduction in occupational life expectancy. The author has been defining a new sports disease “Exercise Induced Pathology (EIP)” for the last five years. The author is convinced that EIP is responsible for over 80 percent of the stress damage to an athlete’s body that contributes significantly to the expression of heart disease as well as other chronic degenerative diseases like, multiple sclerosis, and ALS or Lou Gehrig’s disease. Space limitations in this report prohibit a complete discussion on these factors which will be presented in a future edition of NutriNews.


Exercise Induced Pathology Factors
    1. Free Radicals (Exercise produces millions of these destructive elements which
        damage the heart).