How is your heart health? Many people fear a heart attack, however heart disease is often a lifestyle disease that is avoidable.
Known risk factors, other than smoking and excess drinking, include being diabetic, having high cholesterol and being overweight.
Today let’s look at the dietary changes you might start to make right away to protect your health and that of your loved ones. The good news is that a number of large studies point to simple diet and lifestyle change being key when it comes to prevention. The INTERHEART study, published in the Lancet in 2004, followed 30,000 people in 52 countries. Researchers found that lifestyle changes could prevent at least 90 percent of all heart disease1.
Meanwhile, in 2009, the EPIC study looked the effect of four simple behaviours on 23,000 people. They included: not smoking, exercising 3.5 hours a week, eating a healthy diet, and maintaining a healthy weight. Sticking to these four behaviours alone appeared to prevent 93% of cases of diabetes, 81% of cases of heart attacks and 50% of cases of strokes2.
What is the best strategy for heart health?
Everyone is individual, and there is no official ‘single diet’ that we should all eat. But if there were, then eating to address the essence of the problem – carrying excess weight and having a highly inflammatory internal environment – is key to improving overall health, and heart health in particular.
Before we look at some of the answers, I want to say something about fat because chances are, if you’ve heard one thing about staving off a heart attack, it’s to ‘cut back on fat’, especially the saturated kind.
Dietary fat actually turns off fat production in your liver. In addition, unlike carbohydrates and protein, dietary fat does not trigger your pancreas to secrete insulin. And insulin is the major fat storage hormone in the body. It is worth considering that the success of some low-fat dietary models in weight loss may also be due to the simultaneous reduction of sugar, refined carbohydrates and processed foods.
Having said this, there is one type of fat that we should all avoid – trans fats. This is a highly-processed fat that food manufacturers add to food to improve shelf life and the mouthfeel of products. One study actually found that the risk of coronary heart disease (CHD) doubled with each 2 percent increase in calories from trans fats3, while another researcher concluded: ‘On a per-calorie basis, trans fats appear to increase the risk of CHD more than any other micronutrient’4.
Are any foods bad for my heart?
I know you’ve heard it from me before, but as with so many other health issues, the real villains in the piece are refined grains and sugar. During processing, refined grains are stripped of the bran and germ, the two parts of the grain kernel that contain a wealth of nutrients. The final product is starch with next to no nutritional value, providing little more than carbohydrates and calories. A wide variety of foods contain refined grain, including white bread, pasta and rice, cakes, biscuits, crackers, and bagels. Unfortunately, these foods make up a large percentage of the modern Western diet and may be linked to a higher risk of heart disease. One study from China found that a higher carbohydrate intake, mainly from refined grains, was associated with an increased risk of CHD among 117,366 adults5.
Sugar is one of the main culprits of heart disease. Added sugars from foods like sweets, desserts, juice and soft drinks can spike blood sugar levels, damaging the blood vessels, overloading the liver and increasing the risk of heart disease.
Interestingly, a study from Harvard School of Public Health actually found that participants who drank the highest amount of sugar-sweetened beverages had a 20 percent higher relative risk of developing coronary heart disease than those who drank the lowest amount6.
So which foods should I eat for good heart health?
A lower carbohydrate diet is recommended to balance blood sugar and therefore reduce insulin and blood glucose levels. Elevated insulin is a major risk factor for heart disease and promotes inflammation. It’s also likely that you will lose weight on a lower carbohydrate, blood sugar balancing diet. This in itself will reduce the risk for many chronic diseases, including heart disease and high blood pressure.
- Protein: Eat a source of protein at every meal and snack. This can be fish, seafood, poultry, meat, nuts, seeds, tofu, eggs. Most people eat enough meat already, but not enough fish or vegetable protein. See if you can bring in more fish and more vegetable sources of protein over the week. Ideally, eat two to three vegetable-based protein meals weekly. Replace animal-based protein meals with lentils, legumes, tofu, quinoa or nuts and seeds, for example. If you’re a fish eater, opt for in wild-caught fish (ideally oily ones such as mackerel, sardines and wild salmon which are rich in omega-3 fatty acids) twice a week.
- Fruit and veg: Get plenty of fruit and veg but focus specifically on eating vegetables that grow above the ground and fruit that can be grown in this country. These foods naturally contain either less sugar or lower amounts of carbohydrates. At each meal, aim to cover at least half of your plate with these vegetables. In addition, aim for 7 different varieties a day with ideally 5 coming from vegetables. And over the course of a week, aim to eat all different colours – ‘eat the rainbow’ to enjoy a diverse intake of phytonutrients.
- Fibre: Fibre is a great addition to your diet, especially soluble fibre found in oats, lentils, split peas, flaxseed, citrus fruits and apples. All of those are heart-healthy choices. For insoluble fibre, eat nuts and whole grains.
- Fat: Other than trans-fats mentioned above, fats are essential for good health. Get your fat from avocados, olives, oily fish, extra virgin olive oil, nuts and seeds.
Food groups to be wary of…
- Carbohydrates: Think carefully about the quality (what kind) and the quantity (how much) of starchy carbs like bread, pasta, cereals, potato and rice that you eat. Focus on wholemeal instead of white, sweet potatoes rather than regular white potatoes, basmati or brown rice over white long grain. You can also try introducing a few ‘faux carbs’ to your diet like cauliflower or broccoli rice or mash, courgetti (courgette spiralised into noodle shapes), butternut squash waffles, and so on.
And those to avoid for better heart health
- Processed meat: In recent years there have been numerous studies connecting processed meats, like hot dogs, salami and tinned meat, to a range of adverse effects on health. Not surprisingly, processed meats can also negatively affect heart health, so they are something to enjoy infrequently.
- Vegetable oils: These can be very damaging for heart health. Recent studies show that oils like rapeseed are not helpful (even though the supermarkets are brimming with these options). In fact, the linoleic acid they contain has been linked to cardiovascular disease and cancer.
- Sugar: Remove as much sugar as you can from your diet as this is the real villain in the tale. That means saving sugary treats for high days and holidays and, most of the time, ditching breakfast cereals, cakes, biscuits, pastries, and so on. Also, check the labels of jarred sauces and processed foods, where sugar often lurks.
- Soft drinks: Avoid fizzy soft drinks. Eliminating soft drinks is one of the best things that everyone can do for their heart. Besides being laden with controversial chemicals and unhealthy ingredients, soft drinks are also brimming with added sugars.
A word on salt…
Salt has long been considered a major contributor to high blood pressure. The high salt content of processed foods and junk food has been given at least some of the blame for the high incidence of hypertension and heart disease. However, even this recommendation has recently come under scrutiny and may change in the future.
Recent research has cast doubt on the role of salt intake in hypertension7. However, the WHO and most countries still recommend less than 2g sodium/day, equivalent to <5g/day salt in adults, which is equivalent to 1 teaspoon. Until this changes, we should stick to the guidelines, yet recognise that other factors also contribute to high blood pressure (such as sugars). Where possible choose natural sea salt, which is rich in trace minerals, while avoiding salty snacks that often contain added ingredients as well as a hefty dose of salt.
The healthiest forms of sea salt are the least refined with no added preservatives. Pink Himalayan salt is widely regarded as the ultimate mineral-rich seasoning and the purest of the natural salt family. If you’re looking for extra health benefits in your salt, sea salt is plentiful in trace minerals. It delivers many of the same nutritional compounds that make seaweed so nutritious. The healthiest forms of sea salt are the least refined with no added preservatives. This may mean you might find some clumping in the fine variety.
Do you notice a trend in my diet tips? What’s to focus on is real food, while decreasing the processed options that food manufacturers and marketing companies like to tell us are ok to eat. Truly, your body doesn’t know what’s going on when you give it heavily-processed or chemically-altered foods.
As well as supporting your long term health, eating this way will also help with energy levels in the short term, providing your body with a steady supply of energy through the day, rather than a high-octane rollercoaster of energy spikes and troughs.
Making changes to your diet as well as regularly taking time to de-stress, move your body and prioritise sleep is not always easy to do on your own. It is always helpful to have someone on your side helping you fit what you already know about eating well into your life and keeping you motivated to follow your plan for long enough that you really see a shift in your health.
If you feel you are looking to make changes to your diet and lifestyle to prioritise your health, then please do book in for a health review via my homepage. I offer a free, no-obligation, 30-minute phone call to everyone who wants to find out more and would love to chat to you.
1. Yusuf S. et al. (2004) Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet, 364(9438):937-52. doi: 10.1016/S0140-6736(04)17018-9
2. Ford E.S. et al. (2009). Healthy living is the best revenge: findings from the European Prospective Investigation Into Cancer and Nutrition-Potsdam study. Arch Intern Med., 169(15):1355-62. doi: 10.1001/archinternmed.2009.237
3. Iqbal M. P. (2014) Trans fatty acids – A risk factor for cardiovascular disease. Pakistan Journal of Medical Sciences, 30(1), 194–197. doi: 10.12669/pjms.301.4525
4. Mozaffarian D. et al. (2006) Trans fatty acids and cardiovascular disease. N Engl J Med, 354(15):1601-13. doi: 10.1056/NEJMra054035
5. Yu D. et al. (2013) Dietary carbohydrates, refined grains, glycemic load, and risk of coronary heart disease in Chinese adults. Am J Epidemiol., 15;178(10):1542-9. doi: 10.1093/aje/kwt178
6. de Koning L. et al. (2012) Sweetened beverage consumption, incident coronary heart disease, and biomarkers of risk in men. Circulation, 125(14):1735-41, S1. doi: 10.1161/CIRCULATIONAHA.111.067017
7. DiNicolantonio J.J., Lucan S.C. (2014) The wrong white crystals: not salt but sugar as aetiological in hypertension and cardiometabolic disease. Open Heart, 1(1):e000167. doi: 10.1136/openhrt-2014-000167