February’s a great time to focus on your heart. For one thing, there’s Valentine’s Day. and for another, since 1964, February has been designated as American Heart Month to place a public health emphasis on cardiovascular disease education and prevention. There is certainly a genetic component involved when it comes to heart health, but many lifestyle factors can influence one’s probability of developing cardiovascular issues. One of the most significant modifiable factors is nutrition.
Cardiovascular disease is the leading cause of death in the United States and represents almost 30 percent of deaths worldwide. Atherosclerosis and hypertension are two of the most common conditions classified within cardiovascular disease.
Atherosclerosis is an inflammatory condition that contributes to major incidence of cardiovascular episodes and mortality. It is characterized by the build-up of cholesterol, fat and other molecules in the arteries that results in plaque formation. Excessive calorie intake and inadequate physical activity can contribute to the release of inflammatory molecules that causes fat and cholesterol to penetrate and harden into arterial walls -- creating plaque. As more plaque accumulates over time, blood flow can be restricted and cause cardiovascular episodes. Symptoms can go undetected for a long time, which is why it is important to practice preventative measures through diet and lifestyle.
In addition to nutrition, high total cholesterol, low HDL-cholesterol, high LDL-cholesterol, being sedentary, a diagnosis of type 2 diabetes, or hypertension may also contribute to atherosclerosis. Hypertension is the scientific diagnosis for a high blood pressure reading above 140/90. According to the Centers for Disease Control and Prevention, one in two Americans has hypertension, yet only one in four have it under control.
The DASH diet was created as an eating pattern to tackle the high incidence of hypertension diagnoses. DASH stands for Dietary Approaches to Stop Hypertension, and research has shown the eating pattern alone was the only intervention to decrease blood pressure in patients with both high and normal blood pressure. The typical Western diet is high in plaque-promoting fats and refined carbohydrates with low nutrient density. Compared to the American Diet, the DASH eating pattern emphasizes intake of whole grain carbohydrate, a mixture of plant and animal-based proteins, and is much higher in fruits and vegetables. Today, the Mediterranean Diet is studied and promoted as a well-rounded expansion of the DASH eating pattern to improve blood pressure and cardiovascular measures. Here are a few specific nutrition recommendations for optimal heart health.
Aim for moderate carbohydrate intake from plant-based sources and grains: Carbohydrate is the main source of fuel for both the body and brain; therefore, we absolutely need some carbs on all of our plates. In addition to being our primary energy source, plant-based carbohydrate such as fruits, vegetables, beans and legumes are high in fiber as well as micronutrients that can lead to better arterial function and blood flow. A prime example is polyphenols, the most abundant dietary antioxidants found in plant-based foods. Whole grains like oats and barley contain polyphenols and a type of soluble fiber called beta-glucan, which has been shown to limit cholesterol reabsorption, lowering blood markers of LDL, or “bad” cholesterol. Thinking about trying the low carb, keto diet? Think again. Research shows that low carbohydrate intake can have a negative effect on cardiovascular measurements in the blood and can exacerbate plaque formation. Aim for a fist-sized serving of plant-based or whole grain carbohydrate on your plate at each meal.
Limit refined and processed foods: These foods are typically low in fiber, low in overall nutrients, and high in sodium. Reducing sodium intake has been shown to lower blood pressure in those with high and normal blood pressure readings. In addition to contributing to the flavor of food, sodium is used as a preserving agent to extend the shelf life of packaged foods, commercially baked pastries and some canned foods. The sodium content in canned foods can be easily decreased by draining the liquid from the can and rinsing the food under water to shake off the salt. It’s recommended that sodium intake is less than 2,300 mg per day, which equates to about 1 teaspoon of salt. If you are someone who exercises frequently and sweats heavily, sodium should not be as much of a concern for you.
Replace trans fats and saturated fats with unsaturated fats: Like protein and carbohydrate, fat is the third macronutrient vital for nutrient absorption and to protect your heart and brain. People often believe that lowering cholesterol through food translates to lower blood cholesterol values. However, this is not the case for the majority of the population! Dietary fat is actually a more influential nutrient than dietary cholesterol when it comes to improving cholesterol. “Bad fats” refer to trans fats and saturated fats found in commercially baked foods, processed or cured meats, coconut oil, butter, margarine, vegetable shortenings and desserts like ice cream. We want to limit trans and saturated fats, which raise LDL by carrying cholesterol toward your heart. “Good fat” is found in protective unsaturated fats such as nuts, seeds, olive oil, oily fish, peanut butter, almond butter and avocado. Swapping trans or saturated fats for unsaturated fats has been shown to have a positive effect on lowering markers of cholesterol and improving heart health.
Focus on your overall eating pattern rather than a single nutrient: When I work with a patient aiming to improve heart health and/or lower cholesterol, I find there is typically a fixation on a single nutrient or food, like the cholesterol in eggs or salt in deli meat. Rather than hone in on increasing or supplementing a specific nutrient, emphasis should be placed on maintaining a well-balanced dietary pattern complemented by a variety of nutrients.
Major organizations like the American Heart Association and the National Institute of Health recommend an integrative approach for cardiovascular health that addresses diet, increasing physical activity, low to moderate alcohol consumption, stress management and limits smoking.
Use these nutrition habits to prioritize your heart health this month, and every month.
Emma Willingham is a registered dietitian who practices in an outpatient hospital clinic and through her private practice, Fuel with Emma. Willingham specializes in sports-performance nutrition, weight management and nutrition counseling, and aims to promote a resilient relationship between food, mind and body. You can find her on social media at @fuelwithemma.
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Worried about hypertension? Here's what to eat to keep your heart healthy. - Houston Chronicle
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