Heart Disease: What you need to know
Heart disease (aka: cardiovascular disease) is the leading cause of death in Americans, both male and female. According to the CDC, more than half a million people die of heart disease each year. Age, genetics, and previous heart attacks or strokes all increase the risk of heart disease. The good news is, many things are within our control when it comes to mitigating our heart disease risk.
Improve your numbers.
Cholesterol and lipid profile
We often hear about dietary cholesterol as a contributor to poor health, including heart disease risk. However, there’s more to the story than just total cholesterol levels. Paying attention to HDL (good) cholesterol versus LDL cholesterol is important, as is noting the characteristics of your specific LDL particles - the larger, fluffier particles being less harmful. Also note, studies show that intake of cholesterol-rich foods (eggs, shrimp, etc.) does not necessarily translate to your cholesterol lab values. Instead, our overall dietary patterns are the main culprit, particularly consumption of unhealthy saturated fats and refined sugars, among other things.
Triglycerides are an often overlooked part of the lipid profile, but this type of fat plays a critical role in our health. However, high triglyceride levels can negatively impact your health. Triglycerides increase with the consumption of processed foods, high sodium intake, and refined carbohydrates including sugar, refined grains, and alcohol. Overconsumption of such foods on a regular basis will lead to an increased risk of a poor lipid profile, and subsequent risk of heart disease, heart attack and stroke.
Trans fats, found in margarine, prepackaged cookies, chips, etc., and saturated fats, found in red meats, lard, and processed foods, have a more direct and rapid effect on triglyceride levels. If triglyceride levels are too high, they cause plaque buildup in arteries and harm to the heart. Studies show children as young as age 10 already have fatty streaks in their arteries – the beginning stages of plaque buildup. Extremely high triglyceride levels can lead to other diseases as well, including diabetes, hypothyroidism, kidney and liver disease.
Foods contributing to a poor lipid profile:
Processed (pre-packaged) foods are high in additives necessary for preservation. They are also traditionally very high in sodium, which contributes to higher blood pressure and heart strain.
Foods that are deep fried, commercially packaged meals/snacks, pastries, baked goods, and vegetable shortenings are often made with hydrogenated oils that contribute saturated and trans fats that, overtime, will increase triglycerides and cholesterol levels.
Replace animal saturated fats (lard, red meat) with mono- & poly-unsaturated fats like salmon, tuna, and lean turkey and chicken.
Add olives, olive oil, avocado, nuts and seeds to your weekly routine.
Broil, bake, or roast your meats rather than fry. Remove the skin or visible fat on meats.
Mind your waist line.
Excess calories consumed, but not used, are stored as fat, and over time can lead to weight gain. While being overweight does not necessarily indicate health risk (just as a normal weight status does not necessarily translate to optimal health), where you carry weight makes a big difference.
Weight carried around the mid-section, surrounding the liver and other abdominal organs (think “apple shaped”) is linked to higher levels of “metabolically active” fat. This fat releases inflammatory agents into the system, which are detrimental to health.
Waist circumference of 40 inches or more for men, and 35 inches or more for women (regardless of weight status) is indicative of increased risk. Further, studies show that individuals of “normal” weight status with a waist circumference above the recommended number had three times the risk of death from heart disease compared to normal-weight individuals with a waist size below the recommended number.
Regular exercise and a healthy eating pattern is critical for all individuals, and can especially reduce disease risk for those carrying weight around the mid-section. Studies show that even just 10% weight loss for individuals that are overweight or obese with a corresponding risk factor, can significantly reduce their risk of developing diseases like heart disease, diabetes, and high blood pressure.
Slash your sugars.
Individuals with high blood sugars, diagnosed as diabetic or not, have an increased risk of other diseases. Over time, high blood glucose can damage blood vessels, which in turn may cause heart and organ damage.
The good news is, if you have diabetes you can protect your heart by managing your blood glucose. If you are pre-diabetic (high sugars but not within diabetic range), you have an opportunity to reverse your risk with a few lifestyle improvements. Additionally, individuals with blood sugars within a healthy range can work to keep those numbers low.
Limit sugary snacks like grain-based desserts (cakes, pastries, brownies, donuts), ice cream, candies, syrups, etc. These “fun foods” should be limited to 10% of your calories per day.
Choose unsweetened fruits and snacks, and drinks without added sugar (like infused water, 100% fruit or vegetable juice and milk).
Keep in mind that all simple sugars have an effect on blood sugar levels. This includes honey, raw sugar, agave, etc., not just the ones touted as unhealthy (white sugar, brown sugar, corn syrup, etc.).
Pair carbohydrate snacks and meals with protein and fats to slow your metabolism and blunt sugar spikes. For example, pair a piece of whole wheat toast with 1 tablespoon peanut butter and a sprinkle of ground flaxseed or chia seeds.
Lower your blood pressure.
Plaque buildup in the arteries prevents blood from flowing freely and increases the force needed for blood to travel to and from the heart and other organs. This increase in blood pressure can lead to other conditions ranging from arrhythmia, to heart attack and stroke. We often do not have signs or symptoms of high blood pressure, so knowing your numbers is critical. Just like many other heart disease factors listed above, high blood pressure can largely be prevented through a healthy lifestyle (however, race, age, and family history can also play a role).
Increase foods rich in potassium like leafy greens, sweet potatoes, brussel sprouts, tomatoes, beets, cantaloupe, strawberries, and asparagus.
Limit alcohol to the recommended intake of not more than 1 or 2 drinks per day for women and men, respectively.
Limit your intake of highly processed, prepackaged foods like frozen meals, pizzas, cakes, and pastries, as these are frequently very high in sodium.
Aim for at least 30 minutes of exercise each day.
Reduce stress levels by meditating, exercising, and deep breathing.
An overall healthy eating pattern can reduce inflammation, improve metabolic efficiency, and provide nutrient-rich foods that reduce your risk of developing heart disease. If you are already at high risk, even small changes can significantly reduce or reverse your symptoms and risk for future heart-related conditions.
Add in the fruits and veggies! Fiber found in fruits and vegetables binds to cholesterol, helping to remove it from your system. The more fiber the better in terms of heart health, and gut health too!
Unsalted nuts and seeds – almonds, walnuts, pecans, sunflower seeds, flaxseeds, pumpkin seeds, chia seeds – you name it. All of these nutrient-rich healthy fats will contribute to a healthier heart.
Other healthy fats: avocado, fatty fish like salmon and tuna, trout, sardines and herring. Aim for at least two, 4 oz. servings per week.
Whole grains like 100% wheat, quinoa, buckwheat, farro, oats, barely, brown rice, popcorn, whole grain corn will reduce cholesterol, blood pressure and improve overall health.
Incorporate lean proteins like skinless chicken, turkey, 95% lean ground beef, pork, and eggs. These will add nutrients to your day and reduce your intake of unhealthy saturated fats.
Consume legumes and beans multiple times per week.
Low sodium foods are key. Choose “no salt added” canned foods, fresh or frozen with no added ingredients. Add your own seasoning or marinade (avoid the pre-packed versions), and limit processed meats and vegetables.
Flavor foods with herbs and spices. You’d be surprised how flavorful foods can be without adding too much salt.
Limit sugars and refined carbs: processed, pre-packaged foods, commercially packed snacks and candies and pastries all contribute to increased inflammation in the body overtime. Inflammation in turn leads to increased risk of disease, including heart disease.
You’ve heard the recent saying, “sitting is the new smoking,” – well they weren’t kidding. More than 80% of Americans don't meet the Physical Activity Guidelines for Americans. Regular exercise can lower blood pressure, strengthens the heart, reduce metabolically active fat mass, increase lean body mass, burn calories, and produce feel-good hormones.
Aim for at least 150 minutes of moderate-intensity physical activity per week, or 75 minutes of vigorous exercise. Add in 2 or more days per week of muscle strengthening exercise.
Grab a partner - studies show that exercising with a friend or spouse increases accountability and enjoyment.
Every little bit counts! It doesn't have to all be at once. Take the stairs, stand at work, 5 minutes of stretching in the morning, park further from the store and walk.
Reduce your stress.
You may notice the physical signs of stress: sweaty palms, tension headaches, upset stomach. However, there’s damage being done internally when such signs after present.
Stress can lead to over-production of cortisol, leading to an increase in inflammation. This in turn can increase blood pressure, and lower good cholesterol (HDL), leading to increased risk of heart disease. Stress can also indirectly harm your heart by affecting your sleep habits. A lack of sleep can lead to a decreased likelihood of exercising, poor eating habits, and increased weight - a cycle of heart-harming factors.
Discuss stress levels with your healthcare professional, and especially if you have other risk factors for heart disease like obesity, high blood pressure or diabetes.
Healthy eating and exercise can help reduce inflammation, while also increasing feel good hormones, thereby lowering stress levels.
Take a 5-minute relaxation break to breath deeply and slow down.
Take a short walk outside - studies show fresh air and being outdoors can help lower stress levels.
Take control of your schedule and prioritize what needs to be done each day.
Avoid negative self-talk or focusing on things out of your control.
Quit or avoid smoking.
Unfortunately, 14% or 34 million Americans, still smoke. Even individuals who smoke fewer than five cigarettes per day may show signs of cardiovascular disease. Additionally, exposure to second-hand smoke can cause heart disease in non-smokers.
The chemicals in cigarette smoke cause the cells lining arteries to swell and inflame. This causes narrowing and rigidity in the artery, preventing blood from flowing properly. A loss or decrease in blood flow to various parts of the body can lead to arterial disease, heart attack, stroke, and aneurysm.
Working with a professional to quit smoking is the most effective way to make a permanent change. Those who quit smoking improve their heart health and reduce their risk of harm immediately. Within five years of quitting, smokers lower their risk of stroke to about that of a person who has never smoked! For more information or help quitting, visit www.smokefree.gov, www.cdc.gov/tips or call 1-800-quit-now.
It takes time to implement new recommendations and healthful habits. When working toward improving your lifestyle habits, it is important to take one small, realistic step at a time to make meaningful, permanent changes.
See a Registered Dietitian for tailored recommendations. There’s no “one-size-fits-all” when it comes to health and dietary advice, and professionals can help make you a plan that fits your needs.