Diet and Heart Health

Over the years much research has been carried out to examine the relationship between diet and heart disease. Many studies lead to the idea of “superfoods” to prevent heart disease developing, however, these reports are generally misleading. Some studies have led to campaigns to ban butter and other fats as they are deemed so dangerous to health. A well balanced diet with plenty of exercise is really the best way to reduce the risk of developing heart disease.

Western Diet Causes Heart Disease

Research published in Circulation in 2008 has shown that the western diet is responsible for the increased incidence of heart disease and heart attacks. The research carried out McMaster University in Canada has suggested that switching fried and salty foods for salads and fresh fruits could cut the global incidence of heart attacks by 30%.

The researchers analyzed the diets of 16,000 people in 52 countries and identified three global eating patterns. The typical Western diet, high in fat, salt and meat, accounted for about 30% of heart attack risk in any population. A more prudent diet high in fruit and veg lowered heart risk by 30%.
The Oriental diet, which is high in tofu, soy and other sauces, made no difference to heart attack risk.

“30% of the risk of heart disease in a population could be related to poor diet. The researchers said that while components of the Oriental diet might be bad for the heart – such as the salt in soy sauce – these elements were likely cancelled out by protective components.” Romania Iqbal, of McMaster University in Canada

The data was gathered using a questionnaire to determine dietary risk, and was based on 19 food groups. In total 5,561 heart attack patients and 10,646 people with known heart disease completed the survey. Results showed that people who ate a Western diet had a 35% greater risk of having a heart attack than those who ate little or no fried foods and meat. It is not news that the typical Western diet causes heart disease, however, this is the first conclusive research that has been done in a while. Also high salt in the diet can raise blood pressure and the wrong type of fat, which can block blood vessels.

The researchers’ work suggested that the same relationships between food and heart disease that are observed in Western countries exist in other regions of the world.

“This study shows that it doesn’t matter whether you live in Bolton or Bombay, or whether you like to eat British, African Caribbean or Asian foods. The vital thing is to reduce your intake of salty, fried, fatty food to a minimum but increase the amount of fruit and vegetables you eat.” Ellen Mason, British Heart Foundation.

We really should not need any more proof that fatty, fried foods, and other junk food high in salt and sugar, is bad for us. However, many people do live in a constant state of denial when it comes to their diet. Food is for many one of life’s simple comforts. A hearty meal and a drink is what many people look forward to most after a stressful day working, and the healthy options are rarely given a second thought.

Should Butter Be Banned?

In January 2010 a heart specialist caused a little controversy by suggesting that butter should be banned. In addition to banning butter, heart specialist Shyam Kolvekar says that we should eat much less red meat, drink low-fat milk only and replace butter with olive and sunflower oil.

The argument is that butter is a key cause to clogged arteries that lead to heart disease and heart attacks. He believes that in many cases patients could have avoided heart surgery simply by eating a diet lower in saturate fat.

Mr Kolvekar is a consultant at University College London Hospital. This is his reason for banning butter:

“By banning butter and replacing it (butter) with a healthy spread the average daily sat-fat intake would be reduced by eight grams. This would save thousands of lives each year and help to protect them from cardiovascular disease – the UK’s biggest killer. When a patient comes to me, they have established coronary heart disease. We are the last resort.”

However, rather than ban butter it is far more important that people are educated so that they can moderate their consumption of saturate fat. If we ban butter, what will be next? A ban on cheese, cream, steak, sausages, bacon, chips and beer? Talking of beer …..

Men Should Drink More For Better Heart Health

If there is one thing that annoys the general public most about health advice, it is that it changes each week. Many people we speak to say that they now just ignore the latest recommendations from health organizations because the chances are the information will be updated in a few months anyway. We are told to drink more coffee, less tea, eat more fruit, less dairy. Do gentle exercise everyday, or intensive once a week. Why should we listen to expert advice when they can never make their minds up?

Maybe it is time for us to listen as some good advice that has just come out of Spain. The latest research has shown that men that drink alcohol are at less risk of developing heart disease. In the study, Spanish researchers found that men who drank were up to 1/3 less likely to develop serious heart problems. Better still, the more they drank, the lower the risk. Women don’t seem to benefit though!

The Spanish Study

In November 2009 a study was published that looked at Spanish men and women (15,630 men and 25,808 women) from 29 years to 69 years of age over a 10 year period. The results were very surprising. Those that drank one drink a day were 35% less likely to suffer from heart disease. Those that drank the equivalent of 4 to 11 measures of spirit every day were 50% less likely to develop heart disease.

In Spain many people consume large quantities of wine. However, the study showed that the type of alcohol made no difference to the reduced risk of heart disease. Beer is as effective as wine.

Currently the reason for the health benefit of drinking is still unknown, but it is thought that drinking larger quantities of alcohol raises the HDL type of cholesterol (high-density lipoproteins), which is the good cholesterol that protects our arteries (LDL being the bad cholesterol).

A Word of Caution

However, lets be clear about this. This research does not make heavy drinking a healthy living choice. Drinking heavily still raises the risk of liver problems, stroke and of course obesity which leads to many other health problems.

Trans-Fats Should be Banned, Say NICE, the NHS Watchdog

In June 2010 the National Institute for Health and Clinical Excellence (NICE) stated that they believe that trans-fats should be banned in the UK. NICE say that trans-fats are responsible for many preventable cardiovascular deaths each year. Encouraging people to change their diet will reduce the number of heart attack victims, but many people are unaware of the presence of trans-fats in many foods such as cakes and biscuits (cookies).

What are trans-fats?

Trans-fats are partially hydrogenated vegetable oils which are used to turn oils into solid matter. They are mostly used to extend the shelf life of foods. The main problem with trans-fats is that they raise cholesterol levels, especially bad cholesterol. They have no nutritional benefit at all so really they should not be present in any food that you eat.

Denmark Banned Trans-Fats

Denmark has already banned trans-fats and research from Cuba and Poland has shown that even small improvements in diet lead to relatively quick improvements in heart health.

It seems unlikely the UK will follow the ban of trans-fats though. Government intervention is likely to remain fixed at providing health and nutrition guidance via the NHS and family doctors rather than taking the bold steps to add new regulations to the food industry.

Fish Oil Helps Protect Heart Cells to Prevent Aging

We have known that fish oils, specifically omega 3 fatty acids that are found in oily sea fish such as salmon, mackerel or sardines, are good for our health. “Old Wives” used to attribute intelligence to eating plenty of fish. Finally researchers are getting closer to understanding why fish oil is good for us. The latest research has been published in the Journal of the American Medical Association (JAMA).

“These findings raise the possibility that omega-3 fatty acids may protect against cellular ageing in patients with coronary heart disease,” Dr Ramin Farzaneh-Far, University of California.

The fish oils help to protect our cells from damage. Omega 3 fatty acids seem to form a protective layer around cells making them more durable. This affects several things relating to health:

• Improved cardiovascular strength – i.e. helps to reduce heart disease
• Improved mental ability, plus reduction in onset of senile dementia
• Improved eye health

The current theory is that many health conditions are cause by cellular aging, and that our lifestyle and diet can speed this cellular aging. This goes some way to explain why people that do not get enough sleep are more likely to develop heart problems – they literally speed the aging process.

“This is an interesting study which may offer a further explanation as to why a dietary intake of omega-3 fats from fish can help to protect your heart. It is well established that a dietary intake of omega-3 is good for heart health. Oily fish, such as salmon, mackerel or sardines, is a nutritious source of omega-3.” June Davison, British Heart Foundation.

The omega 3 fatty acids help to “seal” cells preventing damage to DNA. Damaged DNA in the cells leads to degeneration.

In the study, subjects that consumed more than the average amount of omega 3 experienced a reduction in degeneration of cell protection by 32%.

Heart Disease Is Not A Modern Problem

Research published in the Journal of the American Medical Association in November 2009 has shown that heart disease is not a problem of the modern age. In fact heart disease has been affecting people for thousands of years.

The study was a collaboration carried out by a group of scientists from the University of California, the Mid America Heart Institute, Wisconsin Heart Hospital and Al Azhar Medical School in Cairo. They examined several mummies from Cairo’s Museum of Antiquities, performing medical scans on the preserved tissue. The result showed that the mummies were showing signs of hardened arteries.

It is thought that high society in ancient Egypt would have consumed a very rich diet. The mummies studied were a mixture of priests and high ranking servants of the Pharaoh of the time.

Of 16 hearts that were preserved well enough for a medical examination, 9 had calcified deposits in the main artery leading to the heart. Three of the subjects showed serious signs of atherosclerosis (hardened arteries) which is caused by a long term build up of fat, cholesterol, calcium and other substances in the blood vessels. This is the main cause of heart disease.

Both male and female mummies showed similar patterns, which provides further evidence than men are not more prone to heart disease than women.

“While we do not know whether atherosclerosis caused the demise of any of the mummies in the study, we can confirm that the disease was present in many. So humans in ancient times had the genetic predisposition and environment to promote the development of heart disease. The findings suggest that we may have to look beyond modern risk factors to fully understand the disease.” Dr Gregory Thomas, University of California

Stone-age Diet May Lower Risk of Heart Disease

Once again, the modern diet is in the line of fire. Recent research carried out by Swedish scientists at the Karolinska Institute has shown that a Palaeolithic (stone age) diet consisting of berries, nuts, lean meats, fish and vegetables, and with no cereals, grains, flours, refined sugar or dairy products, reduces both blood pressure and fat content, especially fat around the waist. People adopting the stone age diet in the study had slimmer waists within three weeks, losing an average of 2.3kg (5 pounds). Possibly the most important results were the dramatic lowering of levels of a blood clotting agent, which is linked to heart attacks and strokes.

This compares well with three other diet studies, and dieting methods. Firstly, the hunter-gatherer style diet that was investigated and shown on the BBC in January 2007, is very similar, and had similar health benefits. The highlights of this were that:

“All the volunteers lost weight during the experiment, and also there was a dramatic reduction in risk of coronary heart disease and stroke due to noticeable reductions in cholesterol, fat and blood pressure in all volunteers.”

This diet is also similar to our favorite two diets, the Atkin’s / low carb diet, and the Bruce Lee diet. Both Dr. Atkins and Bruce Lee emphasized the importance of avoiding “empty carbs” such as sugar, pasta and refined flours. The Atkin’s diet is similar to the stone age diet in many ways, and Bruce Lee’s method of eating natural foods to allow him to train harder and get leaner, is proof that such a diet really can keep the fat off, keep you slim and in great shape.

There are now many diets that adopt this form, but essentially they are all more or less the same. Some advocate eating less fat, some allow root vegetables, some do not. Whether it is called a “natural diet”, “stone age diet” or simply a “sugar-free diet”, the aim is the same – reduce sugar intake, reduce consumption of refined carbohydrates, processed foods, dairy products, and eat more fresh fruits and vegetables, as well as plenty of lean meats and unprocessed meats.

So, if you are serious about losing weight, it is time to throw out all the sugar, grains and starchy vegetables, and eat like our Palaeolithic ancestors. Just make sure that you take oral hygiene more seriously than they did.

High Blood Glucose May Be A Better Signal Of Heart Disease Than Cholesterol

A new piece of research was published on 25 January 2013 that may change the way the health profession, and individuals, think about sugar. The new study has shown that blood glucose (sugar) levels may provide a better prediction of CVD risk than total cholesterol.

Currently high blood pressure, total cholesterol and smoking are considered the main risk factors for predicting risk of cardiovascular disease. Elevated cholesterol is caused largely by a diet high in saturated fat, whereas elevated glucose is caused by excessive carbohydrates, in particular high GI carbs from refined and processed foods.

“Our study suggests that instead of total cholesterol glucose can be used in models predicting overall CVD mortality risk.” Julia Braun, 2013.

Type 2 Diabetes (T2 Diabetes) is a disease which is placing a huge burden on health departments across the developed world. It is caused by poor diet and lack of exercise. The biggest risk factor of T2 Diabetes is cardiovascular disease. 75% of people with T2 diabetes will die of a heart attack. Previous studies have shown that sugar is a growing CVD risk factor. In 2010 Italian researchers found that women who consumed high amounts of high-GI foods were at greater risk of developing coronary heart disease.

Sabina Sieri explained in 2010 that diet that consists of a lot of carbohydrate can cause an increase in plasma triglyceride levels and a reduction in high-density lipoprotein (HDL). It can also cause blood glucose levels to increase which put pressure on the blood vessels. All of these factors increase the risk of developing cardiovascular disease and having a heart attack.

The new study supports past findings which highlighted the health problems associated with consuming too much sugar and refined carbohydrate.

In another study which was published on October 2012, it was found that people with Type 2 diabetes who lost weight by following an intensive diet and exercise program did not reduce their risk of developing heart attacks and strokes. However, it is important to note that although heart attack and stroke risk were not reduced, incidence of sleep apnea was seen and also patients became less reliant on diabetes medications to manage their condition.

Type 2 Diabetes causes macrovascular (large blood vessels) damage as prolonged periods of elevated blood sugar levels can cause lasting damage to the cardiovascular system. Even if you are a healthy weight and take regular exercise, if your blood sugar levels are not monitored and controlled you will suffer the same damage. Cardiovascular diseases are still the biggest cause of death among people with type 2 diabetes.

In recent decades improvements in health awareness and a reduction in smoking has seen a small fall in cardiovascular disease in the UK and USA, however, there has been a huge rise in cases of diabetes. If the condition is managed poorly we may see a rise in heart attacks over the forthcoming decades.

People with Type 2 Diabetes are advised to learn how a low GI diet can help to regulate their blood sugar, when combined with exercise and medication.

Diet for a Healthy Heart

One of the most important things you can do to help your overall health is maintaining a healthy diet. Good nutrition is very important to success in all diets. Diet planning is not going to do any good unless you are following it. Personal Diet Plan involves your lifestyle, eating habits, and what your goals are. “Diets” itself don’t work. To have lasting results, you have to make real changes in your eating habits.

Eat more dark green vegetables, such as broccoli, kale, and other dark leafy greens. Vegetables like carrots, sweet potatoes, pumpkin, black beans, garbanzo beans, split peas and lentils are also good. Eat a variety of fruits. For example, eat 1 small banana, 1 medium apple, 1 large orange, and 1/4 cup of dried apricots or peaches. Drink fresh juices. Eat at least 3 ounces of whole-grain cereals, breads, crackers, rice, or pasta every day.

If you are trying to plan your diet in order to lose weight, you also need to pay attention to calories. People under medical supervision or with special dietary requirements may have different needs and should check with their doctor.

Guidelines for Heart Healthy Eating

The Heart Healthy Diet is an eating plan that can help keep your blood cholesterol low and decrease your chance of developing heart disease. It is the major factor in reducing the risk of heart diseases.

Saturated and Trans fats

Eat foods that are low in Saturated and Trans fats. Saturated fat is mostly found in animal products, such as beef, veal, lamb, pork, lard, poultry fat, butter, cream, whole milk dairy products, cheeses, and from some plants, such as tropical oils.

Cholesterol

Dietary cholesterol does not directly lead to raised cholesterol in the blood. However, foods that are high in cholesterol are often also high in saturated fats. Therefore it is still recommend that you eat foods which are low in cholesterol. Eat fruits, vegetables, whole grains, low fat or non-fat dairy products, and moderate amounts of lean meats, skinless poultry, and fish. Eggs, although high in cholesterol, are healthy.

Avoid Salt

Salt can also lead to increased anxiety, bring on insomnia and exacerbate conditions like water retention. If you have high blood pressure as well as high blood cholesterol then strictly cut down salt from your diet.

As well as improving your diet it is also vital to get regular exercise. A daily workout is very effective at improving cardiovascular strength and health and will also help you to manage your weight much better.

References

• Western diet ‘raises heart risk’  BBC News, 21 October 2008.
• “Dietary Patterns and the Risk of Acute Myocardial Infarction in 52 Countries” by Romaina Iqbal, Sonia Anand, Stephanie Ounpuu, Shofiqul Islam, Xiaohe Zhang, Sumathy Rangarajan, Jephat Chifamba, Ali Al-Hinai, Matyas Keltai, Salim Yusuf. Circulation. 2008; 118: 1929-1937
• “Alcohol intake and the Risk of coronary heart disease in the Spanish EPIC cohort study”
  Heart, Nov 2009; doi:10.1136/hrt.2009.173419.
• “Association of Marine Omega-3 Fatty Acid Levels With Telomeric Aging in Patients With Coronary Heart Disease” by Ramin Farzaneh-Far, Jue Lin, Elissa S. Epel, William S. Harris, Elizabeth H. lackburn, Mary A. Whooley. JAMA. 2010;303(3):250-257.doi:10.1001/jama.2009.2008
• “Computed Tomographic Assessment of Atherosclerosis in Ancient Egyptian Mummies” Zahi Hawass et al, JAMA, 2010;303(7):638-647. doi: 10.1001/jama.2010.121
• Blood glucose may be an alternative to cholesterol in CVD risk prediction charts by Julia Braun, Matthias Bopp, David Faeh. Cardiovascular Diabetology 2013, 12:24 doi:10.1186/1475-2840-12-24. Abstract.
• Dietary Glycemic Load and Index and Risk of Coronary Heart Disease in a Large Italian Cohort The EPICOR Study by Sabina Sieri (and others). Archives Internal Medicine. 2010;170(7):640-647.
• Trends in coronary heart disease, 1961-2011. (pdf) – British Heart Foundation
• Weight loss does not lower heart disease risk from type 2 diabetes – NIH News, Friday, October 19, 2012.