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Eating Your Way to a Healthy Heart

By Jordan Hopkins, MD, FACC

Many chronic medical issues can be dramatically improved or even avoided by leading an active lifestyle and consuming a heart-healthy diet.  Many fad diets are out there making out-sized claims of cardiovascular health, but how do you know what is REALLY the most heart-healthy way to eat?  Rather than analyzing each and every version of all the fad diets out there today, I think it is more useful to focus on some basic principles of a healthy diet.  Master these principles and you can make any number of diets work for you!

Avoid  Excess Sugars and Simple Carbohydrates
High blood sugar and cardiovascular disease often go hand-in-hand. In our country over 30 million people have diabetes, with even more of our population unknowingly living with prediabetes and Metabolic Syndrome, which can quickly escalate into full-blown diabetes with little to no warning. Metabolic Syndrome comprises a set of problems including elevated blood sugar levels (insulin resistance), high blood pressure (greater than 130/85), obesity (waist circumference greater that 35 inches in a woman, 40 inches in a man), and high triglyceride levels. Consuming a diet high in simple carbohydrates (such as sweets, white bread, white rice, highly refined flour products) can be just as harmful as one high in sugars.  Many people do not realize that simple carbohydrates consist of 2 glucose (sugar) molecules linked together by a chemical bond.  This bond is quickly broken down, converting that white bread to sugar within seconds.  If you doubt this, try leaving a piece of white bread in your mouth for a few minutes.  You will notice it becomes sweeter over time—resulting from the digestive enzymes in your saliva cleaving that chemical bond and turning the bread into pure sugar.  Whole grains and complex carbs offer a great alternative to these less healthy carbs.

If you have diabetes, it’s critical that you see a cardiologist because it’s often not a question of “if” you will develop heart disease, but rather “when?”  High levels of sugars circulating in your blood vessels result in atherosclerosis deposits within the walls of these vessels. Atherosclerotic plaque buildup results in “hardening of the arteries” which blocks normal blood flow and can lead to heart attacks, strokes, and other vascular complications.

Minimize Salt Intake
While the issue of salt consumption is more complex than that of sugar and simple carbs, too much salt in your diet can result in harmful changes to your health as well.  High salt diets are linked to increases in blood pressure, which then opens the door to other forms of heart disease.  If the heart is already weak or otherwise compromised, salt intake leads to fluid retention and leg swelling, shortness of breath, and congestive heart failure.

Potassium consumption can help to process some excess salt out of your body.  The DASH Diet is predicated on this idea.  DASH stands for Dietary Approaches to Stop Hypertension. The DASH diet is a lifelong approach to healthy eating that encourages you to reduce the sodium in your diet and eat a variety of foods rich in nutrients that help lower blood pressure, such as potassium, calcium and magnesium.  Foods high in potassium include bananas, plums, coconuts, avocados, and potato skins.

Keeping your sodium consumption low is one of the primary solutions to keeping your blood pressure well-regulated.  In addition to avoiding heavy salt use during the cooking process and at the table, other common sources of excess sodium include canned, frozen, pre-made or processed foods.  Eating out at restaurants is a common pitfall, often requiring you to ask specifically about the salt content of the menu options you are considering (particularly if you dine out frequently).  Salt substitutes and other spices are available at the grocery store that can be a useful strategy to help your foods remain tasty while your body is getting used to a low-sodium diet. Shopping the periphery of the grocery store is a great way to avoid many of the processed foods, as well as the sugar- and salt-rich foods that tend to be concentrated in the center isles.

Improve Your Diet
There are numerous diets that get popularized for a variety of reasons in our society’s endless quest to achieve sustainable weight loss.  Regardless of the diet plan, it’s a good general principle to consume lots of fresh produce, lean protein like poultry, fish, seafood and eggs, and incorporating generous portions of the healthy “fat-burning fats” such as mono- and poly-unsaturated fats (commonly found in olive oil, nuts, avocados, fish).   Beware any diet that describes itself as “low fat;” such diets all too often sacrifice these sorts of healthy fats, preferentially including less healthy carbohydrates in their place.  Unhealthy fats that should be minimized include saturated fats and especially trans fats.

The Mediterranean Diet – Research has shown that the traditional Mediterranean diet reduces the risk of heart disease. The diet has been associated with a lower level of oxidized low-density lipoprotein (LDL) cholesterol — the “bad” cholesterol that’s more likely to build up deposits in your arteries.  In fact, a meta-analysis of more than 1.5 million healthy adults demonstrated that following a Mediterranean diet was associated with a reduced risk of cardiovascular mortality as well as overall mortality.  Such diets are also associated with a reduced incidence of cancer, Parkinson’s, and Alzheimer’s Disease. Women who eat a Mediterranean diet supplemented with extra-virgin olive oil and mixed nuts may have a reduced risk of breast cancer.  Principles of the Mediterranean diet include:

• Eating primarily plant-based foods, such as fruits and vegetables, whole grains, legumes and nuts
• Replacing butter with healthy fats such as olive oil
• Using herbs and spices instead of salt to flavor foods
• Limiting red meat to no more than a few times a month
• Eating fish and poultry at least twice a week
• Drinking red wine in moderation (optional)

Other diets that have been shown to contribute to healthy hearts include Vegetarian and Vegan Diets, though you should remember the basic principles above and avoid replacing animal protein with simple carbs and unhealthy fats.
Talk with your physician about the right exercise plan for you. Most people can benefit from taking a brisk 30-minute walk, bike ride, or swim. Weight training and other forms of cardio or resistance training can also be a great choice for many people.  Exercise increases circulation, improves nutrient and oxygen-
rich blood flow, and helps you build strength while losing weight. Your goal should be to find a way to get 30 minutes of exercise per day or, alternatively, 60 minutes of exercise 3-4 days per week.  And remember, if you are exercising regularly and making healthy dietary choices but you are not seeing the desired level of weight loss, the next step is to think about portion control.  Keep in mind that the portions you get at your average chain restaurant are way more than any one person should eat at a single sitting.  It’s OK to leave some food on the plate or, better yet, bring some home for lunch the following day.


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