Get full access to Outside Learn, our online education hub featuring in-depth nutrition, fitness and adventure courses, and more than 2,000 instructional videos when you sign up for Outside+..
“Half the people who die of heart disease have normal cholesterol. How helpful is that?” says Steven Masley, MD, author of The 30-Day Heart Tune-Up: A Breakthrough Medical Plan to Prevent and Reverse Heart Disease. More importantly, he says, “Plaque is what causes heart disease.” Plaque constricts arteries, reducing the flow of oxygen and nutrients, and can trigger clots that lead to heart attacks and strokes.
Plaque levels can be tested with a non-invasive Carotid Intima Media Thickness (CIMT) ultrasound scan, but few doctors use it and insurance plans don’t cover the cost. But even without the test, plaque can be controlled and even reversed.
Masley’s heart tune-up plan is based on his research, in which more than 100 patients were able to reduce and reverse plaque with a strategy that includes eating the right foods and taking heart-healthy supplements.
7 Vital Heart Nutrients
You can get most of these important nutrients from a good quality multivitamin. Additional supplements for fish oil, fiber, and possibly vitamin D and magnesium may be required.
“If fiber intake long-term has been about 30 grams per day, almost no one gets heart disease,” says Masley, especially if the person is also physically fit. But the average American gets only 12–14 grams of fiber daily. It’s quite realistic to get enough from a combination of fiber-rich foods and fiber supplements. (Go to amazingwellnessmag.com for a list of recommended foods and fiber gram counts.)
To start your day, try a satisfying shake that will get you about halfway to the 30-gram mark. Blend a cup of berries; a scoop of your favorite protein powder; almond milk; and a tablespoon of chia seeds, flaxseeds, psyllium, or a fruit and vegetable fiber powder.
2. Fish Oil
“Fish oil has been shown in several studies to decrease risk of heart disease and sudden death—it’s just so important,” says Masley, “but more than half of Americans don’t meet their needs.” If you don’t eat low-mercury, cold-water fish, such as wild salmon, herring, or sardines, at least two or three times per week, take enough fish oil to get 1,000 mg daily of EPA and DHA.
Freshness is key, as fish oil can become rancid over time. Masley recommends testing one pill in a bottle by pricking the capsule with a needle and tasting the oil. “It isn’t lemonade, but it should taste pleasant,” he says.
“If you take a calcium supplement without magnesium, it can make a magnesium deficiency worse,” says Masley. Common symptoms of magnesium deficiency include migraines, constipation, muscle cramps, heart palpitations, and high blood pressure. If you have any of these, take 200–400 mg of magnesium one to two times daily. Magnesium can cause loose stools, so start with a lower dose.
See Also Why Magnesium Is Important
Look for an absorbable form of the mineral that’s easy to digest, such as chelated magnesium, magnesium glycinate, or magnesium malate.
4. Vitamin D
We don’t typically get enough sun exposure to make sufficient amounts, even in warm climates, yet vitamin D is essential for heart, immune system, and bone health, as well as cancer risk reduction. Take 1,500–2,000 IUs daily.
5. Vitamin K
If you’re deficient in vitamin K—and most Americans are, says Masley—calcium will shift from your bones to your arteries, where it’s harmful. Eating a daily cup of cooked green vegetables, such as broccoli, kale, or spinach, will give you between 250 and 1,000 mcg, but most people don’t get enough. In a supplement, take 250 mcg daily of vitamin K1 or K2.
“If you’re zinc deficient, that’s a very powerful predictor of arterial plaque,” says Masley. The underlying mechanism is likely this: Lack of zinc contributes to prediabetes, also called metabolic syndrome, which includes high blood sugar, an inability to utilize insulin (insulin resistance), high blood pressure, and a pot belly. These factors lead to heart disease and an overall shorter lifespan.
Oysters, crab meat, pumpkin and squash seeds, wheat germ, lean grass-fed beef, and cocoa or dark chocolate are all good food sources. In a supplement, women need at least 12 mg daily and men require at least 15 mg, amounts that can be found in many high-quality multivitamins and single supplements.
CoQ10 is another important nutrient for heart health. The body’s levels of CoQ10 decline naturally with age, so supplements are essential, especially if you are taking a statin medication for high cholesterol. Even modest dosages of various statins have been shown to lower blood levels of CoQ10 considerably. Researchers have concluded that inhibition of CoQ10 synthesis by statin drugs could explain the most commonly reported side effects, especially fatigue and muscle pain, as well as the more serious side effects such as severe muscle damage (rhabdomyolysis). CoQ10 supplementation in subjects on statin drugs has been shown to reduce markers of oxidative damage and improve tolerance to these drugs. The recommended dosage is 100 mg twice daily if taking a statin.
According to Masley, these are the most important foods for fighting plaque:
Healthy Fats: Olive oil, fish and other types of seafood, almonds, pecans, pistachios, walnuts, and hazelnuts, including nut butters and oils.
Clean, Lean Protein: Organic, grass-fed lean poultry and beef, and organic, grass-fed, low-fat dairy.
Beneficial Beverages: Green tea, cocoa, and dark chocolate, and if you drink alcoholic beverages, red wine in moderation (no more than 1–2 glasses daily).
Flavor: Use chili; curry powder (a blend including turmeric, coriander, and cumin); Italian herbs and spices such as oregano, rosemary, and thyme; and other seasonings to make food taste great.
On the flip side, foods such as sugar and flour increase the odds of prediabetes, inflammation, and plaque production. Most people should avoid them. But healthy, fit people may benefit from nutrients found in whole-grain flour, says Masley.
“There’s a ton you can do to decrease your risk, stop plaque growth, and tune-up your energy, your waistline, and your sex life.” says Masley. “And who doesn’t want that?”
Statin Alternatives: Niacin and Citrus Flavones
Cholesterol-lowering statin drugs such as Crestor (rosuvastatin) and Lipitor (atorvastatin) are ubiquitous these days, and more are being prescribed each year. But questions remain about their safety and effectiveness, and they come with their share of side effects, including decreased liver function, interference with the manufacture of coenzyme Q10 (CoQ10), rhabdomyolysis (the breaking down of muscle tissue, which can be fatal), nerve damage, impaired mental function with prolonged use, possible increased risk of cancer and heart failure with long-term use, fatigue, and weight gain.
Fortunately, there are natural alternatives to statin drugs, including these two stand-outs.
Since the 1960s, niacin (vitamin B3) has been known to be effective in lowering blood cholesterol and triglyceride levels. In fact, in numerous clinical studies niacin has demonstrated better overall results in reducing risk factors for coronary heart disease than other cholesterol-lowering agents—including statin drugs. Niacin typically lowers LDL cholesterol levels by 16–23 percent while raising HDL cholesterol levels by 20–33 percent. These effects, especially the effect on HDL, compare quite favorably with conventional cholesterol-lowering drugs. In addition, some studies have shown that niacin used in conjunction with statins significantly improves patient outcomes, as opposed to using statins alone.
Nonetheless, many people are reluctant to use niacin. The chief reason is that at the levels recommended to lower cholesterol (1,200–3,000 mg per day), it causes a hot, itchy skin reaction known as the “niacin flush.” This problem has been overcome with the development of timed-release “no flush” preparations, shown to be extremely well tolerated with no serious side effects.
Citrus polymethoxlyated flavones work by blocking the enzymes in the liver responsible for manufacturing cholesterol and for triglyceride production. For example, they have been shown to decrease the production of apolipoprotein B, a structural protein needed for endogenous synthesis of LDL cholesterol.
Sytrinol and Bergamonte are special extracts of oranges standardized for their polymethoxylated flavonoid content. These highly concentrated extracts have been shown to lower total cholesterol, LDL cholesterol, and triglyceride levels. Clinical results have shown that Sytrinol and Bergamonte exert effects very similar to statin drugs, but without side effects. Specifically, they have been shown to lower total cholesterol levels up to 30 percent, LDL cholesterol levels up to 27 percent, and triglyceride levels up to 34 percent within 4–12 weeks of use. The recommended dosage for Sytrinol is 150 mg twice daily. For Bergamonte, the dosage is 500 mg once or twice daily.
—Michael T. Murray, ND
Heal Your Heart with Herbs —and a Little “Vitamin L”
Naturopath Beverly Yates, ND, discusses the best herbs for heart health, as well as the importance of living a balanced lifestyle
A Stronger Heart
“Across the board, hawthorn is great for the heart,” says Beverly Yates, ND, a licensed naturopath in Northern California and author of Heart Health for Black Women: A Natural Approach to Healing and Preventing Heart Disease. “Research shows it supports stronger oxygenation and flow and contains flavonoids that help support cell wall integrity and combat free radicals. It keeps blood pressure in the normal range. And if there is any weakness of the heart, it helps to strengthen the heart. It’s a go-to.”
“Cholesterol is not sticky, so it won’t cause you trouble unless inflamed,” says Yates. She recommends anti-inflammatory herbs turmeric and Japanese knotwood. Like red wine, Japanese knotwood is a natural source of heart-healthy resveratrol. “People don’t have to drink 10 bottles of wine to get the benefits of resveratrol,” says Yates.
Yates advises taking a combination of dandelion, artichoke, and Coleus forskohli to promote healthy cholesterol levels, boost HDL (good), and mitigate bad cholesterol. “Research shows that ginger, hawthorn, and turmeric help to modulate and improve
cholesterol, making it less likely that unhealthy cholesterol levels will become deadly,” she says.
What about cholesterol-lowering statin drugs? Going on a statin should not be a knee-jerk decision, warns Yates. “There are certain kinds of cholesterol that don’t pose a problem—women tend to have more HDL cholesterol than men, for example—so their overall cholesterol might be high, but it’s good cholesterol.
Before you go on a statin, take an inflammatory marker test. If you don’t have lipoprotein (a), or LPa in the blood, a known risk factor for cardiovascular disease and stroke, it isn’t likely that cholesterol will be a problem.”
A Healthy Lifestyle And Healthy Relationships
The pressures of modern life can take a toll on our hearts. “I used to recommend people start taking herbs at 60, but now I recommend them to people in their 30s and 40s—particularly if you have a family history of heart disease or a type-A personality,” says Yates. “A lot of people today are stressed, eat what’s convenient, don’t exercise, and may or may not drink too much,” she continues, adding that the herbs she recommends to clients can mitigate some of these deleterious effects.
People should feel “encouraged and not discouraged” when it comes to making improvements in their lifestyles, says Yates, acknowledging that it’s difficult to make radical changes overnight. “Focus on nutrition one week, for one meal a day. The next week walk every day for a half-hour, the next week do something fun for 10 minutes a day that’s not toxic—look at a beautiful sky, text a loved one you haven’t talked to in a while, do a crossword.” And she feels that it’s important to live a life of balance. “Do meditation, prayer, yoga—whatever feels right for you—and foster healthy relationships, she says. “I believe in the healing power of vitamin L (love).”
Maitake Benefits High Blood Pressure
Research published in the International Journal of Medical Sciences concludes that two types of maitake mushroom extracts sold as supplements (SX-Fraction and D-Fraction) may lessen age-related hypertension. The animal study showed that over a period of four months, both extracts helped to stop the elevation of systolic blood pressure. The study also concluded that the extracts reduced inflammation, another heart disease risk factor. Try: Mushroom Wisdom SX-Fraction.
Fiber is important for heart health. Some good sources:
Raspberries (1/2 cup frozen): 5.5 grams
Pear (medium): 5.1 grams
Apple (medium): 3.3 grams
Banana (medium): 3 grams
Vegetables and legumes
Beans (1/2 cup): 5–10 grams
Split peas (1/2 cup cooked): 8 grams
Avocado (1/2 medium): 6.5 grams
Artichoke hearts (1/2 cup): 4.5 grams
Spinach (1 cup cooked): 4.3 grams
Mixed vegetables, frozen (1 cup): 4 grams
Sweet potato (medium, with skin): 4 grams
Potato, baked (medium, with skin): 3.8 grams
Superfoods & Supplements
(Amounts vary by product)
Psyllium (1 Tbs.): 3 grams
Chia seeds (1 Tbs.): 3–5 grams
Flaxseed, ground (1 Tbs:.)2 grams