Heart disease shortens the lives of millions of people and diminishes the quality of life for millions more.
The good news is that few diseases are as preventable, or at least as modifiable by lifestyle choices, as heart disease. Though there are certain factors that you can't control, such as genes, they pale in comparison to the ones that you can.
Five simple behaviors can reduce the risk for heart disease by a number greater than the effect of any drug available:
- Eating a healthy diet.
- Maintaining a healthy body weight.
- Doing moderate physical exercise.
- Abstaining from smoking.
- Limiting alcohol consumption.
In the famous Nurses' Health Study, these five behaviors lowered the risk of heart disease by a staggering 83 percent. Look at what happened in the Lyon Diet Heart Study: Researchers divided approximately 600 participants at high risk for a heart attack into two groups. The first group didn't receive any specific dietary advice, but were merely told to "eat a prudent diet," which is code for the same old tired advice the American Dietetic Association has dished out for years: low fat, low cholesterol-the usual things.
The second group was put on the Mediterranean diet-they ate fish and poultry, not too much red meat, and a lot of vegetables, nuts, olive oil, omega-3 fats, whole grains, and moderate amounts of wine. Want to know what happened? They stopped the study. The group eating the Mediterranean diet got such outstanding results that the researchers felt ethically compelled to stop the study after a year and put everyone on the Mediterranean plan. After a four-year follow-up, those still following the Mediterranean-style diet had a 50 to 70 percent lower risk of heart disease.
And by the way, their cholesterol levels didn't budge much. What matters here is that by changing their diets, they were able to reduce their risk of cardiac death and nonfatal heart attacks by double digits.
Keeping Your Heart Healthy: Beyond Cholesterol
Cholesterol may not be the most important thing you need to pay attention to when it comes to protecting the heart. Emerging research is pointing in the direction of oxidation and inflammation as far more serious concerns than cholesterol. Cholesterol may accumulate at the site of injury, but if we want to slow aging and prevent damage we need to better understand (and prevent) the injuries in the first place. Blaming cholesterol for heart disease is like blaming the St. Bernard for the avalanche. That's why the true "heart-healthy" diet is not necessarily low in cholesterol. But it is high in anti-inflammatories and antioxidants.
Cholesterol doesn't become a problem until it's oxidized (i.e., damaged by free radicals). Plaque develops as the body attempts to repair injuries, usually caused by inflammation. So oxidative damage and inflammation are the real roots of the problem-not cholesterol. Addressing them seems to be number one with a bullet when it comes to keeping your heart young and vibrant. And it starts with the diet.
More than a low-fat diet, and much more than a low-cholesterol diet, an anti-inflammatory diet is of paramount importance in keeping you young. More good news: the foods that are loaded with anti-inflammatories also tend to be loaded with antioxidants. When you eat these heart-healthy foods, you get a double dose of protection, combating the twin enemies of oxidative damage and inflammation.
Cholesterol levels are actually a lousy predictor for heart disease when considered on their own. Fully half the people who have heart attacks have perfectly normal cholesterol, and half the people with elevated cholesterol do not. Using cholesterol levels as an independent risk factor to predict heart disease will give you slightly better results than using tea leaves to predict the weather.
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The Five Principles of a Heart-Healthy Diet
So what exactly is a heart-healthy diet? In 2002, two distinguished professors at Harvard Medical School, Frank Wu, MD, and Walter Willett, MD, examined a massive amount of research in the area of diet and heart disease in an attempt to answer that very question.
Here are the five principles they came up with:
- Increase your consumption of omega-3 fats from fish, fish oil supplements, and plant sources (such as flaxseeds).
- Substitute nonhydrogenated, unsaturated fats for saturated and trans fats.
- Eat a diet that is high in vegetables, nuts, fruits, and whole grains and low in sugar and refined grain products.
- Avoid processed foods.
- Choose foods, food combinations, and food preparation methods that are low on the glycemic index.
Several years ago, explorer Dan Buettner visited four of the regions in the world where the inhabitants consistently lived longer and healthier than anywhere else. These areas also had some of the highest numbers of healthy centenarians in the world: Sardinia, off the coast of Italy; Okinawa; Loma Linda, Calif.; and the Nicoya Peninsula in Costa Rica. While there were differences in the diets of these four regions, what was remarkable was the similarities.
The Sardinians' diet consisted of whole-grain bread, beans, garden vegetables, fruit, and a cheese high in omega-3 fats that are made from the milk of grass-fed sheep. The Okinawans eat a plant-based diet, including stir-fried vegetables and tofu, plus a high-antioxidant food they call goya, which contains compounds that lower blood sugar. Many of the Seventh Day Adventists in Loma Linda consume nuts at least five times a week (and have about half the risk of heart disease as those who don't). They also eat two or more servings of fruit a day and beans (or peas) about three times a week. And the Nicoyans in Costa Rica eat a nutrient-rich diet based around fortified maize and beans.
All of these societies eat meat, but in very small amounts. Plus, the meat they do eat comes from healthy, locally raised, grass- or pasture-fed animals and is never filled with the hormones, steroids, and antibiotics that come with virtually every serving of feedlot-farmed meat in the United States.
And all eat a lower-calorie diet than the typical American. None of these folks worry about the saturated fat or cholesterol in their diet. They don't have to. By eating high-fiber foods, like beans, and consuming the tons of antioxidants and anti-inflammatories that come with a whole-food, plant-based diet rich in vegetables, they are automatically lowering their risk for heart disease.
There is no single magic food that makes a diet heart-healthy. It's the combination of low sugar, high antioxidants, high anti-inflammatories, high-quality protein, omega-3 fats, and the absence of trans fats that does the trick, and the exact details matter less than the way the parts fit together. That said, there are some superstars among the heart-healthy foods, and you should consider including them on a regular basis if you want to protect your heart and live long and strong.
5 Heart-Healthy Foods You Should Be Eating
1. Wild Salmon
Wild salmon has more omega-3s than farm-raised salmon, and less of the pro-inflammatory omega-6 fats. Wild salmon is also loaded with antioxidants and is far less contaminated than farm-raised salmon.
The plant compounds that make blueberries that rich shade of blue are called anthocyanins, powerful antioxidants that help to protect the structures of the entire vascular system.
Many studies have demonstrated that a diet rich in vegetables, especially the brassica group (cabbage, broccoli, Brussels sprouts), is linked to a significantly decreased risk of stroke and heart attack.
Researchers following 16,000 middle-aged men in seven countries for 25 years found that those who ate the most legumes had an 82 percent reduction in risk of death from heart disease!
According to Penny Kris-Etherton, PhD, distinguished professor of nutrition at Penn State, five large epidemiological studies and 11 clinical studies have demonstrated that frequent nut consumption decreases the risk of coronary heart disease.
The Exercise Connection
Exercise doesn't have to be intense to benefit the heart. Ping-Pong, tai chi, and ballroom dancing are just a few of the many ways to keep your heart healthy and your body young. Though you can get cardio benefits from as little as three half-hour sessions a week, the optimal amount seems to be the equivalent of 30 to 60 minutes five days a week.
Probably no supplement on Earth gives you as much bang for the buck as omega-3 fatty acids. Hundreds of studies have demonstrated the heart-healthy properties of omega-3 fats, especially EPA and DHA (found in fish and fish oil). Take fish oil supplements on a daily basis, and for extra credit, put flaxseed oil on your salads and sprinkle flax meal over your salads and on other foods.
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Other supplements that have been found to be extremely heart healthy include CoQ10 and L-carnitine. For anyone on cholesterol-lowering medication (statin drugs), CoQ10 is a must, since statins deplete this important heart-healthful nutrient. And magnesium is also wonderful for the heart, as it helps relax blood vessels.
Summing It Up
You can increase the odds that your heart will stay healthy and robust well into your ninth decade and beyond by following some simple steps:
- Lower inflammation with a low-glycemic diet high in cold-water fish, vegetables, fruits, nuts, and beans.
- Maintain a healthy body weight.
- Keep an eye on blood pressure.
- Exercise at least five days a week.
- Don't smoke.
- If you drink alcohol, do so in moderation.
- Supplement with fish oil on a daily basis.
- Consider supplementing with CoQ10, L-carnitine, and magnesium.
It's no accident that the heart has been used as a metaphor for everything from courage to love. It's the foundation organ if there ever was one, at the heart of being human! Take good care of it-it will reward you with a long and vibrant life.
Editor's Note: This article has been adapted from Jonny Bowden's book, The Most Effective Ways to Live Longer, published by Fair Winds Press, 2010.