How to Keep Your Heart Healthy
The latest evidence on the best diet, exercise, and heart supplements—even if you take prescription drugs to reduce harmful blood clots, cholesterol, or blood pressure.
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Being physically fit and eating a heart-healthy diet can each cut risk for heart disease in half. Does that mean you’ll be free of heart problems forever if you do both? No one has tested the premise, but you’d certainly be in better health.
Best Foods for a Healthy Heart
Despite decades of a low-fat diet being promoted as the answer, recent evidence paints a different picture. In fact, the key drivers of heart disease are sugary and starchy foods, rather than fat. A major U.S. study found that people who get 25 percent of their calories from added sugar (sodas and other sweetened drinks are major sources) are more than twice as likely to die from heart disease as those consuming less than 10 percent of calories from added sugar. Another study found that eating foods that trigger high blood sugar—including sweetened drinks and starchy foods—contributes to atherosclerosis
and doubles risk of heart-related death.
In contrast, eating more seafood rich in omega-3 fats, non-starchy vegetables, fruits, nuts, and seeds has a protective effect on the heart. A moderate amount of full-fat dairy foods and unprocessed red meat are also good. In other words, aim to eat more vegetables (other than potatoes), more fish and seafood, more fresh fruit, and some nuts and seeds. Some dairy and meat are fine as well. Go easy on grains, because many of today’s dishes are overloaded with them—big bowls of pasta, large buns for burgers and sandwiches, and pizza with thick crusts are common examples.
When it comes to exercise, spending endless hours on a treadmill is not the most effective regimen for heart health. Activities such as brisk walking or running at a moderate, steady pace have been the standard for improving fitness, but they aren’t the best. An analysis of studies following nearly 1,000 people with heart disease found that interval training—short spurts of intense activity alternated with movement at a relaxed pace—is more effective.
Here’s an example: Instead of walking at the same pace for 20–30 minutes, walk as fast as you can for a block and then walk at a slower, more comfortable pace for one or two blocks, and repeat the cycle multiple times.
Weightlifting is an alternative. A study at the University of Iowa looked at 13,000 people and found that just lifting weights—twice per week—reduced risk for heart attacks and stroke by 49–70 percent. Spending more than an hour a week on weightlifting didn’t produce any added benefits. The key is to challenge muscles.
Three out of four American adults take supplements, and heart health is a leading reason. However, despite the growing use of drugs to reduce cholesterol, blood pressure, or harmful blood clots, there’s a scarcity of research about how to safely combine these with supplements for optimum benefits.
Both supplements and drugs are typically tested in isolation, and warnings about interactions can be unnecessarily alarming. According to the National Institutes of Health, “Concerns about herb-drug interactions are often not based on rigorous research. Most herb-drug interactions identified in current sources are hypothetical, inferred from animal studies, cellular assays, or based on other indirect means.” That said, some drug-supplement combinations can be dangerous.
Studies have found, for instance, that St. John’s wort, popular for depression, can reduce drug potency and should not be taken with prescribed drugs unless closely monitored by a physician. Based on research and his clinical experience, Stephen Sinatra, MD, a pioneer in integrative cardiology and author of The Sinatra Solution: Metabolic Cardiology also recommends avoiding:
- Licorice with blood pressure drugs, as the herb can raise blood pressure.
- Extended-release niacin with cholesterol-lowering statins, as the combination can put too much stress on the liver.
- Specific blood-thinning nutrients and herbs with drugs that thin blood, as the combination could lead to dangerous bleeding. (Keep reading for more on blood-thinning supplements).
On the other hand, medications can deplete nutrients that are vital for heart health, and the right supplements are essential to counteract such depletions, reduce some drug side effects, and improve heart health and overall wellbeing. Can supplements replace the need for drugs? Along with diet and lifestyle changes, perhaps—in some cases.
“Certainly there are large numbers of the population with mild to moderate hypertension, for example, or borderline type 2 diabetes, who can certainly come off pharmaceutical drugs with lifestyle changes such as weight loss, eating a better diet, and taking targeted nutritional supplements,” says Sinatra. But, he adds, “Pharmaceutical drugs are life-saving in many situations, especially in heart failure or arrhythmias.”
If you’re taking medications, Sinatra emphasizes that it’s vital to tell your doctor about your supplements. If it’s possible that you could reduce or eliminate medications, it’s a process that must always involve your doctor.
Blood Thinner Warnings
Blood thinners help prevent harmful clots that can trigger a stroke or heart attack. The oldest blood thinner, warfarin (brand names are Coumadin and Jantoven) works by blocking vitamin K, which is needed to form clots and stop bleeding. Taking vitamin K supplements or eating too many vitamin K-rich foods reduces the drug’s effectiveness.
In addition, warfarin should not be combined with supplements that thin blood, says Sinatra, especially nattokinase, ginkgo biloba, garlic, ginger, and vitamin E in doses of more than 400 IU daily.
Sinatra says that these heart-healthy supplements should not be problematic for those on blood thinners: fish oil in doses of 1,000 mg daily of an EPA/DHA combination, magnesium, a low-dose multivitamin (without vitamin K), and CoQ10. However, there have been some case reports of excessive bleeding or reduced drug effectiveness when CoQ10 was combined with warfarin, so its use with the drug should be monitored by a doctor. Taking warfarin requires blood tests, usually performed every few weeks.
Newer blood thinners such as Xarelto, and Eliquis don’t affect vitamin K, but the warfarin cautions mentioned above also apply to the newer drugs.
Supplements, Statins & Blood Pressure Drugs
Other than St. John’s wort, licorice with blood-pressure drugs, and extended-release niacin with statins, supplements should not be a problem with statins and blood pressure medications, says Sinatra. Rather, it’s vital to avoid these nutrient depletions:
- CoQ10: Statins are known to deplete CoQ10, contributing to muscle weakness and pain. Taking CoQ10 can alleviate these symptoms. Drugs to lower blood pressure and blood sugar can also deplete the nutrient. CoQ10 is essential for the heart to produce energy. It reduces fatigue and risk for heart attacks and heart failure. Exposure to pollutants also diminishes it, and levels naturally drop as you age. Use the Ubiquinol form of CoQ10 for optimal absorption.
- Vitamin K: Depleted by statins, vitamin K is essential to prevent calcium deposits from blocking arteries and to enhance calcium absorption in bones. For anyone over age 50 who is not taking warfarin, Sinatra recommends taking vitamin K in the form of MK-7 (menaquinone-7).
In addition to keeping your doctor apprised of your supplement regimen, it’s prudent to have your medications reviewed to make sure there are no potential drug-drug interactions.
Heart-Healthy Supplements for Everyone
Whether you take prescription drugs or not, these are Stephen Sinatra’s top supplement recommendations for a healthy heart. Don’t take vitamin K if you’re taking warfarin. Otherwise, all these can be taken with blood thinners, statins, and blood-pressure drugs—just let your doctor know about any supplements you take.
- CoQ10: After age 30, take 50–100 mg daily of CoQ10 (preferably Ubiquinol). After age 60, take 100 mg daily. If taking statins, try 100 mg, and if there’s no improvement in the way you feel, take 200–300 mg daily. If you take warfarin, make sure to get regular blood tests and tell your doctor that you’re taking the supplement.
- Vitamin K: After age 50, take 150 mcg daily of the MK-7 form (but not if you’re taking warfarin).
- Fish Oil: Add the amount of EPA and DHA in a product. Take at least 1,000 mg of an EPA/DHA combination daily.
- Multivitamin: If taking medications, take a daily serving of a product that contains no more than 100 percent of the Daily Value (% DV in Supplement Facts) of each nutrient. Otherwise, take any multivitamin of your choice.
- Magnesium: Take 400–800 mg daily. If you get loose stools, decrease the dosage.
- Curcumin: It reduces inflammation that can damage the heart. The dosage for patented forms (e.g., BCM-95, CurcuWIN, or Meriva) range from 250–750 mg daily; for all other brands, follow label guidelines.
- Resveratrol: A strong antioxidant and anti-inflammatory substance found in red grapes and wine, it protects the heart and helps control blood sugar. Take 10–50 mg daily.
- Astaxanthin: An antioxidant that gives salmon and other seafood their red color, it protects the heart, skin, eyes, and brain. Take 6–12 mg daily.
It’s always best to take supplements with food. If you’re taking any medication,
take supplements a couple of hours after the drug.
The Most Studied Heart-Healthy Herb
More than 750 studies and scientific articles have documented the benefits of Aged Garlic Extract (AGE) for heart health. Some highlights:
- AGE slowed the accumulation of arterial plaque by 80 percent and reduced levels of existing plaque, effectively slowing down and even reversing atherosclerosis.
- When taken for at least 2 months, AGE reduced harmful LDL cholesterol by up to 10 percent.
- AGE lowered blood pressure by an average of 5.1 mm Hg in systolic pressure (the top number) and 2.5 mm Hg in diastolic pressure.
In studies that produced these types of benefits, daily doses have ranged from 1,000–2,400 mg per day. An average recommended dose for heart health is 1,200 mg daily.