What is heart disease?

Heart disease is the leading cause of death for both men and women in the United States. It is responsible for 1 in 4 deaths and costs us $200 billion in healthcare costs each year. The biggest risk factors for heart disease include hypertension (high blood pressure), high LDL cholesterol, and smoking. A whopping 49% of Americans have at least one of these risk factors (1). Other risk factors include being overweight, lack of physical activity, poor diet, and diabetes. Genetics, age, sex, and ethnicity also play a role.

The most common type of heart disease is coronary artery disease (CAD). CAD is caused by atherosclerosis of the arteries that supply blood to the heart. Atherosclerosis occurs when cholesterol, cellular wastes, and other substances build up in the arteries causing plaques that harden and narrow the vessels. Blood struggles to travel through these narrowed vessels, restricting flow to the heart, which in turn causes the heart to work harder to pump more blood throughout the body. This inevitably results in high blood pressure, explaining why many individuals with hypertension also have high cholesterol. Without an adequate blood supply, the heart is deprived of the oxygen and nutrients it needs to function which can result in chest pain. Oftentimes, a heart attack is the first sign of CAD. According to the CDC, someone in the U.S. has a heart attack every 40 seconds (2).

What about cholesterol?

Let’s talk more about cholesterol. Cholesterol is a waxy fat-like substance found in cell membranes. It’s used to make hormones, bile acids, and vitamin D. The body makes most of its own cholesterol. There are two major types: HDL and LDL. HDL is considered to be “good” cholesterol, while LDL is considered “bad” cholesterol. In reality, we need both, but they should be in a healthy ratio. LDL tends to circulate in the blood stream and form plaques in the arteries when levels become too high. HDL actually absorbs and carries LDL to the liver, where it will eventually be excreted from the body.

Wait, isn’t all cholesterol bad for you? Authorities have traditionally recommended low-fat diets in order to limit cholesterol intake from foods. This recommendation has since been revoked due to lack of evidence, although the belief is still widespread (3). We now know that dietary cholesterol has little to no impact on blood cholesterol levels. This misguided recommendation led to increased consumption of low-fat foods that are higher in sugar. Fat makes food taste good, so companies add more sugar to low-fat products to preserve the taste. Instead of reaching for foods with “fat-free” labels, opt for items like full fat plain yogurt, avocados, olive and coconut oil, nuts and seeds, fatty fish, organic pasture raised eggs, and grass-fed butter. These are good examples of heart healthy fats.

What can you do to prevent heart disease?

Fortunately, diet and lifestyle changes are effective strategies.

Dietary Recommendations:

The Mediterranean Diet is one of the most well researched diets for heart health. Search for the phrase “Mediterranean Diet AND heart disease” and read up. This dietary pattern focuses on eating whole foods like vegetables, fruits, whole grains, legumes, nuts, seeds, eggs, poultry, fish, and moderate amounts of red meat and dairy. This diet is high in fiber, low glycemic index, low in refined sugar, and includes plenty of quality fats like olive oil and fatty fish. You really can’t go wrong with this eating style.

Lifestyle Recommendations:

Therapeutic Foods and Supplements:

The most effective intervention is a healthy, balanced diet rich in whole foods. Supplements should always be discussed with your provider, especially if you’re currently taking medications. Here are a few helpful nutrients and supplements to consider.

• Quality multivitamin

• Vitamin D with vitamin K2 (dairy, meat, eggs)

• Niacin (liver, meat, fish, whole grains, mushrooms)

• Omega 3 fatty acids (fish oil, salmon, flaxseeds, walnuts)

• Nattokinase (the active ingredient of a food made from fermented soybeans)

• Green tea

• Garlic

• Red yeast rice

• Artichoke extract

• Bergamot

Helpful lab tests:

Ask your provider for blood lipids test. A basic screening test should include:

• Total cholesterol

• HDL-C

• LDL-C

• VLDL-C

• Total cholestrol/HDL ratio

• Triglycerides

If you’re in a high risk category for heart disease (obesity, type 2 diabetes, metabolic syndrome, hypertension, taking statins, family history) then you might want to ask for advanced lipid testing. This type of testing assesses the particle size of your cholesterol. You want larger particles, not smaller ones.

Takeaways

There is a lot you can do to prevent heart disease from dietary changes to comprehensive lab testing. While factors like sex, age, and race play a role, the majority of risk factors are lifestyle induced. You can control factors like diet, physical activity, and stress levels. In addition, there are many helpful supplements and therapies that are inexpensive and accessible to most. So, grab your sweetheart and do something heart healthy this Valentine’s Day! If you need help implementing heart healthy habits, we’re here for you.

References:

1) Heart Disease Fact Sheet|Data & Statistics|DHDSP|CDC. Centers for Disease Control and Prevention, Centers for Disease Control and Prevention. Retrieved from: www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_heart_disease.htm.

2) Heart Attack Facts & Statistics. Centers for Disease Control and Prevention, Centers for Disease Control and Prevention. Retrieved from: www.cdc.gov/heartdisease/heart_attack.htm.

3) Dietary Guidelines Advisory Committee. 2015. Scientific Report of the 2015 Dietary Guidelines Advisory Committee: Advisory Report to the Secretary of Health and Human Services and the Secretary of Agriculture. U.S. Department of Agriculture, Agricultural Research Service, Washington, DC. Retrieved from: https://health.gov/our-work/nutrition-physical-activity/dietary-guidelines/previous-dietary-guidelines/2015/advisory-report

4) How smoking affects heart health. U.S. Food and Drug Administration. Retrieved from: https://www.fda.gov/tobacco-products/health-effects-tobacco-use/how-smoking-affects-heart-health

5) Chevalier, G., Sinatra, S. T., Oschman, J. L., & Delany, R. M. (2013). Earthing (grounding) the human body reduces blood viscosity-a major factor in cardiovascular disease. Journal of alternative and complementary medicine (New York, N.Y.), 19(2), 102–110. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3576907/

6) Azab AE, Ebrahim SA. Exposure to electromagnetic fields induces oxidative stress and pathophysiological changes in the cardiovascular system. J Appl Biotechnol Bioeng. 2017;4(2):540-545. Retrieved from: https://medcraveonline.com/JABB/exposure-to-electromagnetic-fields-induces-oxidative-stress-and-pathophysiological-changes-in-the-cardiovascular-system.html

7) Hamilton, J. A., Hasturk, H., Kantarci, A., Serhan, C. N., & Van Dyke, T. (2017). Atherosclerosis, Periodontal Disease, and Treatment with Resolvins. Current atherosclerosis reports, 19(12), 57. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/29110146/