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When the heart and blood vessels aren’t fueled properly with sound nutritional habits, a laundry list of problems can develop under the cardiovascular disease (CVD) umbrella.
The heart is more than just a pump, which is why nutrition for heart health can get a little complicated.
Yes, the heart’s primary job is to pump oxygen-rich blood to the body’s tissues, but it also must keep blood pressure at a healthy level, clear metabolic waste from your system, receive oxygenated blood from the lungs, and help hormones reach their target tissues.
To cover this task list efficiently, the heart and blood vessels need to be fueled properly.
These problems include coronary heart disease, cerebrovascular disease, peripheral arterial disease, deep vein thrombosis, and several others.
Before examining the nutritional connection to heart health, a quick look at the staggering scope of this problem.
A Lethal Epidemic
For a largely preventable issue, CVDs are bafflingly prevalent throughout the Western world.
According to the World Health Organization (WHO), CVDs are the #1 cause of death globally, killing 17.9 million people in 2016, which accounted for just under a third (31%) of all deaths that year.
Of these deaths, the vast majority (85%) were associated with a heart attack or stroke.
The main drivers of this sharply worsening trend are poor diet and inactivity.
Stress, genetic predisposition, drug use, and other factors also play a role.
Thanks to fervent awareness campaigns of the latter 20th century and on, most are vaguely aware that eating too much processed food and/or red meat can cause heart issues, but diving a little deeper into exactly how this works can aid prevention and inspire lasting lifestyle changes.
Exploring the Nutrition and Heart Health Connection
Before reviewing foods that can raise or lower heart disease risk, it’s important to understand the (very) general physiology behind how CVDs develop in the first place.
For example, systemic inflammation in the body over an extended period of time is a powerful enabler of heart disease.
The biochemistry can get very complex, but for the purpose of simply relating dietary choices to heart disease, we don’t have to dive that deep.
Here’s your plain-speak breakdown of the main drivers of heart disease.
Per the review, studies have found that levels of cytokines, a group of compounds that cause inflammation in the body, are consistently higher in patients with heart failure.
Additionally, patients suffering from “acute coronary syndromes” have a lower survival rate as their cytokine levels go up, and heart disease risk is higher in patients who have chronic inflammatory diseases (arthritis, dermatitis, etc.).
Inflammation is an important part of the immune response, and cytokines are needed by the body to carry out these functions.
However, as we’ll review, much of the processed food we eat forces this otherwise healthy response into overdrive.
Perhaps the most readily understood link between nutrition and heart disease is the matter of triglycerides, which are fats in the bloodstream.
The way in which triglycerides are stored and released into the bloodstream can get a little complicated, but suffice it to say, abnormally high triglyceride levels in the blood due to a high-fat diet (combined with inactivity) can significantly increase the risk of a heart attack or stroke by causing blockages in arteries among other issues.
This is strongly evidenced in many studies, like this meta-analysis from the University of Washington in Seattle, where the results of seventeen studies revealed that men with high triglycerides had a 30% increased risk of cardiovascular disease, and women had a 75% increased risk.
Even when a healthy level of “good cholesterol” (high-density lipoproteins) is present, high triglycerides still elevate CVD risk.
This is a two-dollar term for an overabundance of free radicals in the body.
As this article from Innsbruck Medical University of Austria explains, “Increased ROS (reactive oxygen species, aka free radicals) lead to decreased nitric oxide availability and vasoconstriction, promoting arterial hypertension. ROS also negatively influence myocardial calcium handling, causing arrhythmia…”
In English, too much oxidative stress can make it harder for the blood vessels to expand to allow healthy blood flow, and can also interfere with how the heart utilizes nutrients like calcium, leading to irregularities.
Oxidative stress can even pair up with triglycerides to enhance the formation of plaques that cause the blockages we referred to.
Here are some common causes of oxidative stress:
- Fatty, sugary, processed foods
- Tobacco and alcohol
- Some drugs
- Exposure to certain chemicals
- Environmental factors (pollution, radiation)
The Most Heart-Healthy Diets
Now that we’ve outlined the general diet-driven processes that contribute to heart disease, let’s review actual diets/foods that can counteract these issues.
In short, diets that steer clear of pro-inflammatory foods, artificial ingredients, and excess fat/sodium are off to a great start.
This clinician’s guide to healthy eating authored by Johns Hopkins cardiovascular disease experts claims that “Dietary Approaches to Stop Hypertension (DASH), Mediterranean, and vegetarian diets have the most evidence for CVD prevention.”
These diets all have the above prerequisites checked; they’re loaded with plant-based, low-fat options that will gently reduce inflammation, lower cholesterol, and reduce the impact of oxidative stress.
The great news is that in some contexts, even meat and dairy can still be worked into these diets.
Here’s a short list of foods and their impact on CVD, as relayed by a World Heart Federation report:
Meat is nutritionally dense (iron, protein, zinc, and B-vitamins), but usually high in cholesterol, which explains why processed red meat consumption has been linked to higher rates of CVD as well as type two diabetes.
However, unprocessed red meats are associated with a significantly lower risk of developing CVD, and of course, lean poultry and fish are even lower.
Per the report, low-fat dairy consumption is actually associated with a decrease in “bad cholesterol” (LDL, low-density lipoproteins).
The scientific community is currently revising the “good cholesterol versus bad cholesterol” idea, since the relationship between cholesterol and heart disease is actually much more complicated, but most are in agreement that fewer LDLs is a good thing.
Milk consumption also decreased risk for hemorrhagic stroke in a large study out of Japan.
Keep in mind that this refers to low-fat dairy products.
Though these findings are promising, the connection is still weak; milk did not significantly decrease CVD risk.
Fruits and Vegetables
Unsurprisingly, a higher intake of fruits and vegetables lowers cholesterol, blood pressure, and overall risk of CVD (as well as diabetes).
There’s no “but” here; fruits and vegetables are consistent in their ability to protect against a litany of epidemic-level diseases affecting humankind at alarming rates.
Though sodium gets a thorough undressing from many health nuts, the body needs this nutrient for many vital processes.
The problem is that the Western diet is already way, way overloaded with sodium, which is directly connected to several indicators of CVD (high blood pressure being a primary issue).
Most authorities recommend somewhere between 1,500mg and 2,000mg for the maximum daily amount of sodium.
To provide context, that’s about one and a half slices of pizza (with meat) or just a single can of soup.
It’s high time Westerners fought back against the CVD epidemic, which starts with resisting the temptation to snack on sugary, fatty, processed foods.
If you simply maintain a set of best practices, there’s no need to spiral down the search engine rabbit hole and panic-learn your way through 3000-level Biochemistry curriculum.
Avoid crappy food, eat more plants, and exercise—that’s it.