by Doc Mok

It is one of the most important organs in the body.  Without your heart, you cannot live.  Yet, with something so important, why is it that heart disease continues to be the number one killer of the American people?  This week at Maximal Being we hash out 7 Heart Healthy Tips That Will Save Your Life.

Heart-Healthy Grains and Babies with Plaques

It doesn’t matter what source you go to; heart disease is king.  What I mean is coronary artery disease and the many issues that arise as a result, continue to be the leading cause of death in America. 

Coronary artery disease (CAD) involved the formation of plaques within the wall of the blood vessels that supply oxygen and nutrient-rich blood to your heart.  We are actually born with early deposits of fat in the wall of our arteries.  That is right, babies, who have never had a fast-food cheeseburger are destined from day 1 to have heart disease.

A dismal future I know, add on years of the advertising agency promoting bioscience and well, here we are.  Such useful chestnuts like the branding of heart health grains on every cereal box in America have landed us in this heart-healthy pandora's box.  Since when has something with 13 grams of sugar in 1 cup, made of chemicals, been “heart-healthy.”  Fret, not, as science is here to save the day!

The 7 Health Healthy Tips

The overarching theme to eliminating your heart disease risk and preventing further damage to those fatty baby vessels is disease risk modification.  By this I mean, you cannot unclog those plaques that have been there since birth, but you can prevent them from becoming inflamed and causing narrowing. 

To summarize these modifiers, there are 7 key components, some of which are intermingled. 

1. don’t smoke
2. eat right
3. lower BP
4. lower cholesterol
5. normalize blood sugar
6. maintain healthy weight
7. exercise

Tobacco Heart Health Tip Enemy Number One

Smoking, chewing, or vaping tobacco is the MOST IMPORTANT cardiovascular risk factor.  Since the publication of tobacco being harmful in Reader’s Digest back in the 1950’s, tobacco use did decline, however still remains a habit in 15% of Americans (36.5 million).  Risk of most cancer in the human body aside, tobacco is responsible for one out of every 5 deaths and doubles your cardiovascular risk.

One year after you stop, not only do you save around 2,000 dollars annually (assuming the average cost is 5.51 USD and you don’t live in New York City), but your risk of heart disease drops by 50% the first year and 1-5% each additional year you do not smoke.

Some may prescribe e-cigarettes as an alternative, however, a study in JAMA from 2017 showed that the risk for such inhalants is equal to cigarettes.  For some, it takes nicotine replacement therapy with the patch AND gum.  A tip is to bite the gum and place under your lip and not chew it.  Mindfulness, meditation, therapy and several apps including Quit Guide and QuitSTART can assist on this journey.  Trust, me TOBACCO = BAD…period! STOP Today!

High Blood Pressure and Heart Health

Also tied into tobacco use is your blood pressure (BP).  BP is the ability for your body to pump blood to the vital organs against those pesky plaques.  Imagine water flowing through your kitchen pipes without bacon grease and with it.  Eventually, with enough grease, you either have to force the water through (pressure) or unplug the pipes.

The effect of such high pressure is to place mechanical stress on the artery walls, which leads to inflammation and scarring, narrowing the vessel and lowering the flow.  You then get CAD and will likely have damage to the heart muscle, termed a heart attack. 

This risk goes up as we age (people > 60 years old have a 65% risk of high blood pressure), have diabetes and amongst African Americans (40% versus non-African American counterparts 28%).  Though this may seem all doom and gloom, there are ways to fix the pressure problem

Tips to Reduce Your Blood Pressure and Improve Heart Health

By improving your BP by 10 points (mmHg), you can lower your risk of heart disease by 17%, heart failure by 28%, and stroke by 27%.  General tips for doing this can be with medication, or with lifestyle.  A landmark paper entitled the Framingham heart study, identified that weight loss can reduce the heart disease risk by 26% in men and 28% of cases in women.  

As easy as this may sound, these recommendations are somewhat macroscopic, thus further study has noted that moderating alcohol and watching salt intake via the DASH diet have the highest nutritional impact.

The DASH diet involved the below basic principles and has shown variable results when complemented with low sodium intake.  When I was in training, this was out of vogue, now it appears to have come back.  Here are the data for your interpretation. 

Either way, the general principles of this diet seem relatively intuitive, however, grains and cholesterol may be caveats to DASH which could be argued. 

The DASH diet Summary:

• is low in saturated fat and dietary cholesterol
• is low in sodium (if following the low-sodium version)
• is rich in potassium, magnesium, calcium, protein, and fiber
• emphasizes fruits, vegetables, and low-fat dairy
• includes whole grains, fish, poultry, and nuts
• limits red meat, sweets, and sugary beverages

Cholesterol in your Diet Does Not Equal Cholesterol in Your Heart

One of the biggest misconceptions in our recent nutritional history is the thought of cholesterol in is BAD.  The original iterations of the Framingham Heart Study were politicized leading to decades of accepting FAT = BAD, Grains = Good.  Really, the opposite may be true.  High simple carbohydrate intake actually will lead to high triglyceride levels (a type of cholesterol).  I encourage you to read this article for the granular details on fat demonization, but scary.  

Like most things in the human body, we are not that simple.  So, the sentiment that fat in = fat in the heart is a rudimentary one.  The case and point are Mediterranean societies that consume a fairly high concentration of healthy fats (monounsaturated and polyunsaturated).  Many components of this Mediterranean Diet are linked to lower blood cholesterol levels and lower heart disease, despite a high-fat content. 

To summarize the Mediterranean diet:

• Daily consumption of vegetables, fruits, whole grains, and healthy fats
• Weekly intake of fish, poultry, beans, and eggs
• Moderate portions of dairy products
• Limited intake of red meat

Apart from the Mediterranean diet, general ways to consider individual food interventions include the following: 

• Fish – lower LDL and TG
• Nuts – increase HDL lower LDL
• Soy products -lower LDL
• Pectin (fruits) – lower LDL
• Olive oil – monounsaturated fats lower LDL
• Veggies – lower LDL due to fiber

Generally, all of these components of a diet are healthy.  They are all clean and are real food.  They are limited in terms of sugar intake, as sugar also plays an important role in these heart-healthy tips.

Heart Healthy Tips to Limit Sugar Intake

Sugar is NOT sweet when it comes to your heart health.  In fact, the BMJ demonstrated that those with high blood sugars (meaning pre-diabetes over 100-125 mg/dL, diabetes over 126 mg/dL) had higher heart-related death rates.

As we discussed in our article on Insulin resistance (HERE) and Why Your Drink is Your Enemy (HERE) high intake of carbohydrates leads to fat around the middle via insulin resistance.  As above, high simple carb intake, also leads to worsening heart health via conversion of the excess into fat, meaning cholesterol. 

The inputs into obesity and insulin resistance are many including alcohol, simple carbs, added sugar, hormones, and stress.  Therefore, limiting the effect of these inputs by low or no alcohol, low (50 grams/day or less) in sugar are important success heart health modifiers. 

Obesity Metric Tips for Heart Health

On the same note, obesity follows such sugar-modifiers to improve your heart health.  Using the above dietary guidance, you will, by definition improve abdominal fat.  Please make sure that you use the right metric. 

Many worry about weight and body mass index, including us healthcare providers.  However, as we discussed in this article on GOALS (HERE) using measurements, calipers, electronic devices and just that satisfaction with the person in the mirror may be better than the scale. 

Variations in your weight may be due to your salt intake and the amount of glycogen (stored carbs) that you have.  Rapid fluctuations can even be from the scale that you use.  If you need help with losing fat, let us know via email, speak pipe or click here.  Wanting to know more on the impact of exercise on your heart health, read on. 

We have Nutrition Down, Now Let’s Exercise for Heart Health

As discussed in our article on NEAT, America is moving less (HERE).  Along the same lines, the CDC recommends 2 sessions of resistance training 30 min each and 150 min of moderate-intensity aerobic exercise (moderate intensity means 64-76% of your heart rate goal, meaning 220-age). 

• Exercise will grant you the following benefit for your heart health
• strengthens CV system
• increases HDL, lower TG
• lowers BP and HR
• lowers inflammation
• increase insulin sensitivity

The benefits of meeting these goals are proven since the 1950s, when London’s double decker bus drivers had lower heart disease risk, as did mail carriers versus phone operators.  The reason, movement!  Similar to walking, only 20% of American can meet these guidelines.  For most, the difficulty in employing such exercise techniques is time. 

Time Tips for Heart Healthy Exercise

Look, busy for you is busy.  RN Graham works 80 hours a week and makes time for his exercise and his family.  Motivation and prioritization of exercise is why he is successful.  He realizes the benefit and executes it.  True some people are just busy, but trust me, you can find time to work on yourself and your heart health. 

The good news is, that you can maximize your time.  As we discussed in our article on EPOC (HERE) and on HIIT (HERE), high-intensity interval work, may save your time and grant you improved results versus moderate-intensity exercise.  Not all folks can exert this much effort, however, working toward this level of intensity is a great goal. 

Research performed by Dr. Gillen in 2016 showed that you can obtain the same benefit with 5 times less time using HIIT when compared to moderate intensity.  The results are not just in preventing heart disease-related hospitalization, but will also improve your other modifiable risk factors as above.

Miscellaneous Heart Healthy Interventions

Another runner-up intervention includes mitigating stress with practices such as mindfulness (Link here for Elle Mok’s article).  Among this mindfulness, technique nature walks and mediation can lower your disease risk, blood pressure, and stress level.  Owning at pet can also assist with stress and improve heart health outcomes and they are adorable to boot.  

Though not within my area of expertise, dental health lowers heart disease risk by 24-34%.  Finally, beverages, namely red wine (1 glass) will improve HDL and the data on tea is mixed, but likely cannot hurt you.  I would also like to note that alcohol, maybe more dangerous for the rest of your body, but these data are intriguing nonetheless. 

Summary Tips for a Heart Healthy Life

Ignore the bioscience and advertising ploys of heart-healthy grains and the mantra that fat in your diet leads to cholesterol in your vessels.  Rather, eat a diet that contains healthy fats, is low in simple carbohydrates, and rich in vegetables.  Consider the two heart healthy diets Mediterranean and DASH but note key modifiers (limit simple carbs and grains).  Get up and move with the intensity that suits you, but if you increase the intensity, you can lower the time required.