Matters of the Heart: Food, Lifestyle Factors and Nutrients for Heart Health

There are many things that contribute to heart health and heart disease.  Since it is a leading cause of death, its a good idea to learn your risk for heart disease and what you can do right now to lower your risk.  

Think of your heart like your car’s engine, it keeps the body moving with the help of the electrical system.  The heart has two sides, each with a top chamber, atrium,  and a bottom chamber, ventricle. The right side pumps blood to the lungs to pick up oxygen. The left side receives oxygen-rich blood from the lungs and pumps it through arteries throughout the body. An electrical system in the heart controls the heart rate (heartbeat or pulse) and coordinates the contraction of the heart's top and bottom chambers.  Your nervous system and hormones, like epinephrine, control the rate at which your heart pumps, causing your heart rate to go up or down.  A normal resting heart rate is between 60 and 100 bpm depending on age. Here’s how healthy eating, not smoking and exercise help your heart: Healthy eating:  eating too many salty foods can make the heart and kidneys work harder.  When we eat too much salt or sodium, we hold on to excess water.  The kidneys have to filter this and the heart has to work harder to pump the extra fluid.  When done often, this can damage the kidneys and the heart, leading to high blood pressure.  

Also, as we age artery walls become stiff leading to arteriosclerosis, or hardening of the arteries.  This causes high blood pressure as the heart isn’t able to pump as efficiently as it can with flexible, less hardened arteries.  The combination of hardened arteries and plaque build up in the arteries lead to atherosclerosis and stop oxygenated blood from flowing as easily from the heart through the body and back again.  Less oxygen, less blood equals problems.  Once a large artery becomes narrowed or blocked by plaque or the plaque area ruptures, this causes chest pain or heart attacks. Having a diet that is high in fiber can help reduce cholesterol levels and in theory reduce plaque build up in the artery walls. Soluble fiber absorbs water and forms gel-like material which binds and sequesters cholesterol, and thus decreases absorption by the liver and increases excretion from the body, which in turn lowers blood lipid levels.  Some of the best soluble fiber sources are beans, oats, brussel sprouts, oranges and ground flaxseed. In the average American's diet, about 20% of calories that come from fat are omega-3 and omega-6 fatty acids. Most of the omega fatty acids are omega-6s. Experts have found that people who eat foods with high levels of two of the omega-3 fatty acids, eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA), have lower rates of heart disease. EPA and DHA are also called marine omega-3s because they are found in fatty fish like mackerel, lake trout, herring, sardines, albacore tuna, and salmon. They are also in supplements called fish oils. Another source for EPA and DHA is alpha-linolenic acid. This is found in soy and canola oils, flaxseed, walnuts, and other nuts. It can be changed into omega-3 fatty acids in the body, but its benefit in preventing heart disease is not as clear. Keep in mind it’s never one aspect of a diet or exercise plan that leads to good health or poor health.  It’s the combination of things.  That’s one reason the Mediterranean diet seems to be beneficial for so many things (diabetes, high cholesterol, weight loss).  It’s the combo of eating more produce, more omega 3 fats, less processed food and more physical activity that improves health. Smoking cigarettes robs the body of vitamin C, a nutrient that humans can’t make on their own unlike most animals.  Vitamin C is important for immune function, absorption of iron, collagen formation and is an antioxidant.  People who smoke require 35 mg/day more vitamin C than nonsmokers.  Chemicals in cigarettes are inhaled into the lungs, which in turn gets into the blood and distributed through the body. The chemicals cause damage to your heart and blood vessels, plus change the chemistry of the blood, increasing the things we mentioned earlier, artery hardening and plaque build up.  Chewing tobacco can also increase heart rate and blood pressure, so it’s not just smoking tobacco that’s risky. The heart is a muscle and needs it’s workouts, so exercise is vital to heart health.  When you hear “cardio” or “cardiovascular” exercise, think heart health.  Cardiovascular endurance is the ability of the heart, lungs and blood vessels to deliver oxygen to your body tissues. The more efficiently your body delivers oxygen to its tissues, the lower your breathing rate is.  The worse your cardiovascular endurance, the harder it is to climb stairs, chase your kids or walk the grocery store without feeling winded.  By exercising, you are improving your endurance, which makes day to day tasks easier.  Examples of this type of exercise are brisk walking, jogging, swimming, biking or dancing. There are certain numbers you’ll want to know to see how your heart and arteries are doing.

1. Blood pressure- this will tell you how hard your heart is working essentially.  A normal blood pressure for most people is 120 over 80.  Typically, more attention is given to systolic blood pressure (the first number) as a major risk factor for cardiovascular disease for people over 50. In most people, systolic blood pressure rises steadily with age due to the increasing hardening of the arteries and long-term buildup of plaque in the artery walls.

2.  LDL cholesterol- LDL is a carrier of cholesterol and carries it back to the body where it can collect around organs and in arteries.  So having too much LDL is a bad thing.  To remember this one, think L as in lousy cholesterol.  On the other hand, you have HDL which carries cholesterol out of the body, and is good to have more of.  Think H and happy, HDL is the happy cholesterol carrier.  Cholesterol is a waxy substance needed to build cell walls so it’s not inherently “bad.” Too much though can lead to problems.

A good target for LDL is 100 or less.  For HDL, 40 or higher for men and 50 or higher for women is good.

3.  Triglycerides are another number that gets drawn in a lipid panel.  Too much triglycerides, think of these as an extra form of energy storage in the body, floating around in the blood stream until they are needed, can cause damage to the arteries or pancreatitis if very elevated.  A good target is 150 or less.  People who drink excessive alcohol, eat fast food and highly processed food regularly tend to have high triglycerides. There is familial high cholesterol which is controlled mostly by genetics. Again, it’s a combo of factors that increase your risk of heart disease, not just one of these.  Someone with an elevated LDL but also a good HDL will likely be able to stay off medications if all other factors are okay. What can you do to improve cholesterol and lower blood pressure? LDL:  eat more fiber, eat less saturated fat, exercise more.

HDL: to increase, exercise more.

Triglycerides: exercise, reduce alcohol, reduce sugar, reduce low fiber carbs like white bread; eat more omega 3 fats or take an omega 3 supplement, 2000-4000 mg/day at least.

Cholesterol: all of the above, plus phytoesterols or plant sterols. These are found in vegetables nuts and seeds but you would have to eat bowls full a day to get the amount you can get from a supplement.

Blood pressure: exercise, reduce sodium intake, eat more fruits and veggies to increase potassium, more plants to increase magnesium, don’t smoke and alcohol in moderation or none.  Beets have been shown to help lower blood pressure as well from the natural source of nitrates, which can increase nitric oxide availability.  This has many functions in the body including blood flow, regulation of neurotransmission and physiological and cognitive performance benefits. The acceptable daily range has been set at 3.7 mg per kilogram of body weight. This is because a small amount of nitrates are converted into n- nitrosamines in the body, which have been implicated in certain cancers. Think about what you hear about cured meats and colon cancer for instance. Despite this there is no current evidence on negative effects from nitrate consumption from vegetables versus like beets or spinach. 

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