How healthy is your heart?
Heart disease is one of the leading causes of UK deaths, so it’s imperative to look after your ticker. This blog discusses the role a healthy diet can play in heart health.
Indeed, a healthy diet plays a major role in many aspects of your physical and mental health. It can help reduce your risk of developing heart disease and other unpleasant conditions such as unhealthy weight gain, diabetes, and high blood pressure and stroke.
“There is no doubt that a healthy diet can be a powerful tool in the management of cardiovascular risk” – Mr Inderpaul Birdi, Consultant Cardiac Surgeon at The Keyhole Heart Clinic London.
It is not uncommon for certain food to influence blood pressure, triglycerides, cholesterol, blood glucose levels and inflammation, all of which are risk factors for heart disease:
Read on to discover some of the best and worst foods for your heart.
Foods Rich in Omega 3
The consumption of oily fish rich in Omega 3 fatty acid has long been linked to maintenance of a healthy heart. Oily fish include salmon, mackerel, anchovies, and sardines. The most important effect of fish oil is in reducing plasma triglycerides which may be beneficial in preventing the development of furring of arteries in the heart and body in general.
Another potential protective effect may be mediated by the anti-inflammatory effects of Omega-3. Remember also that the body is unable to produce Omega-3 and requires active consumption to remain healthy.
It’s important to note these are potential effects of Omega 3, since the actual evidence for reduced cardiovascular risk has been mixed, and randomised trials comparing populations who consume varied amounts of oily fish are lacking.
In a recent article which studied a large human cohort of nearly 200,000 participants, minimal oily fish intake of 175 g (approximately 2 servings) weekly was associated with lower risk of major cardiovascular disease and mortality among patients with prior cardiovascular disease but not in general populations with no previous history of cardiovascular disease.
The best advice, for now, is to include two portions of oily fish in your diet each week as part of a balanced Mediterranean style diet (also known as a pescatarian diet.)
With recent concerns over climate change and the environmental impacts of farming, many have chosen to go vegetarian or vegan. If you are on either of these diets, it is important to research healthy options for Omega 3. For example, one of the best sources for vegan Omega 3 is none other than algae. It shouldn’t come as a surprise since fish and krill feed on them. You can get omega 3 supplements with algae as the primary ingredient. Spirulina, flaxseed, chia seeds, walnuts, Brussel sprouts are other examples of Omega 3 Sources.
Healthy Fats Are Important for Heart Health
Food such as avocado are rich in heart healthy mono-unsaturated fatty acids and phytosterols, which can help to reduce cholesterol levels by blocking the absorption of cholesterol through the gut wall. Avocado is also rich in glutathione and vitamins C and E. As well as being a powerful antioxidant, vitamin E can protect LDL cholesterol from oxidation, which helps to prevent damage to the blood vessel lining and thus plaque formation.
Another example of healthy fats is nuts which contains the plant form of Omega-3, known as Alpha Linoleic Acid (e.g.,walnuts, flaxseed, chia seeds, hemp seed).
These nuts are the best plant-based sources of Alpha Linoleic Acid, which like Omega-3, may help to prevent hardening of arteries and reduce atherosclerotic plaque build-up.
Walnuts can be eaten whole but to reap the benefits of flax and chia seeds, they need to be freshly ground before adding them to your food, otherwise they will pass through the gastrointestinal tract largely undigested. Alternatively include cold pressed flaxseed oil into your diet in salad dressings or drizzled on cooked foods, but it should not be used for cooking on heat.
Cold pressed extra virgin olive oil has been strongly linked with lower risk of cardiovascular disease in Mediterranean and other world populations. The cardioprotective effects are thought to be because of polyphenols which are known to have antioxidant and anti-inflammatory effects. There remains debate about how this is best consumed. We recommend consumption by drizzling directly onto food rather than heating the oil.
Plenty of Fruit and Vegetables
Consumption of whole fruit and vegetables is recommended as part of a balanced multi-source cardioprotective diet. Both food types contain antioxidants which may be cardioprotective. In addition, the high fibre content of these whole foods helps to improve blood sugar regulation, increase healthy gut bacteria, and facilitate optimal weight management.
Prime examples of such foods include berries, apples, watermelon, green leafy vegetables, red cabbage, aubergine and more. Furthermore, peas, beans, lentils which contain chemicals called phytosterols are very helpful in reducing blood cholesterol levels.
Bearing the above in mind, there’s no doubt why when it comes to fruit a vegetable intake that a ‘rainbow of colours” is advised. Fruit juice and vegetable juice extractions are not recommended since the essential fibre elements of these foods is lost.
Rolled oats contain a water-soluble dietary fibre called beta glucan which has been clinically proven to reduce cholesterol in the digestive tract. Oats also help to regulate blood sugar levels which is good for overall health and energy levels. If you’re a fan of oats, then best results come from using jumbo oats rather than finely milled instant oats.
Eggsellent Heart Foods
Historically, and perhaps controversially, eggs have received a bad press because they contain dietary cholesterol, but that’s not what we need to be concerned about in terms of managing blood cholesterol levels.
Eggs are a naturally rich source of iron and protein. The easily digestible protein in eggs can help to suppress our appetite and can aid weight loss efforts.
Eggs also contain vitamin B6, B12 and folic acid, which help to lower homocysteine levels in the blood. Homocysteine is a normal by-product of metabolism, but if not efficiently cleared, elevated levels are associated with cardiovascular disease.
Finally, eggs are a rich source of vitamin D which is vital for a strong immune system. We have long recognised Vitamin D deficiency in non-sunny climates such as the UK and the inclusion of eggs as part of a balanced cardioprotective diet is advised.
For those on a vegan diet, it is important to take to time research and consider the correct food substitutes for these important elements of eggs. For example, eating plenty of greens for iron instead, and plant-based protein such as tofu.
What Are the Worst Foods for Your Heart & Why?
On the flip side, there are some foods that you should avoid sustaining a healthy heart.
Refined and added sugar
Refined added sugar (sucrose) is part metabolised directly into storage in fat cells. High consumption of sugar is associated with poor weight regulation, which in turn is associated with the development of diseases such as diabetes and hypertension. As we now know, these diseases have been linked with the development of cardiovascular disease and death.
To avoid refined and added sugar, refrain from buying sugar and artificially sweetened beverages, shop bought sauces, soups, desserts, refined carbohydrates (white bread, pasta, rice). Remove all such forms of added sugar from your diet, and experiment more with home-cooking. Also, be aware that many low-fat foods often contain large portions of added refined sugar.
Regarding fruit, it’s best to opt for low sugar fruits (whole berries, green apples, rhubarb, kiwis) and reduce dried fruits.
Excessive intake of salt is directly associated with poor blood pressure control. High blood pressure is one of the most potent risk factors for the development of cardiovascular disease related morbidity and mortality.
Remember that adding table salt to your food is not the only way by which you may be consuming excessive salt. Preparations such as smoked, salted, or cured foods, soy sauce, mustards, pre-prepared meals, soups, sauces, condiments, canned foods with added salt, and salted snacks are hidden sources of excessive salt intake. Take careful considerations to look at the habitual meals you eat and the ingredients you use to understand more about how you can reduce your salt intake.
Excess Fats but Not All Fats
“Not all fats are bad for you. Fats from oily fish, nuts and seeds, and olive oil have potential cardioprotective effects and should be included in a balanced Mediterranean type of diet to help to reduce cardiovascular risk” – Mr Inderpaul Birdi, Consultant Cardiac Surgeon at The Keyhole Heart Clinic London.
Fats in general are essential for our health. The energy generated from fat metabolism helps us to regulate our body temperature. Fats also allow us to absorb essential nutrients such as vitamin A, D and E. Fats are needed to make hormones that help our bodies work the way they should. We have also seen that certain essential fats like Omega-3 are cardioprotective.
The American Heart Association (AHA) guidance is that less than 6% of our calorie intake should come from saturated fats. This means that if you eat 2,000 calories per day, then you should only consume 11-13 grams of saturated fat. The AHA advise against the consumption of tans-fat
The UK government recommends that:
men should have less than 30g of saturated fat per day
women should have less than 20g of saturated fat per day
men and women should have less than 5g of trans fat per day
children should have less trans-fat and saturated fat per day than adults.
What about trans-fats?
Trans-fats are a form of partially hydrogenated fats that occur naturally in small amounts. Industrially produced trans-fats also exist and have been a source of controversy for some time. These trans-fats are known to increase the amount of cholesterol in your blood, which is believed to be linked to cardiovascular disease development. Some countries have banned the use of industrially produced trans-fats. However, some food groups may still contain trans-fats. The key is to avoid foods that contain “partially hydrogenated vegetable fait/oil”.
The AHA advise that trans-fats should be avoided. Trans-fat consumption is associated the development of other diseases such as stroke, liver dysfunction, diabetes, and Alzheimer’s.
If you eat meat, it’s important to trim the fat from any meat that you may consume, reduce butter and lard when cooking, and avoid foods containing partially hydrogenated fats.
Is it ok to consume some ‘bad foods’ for your heart in moderation? If so, how often can you feel ok about eating them?
The general advice is to eat a balanced and varied diet that contains as many of the cardioprotective nutrients as possible. Practically speaking, however, life is for living. There are ways that we can still break the rules occasionally.
For example, alcohol should be reduced as much as possible. However, a small glass of wine once or twice per week “may’ have cardioprotective effects. If you have a sweet tooth, then a small amount of dark chocolate with a hand full of healthy nuts is a great way to be “naughty but nice” to your heart occasionally.
We advise on avoidance of sugar and salt as much as possible and whilst not all fats are bad for you, we strongly recommend the avoidance of trans-fats in the diet.
“Genes may load the gun, but lifestyle pulls the trigger. Stop smoking, reduce alcohol, and improve your diet to reduce cardiovascular risk” – Mr Inderpaul Birdi, Consultant Cardiac Surgeon at The Keyhole Heart Clinic London.
In conclusion, the link between diet and heart disease grows stronger as new research continues to emerge. What you eat can influence almost every aspect of heart health, from blood pressure and inflammation to cholesterol levels and triglycerides.
Including these heart-healthy foods as part of a nutritious, well-balanced diet, and avoiding the latter can help keep your heart in good shape and minimise your risk and symptoms of heart disease.
Eating well forms the foundation of good health and the avoidance of disease, but the myriad of information available on the subject can create confusion. Healthy eating should not feel like an eternal “diet”, rather, it should empower you, fuel you and allow you to celebrate the joy that great tasting food can bring. You can access support from cardiac dietitians if you feel unsure on your next steps.
Author: Mr Inderpaul Birdi, Consultant Cardiac Surgeon at The Keyhole Heart Clinic London.