It’s not rocket science
Heart Healthy Eating
What's the best way to eat?
In a nutshell, what do you tell your heart attack patients?
Did you know that the chance of you keeping weight off with a diet is smaller than your chance of surviving metastatic colon cancer? The problem with a diet, is just that, it’s not for life. Eating does not have to be complex like our society has made it. If most of what you eat follows the following 4 rules, you’re going to do well. Here’s what I recommend for all heart attack patients:
1). Eat mostly plants.
2). Eat things that swim–especially fish from the ocean.
3). Avoid processed foods
4). DO eat fat–especially from plants and fish
How do we know that what we eat causes or prevents disease?
Science really began to take notice of food and health in the 1950’s when Dr. Ancel Keys, a Minnesota physiologist, brought together a group of scientists across the world to answer the question: Does the lifestyle found in different countries affect the rate of coronary artery disease?
This landmark study identified that cholesterol, blood pressure, diabetes and smoking are risk factors for heart disease. They observed something quite interesting about diet. Coronary events were low in the Mediterranean (a high fat diet) and in Japan (a low fat diet).
Is there a pattern of eating that really works at preventing heart disease?
Our answer begins in two mental hospitals in Finland.
Eating foods with polyunsaturated fat WILL lower your risk of heart disease.
Highighted studies
What other studies show a relationship between food and heart disease?
Two mental hospitals in Finland were involved in a study from 1959-1971. At one hospital the patients were fed a diet high in polyunsaturated fat but low in saturated fat and cholesterol for 6 years. The other hospital patients ate a “regular” diet. After 6 years, the hospitals switched the eating pattern. Heart attack numbers were cut in half in those eating the diet high in polyunsaturated fat.
In a Los Angeles VA hospital institution, elderly men were placed into one of two groups. The first group ate a diet high in unsaturated fat of plant origin and low in saturated fat and cholesterol. The second group ate “normal.” The rates of heart disease were lower in the plant fat group.
Two studies is good, do you have another?
In Norway, men who had heart attacks were encouraged to eat a plant based diet while others had no counseling on how to eat. Amazingly, for every 8 people, placed on the plant based diet, one heart attack was prevented over the course of the study.
Okay hotshot, do you have another study that wasn’t done a LONG time ago?
The Lyon Heart Study in France is a more recent study. This study took heart attack patients and placed them on one of two diets–the first was a Mediterranean style diet. This type of eating pattern contained bread, root and green vegetables, fish, nuts, fruit, and margarine (with the same fat content as olive oil). Olive oil and Canola oil were recommended for salad dressing. They even measured blood for markers of this diet during the study. The other diet was a typical or regular diet.
How did the Lyon Heart study turn out?
If you remember one thing: for every 5 people that ate the Mediterranean way, 1 heart attack or death was prevented.
Wow! That’s pretty powerful. If I had a medicine that could do that I would do cartwheels, stand on my head, juggle chainsaws….with them running…with my eyes closed…to get people to eat that way.
What about red meat? What about fat in foods?
Okay, let’s talk about the elephant in the room. Is a low fat diet the right way to eat?
In 1977, dietary recommendations encouraged avoiding fat. Most of the data for this recommendation involved less than 3,000 people. One of the largest studies to date done in 2006, showed that reducing TOTAL fat and replacing this with fruits, vegetables, and whole grains, did not have any impact on reducing strokes or heart attacks. Woah?!? Really?
You’re turning my world upside down. You mean replacing fat with healthy stuff didn’t reduce heart attacks?
According to a large analysis of many dietary studies, replacing saturated fat with simple carbohydrates, does NOT prevent heart disease. Replacing saturated fat with whole grains reduced heart attacks slightly. However, the best replacement for saturated fat was poly and mono-unsaturated fats (25% and 15% reduction in heart attacks, respectively). So what foods have these “good” fats in them? In short, plants and fish (see eating really isn’t as hard as heart surgery).
Plants and fish: You’ve got to give me more than that.
But for those of you who are too lazy here’s a partial list of foods containing poly/monunsaturated fats: Walnuts, flaxseeds, salmon, mackerel, herring, trout, tuna, whole grain wheat, almonds, cashews, peanuts, olives, avocado’s, popcorn, sunflower seeds, soybeans, corn, etc…
Can I satisfy my inner carnivore and eat red meat?
One of the things most people are proud to tell me after a heart attack is that they hardly are eating red meat. So what about saturated fats found in beef, pork, lamb, chicken, lard/cream, butter, cheese, milk, etc…One of the largest reviews of 21 studies showed that there is NO evidence that saturated fat is associated with an increase in heart disease or strokes. Yes–I did just tell you it’s okay to eat red meat and drink milk.
Finally, some good news. I can eat red meat…you mean all red meats….Bacon?
In 2010, 20 studies were reviewed looking at red meat and heart disease. The bottom line is that there’s a lot of carnivores in the United States. No seriously, the real conclusion was that PROCESSED red meat consumption was associated with a 42% increase in heart disease. Total meat consumption was NOT a factor. Sorry to all bologna, pepperoni, luncheon meat, bacon and sausage lovers out there. Yes, I did tell you not to eat bacon.
You’ll take away bacon. You better leave my donuts alone. That’s not a question either.
The other bad foods are those that contain trans fats. Trans fats are great at raising your cholesterol (hint: bad idea). Trans fats are found in many baked goods like doughnuts, cakes, pie crusts, biscuits, frozen pizzas, cookies…just read the label.
No study shows that chocolate is bad for you. Make sure it’s got plenty of Cacao
What else?
I’m scared to ask about chocolate. Is that okay?
Chocolate deserves mention because it tastes really darn (this is a family website) good. The active heart healthy ingredient in chocolate are flavonoids which are also found in tea, red wine, blueberries, apples, pears, cherries, and nuts. Flavanoids are abundant in the cacao beans which gives us the cocoa powder to make chocolate (I think when you make the powder the “o” and the “a” order in cocao gets messed up too). There is evidence that a higher intake of chocolate may be associated with a lower rate of cardiovascular disease. Certainly there is no study saying it should be avoided.
Fish?
How much fish should I eat? The most benefit is seen in individuals who eat fish up to 4 times weekly. Interestingly fish oil is not associated with any cardiac benefit in the majority of studies. Don’t tell that to the 1.15 billion dollar fish oil industry.
I’ve heard a lot about sugar in the news. Does sugar cause heart disease?
Sugar is in everything…even in songs about what little girls are made of. That may be literal too, as the average american consumed 130 pounds of sugar in 1 year in 2012. I think my son, did that on Halloween night alone last year. Higher total sugar intake is associated with death from heart disease. One to two soft drinks a day is associated with an increase risk of heart related death. Know this, to burn the calories in a 16 ounce bottle of coke you need to jog 2.5 miles, swim for 30 minutes, mow the lawn for an hour (please come do mine), or cycle for 35 minutes.
What about whole grains?
Unfortunately, the sugar thing has led to many diets recommending strict avoidance of carbohydrates. I think that’s akin to saying all fat is bad for you. Whole grain intake ABSOLUTELY prevents heart disease.
In Summary
1. Eat mostly plants (fruits/vegetables, whole grains, beans, nuts, seeds, legumes)
2. Eat things that swim at least two times weekly.
3. Avoid processed foods especially processed red meats, baked goods with trans fats and high sugary foods.
4. Moderation with meat, dairy, eggs, and chocolate. Emphasize plants.