But you can make changes to protect yourself from heart disease, regardless of family history. The evidence continues to highlight lifestyle changes, including diet, as the most important factors in preventing heart disease. Changes that garner a big bang for your buck include consumption of chocolate, legumes, nuts, fiber, and omega 3 polyunsaturated fatty acids.
Preliminary evidence published in the British Medical Journal shows that two pieces of chocolate a week may decrease the risk of a heart attack by 37 percent, compared to those who consume less.
In a meta-analysis of six studies presented at the European Society of Cardiovascular Congress in Paris, the authors warned against the idea that more is better; in fact, high fat and sugar content and calorically dense aspects may have detrimental effects when consumed at much higher levels.
Benefits may be attributed to micronutrients referred to as flavonols. I usually recommend that patients have one to two squares – or about 20 to 40 percent of an ounce – of dark chocolate daily. Who says prevention has to be painful?
The Role of Fiber
Fiber has a dose response to reducing risk. In other words, the more fiber intake, the greater the reduction in risk. In a meta-analysis of ten studies, results showed for every 10 gram increase in fiber, there was a corresponding 14 percent reduction in the risk of a cardiovascular event and 27 percent reduction in the risk of heart disease mortality.
The standard American diet provides about 15 grams per day of fiber. The American Dietetic Association recommends 25 to 38 grams of fiber a day. Therefore, we can reduce the risk of heart disease significantly if we make a conscious effort to increase our consumption of fiber to reach recommended levels. Good sources of fiber are whole grain, cereals, fruits, vegetables, beans and legumes.
In the First National Health and Nutrition Examination Survey Epidemiologic Follow-up Study (NHEFS), legumes reduced the risk of coronary heart disease by a significant 22 percent. Those who consumed four or more servings per week, compared to those who consumed less than one serving, saw this effect.
The legumes used in this study included beans, peas and peanuts. There were over 9,500 men and women involved in the study spanning 19 years of follow-up. I recommend that patients consume at least two servings a day. Imagine the impact that would have, compared to the modest four servings per week used to reach statistical significance.
Omega 3 Fatty Acids
In a study with over 45,000 men, there were significant reductions in coronary heart disease with omega 3 polyunsaturated fatty acids (PUFA). Both plant-based and seafood-based omega 3s showed these effects.
Interestingly, high or low levels of omega 6s, considered the pro-inflammatory agents that are high in the standard American diet, had no impact on these results. Good sources of omega 3s from plant-based sources include nuts, such as walnuts, and ground flaxseed.
The goal should ultimately be to become “heart-attack proof,” a term used by Dr. Sanjay Gupta and reinforced by Dr. Dean Ornish. This requires a plant-based diet. After having a quadruple bypass, former President Bill Clinton has embraced this approach with the guidance of Dr. Ornish and Dr. Caldwell Esselstyn.
The more significant the lifestyle modifications you make, the closer you will come to potentially preventing this disease from occurring. But even modest changes in diet will result in significant reductions in risk.
So please take advantage of the evidence to help make cardiovascular disease obsolete.
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