Health and wellness of the heart are fundamental to our overall well-being. The heart is a constant powerhouse that works in complement with our lungs to provide oxygen to our tissues and brain.  It transports nutrients that we gather from the foods we eat throughout our body and helps to eliminate waste we accumulate. Many genetic, lifestyle and environmental factors can impede proper functioning of the heart and, over time, lead to heart disease.

With heart disease being the number one cause of death in Wisconsin, in conjunction with our growing senior population, prevention should be emphasized now more than ever. Fortunately, Naturopathic Doctors excel at preventative medicine and there are many ways in which we can help you take your cardiovascular health into your own hands! The first step is assessing and modifying your diet.

What diet should I follow to prevent cardiovascular disease?

Studies over the past decade have consistently shown that those who follow a Mediterranean diet have reduced cardiovascular risk factors such as reduced coronary artery disease, blood pressure, atherosclerosis, arterial stiffness, and cholesterol. (1)

How was the Mediterranean diet developed and does it work?

Blue zones are regions of the world that are home to populations of people with greater longevity than everywhere else in the world. Two of the blue zones include Sardinia, Italy and Icaria, Greece, both of which are located in the Mediterranean. Researchers dove deeply the diet of these groups of people in order to gain insight into potential sources of their higher health status. The results of these investigations lead to the development of the Mediterranean diet, which emphasizes a whole food diet that is mostly plant based with quality protein and fat sources. All in all, this diet has ample evidence to back its efficacy! Researchers dove deeply into the diet of these groups of people in order to gain insight into potential sources of their higher health status. The results of these investigations lead to the development of the Mediterranean diet, which emphasizes a whole food diet that is mostly plant based with quality protein and fat sources. All in all, this diet has ample evidence to back its efficacy!

Where do I start?

You can find a breakdown of the 8 general guidelines below, as well as specific foods that are power packed with nutrients to support cardiovascular health:

1.) Heart Healthy Vegetables

• 5+ servings daily (1 cup or heaping handful leafy greens, ½ cup cooked veggies)
• Green Leafy & Other Veggies
  • No limit to the number of veggies you can eat in a day
  • Packed with fibers and sterols that bind cholesterol to properly eliminate it from the system and support digestive function
  • Contain phytonutrients and antioxidants that support proper cell regeneration and blood vessel health
  • Sometimes raw veggies can be hard to digest, so if you experience bloating after eating veggies, consider cooking them down first to ease digestion.
  • Ideally half your plate at each meal should consist of vegetables
  • Diversity on your plate is not only beautiful but very nutritious! Try to incorporate at least three different colors of veggies into your diet daily
• Artichoke
  • Commonly grows in Mediterranean regions and a 2018 meta-analysis found it to decrease total cholesterol, LDL-C (“bad cholesterol”), and triglycerides in those with high cholesterol. (2)
  • Also used in blood pressure and atherosclerosis support

2.) Antioxidant Rich Fruits

• 2-4 servings daily (½ cup of whole berries or fresh cut fruit, 1 medium sized fruit, ½ banana)
• Berries
  • Blueberries, strawberries, cranberries, blackberries, raspberries, bilberries, acai berries
  • Contain high levels of antioxidants (i.e. vitamin C, flavonols, resveratrol, anthocyanins, etc.) and fiber that help blood vessels combat toxins and promote wellness of the heart
• Pomegranate
  • Contains ample supply of antioxidants
  • Shown to be cardio-protective
  • Studies have shown that pomegranate acts to reduce atherosclerotic plaque formation, inflammation in the blood vessels, and blood pressure. (3)
  • Serving: One cup of 100% pomegranate juice or ½ cup seeds

3.) Ancient Grains

• 2-4 servings daily (½ cup cooked grain)
• The most nutritious grains that are good sources of protein and fiber include quinoa, buckwheat, wild / brown rice, oat, spelt, teff and millet.
• If possible, prepare the whole grain at home and allow it to consume ¼ of your plate maximum per meal.
• Avoid: refined white breads, pastas, bagels, etc.

4.) Fish & Fats

• Fish
  • 2-3 servings of fish weekly
  • Rich in EPA and DHA omega-3 fatty acids (FA)
  • Omega-3 Rich Fish Low in Mercury: wild caught Salmon, Mackerel, Anchovies, Sardines, Herring
  • Studies have shown that consumption of fish anywhere from once weekly to once daily resulted in overall lower triglycerides and higher HDL-C (“good cholesterol”). (4)
• Olive oil
  • 2 tbsp of olive oil daily
  • Shown to reduce cardiovascular risk and mortality in those with a high-risk profile
• Flax Seed
  • 2 tbsp of ground flax seeds daily
  • Rich in alpha-linoleic acid, which is a different omega-3 fatty acid than those found in fish
  • Modestly lowers total cholesterol and LDL-C
  • Lowers triglycerides
  • Lowers blood pressure
  • Lowers CRP (marker of inflammation that is a risk factor for cardiovascular disease) (5)

5.) Herbs and Spices (use freely & daily)

• Garlic
  • Dose: 1500-3000mg of standardized garlic extract daily or 2-3 chopped cloves daily (6)
  • Prevents plaque formation by preventing bad cholesterol from oxidizing and sticking to the blood vessels
  • Supports age related vascular damage
  • Prevents blood clot formation
  • Reduces blood pressure by relaxing and dilating constricted blood vessels
• Avoid: foods and spice mixes that are high in sodium, as increased sodium content in the blood can cause the blood vessels to constrict, leading to high blood pressure.

6.) Minimize Dairy

• 1-2 servings per day maximum (1 cup of plain yogurt or kefir, ¼ cup of cheese or two thumbs worth)
• Approximately 65% of adults have reduced ability to digest lactose. (7) Therefore, for the majority of people world-wide, consuming dairy may lead to low grade inflammation throughout the body. Continued exposure to this inflammation may leave the body susceptible to pain, fatigue, poor nutrient absorption and dampened immune function.  The Mediterranean diet recommends that dairy be consumed conservatively at 1-2 servings per day maximum.

7.) Drinks

• Red Wine
  • 1 glass maximum per day of red wine
  • Red wine contains polyphenol compounds that can lower cardiovascular risk factors such as stroke, diabetes and elevated triglycerides. (8)
  • On the other hand, the additive effect of alcohol consumption has been linked with increased risk of other conditions that include, but are not limited to, certain types of cancers and high blood pressure.
• Green Tea
  • 1+ cups of green tea daily
  • Contains polyphenols that prevent bad cholesterol from sticking to your blood vessels producing plaques
  • Lowered risk of ischemic heart disease due to its anti-inflammatory, lipid lowering, and anti-oxidant properties (9)

8.) Enjoy your meal with friends and family!

• A key element of this diet is socializing and sharing meals with loved ones. Not only does talking allow you time in between bites to let yourself digest but it nourishes the heart and soul.
• From a Chinese medicine perspective, the heart is nourished when time is taken to relax, relate and relieve daily stress, worry and busy lifestyles with those you love. When we don’t take time for this, the heart is prone to anxiety, disturbed sleep, and discomfort in the chest.

References:

1. Jennings A, Berendsen AM, De groot LCPGM, et al. Mediterranean-Style Diet Improves Systolic Blood Pressure and Arterial Stiffness in Older Adults. Hypertension. 2019;73(3):578-586.
2. Sahebkar A, Pirro M, Banach M, Mikhailidis DP, Atkin SL, Cicero AFG. Lipid-lowering activity of artichoke extracts: A systematic review and meta-analysis. Crit Rev Food Sci Nutr. 2018.
3. Sohrab G, Roshan H, Ebrahimof S, Nikpayam O, Sotoudeh G, Siasi F. Effects of pomegranate juice consumption on blood pressure and lipid profile in patients with type 2 diabetes: A single-blind randomized clinical trial. Clin Nutr ESPEN. 2019;29:30-35.
4. Alhassan A, Young J, Lean MEJ, Lara J. Consumption of fish and vascular risk factors: A systematic review and meta-analysis of intervention studies. Atherosclerosis. 2017;266:87-94.
5. Rodriguez-leyva D, Dupasquier CM, Mccullough R, Pierce GN. The cardiovascular effects of flaxseed and its omega-3 fatty acid, alpha-linolenic acid. Can J Cardiol. 2010;26(9):489-96.
6. Lawson LD, Hunsaker SM. Allicin Bioavailability and Bioequivalence from Garlic Supplements and Garlic Foods. Nutrients. 2018;10(7)
7. Genetics Home Reference: NIH U.S. National Library of Medicine. January 7, 2020. Accessed from: https://ghr.nlm.nih.gov/condition/lactose-intolerance#statistics. Accessed: 1.15.20.
8. Focus On: Chronic Diseases and Conditions Related to Alcohol Use. NIH National Institute on Alcohol Abuse and Alcoholism. Alcohol Research Current Reviews. 2013;35(2):155-173
9. Li X, Yu C, Guo Y, et al. Tea consumption and risk of ischaemic heart disease. Heart 2017;103:783-789

Editor’s Note: The information in this article is intended for your educational use only. Always seek the advice of your physician or other qualified health practitioners with any questions you may have regarding a medical condition and before undertaking any diet, supplement, fitness, or other health program.