GUARD YOUR HEART
Women often anecdotally speak of “broken hearts” from failed relationships, suffering loved ones, or disappointments in life. What they don’t realize is that their “broken hearts” are more deadly than they think. According to the FDA, heart disease is the NUMBER ONE killer in women. There is even a syndrome that often affects women called Takotsubo cardiomyopathy, which is brought on by sudden stress or grief, and can cause temporary EKG changes, chest pain, heart failure, and elevated troponin levels in the blood (similar to symptoms seen in heart attacks).
Although Takotsubo syndrome generally resolves with treatment, heart disease that causes permanent heart damage or death is a very real risk for women, despite the fact that women are rarely depicted as having heart attacks in movies and television. Women also have less typical symptoms of heart attacks and present with vague complaints like weakness, nausea, pain between the shoulder blades or jaw, and shortness of breath.
Heart disease is generally caused by circulation failure to the heart due to congested or blocked arteries that feed the heart muscle. It can also be caused by a weakened heart muscle, leading to heart failure. The heart is unable to pump blood around the body, which causes backup of fluid into the lungs and extremities. The major tasks in preventing heart disease are twofold: protect the pump (the heart muscle) and protect the pipes (blood vessels)! Fortunately, the same strategies I discuss here will protect both.
Atherosclerosis is the condition that describes congested arteries. It is a disease of all the arteries, not just the heart’s arteries. Inflammation from multiple sources (cigarette smoke, trans-fats, stress, high sugar) irritates the lining of the arteries, causing LDL cholesterol (the body’s homemade and highly oxidized bandaid) to patch up the rough spots, and attracting white blood cells and platelets. A “plaque” forms from the deposited fats and cellular debris. As the plaque builds up, it can decrease the diameter of the artery, causing less blood to flow through to the heart muscle, especially during exercise. Chest pain on exertion is a classic symptom. As the artery diameter becomes more congested, chest pain occurs even at rest. Sometimes the plaque can rupture, creating a blood clot that completely blocks off the artery, causing death to the distal heart muscle that it supplies. This is known as a heart attack, and it can be fatal or result in heart failure.
Uncontrolled and chronic high blood pressure is extremely damaging to the heart muscle. The heart muscle must pump blood through the body against high resistance of the body’s arteries, which may be narrowed due to atherosclerosis or sympathetic stimulation from stress, stimulant drugs, or nicotine. Eventually the heart muscle gets over-distended from backed up blood, stretches out, and can’t recoil as well, leading to weak pumping and backup of fluids. Congestive heart failure is one of the most miserable conditions I have seen in the ER, in which patients are literally drowning in their own fluids, can’t breathe even at rest, and are so swollen they can barely walk.
How do we protect our hearts from these debilitating and fatal diseases? Believe it or not, the answer does not lie in a handful of medications (although that may be necessary in advanced disease). You can prevent and even reverse heart damage NOW by following THREE simple steps:
1). Eat an anti-inflammatory diet: low saturated fats, no toxic fats, low sugar, plant-based.
2). Exercise on a regular basis.
3). Quit smoking (and avoid exposure to secondhand smoke).
Contrary to popular new theories, butter is NOT back! Saturated fats (almost exclusively from animal foods and also from coconut oil and palm oil) and trans-fats (in processed junk food and sweets) are major culprits of atherosclerosis by increasing LDL (“bad”) cholesterol levels. Dietary cholesterol (only in animal foods) plays a less significant role in elevating blood cholesterol levels. According to the famous Framingham Heart study published in The Lancet, a blood LDL level of 70 or less and total cholesterol of 150 or less eliminated deaths from coronary artery disease (Greger, 2015). Your liver makes cholesterol for the necessary functioning of hormones, tissues, and cell-membranes. You do not need to ingest additional cholesterol for health. If your body is in a state of inflammation from your lifestyle or the foods you eat, the liver will make more cholesterol, which can lead to the diagnosis of “high cholesterol” or “dyslipidemia”. I recommend checking your fasting blood lipid levels once a year. Women should also aim for an HDL (“good”) cholesterol level of over 50, and men aim for over 40. You can increase your HDL through exercise and high Omega 3 foods such as walnuts, flaxseed, hemp seed, and algae oil.
Healthy fats are those from plant foods that have been minimally processed and do not oxidize quickly over time or in high temperatures. Oxidized vegetable fats are just as toxic to the arteries as saturated fat because they are inflammatory, and inflammation draws cholesterol to the scene like a troop of police officers (Shanahan, 2009). Stick with expeller pressed virgin coconut oil (in moderation) or avocado oil when cooking or baking, which are stable under heat. Expeller pressed olive oil has antioxidants and beneficial monounsaturated fatty acids that can help lower LDL, and can be used on already cooked food or as a salad dressing to help absorb the fat soluble vitamins from vegetables. Avoid other plant oils such as soybean, canola, sunflower, safflower, and grapeseed oil, since they tend to be highly processed and rancid or oxidized by the time they arrive at your mouth. Avoid processed foods (fast food, pastries, cookies, and crackers) that contain hydrogenated/partially hydrogenated fats (which are essentially trans fats).
Lipitor: You’ve probably heard about this statin medication as a quick fix for high cholesterol levels. The problem is it doesn’t address the cause of high cholesterol and can lead to scary side effects such as muscle damage, liver damage, memory loss, invasive breast cancer, and type 2 diabetes (Greger, 2015).
SUGAR: It’s no surprise that diabetics have an increased risk for heart disease. In the same way that high blood sugar levels damage circulation in the hands, eyes, feet, and kidneys (causing neuropathy, blindness, amputations, and kidney failure), high blood sugar levels damage the arteries in the heart, leading to inflammation and increased atherosclerosis. Refined carbohydrates (white bread, white flour, baked sweets) increase cholesterol levels and blood pressure (Murray, 2000).
PLANTS: A plant-based diet is one with few animal foods, and consequently high in fiber, vitamins and minerals, antioxidants and phytonutrients, and low in saturated fat and cholesterol. Because plant-based foods result in a more alkaline cellular environment, the body has less inflammation. Remember, inflammation contributes to artery disease. It also contains less arachidonic acid, a precursor to inflammatory chemicals in the body (Sutter, 2012). Studies show that people with advanced heart disease, when put on a plant-based diet, decreased the level of plaques in their arteries, some of them completely reversing their heart disease (Greger, 2015). A plant-based diet also lowers blood pressure, another huge risk factor in developing heart disease and heart failure. Eat five or more servings of fruits and vegetables per day. To make this easier on a daily basis, always incorporate a large salad with lunch, a vegetable based snack, a fruit at every meal, and at least two vegetables at dinner. Adding spinach to your morning smoothies is also a good way to add veggies to your breakfast.
EXERCISE: There are so many benefits to exercise, but one of the important ones for this topic includes exercise’s ability to increase HDL levels. HDL (“good cholesterol”) is made by the liver and shuttles fats out of the arteries and back to the liver. High levels of HDL decrease risk of heart disease (Murray, 2000). Exercise also lowers blood pressure, stress levels, decreases body fat levels, and can improve blood sugar regulation (Barnard et al., 2009). Aim for at least 30 minutes of vigorous activity per day.
SMOKING: I don’t need to tell you that cigarette smoke is carcinogenic. But did you know that it is also a major risk factor for heart disease? Cigarette smoke contains inflammatory toxins including cadmium (a heavy metal), which damages coronary arteries, causing inflammation and leading to atherosclerosis/coronary artery disease. It also increases platelet aggregation, increasing risk of blood clots that lead to heart attack and stroke. The nicotine in cigarette smoke is a stimulant, increasing blood pressure and the workload of the heart (https://www.nhlbi.nih.gov/health-topics/smoking-and-your-heart).
The month of February has been designated “Go Red for Women” is the American Heart Association’s national movement to end heart disease and stroke in women. It is a great time to start thinking about your heart health. No matter what your health status is, you can begin implementing these three principles to heal your heart and prevent heart disease from developing. The good news about these three principles is that they also decrease co-morbid diseases like diabetes, high cholesterol, and high blood pressure – the three diagnoses I see most often in my chest pain patients that come to the ER. So guard your heart by paying attention to what you put into your body!
Barnard N, Weissinger, R, Jaster B, Kahan S, & Smith C. (2009). Nutrition Guide for
Clinicians. (2nded.) Washington, DC: Physicians Committee for Responsible Medicine.
Greger MD, Michael. (2015). How Not to Die: Discover the foods scientifically proven to prevent
and reverse disease. New York, NY: Flatiron Books.
Murray MD, Michael. (2000). Dr. Murray’s Total Body Tune-Up. New York, NY: Bantam Books.
Shanahan MD, Catherine. (2005). Deep Nutrition: Why your genes need traditional food. Lawai,
HI: Big Box Books.
Sutter MD, Fredrick. (2012). Surgery. From Advancing Medicine with Food and Nutrients.
(2nded.) Boca Raton, FL: Taylor & Francis Group.