The Case for Diet, by Hal Higdon
26 June 2009
While exercise is essential if you want to prevent coronary heart disease, diet and nutrition rank equal in importance.
Why emphase diet? More than half the deaths that occur every year in the U.S. occur because of clogged arteries. Twice as many people die of cardiovascular diseases than cancer. Use proper food choices as your best weapon against heart disease.
The first rule of managing heart health with nutrition is getting the fat content of your meals into the 20 to 30 percent range. For most people, this means lowering fat content, but some individuals already on low-fat, or vegetarian, diets may actually need to increase fat intake. The best fats are the monounsaturated fats found in olive oil, canola oil and nuts. Also ranking high among nutritionists are the Omega-3 fats found in fish, as well as in flaxseed meal and oil. The worst are the saturated fats found in animal products and processed foods, which also contain artery-clogging hydrogenated fats, or trans-fats.
“You need to know your blood lipid profile to make effective food choices,” explains Joanne Milkereit, R.D. of the Medical University of South Carolina. “Individuals who choose low-fat diets usually have low levels of LDL cholesterol, but they sometimes have high triglycerides and not enough of the (good) HDL cholesterol.” Consult a physician to determine whether you should change your diet to improve your lipid profile; consult a dietitian for advice on how to do it.
Heart strategy is also important. It’s not only what you eat, but when you eat it, claims Nancy Clark, R.D., a nutritional consultant from Brookline, Massachusetts. Clark identifies breakfast as the key meal of the day. “If you eat a hearty breakfast featuring a high-fiber cereal covered with lots of fruit, you won’t get as hungry later in the day,” she says. “You’ll be less likely to snack on fatty foods that are bad for your heart.”
Current research identifies fiber as important for heart health. Elizabeth Applegate, Ph.D. recommends that in addition to choosing that high-fiber cereal (she prefers oats), keep peels on fruits and select whole versions of other grain products. She also likes beans, particularly kidney beans and lentils. “The amount of fiber in beans is staggering,” says Dr. Applegate. “Everybody should be eating beans four or five times a week.”
While you are getting the fat out, get into your diet the vitamins that research suggest promote a healthy heart. These would include the antioxidant vitamins C and E along with carotines. And although many cardiologists prescribe supplemental vitamins such as B6, B12 and Folic Acid to help keep homocysteine levels low, nutritionists such as Milkereit, Applegate and Clark prefer that individuals first seek those vitamins in the refrigerator rather than in the medical cabinet. Here are some heart-healthy foods they suggest you add to your table:
- Oil and Nuts: Researchers suspect that the olive oil present in the diets of people living in Mediterranean countries is one reason people from those countries have a lower rate of heart attacks than Northern Europeans. Choose an olive oil-based salad dressing instead of the creamy kind. Almonds and peanuts also are good sources of monounsaturated fats. If you’re eating peanut butter, avoid the creamy, hydrogenated kind. (Preferable is “natural” peanut butter where the oil floats to the top of the jar.) And don’t add monounsaturated fats without subtracting saturated fats. “If you are already getting 30 percent of your calories from fats, adding olive oil and nuts will be too much,” warns Milkereit.
- Fish: Eskimos traditionally followed diets containing as much as 50 percent fish, yet rarely died of heart attacks. This is because the fats they ate typically were Omega-3 fats found in cold-water fish. (This is a liquid form of fat different from the hard fat found in butter and diary products.) Rather than clog arteries, Omega-3 fats lower blood cholesterol and triglycerides and decrease the likelihood of blood clots by making platelets in the blood less “sticky,” thus less likely to stick to artery walls. Salmon, a fish found in the waters around Alaska, but also in the Great Lakes, is a particularly good menu choice. “If you don’t eat fish at least once a week,” suggests Dr. Applegate, “you aren’t taking advantage of a heart-healthy diet.” Tuna, as well as salmon, is a particularly good source of Vitamin B12.
- Veggies: “Go for the dark green stuff, such as broccoli and spinach” advises Clark. Spinach is a good source of Folic Acid, often prescribed for heart patients. Clark recommends any vegetables with color such as tomatoes and carrots. “No vegetables are bad,” she says. “Some are just better than others.” Milkereit’s favorite vegetable is the sweet potato, which she would rather see on the plates of carbo-loading runners than pasta. “Pasta attracts a lot of attention, but it’s made from processed grain,” she says. Beans are good heart protectors, particularly soybeans.
- Soy: Regardless of how it comes–tofu, miso, natto, tempeh, soymilk, soyu flour, soybeans, soynuts, soy sauce–soy has leaped to the top of the charts among nutritionists seeking to prevent heart disease. Soy contains phytochemicals that prevent blood clots from forming. Dr. Applegate recommends that runners get at least one serving of soy into their diets each day. “When soy protein is substituted in the diet for other proteins such as milk or beef, cholesterol levels fall off the chart,” she says.
According to Pamela Douglas, M.D. of Harvard Medical School: “The most powerful thing you can do to prevent heart disease is to exercise and eat well. Fitness is tremendously important in preventing heart disease, but you have to utilize a nutritional diet as well. Do so, and you will reap the benefits for years to come.”
Editor’s note: remember, tracking what you eat is the best way to stay in control of your diet! Sign up for a free TrainingPeaks account and keep a meal diary using our database of thousands of USDA foods and more. Track your workouts too for a complete overview of your fitness and well-being.
If you have a question for Hal Higdon, you can ask it by visiting his Virtual Training Bulletin Boards.
One Response to “The Case for Diet, by Hal Higdon”
October 18th, 2009 at 9:12 am
high fiber diet menu…
After reading your article I am left with the feeling that there is more to this topic than I originally thought….