Heart Disease Q&A
What is the prevalence of heart diseases in Americans?
Heart disease is the biggest killer of all of the chronic diseases. Cancer comes second. They say if you don’t die of heart disease you’re likely going to die of cancer, but heart disease is the one that gets us first. I think probably over 20 percent of deaths are heart related as this point in time.
How big of an impact does diet have on the heart?
Well, diet plays a big role. We know genetics is a big factor, too. That’s the thing with heart disease, there are just so many factors that come into play, including your level of physical activity, your genetics, and how you’ve managed your blood pressure and blood cholesterol levels. Now, we’re looking at homocystine levels and then the C-reactive protein that’s associated with inflammatory activity in the body. All of these things come into play. So, diet fits in with that whole scheme of things as a real important factor. The way I look at it a lot of times is that if you’ve got a family history of heart disease then its even more important for you to focus on a heart-healthy diet.
You just touched on C-reactive protein. What is CRP?
Essentially, it’s associated with increased inflammatory activity in the body. We know increased inflammatory action in the body puts stress on the heart. It also is related with a lot of other diseases like arthritis, for example. It is a known risk factor for heart disease, and so we are looking at it as a risk factor similar to things like blood cholesterol, low-density lipoprotein, high-density lipoprotein levels, homocystine and things like that.
How much would a healthy diet impact somebody’s health? Could it prevent heart disease?
The size of a role that diet plays in preventing heart disease probably depends on somebody’s genetics. However, studies like those done by Dr. Dean Arnish in San Francisco where he looked at the role of diet, he also incorporated exercise, stress reduction, and also enjoyable social situations. All of these things seemed to play a role, and any one alone was not really the whole piece of pie. Diet probably plays a pretty big factor, but I don’t think heart disease can be prevented by diet.
So a healthy diet is just one piece of the puzzle?
Right. You could be very physically active, in great shape from a lot of exercise and doing your yoga, reduce your stress, but if you have a junk diet then that’s another brick in that wall so to speak that’s missing and it’s going to fall down. A healthy diet is one of many bricks that help hold up the wall.
Specifically, how do fruits and vegetables affect the heart?
Fruits and vegetables impact the heart in a lot of ways actually. One of the basic things is that they are a good source of dietary fiber, and dietary fiber is associated with helping reduce the amount of cholesterol that gets absorbed or reabsorbed into the body. Dietary fiber is also good for overall intestinal health. The other things that are in all of these fruits and vegetables is a lot of important minerals. For example, a banana is very high in potassium, which is a real heart-healthy mineral. There are a lot of vitamins, of course. There is vitamin C in things like mangos, papayas and of course oranges. You can find vitamin A in colorful vegetables, including the green vegetables. So, carrots, red bell peppers, spinach and broccoli are all good sources of vitamin A.
How is vitamin A helpful?
Vitamin A is in the form of what’s called beta carotene and other carotenoids, and it functions as an antioxidant. Certain amounts of heart damage and blood vessel damage is thought to be related to oxidative stress, and so components such as beta carotene help reduce that oxidative stress on the body. There are also other chemicals in a lot of these fruits and vegetables that we call phytochemicals — phyto meaning plant and plant chemicals. A lot of them are very powerful antioxidants. They don’t function as nutrients so it’s not like we actually need them like we need vitamin C and vitamin A, which are required nutrients. These things aren’t really required but they enhance health if they are consumed.
Say someone hates fruit but he has got to work fruit into his diet, what are the most powerful players?
If you have a fruit-phobic person, usually I just encourage him to eat the ones he likes the most because they all have different strengths and weaknesses from a nutrient and phytochemical perspective. Variety really is the spice of life in terms of health. I guess if I was to pick just a few I would probably go with something like the colorful grapes for the nice phytochemicals that we know that those have. Wine is famous for that as well. Then I would want to have something that was a good source of vitamin C, and so that could be something like an orange or even pineapple. Then if you have your vitamin A and your vegetables, you want to think about the type of minerals that are important in these foods too and maybe throw in the banana for the potassium.
What about for vegetables? If you could only have one vegetable, what are the most powerful players?
Well, would it be better to have broccoli than a potato if you were real picky? Certainly, a potato is considered a vegetable, and potatoes have some strengths that often aren’t recognized. For example, they’re a real good source of vitamin B6, which we know is a heart protective nutrient. But I think if I was only going to go with say three vegetables, I would want to have probably three different colored vegetables — maybe an orange or yellow vegetable would be one, certainly a green vegetable would be another, and the other one could be like the red bell pepper, potato or a sweet potato. It’s really the variety that confers the most protection.
What is fiber’s role as it protects the heart?
We’re probably still just beginning to understand it, but fiber, on one hand, tends to bind up certain lipid-type of compounds, especially cholesterol and some of the bio acids that are released from our liver into the intestinal tract. What happens with these bio acids is they get reabsorbed into the body and reutilized. But if the fiber holds onto them and pulls them on through the body, and what happens is in order to make more of those bio acids, we need to use some of our body’s cholesterol to produce them. So it reflects a drain on our body’s cholesterol.
What are some of the foods that pack the most fiber?
Probably near the top of the list are beans and legumes, which often times don’t get recognized for their high levels of dietary fiber. Next would have to be fruits and vegetables. The grains, if they’re whole grains, are equivalent pretty much to fruits and vegetables. If you pick some of the cereals too, even some of the ready-to-eat cereals, are extremely high in fiber.
How much fiber should the average person get in a day?
The recommended intake of fiber is around 14 grams of fiber for every 1,000 calories in your diet. That’s sort of the standard recommendation. So for most people, that comes out to about around 25 to 30 grams per day.
What would be an example of what you would need to eat in a day to get that?
Generally, you could get that by eating according to the old food guide pyramid way. Most people kind of zone out when you mention the food guide pyramid because they’ve seen it too much. But the reality is if you get those number of servings from the grain group in terms of the whole grain products, the fruits, and you include beans as part of your high-protein food group, then you’re going to get that easily.
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