The best ways to prevent heart disease....

Today's Post: Thursday, 4-8-2010

I saw two similar items online earlier today.

Heath Day online news does a series of very brief tips and did one on preventing vascular disease-- which underlies heart disease; and my email from Everyday Health had a short piece by Dr Arthur Agatson, MD who wrote the South Beach Diet.

I’m doing this post to upgrade that advice and add some key points neither one included.

Health Day had these tips from “The American Academy of Family Physicians”

Don't smoke.

Get regular exercise -- at least 30 minutes, four to six times per week.

Stick to a healthy low-sodium, low-fat diet.

Take medications if you need them to help lower your cholesterol and lower your blood pressure.

These are in descending order for quality I think.

1. Don’t smoke is totally correct; but so spectacularly so I think it deserves more emphasis!

Tobacco smoke is so deadly for its creation of heart disease and heart attacks that it’s critical to avoid it. Every single time a smoker smokes even in a very young smoker or someone who smokes very little, it begins to cause heart disease in multiple ways; and every 5 minutes of second hand smoke has similar effects.

Some smokers don’t get lung cancer and some don’t get the other cancers it causes though many do. So smokers tend to simply think they won’t get either and keep right on going.

For heart disease, the picture is dramatically worse. Every single time you are exposed to tobacco smoke you are getting heart disease. ALL smokers get it and many exposed to second hand smoke do too.

It’s heart attack starter on steroids. These same vascular effects also cause impotence in male smokers and high blood pressure and strokes and more.

Now for the really bad news. It’s been recently shown that being exposed to tobacco smoke even as a second hand smoker TRIGGERS heart attacks in people who would not otherwise have gotten them.

2. Get regular exercise -- at least 30 minutes, four to six times per week. That kind of exercise IS heart protective but few people have time for that much. That much walking is ideal in fact.

But, steady state cardio at high exertion in many people for periods that long can trigger heart attacks.

Further, we now know that much shorter bursts of exercise done regularly in sessions a quarter to a sixth that long of vigorous interval cardio and/or strength training that is built up to slowly over time have several huge benefits. Far more people have time to do them. They are actually even more effective at promoting vascular health. And, they also tend to turn off insulin resistance and have been shown to lower higher levels of blood sugar and its most accurate measure, HBA1C.

That kind of exercise also directly reduces the particles of the dangerous small particle LDL that is one of the key causes of heart disease. And, as a result, it results in higher HDL and lower triglyceride levels.

If you have time for 120 to 180 minutes of walking or other more moderate exercise too, that’s great and can help keep your weight down even more.

But the more vigorous exercises are more effective at preventing heart disease and far more people can find time to do them.

So, I give them only half credit for that advice.

3. Stick to a healthy low-sodium, low-fat diet. I give them only half credit for this one.

They get full credit for the low-sodium part. It’s accurate and most people now ingest over four times too much sodium and salt for good heart health.

Eat lots of organic produce that has the counterbalancing potassium instead; always taste your food before you salt it; go very easy on any salt you add; use other savory spices such as curry, paprika, chili powder, and garlic powder in addition to a tiny bit of salt or instead of adding more salt for most foods; and eat very little commercially baked breads, baked goods, or packaged desserts or packaged snacks as they are all far too high in salt already added.

(Note that the first and last of these things to do to limit salt are each extremely heart protective in multiple ways also and tend to prevent you from getting fat or being unable to lose fat.)

The lowfat diet part is simply wrong in some ways and dramatically incomplete in others.

Some fats cause heart disease and others tend to while some kinds prevent it.

In addition, many people ate more refined grains and sugars on diets that had the fat taken out of them. And that’s actually WORSE for their hearts.

So the correct advice is to never eat some fats; go very easy on some; and eat a moderate amount of the heart healthy kind daily.

Never eat trans fats or hydrogenated oils. They are heart attack starters; but you still have to read labels to avoid foods that contain them. They are like tobacco smoke. There is no safe amount to consume except absolutely none.

Avoid oils high in omega 6 such as soy, corn, and even canola if you can. Most people eat 7 to 20 times too much of these which causes CRP inflammation – which is proven to cause heart disease.

Sharply restrict the amount of animal based saturated fat from animals fed grain. But we now know small amounts, particularly from naturally fed animals is not as dangerous as we once thought.

Eat wild caught fish that are high in omega 3 oils at least twice a week and take a purified omega 3 supplement daily.

Dr Agatson includes this one as his first recommendation. It lowers inflammation AND triglycerides. Omega 3 oils also tend to prevent heart rhythm problems. Recently research was reported that these omega 3 oils slow aging – which is also heart protective.

When you want to use an oil, use extra virgin olive oil since the monosaturated oils in it increase HDL or keep it from falling and tend to keep your LDL levels down. In fact, the Mediterranean diet it is a key part of has a track record for helping people stay healthy in dozens of ways.

In addition, unsalted and raw or dry roasted nuts – but those kinds only – are high in monosaturated oils and also tend to produce good health except for people allergic to them. Avocados and guacamole made from them are even better, their oil is monosaturated and they are so nutritious they could serve as a multivitamin.

4. Take medications if you need them to help lower your cholesterol and lower your blood pressure.

That’s all most doctors know how to do. In a few cases, taking statins to lower cholesterol or CRP inflammation can be helpful. But the other methods to do each of these is both effective and far safer.

And, blood pressure drugs are often less desirable than nondrug methods in blood pressures under 160 over 100. In addition, most doctors prescribe then in a way that ignores their more dangerous and quality of life damaging side effects. (Many of the most heart protective steps here also help people to lose fat weight or not gain it. This and the other steps here tend to prevent or reverse high blood pressure and do NOT have the bad side effects.)

The good news is that low doses of ARB drugs tend to have few side effects and calcium channel blockers even at low doses are extra protective due to lowering blood pressure variability and early morning blood pressure surges. So if your blood pressure is over 160 over 100 they may be the best choice. The drug Exforge that has one of each is an effective reducer of high blood pressure.

For lowering cholesterol, a subject Dr Agatson did well with, taking sterol supplements as he recommended both lowers LDL cholesterol and does so far more safely than statin drugs. The omega 3 oils he recommends are effective at lowering inflammation and lower triglycerides too without serious side effects except for people taking blood thinners or who are about to have surgery. With that exception, omega 3 oils are far safer than statin drugs and more heart protective.

Dr Agatson recommends taking fiber supplements. Soluble fiber in particular helps to lower LDL cholesterol. But it’s both safer and far more heart protective to eat real foods high in fiber and soluble fiber such as lots of organic produce, beans and lentils, and in moderation whole grain oats and oatmeal.

Lastly, Dr Agatson left out niacin. The Berkeley Heart lab has the most advanced classification of types of people and what they need to protect their hearts. All those groups but one are far BETTER protected by taking niacin than by taking statins.

If you take two 300 mg tablets of real niacin after two meals a day, you get very little flushing. In addition two 300 mg capsules a day of inositol hexaniacinate a day breakdown into about 500 mg of niacin in a very gradual time release style with NO flushing at all. Chromium polynicotinate has niacin also and helps you process sugars without causing your blood sugar and insulin to spike.

These three supplements increase HDL, lower LDL, AND lower triglycerides. (Doses larger than the above can cause liver problems and must be monitored by a doctor.)

Each of these effects protects your heart. Getting all three at once is very protective.

The last step that both The American Academy of Family Physicians and Dr Agatson left out of their lists is to sharply limit or simply stop ingesting all refined grains, all high fructose corn syrup, and most sugar.

These foods are quadruple threat heart and blood vessel harmers.:

a) They increase inflammation.

b) They sharply increase triglycerides.

c) They cause excessive levels of blood sugars and insulin which directly harm your blood vessels.

d) And, this last effect ensures, along with the rebound hunger such foods cause, that those eating them will be far fatter than they should be for good health.

They are not quite as bad for your heart as smoking or eating trans fats. But they aren’t far behind!

Dr Agatson gets a pass for not listing this step since he DID write the South Beach Diet showing that eating these foods makes you fat and makes it hard to lose fat.

But, The American Academy of Family Physicians should know better by now I think.