Heart Disease and Nutrition: What You Eat Can Save Your Life

by Dr Albert Hicks III, a Senior Cardiology Fellow at Johns Hopkins Hospital

Heart disease is the leading cause of death in the United States, and in most of the developed world. Cardiovascular conditions such as coronary artery disease, heart failure, and hypertension also disproportionally affect African Americans and other minority groups in the US. In my Cardiology practice, patients frequently ask what lifestyle changes they can make to reduce their chance of developing heart disease. For years I would tout the mantra of increasing exercise, quitting smoking, taking the right medications, and healthy eating.

The first three suggestions were easy to sell since the evidence supporting them was so robust. Exercise training has been shown to reduce deaths in people with heart failure and in folks that just had a heart attack. Cigarettes accelerate atherosclerosis and increase cardiovascular deaths, while quitting substantially reduces the risk of death. There are numerous medications such as Aspirin and Statins, that have been shown to reduce mortality in folks with heart disease. The last point regarding a healthy diet has been notoriously difficult to define.

What exactly does ‘eating healthy’ mean? Is it eating exclusively fruits and vegetables? Does it mean a diet high in protein and fat like the Atkins diet? Are carbohydrates a staple in a healthy diet? Or perhaps a diet very low in carbohydrates is healthy?

Unfortunately, at some point all of these diets were in vogue within the medical community. They were recommendations that made common sense. But when studied on a population level, none of these diets demonstrated an improvement in heart disease outcome. Because of the lack of clear cardiac benefit of any particular diet, many fad diets flooded the market. It is no wonder why my patients never know what types of foods they should eat to be healthy. But finally that has all changed.

A Gift from the Mediterranean
For years there has been discussion in the medical community regarding the potential benefits of the Mediterranean diet. The diet represents foods traditionally found in the Mediterranean part of the World, particularly Greece and southern Italy.

But variations of the diet are found in Spain, Portugal, the Middle East, Northern Africa, Turkey, and the Bulkan region. Scientists observed that people who live in these parts of the world suffered from significantly less chronic diseases and had higher life expectancies than their Western counterparts.

What foods comprise the Mediterranean Diet
The following foods are staples in the Mediterranean Diet:
• VEGETABLES
• Fruits
• Cereals, Pasta, Bread
• Legumes, Nuts, Seeds
• OLIVE OIL
• Moderate fish, poultry
• Small amounts of red meat
• Moderate dairy (GREEK YOGURT, cheese)
• Moderate consumption of wine w/ meals

Screen Shot 2014-04-01 at 12.28.59 PMThe foods in should be grown and produced locally. Quality of food is heavily stressed over the quantity. Fresh foods are essential to the diet. Lastly, the creators of the diet stress that food should be savored, and enjoyed.
In April 2013, the New England Journal of Medicine published the results of a ground- breaking dietary study that has transformed my practice. The study examined the benefits of a Mediterranean diet on cardiovascular disease. The researchers followed over 7400 people who were at high risk of developing heart disease but were free of heart disease at the beginning of the study. The participants were then assigned to assigned to one of three diets: a Mediterranean diet supplemented with extra-virgin olive oil; a Mediterranean diet supplemented with mixed nuts, or a Control diet that was low in dietary fat. They followed folks for five years.

The results of the study showed that in people at high cardiovascular risk, a Mediterranean diet supplemented with extra-virgin olive oil or nuts reduced the incidence of major cardiovascular events including heart attack, stroke, and death.

This study finally validates a diet that can save lives and reduces the chances of developing heart disease. I now recommend the Mediterranean diet to all of my patients, friends, and family. Additionally I challenge them to change their eating culture: eating as a family, experimenting with new foods, and eating for longer periods of time to truly enjoy the experience.

I challenge anyone that is reading this article to try this diet out. It just one day may save your life.

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