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The heart of the matter

Heart disease is an everyone disease. Thankfully, your lifestyle has the power to protect your lifelong health. First published in Nourish Magazine.

Woman Running

The heart is a magnificent pump made of very specialised tissue that, over an average lifetime, beats about 2.5 billion times. For long-term health, we need to look after this vital organ – and it’s never too early to start.

Sadly, heart disease is the number one cause of death in Australia and New Zealand, with more than 50 people dying of this condition in our region every day. While the statistics are eye-watering, the good news is that positive lifestyle changes can help you avoid and, in some cases, even reverse coronary heart disease. Chief among them is adopting a dietary pattern centred on whole plant foods, with every step in this direction offering greater benefits for your heart health.

But am I really at risk?

The process that leads to the development of heart disease starts from a very young age in most of us. So, understanding the risk factors and ailments associated with the disease is an important step to take to prevent yourself, or your loved ones, from becoming a statistic.

Major mechanisms in this process include the build-up of fatty cholesterol-laden plaques in our coronary arteries and the inflammation that develops in the lining of our blood vessels, known as endothelial dysfunction. Heart disease develops when plaque – made of fat, cholesterol, calcium, and other substances in the blood – builds up inside the artery walls, limiting the supply of oxygen-rich blood to the heart muscle.

The plaque inside these inflamed blood vessels can rupture, causing a clot that interrupts blood flow to the heart, and without oxygen, the heart muscle dies leading to a heart attack or sudden cardiac death.

Given modern lifestyles, most of us are at some risk. Who hasn’t had a chat with their doctor about cholesterol by the time our thirties are behind us?

Doesn’t it come down to genetics?

It has been said that we not only inherit our genetic makeup from our ancestors but also the family recipe books and habits. And, in many cases, the latter is more influential in determining our health trajectory than our genes. In fact, through good lifestyle choices, we can actually modify the expression of our genes. This is known as the science of epigenetics.

In the case of heart disease, we can significantly decrease our risk by eating a healthy plant-based diet, which naturally helps us maintain a healthy weight, decrease our LDL (or ‘bad’) cholesterol, dampen endothelial inflammation, decrease our diabetes risk, and support a healthy gut microbiome.

By eating this way, we are following the consistent advice of national health bodies: to eat a diet rich in nutrient-dense whole plant foods; naturally high in fibre, antioxidants, and anti-inflammatory compounds; and one that is low in unhealthy fats, salt, and added sugar.

While we cannot change factors such as our age, sex, and genetics, a healthy lifestyle gives us the best chance at supporting our heart through all stages of life.

Fresh produce

Lifelong health is built with lifestyle

A diet based on plentiful whole plant foods is the foundation of good heart health. It is also fundamentally important to keep active, develop good sleep patterns, cultivate healthy ways to manage stress, and nurture positive social connections. These lifestyle interventions not only offer protection against developing heart disease but can even halt and reverse the condition.

By adopting a healthy lifestyle and a wholefood, plant-based diet, we are addressing the root causes of heart disease. The fact that common biological processes underpin virtually all chronic diseases means that your wholefood, plant-based way of eating doesn’t just reduce one risk factor – it has an influence on them all. This is different to using medications, which target specific conditions that are seen as risk factors for heart disease. For example, statins that are prescribed to lower cholesterol or anti-hypertensive medications that are prescribed to treat high blood pressure.

Cultivating a healthy lifestyle helps to circumvent the causes of disease and illness, hopefully avoiding the need to treat the symptoms of disease later.

Yes, there’s proof that plants work

In fact, a low-fat, wholefood, plant-based diet is the only diet that has been shown to halt and reverse heart disease. For example, lifestyle medicine pioneer Dr Dean Ornish is famous for helping Bill Clinton use a vegan diet to reverse heart disease. Dr Ornish also conducted a randomised controlled trial in which patients adopted a low-fat, plant-based diet alongside regular walking, relaxation, and group support.

The study group showed regression of atherosclerosis (arterial plaques) after one year, with further improvement after five years. The study group also experienced a 72 percent reduction in the frequency of chest pain (angina) compared to just 36 percent in the control group receiving standard care, of whom 60 percent needed cholesterol-lowering medication and 20 percent required the placement of a stent.

These kinds of results have been demonstrated in both small and large groups of patients, using a wholefood, plant-based diet alone – even at a population level where we can observe the overwhelming relationship between plant-predominant dietary patterns and the virtual absence of heart disease.

The wholefood approach

It is important to appreciate that a plant-based diet cannot be automatically assumed to be a healthy one. Saturated fat, processed sugars, and excessive salt from any source can negatively affect your health. It’s best to limit or avoid processed or manufactured foods because there are often fats, salt, artificial flavourings, and sugars added to enhance palatability. We also want to limit sources of plant-based saturated fat, such as coconut oil, and calorie-dense foods, such as cakes, burgers, and pizzas.

You can decrease your heart disease risk factors by emphasising simple wholefoods and minimising processed and packaged products. The enormous health benefits of a plant-based dietary pattern are all linked to this lower calorie density, higher nutrient density way of eating. This healthy eating pattern focuses on wholegrains, legumes, starchy and non-starchy vegetables, fruits, herbs, and spices – ingredients that lend themselves to a wide range of delicious dishes in flavours and styles from cuisines around the world.

Obviously, the more that you lean in the plant-based direction, the more the beneficial effect. For people with existing markers of heart disease, it certainly pays to go ‘all in’, with the supervision of a knowledgeable health professional. However, if your aim is to maintain and optimise good health, you may prefer to start small and work towards a more committed wholefood approach as you feel the benefits for yourself.

A healthy lifestyle helps to circumvent the causes of disease and illness

Exercising outdoors

But wait! There’s more

When talking about heart disease here, we’ve been focusing on coronary artery disease, which is caused by narrowing or obstruction of the coronary arteries that supply the heart. However, the same processes that occur in the arteries of the heart also occur elsewhere in the body, manifested in many ways.

For example, blockages and reduced blood supply to the brain are major causes of strokes, cognitive decline, and dementia. Peripheral vessels can also become narrowed or blocked, limiting blood supply elsewhere in the body. This, by the way, is why erectile dysfunction is commonly thought of as a ‘canary in the coal mine’ for heart disease.

Shockingly, cardiovascular diseases as a whole cause nearly one in three deaths in Australia and New Zealand, and an enormous amount of suffering and disability. The powerful flipside is that the same lifestyle changes that prevent and treat coronary heart disease also offer protective and therapeutic benefits for all of these associated vascular diseases.

These lifestyle measures are not only life-enhancing, but often more effective. And it keeps going. They also offer protection from a wide range of other diet-related diseases from diabetes to cancer – bringing only the very best of side effects, from maintaining a healthy weight naturally to enjoying clearer skin and more energy. Pass the plants, please!

6 heart healthy foods

Eating a rainbow of whole and minimally processed plants is a proven way to reduce risk factors for heart disease. Here are just some of our favourites.

Blueberries – rich in antioxidants, helping to decrease inflammation in blood vessel walls.

Tomatoes – rich in the potent antioxidant lycopene, shown to help lower cholesterol and decrease heart disease.

Broccoli – loaded with fibre, antioxidants, and vitamins, helping to guard against calcification of blood vessels.

Green leafy vegetables – provide a natural package of heart-healthy nutrients including vitamins A, C, E, and K.

Beetroot – contains a high concentration of healthy plant-based nitrates that help dilate or open blood vessels, leading to lower blood pressure.

Oats – help lower LDL and total cholesterol while improving insulin response to sugar and supporting a healthy gut microbiome.

This article is republished with permission from nourishmagazine.com.au.

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