Have a Healthy Heart

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Anthocyanins (found in purple-colored fruits and vegetables) have strong antioxidant properties.
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One fresh garlic clove daily is sufficient to reduce cholesterol.

Heart disease is the leading cause of death in
the United States. According to the American Heart Association,
about 1.5 million Americans will suffer heart attacks this year.
However, statistics do not equal fate. Many proactive steps are
available to help reduce the risk, from the foods we eat (and
avoid), to the herbs and supplements we take and the lifestyle
changes we incorporate.

Health practitioners have known for some time that for good
heart health, we need to avoid saturated fats and watch our
cholesterol levels — and many studies continue to confirm this.
Lowering our cholesterol concentrations can result in a 25 percent
decrease in death from heart disease, according to research
published in the British Medical Journal.

People tend to be much more aware of their blood lipid profiles
today than they were even a few years ago. A lipid profile is a
blood test that measures levels for total cholesterol, high-density
lipoprotein (HDL, also known as “good” cholesterol), low-density
lipoprotein (LDL, also known as “bad” cholesterol) and
triglycerides.

The goal is not to achieve as low a cholesterol level as
possible but to achieve a healthy cholesterol ratio. This ratio
refers to the amount of total cholesterol to HDL cholesterol and
should be at least 3.5:1 — higher numbers are associated with a
lower risk of heart disease. (To find this ratio, divide your total
cholesterol by your HDL level.) Because this ratio increases with
higher HDL levels, increasing HDL is important for a healthy heart.
The best way to increase HDL is to exercise. Decades ago, heart
patients were told to rest, but now we know that 20 to 30 minutes
of aerobic exercise three to five times a week can prevent the
development of heart disease (and reduce symptoms in those who
already have heart disease).

Besides cutting down on foods that are high in saturated fat,
such as red meat, eating more plant sterols can help reduce
cholesterol levels. Sterols are lipid-soluble compounds that
include beta-sitosterol, stigmasterol and campesterol. Good sources
of plant sterols include peanuts, seeds, whole grains, nuts and
legumes, such as soybeans. Plant sterols decrease cholesterol by
reducing the amount of cholesterol absorbed by the gastrointestinal
tract.

In fact, according to research published in the Journal of the
American Medical Association (JAMA), a diet that included 2 grams a
day of sterols, 42 grams a day of soy protein and 19 grams a day of
viscous fiber, such as oats, decreased cholesterol as effectively
as statin drugs did.

If you need more motivation to reduce red meat in your diet — or
eliminate it altogether — consider this: Red meat is not only high
in saturated fats but also high in methionine. This essential amino
acid is converted to homocysteine by the body. Homocysteine has
been identified as another risk factor for heart disease.
Homocysteine can be lowered by taking vitamin B6, folic acid and
vitamin B12.

Beyond Cholesterol

Lowering cholesterol is not the only factor involved in reducing
the risk of heart disease. Besides high cholesterol, the most
important risk factors for cardiovascular disease are smoking and
high blood pressure. In fact, smoking could be the most detrimental
of these risk factors. One review of the medical literature,
published in JAMA in 2003, found that for patients with heart
disease, the risk of death was decreased by 36 percent if the
patients quit smoking. The next important risk factor is high blood
pressure. Many people have high blood pressure without knowing it,
so it’s important to have your blood pressure checked
periodically.

An estimated 10 percent to 50 percent of people who develop
heart disease do not have high cholesterol or high blood pressure,
nor do they smoke, according to another 2003 JAMA article. This
means many people can be unaware that they were at risk for heart
disease until it is too late. Consider some of the following
additional means to keep your heart healthy, whether you have known
risk factors or not.

The main form of heart disease involves atherosclerosis of the
coronary arteries. This means the blood vessels that bring
essential nutrients and oxygen to the heart muscle have become too
narrow to perform their function, so the heart muscle starves. The
earliest step in this process is thought to be damage to the inner
walls of the blood vessels. After the vessel is damaged, narrowing
can occur by the buildup of plaque. Once this happens, the body
responds by creating inflammation and blood clotting, processes
that can block blood flow through the vessels.

Controlling inflammation and excess blood clotting are important
factors in decreasing the risk of heart disease. Eating plants that
contain flavonoids (see “Fabulous Flavonoids” for examples) as well
as dietary fiber, vitamins and minerals, ranks with getting enough
exercise, reducing cholesterol and controlling blood pressure as a
key component in preventing heart disease.

Whether you have heart disease or want to make sure you never
do, the following tips and information can help keep your heart
healthy and happy.

Fat Facts

Rather than reducing your intake of saturated fat by
substituting carbohydrates, it might be more beneficial to
substitute unsaturated fats — those that are liquid at room
temperature. Unsaturated fatty acids include monounsaturated and
polyunsaturated fats. Monounsaturated fats reduce blood cholesterol
and triglyceride levels, and decrease proteins associated with
blood clotting, which decreases the risk of heart disease. Sources
of monounsaturated fats include olive oil, canola oil, peanut oil
and avocados.

The most important fatty acids are the omega-3s (components of
polyunsaturated fatty acids), because they can decrease
triglyceride levels and LDL without decreasing HDL. They also
decrease inflammation, inhibit platelet stickiness and lower blood
pressure, according to research published in the American Journal
of Clinical Nutrition in 2000. Omega-3 fatty acids are found in
fatty fish such as halibut, mackerel, herring and salmon. Vegetable
oils high in omega-3 fatty acids include canola oil, flaxseed oil,
walnut oil and soy oil. Flaxseeds are a particularly rich source
and are easy to add to your diet — just grind the seeds and
sprinkle them on top of cereal or yogurt. Additional foods
containing omega-3 fatty acids are pinto beans, walnuts, pumpkin
seeds, purslane, spinach and leeks.

Trans fatty acids are unsaturated fats that have been processed
by hydrogenation to make them solid. The best-known trans fat is
margarine. Although margarine was once touted as a beneficial
alternative to butter — which is high in saturated fat — we now
know trans fats can raise LDL, lower HDL and raise triglyceride
levels, according to research from countless sources, including the
New England Journal of Medicine. These fats should be avoided — not
always an easy task because they are ubiquitous in processed foods,
such as crackers, cookies, packaged baked goods and microwave
popcorn. You can identify trans fats by looking for the phrase
“partially hydrogenated vegetable oil” on product labels.

Fabulous Flavonoids

Flavonoids (also known as polyphenols) are products of plant
metabolism that have strong antioxidant properties in the body.
Literally thousands of flavonoids have been identified, too many to
possibly name them all here. But this large family of plant
chemicals includes lignins (found in nuts and whole grains);
proanthocyanins (in grapes and pine bark); anthocyanins (found in
grapes, red wine, berries and purple-colored fruits and
vegetables); isoflavones (found in soybeans); catechins (found in
tea, grapes, cocoa and wine); tannins (in tea and nuts); and
quercetin (in grapes, wine and onions).

Several studies, including one published in 2002 in the American
Journal of Clinical Nutrition, have found that increasing
consumption of flavonoids decreases the risk of coronary heart
disease. Flavonoids act as antioxidants to prevent the oxidation of
LDL, a process thought to be the first step in plaque formation.
Flavonoids also can inhibit platelet activity, which decreases
abnormal clotting. Heart patients are often advised to take an
aspirin daily to achieve the same anti-clotting effect.

To increase your consumption of flavonoids, eat onions and soy,
or drink tea and wine, or just increase your consumption of fruits
and vegetables in general. One long-term study, published in the
American Journal of Clinical Nutrition in 2002, found that people
who ate more than three daily servings of fruits and vegetables had
a 27 percent lower risk of dying from heart disease over the
19-year period of the study. And the benefits didn’t extend to just
heart disease — those who ate more fruits and vegetables had a 15
percent lower chance of dying from any cause than people who ate
less than one serving a day.

The Stinking Rose: Great for Your Heart

The Allium family, which includes garlic (Allium sativum),
onions (A. cepa) and leeks (A. ampeloprasum), is the primary
contributor of plant organosulfur compounds. In many clinical
trials, garlic has been found to reduce total blood cholesterol
levels, LDL levels and triglyceride levels, according to a research
review published in 2002 in the Nutrition Journal. Raw garlic seems
to have the most beneficial effect. Powdered garlic, which is low
in allicin, the compound responsible for garlic’s greatest health
benefits, has the lowest effect.

Garlic extracts inhibit platelets, as well as several other
factors involved in blood clotting. Garlic also helps lower blood
pressure. Many preparations of garlic are available, not all of
which have been studied, but one fresh garlic clove per day is
sufficient to reduce cholesterol and reduce platelet function. Side
effects of garlic can include gastrointestinal discomfort and
nausea. As with any herb or drug that affects blood clotting, you
should let your physician know prior to having surgery if you’re
taking garlic.

Eat Your Fiber

Fiber refers to plant carbohydrates that our digestive system
cannot digest. They pass through the gastrointestinal tract without
being absorbed, carrying cholesterol with them. Fiber is found
mainly in whole grains, such as whole-wheat bread, oatmeal and
brown rice. Besides containing fiber, these grains are high in
magnesium, selenium, phytosterols and other plant chemicals. Whole
grains can improve lipid profiles, decrease blood pressure and
improve blood glucose levels. In the United States, wheat often is
supplemented with folic acid, which decreases the risk of heart
disease.

Vital Vitamins and Minerals

Magnesium deficiency is associated with an increased risk of
heart disease. Studies, including one published in 2003 in the
American Journal of Cardiology, have found that people who eat
foods rich in magnesium have a lower risk of heart disease. Good
magnesium sources include whole grains, peanuts, beans, seeds and
leafy green vegetables. If you live in an area with hard water,
your drinking water already contains plenty of magnesium.

Folic acid, vitamin B6 and vitamin B12 all help prevent heart
disease by decreasing levels of homocysteine, according to a 1997
article published in Cardiology. Enriched grain products in the
United States are fortified with at least 140 grams of folic acid
per 100 grams of grain. Other good sources of folic acid include
dark, leafy green vegetables, lentils and chickpeas. Because
vitamin B12 is found mainly in meat, vegetarians may need to
consider supplements, although eggs, dairy products and brewer’s
yeast are also good sources. Niacin can decrease LDL levels and
increase HDL levels and is often prescribed in high doses for this
purpose. Food sources of niacin include asparagus, bean sprouts and
red raspberry (Rubus idaeus) leaf.

Because foods contain a wealth of plant chemicals, it’s
difficult to determine which of them is individually responsible
for specific activities. It appears that supplementation with
antioxidant vitamins E and C is not as important in preventing
heart disease as eating a variety of foods. People who eat foods
high in these vitamins reduce their risk of heart disease,
according to a 2004 article from Current Treatment Options in
Cardiovascular Medicine. Food sources high in vitamin E include
walnuts, green leafy vegetables, sunflower seeds, purslane, whole
wheat and pansy flowers (Viola tricolor). Vitamin C-rich foods
include kiwis, sweet peppers, cashews, watercress, rosehips and
garden sorrel.

Herbs Can Help, Too

Besides their high levels of beneficial flavonoids, many herbs
have additional properties that are good for the heart.

Hawthorn (Crataegus spp.) has a long history of use for heart
disease. The leaves, flowers and berries have been used for
treating congestive heart failure, high blood pressure and
atherosclerosis. Several studies, including a meta-analysis
published in The American Journal of Medicine in 2003, have found
that hawthorn extracts can decrease the fatigue and breathing
problems associated with mild to moderate chronic heart
failure.

Asian ginseng (Panax ginseng) also has been used historically
for treating heart and circulatory disease, especially in China.
Some studies have shown that ginseng can improve aerobic capacity
during exercise, in which heart function is very important. It may
help the heart by inhibiting platelet activity, acting as an
antioxidant, opening up the blood vessels and decreasing an
elevated heart rate. Thorough clinical studies have not been
conducted, however. Asian ginseng should not be taken with drugs
intended to influence blood coagulation, especially warfarin.

Keep Your Heart Happy

All of the studies mentioned in this article indicate that good
heart health is primarily a function of lifestyle. No single food
or supplement can prevent heart disease. The triad of eating a
healthy diet with a wide variety of minimally processed foods, not
smoking and getting plenty of exercise is the best and most
established way of preventing heart disease — and managing the
disease if you already have it. These measures not only will go a
long way in preventing heart disease but are also the cornerstone
of preventing diabetes, cancer, obesity and other common
diseases.


Cindy Jones, Ph.D., is a biochemist who works as a medical
writer and health educator specializing in herbs and nutrition. She
is the author of the Healthy Heart Guide (Woodland, 2004). Her
website is www.sagescript.com.

The reference list for this article is extensive. If you would
like a copy, please send a self-addressed, stamped envelope to
“Heart Health,” Herbs for Health, 1503 SW 42nd St., Topeka, KS
66609; or e-mail us at editor@herbsforhealth.com.

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