"Let food be thy medicine, and medicine be thy food."
What is a heart healthy Diet?
What is a heart healthy diet? The honest answer is that we still do not know for certain. Quality, easy to interpret, data- driven, nutritional science is lacking.
Dr Zurick generally recommends a primarily plant-based, whole-food, high-fiber, low sugar and processed carbohydrate diet for his patients. No one dietary prescription is correct for every person, however maintaining healthy eating behaviors is one of the most important ways to maintain general cardiovascular health throughout your life.
Look at how our eating patterns as a society have changed since the 1960s:
Sugar consumption per person in the this country has more than doubled in the past 20 years! Our current consumption of high fructose corn syrup is nearly 63lbs per person per year, and total sugar consumption is nearly 75 lbs per person per year in the United States! This is a systematic problem brought about by congressional inaction, special interest lobbying from the food/beverage industry, and a movement by the consumer away from whole natural foods, to ones that are processed and adulterated. Restricting calories is not the answer. Improved eating behaviors, including access to more fresh fruits and vegetables, legumes, nuts, whole grains, and fiber are paramount.
Get rid of added sugar! Grow your own garden at home. Call your congress-person. Get involved. Talk to your kids school districts.
In general, Dr Zurick recommends creating a healthy food environment in your home - this is an extremely important and effective strategy for ensuring that your home food choices are optimal. This means get rid of the bad snack and drink options. No sugar sweetened beverages. No candy. Consider mixed nuts, popcorn, or kale chips as snacks. Drink water! Remember your body is made of 70% water.
Nutrition Articles Worth a Read:
Malik et al. JAmCollCardiol2015;66:1615–24 - Nice article reviewing the role of fructose and sugar-sweetened beverages on our cardio-metabolic health.
Johnson RK et al. Circulation. 2009; 120:1011-1020. American Heart Association position statement on the effect of sugar on cardiovascular health. Explains the increase in sugar consumption over the past four decades.
Sabate J. Am J Clin Nutr 1999;70(suppl):500S–3S - Article reviewing the role that nuts have in protecting against ischemic heart disease.
Shikany JM et al. Circulation. 2015;132:804-814 - REGARDS study. 5 year longitudinal study looking at a variety of dietary patterns. Southern style diet consisting of added fats, fried food, eggs, organ meats, processed meats, and sugar-sweetened beverages was associated with the highest rates of cardiovascular mortality.
Estruch R et al. N Engl J Med 368;14 - PREDIMED trial. Prospective, mutlicenter, randomized clinical trial involving >7000 patients in Spain evaluating Mediterranean diet. Among persons at high cardiovascular risk, a Mediterranean diet supplemented with extra-virgin olive oil or nuts reduced the incidence of major cardiovascular events.
Tricopoulou A et al. Modified Mediterranean diet and survival: EPIC-elderly prospective cohort study. BMJ. 2005 Apr 30;330(7498):991 - The Mediterranean diet, modified so as to apply across Europe, was associated with increased survival among older people.
Iqbal R et al. Circulation. 2008;118:1929-1937 - INTERHEART Study. The INTERHEART study is a large case-control study of AMI (acute myocardial infarction) in 52 countries that documents the association of various risk factors with the risk of AMI globally and in individuals from various regions of the world. The "prudent" dietary pattern consisting of higher consumption of vegetables and fruits was associated with lower overall risk of acute myocardial infarction (heart attack).
Dehghan M et al. Associations of fats and carbohydrate intake with cardiovascular disease and mortality in 18 countries from five continents (PURE): a prospective cohort study. Large prospective epidemiological trial looking at the effect on health of different dietary ratios of carbohydrate, protein, and fat. high carbohydrate intake (more than about 60% of energy) was associated with an adverse impact on total mortality and non- cardiovascular disease mortality. Lancet 2017; 390: 2050–62
Plant Based diets:
Song M et al. Association of Animal and Plant Protein Intake with All Cause and Cause-Specific Mortality. High animal protein intake was positively associated with cardiovascular mortality and high plant protein intake was inversely associated with all-cause and cardiovascular mortality, especially among individuals with at least 1 lifestyle risk factor. Substitution of plant protein for animal protein, especially that from processed red meat, was associated with lower mortality, suggesting the importance of protein source. JAMA Intern Med. 2016;176(10):1453-1463
Links to Useful resources
YouTube Video: Dr Robert Lustig's - Sugar: The Bitter Truth