Heart disease is the leading cause of death in Australia, claiming more than 60 lives each day. Currently, more than 800,000 Australians have heart disease – that’s three out of 10 adults. Accredited Practising Dietician Nicole Senior sheds light on five new things you need to know about your health.
We all know the basics of keeping our hearts healthy: keep cholesterol levels, weight and blood pressure under control; eat well; exercise often; and avoid smoking. However, there is more to it than these essentials. Emerging research has uncovered some new risk factors that may prove to be just as important in keeping your heart healthy.
1. High blood sugars increase your risk
Having diabetes puts a big strain on your heart health; so much so that people with diabetes have double the risk of suffering a heart attack than those who don’t. However, you don’t need to have actual diabetes to be at risk, according to new research – simply having higher than normal blood sugar levels (known as pre-diabetes) is a problem. Diabetes Australia says a fasting blood glucose level of less than 5.5mmol/l is considered normal. The scary thing is that one in two people who have high blood sugar don’t even know it.
So how does high blood sugar affect your heart? Eating any food containing carbohydrate increases the level of sugar (or glucose) in your blood. In a healthy body, the hormone insulin helps move the sugar from your blood into your cells, where it can be used for energy. So if your body doesn’t use or produce insulin properly, such as when you have diabetes or pre-diabetes, the sugar builds up and causes damage to your blood vessels. It does this by making ‘bad’ LDL cholesterol denser and stickier. This increases the chance of a blockage and therefore the chance of a heart attack or stroke. A simple blood test can help to identify if your blood sugar levels are high – ask your doctor during your next visit. The good news is that high sugar levels can be reversed with healthy diet, exercise and weight loss.
Things you can do
If you’re overweight, lose some of it. Losing as little as 7% of your body weight can help lower because reducing body fat improves the effectiveness of
Get some exercise. Physical activities that cause you to puff a little improve the flow of sugar from your blood into your cells. Health experts recommend at least 30 minutes of exercise a day, 5 days a week. However, the more you do the better, and for weight loss you need to be moving for 60 minutes 5 days a week.
Choose low-glycemic index (GI) foods. Low-GI foods are absorbed into your blood stream at a much slower rate than high-GI foods. This means they don’t cause large increases in the level of sugar in your blood. Oats, pasta, dense grainy bread, milk, yoghurt and most fruits are low-GI. To lower a meal’s GI, include lean protein, vegetables and some good fats like olive oil, margarine, nuts or avocado. For more information on GI, visit www.glycemicindex.com.
Watch your portion size. Eating too much carbohydrate at once can overwhelm your body’s insulin, leading to a build-up of sugar in your blood. Spread your consumption of carbs evenly throughout the day and limit your portions of carbohydrate-rich foods such as rice, potatoes, pasta or bread to a quarter of your dinner plate.
2. Inflammation is bad for the heart
Short-term inflammation is part of your immune system’s response to injury or infection. It is important because without it, you wouldn’t be able to protect and heal yourself. However, things get ugly when there are low levels of inflammation present all the time due to atherosclerosis (fatty plaques in the blood vessels), high blood sugar levels, obesity, overeating, or chronic inflammatory conditions (such as gum disease, see right). Long-term inflammation encourages fatty plaques (hardened fat on blood vessel walls) to get bigger, and blood vessels to swell, increasing the risk of a heart attack.
Things you can do
Get enough long-chain omega-3s. Long-chain omega-3s are ‘good’ fats which act as natural anti-inflammatories and calm inflammation in the body. To meet your needs, eat 2–3 serves of oily fish (eg. tuna, salmon, sardines or mackerel) per week, or take fish oil supplements or other foods with natural or added omega-3. Some packaged foods contain omega-3s and these will be listed under ‘polyunsaturated fats’ on the nutrition information panel. Women should aim for 430mg per day and men for 610mg (or 1000mg if you already have heart disease). Plant sources of (short-chain) omega-3 such as walnuts, linseeds, chia seeds and canola oil are also great for the heart, but not as potent in reducing inflammation so be sure to include long-chain sources as well.
Include antioxidants. These neutralise the damage of trouble-making free radicals, triggered by poor diet and lifestyle. Antioxidants are found in richly coloured fruits and vegetables such as Asian greens, broccoli, beetroot, carrots and berries as well as olive oil, tea, cocoa powder and red wine in moderation (no more than two glasses per day).
Eat more fibre. A review of the National Health and Nutrition examination Survey (USA), found people with higher fibre intakes (32g per day) had significantly lower levels of inflammatory markers in the blood than those who ate very little (5g per day). Researchers believe fibre reduces inflammation by producing anti-inflammatory molecules. Boost fibre in your diet (aim for 30g a day for men, 25g per day for women) by eating nuts and seeds; choosing wholegrain breads and high-fibre breakfast cereal; eating two serves of fruit and five serves of vegies daily; and including two meals with legumes each week.
3. Healthy gums, healthy heart
While it may seem strange, a link has been found between periodontal (gum) disease and poor heart health, with new studies finding it can increase your risk of heart disease by 25%. Periodontal disease is an inflammatory gum disease caused by bacteria. It leads to the breakdown of your gums and the tissues around it. Surprisingly, this disease is quite common, affecting 1 in 5 Australians at any given time. The most common cause is poor dental hygiene – simply not brushing and flossing your teeth properly and regularly.
It is believed that when periodontal disease is present, bacteria from the mouth (or their toxins) enter the blood vessels through broken gums. This triggers inflammation elsewhere in the body, such as in the blood vessels in the heart, and increases the chance of heart attack.
Things you can do
Brush twice a day and floss at least once. Be sure to brush where the gum line meets the tooth and be gentle when flossing to prevent damage.
Snack right. Each time you eat, your teeth are attacked by plaque acid for 20 minutes or more. The best snacks are reduced-fat dairy foods, nuts and fresh crunchy fruit and vegetables as they are tooth-friendly. Avoid high-sugar sweets, which provide food for bacteria.
Visit the dentist regularly. Arrange a check-up every six months.
Get enough vitamins from your food. If your diet is lacking, it may be more difficult for your gums to resist and fight an infection. This is particularly true for B vitamins and vitamin C, which are essential to keeping your gums strong and healthy. Aim for two serves of fruit and five serves of vegetables a day to get your vitamin C, and include wholegrains, dairy and meat for B vitamins.
4. Refined starches are just as bad as saturated fats
Cutting down on saturated fat is vital for improving your heart health, but be careful what you replace it with. Restrictive low-fat diets are not the best option because we do need good fats, but we also need to be choosier with carbohydrates.
Recent evidence shows replacing saturated fat with high-GI carbohydrates such as refined starches actually increases the risk of heart disease. That’s right: it’s counter-productive to swap butter cake for rice crackers – you’re better off eating a small piece of cake made with oil or margarine (or better still, a handful or two of nuts). A 12-year study of 53,000 people found the more high-GI foods they ate, the higher their risk of heart disease and vice versa.
It is thought high-GI carbohydrates increase heart disease risk by raising blood sugar levels after a meal. This results in a cascade of hormones, altered blood fats, inflammation and changes to the blood vessel wall. A high-GI diet also causes ‘good’ HDL cholesterol to fall, which increases heart disease risk further.
Things you can do
Choose low-GI carbohydrate foods. A low-GI carbohydrate is one with a GI value of less than 55. Dense, grainy bread is better than the refined white kind, while oats and muesli trump the highly processed, low fibre ‘puffed’ cereals. Pasta and legumes beat white rice and most potatoes. You can find GI values of foods at www.glycemicindex.com.
Limit saturated fat. Remember, saturated fat is found in many packaged foods, as well as butter, cream, cakes, pastries, full-cream dairy foods, fatty meat and fried takeaways. Use the ‘per 100g’ column on the label to compare products and find the smallest amount possible. The recommended daily limit for saturated fat is 24g.
Replace saturated fat with unsaturated fat. According to the Heart Foundation, replacing saturated fats with polyunsaturated fats like those in sunflower oil, walnuts and some margarines will provide you with the biggest benefit. By the Foundation’s assessment, doing this can reduce deaths from heart disease by more than 25%. Monounsaturated fats are also a great replacement for saturated fats, and are found in most nuts, avocado olive and canola oils, and some margarines.
5. Depression can really break your heart
Depression and social isolation have been found to increase the risk of heart disease by up to five times, with one study labelling it as the biggest risk factor for having a heart attack. How depression has such an adverse physical effect isn’t yet clear, but it is thought that it causes hormonal changes that lead to higher levels of blood fats, inflammation and increased blood clotting.
Researchers also suggest that people who are depressed or isolated lack the support they need to change their unhealthy behaviours. This may include quitting smoking, improving their diet or starting an exercise program.
Even if you do not suffer clinical depression, nutrition can play a role in boosting your mood. Not getting enough nutrients from your food can lead to changes in your brain, affecting the way you think and feel. Deficiencies in selenium, folate and B vitamins have been linked to depression, while eating long-chain omega-3 fats appears to reduce the risk in some people. Deficiencies in thiamine, riboflavin and iron can make you feel tired and sluggish, making it harder to deal with stress. Tea and coffee contain caffeine, which boosts energy levels and produces more feel-good brain chemicals (such as dopamine).
Things you can do
Eat a healthy balanced diet. Simply eating a varied diet from all the food groups can give your brain the nutrients it needs to function well and improve your mood.
Eat protein. Protein from eggs, fish, meat, dairy, wholegrains, legumes and tofu provides the building blocks for many feel-good chemicals in your brain the boost mood and alertness.
Include long-chain omega-3 fats. The best sources are oily fish such as sardines, salmon, mackerel, herring and tuna, but you also get some from lean red meat and eggs, and foods with added long-chain omega-3s such as some varieties of milk, bread and yoghurt.
Grab a coffee. While some caffeine can help your mood, don’t go overboard as too much can lead to headaches, heart palpitations and anxiety. Up to 300mg caffeine a day is considered moderate and you can get this in three espresso shots/brewed coffees, four instant coffees or six cups of tea.
Maintain social connections. Maintaining good, strong relationships with family and friends and making time to do things you enjoy are essential to wellbeing. It is important to look after your whole self – mind, body and soul.