HEART HEALTH

The World Health Organization has recognized coronary heart disease (CHD) as the number one worldwide preventable killer. Every day approximately 120 Canadians and 1,500 Americans die of heart attacks. Millions more suffer non-fatal heart attacks.  Mounting evidence points to our affluent lifestyles as responsible for the epidemic. 

Why is Prevention Key?   Coronary artery narrowing, a primary precursor to strokes and heart attacks, can be non-symptomatic, and therefore undetectable for up to 30 years.  This means that our habits as early as age 20 can affect our heart health for years to come.  Only when our arteries are blocked by more than 60% do most people experience symptoms.  

What are the Modifiable Risk Factors?  Most risk factors for CHD are things we have control over.  The classical risk factors are smoking, hypertension, obesity, diabetes and elevated cholesterol.  Smoking increases the risk of sudden cardiac death by tenfold in men and fivefold in women.  Those with high blood pressure are 2-3 times more likely to sustain a heart attack.  Excess weight in the truncal area (i.e. apple shaped persons) makes us prone to heart disease, diabetes, and some cancers (bowel, prostate, breast, uterus).  Having adult onset diabetes increases the risk twofold in men and four-to-six-fold in women for developing coronary heart disease.  However, it is the years of high insulin levels in non-diabetics (with normal blood sugars) that cause coronary damage.  Insulin is not tested for in routine yearly blood tests.  High cholesterol levels are also associated with cardiovascular diseases and are measured yearly at routine physicals. 

New evidence of other possible risk factors are beginning to surface.  High fibrinogen levels make blood clots much more likely.  They tend to be higher in those with diabetes, hypertension and obesity.  High homocysteine levels are associated with a widespread aggressive form of arteriosclerosis that runs in families. If any family member has died of a heart attack before age 50 this should be check in all family members.  Lastly, high levels of chronic inflammation in the body (measured by a laboratory marker C-Reactive Protein) are a strong predictor of cardiovascular events in some studies.  Weight loss, exercise and smoking cessation are linked to lower levels of inflammation. 

How Does the Diet Effect Arterial Health?  We have good evidence that antioxidants, fibre and healthy oils are protective against the development of CHD. 

Without enough antioxidants our cells become overwhelmed by oxidants (free radicals) that attack and damage cells, contributing to CAD as well as aging, cancer and other chronic diseases.  Some major contributors to this process are smoking, chronic infections, alcohol, environmental pollution and excessive UV light. A diet high in fresh fruits, vegetables and whole grains provides key antioxidants such as flavanoids, vitamin E and C. 

A high fiber diet can lower cholesterol levels by as much as 10%, a major risk factor for CHD.  Eating whole fruits instead of juices, and whole grains instead of refined grains, and more vegetable proteins (nuts, seeds, beans, lentils and tofu) instead of animal proteins (dairy, poultry and meat) can significantly raise our fiber intakes. 

Both fish oils and olive oil are believed to play an important role in heart and vessel health.  The time-honoured practise of eating cod liver oil was a prudent one.  According to an epidemiological study done by the Danish, the Greenland Inuit have only 1/10^th the incidence of heart attacks that their Danish counterparts had.  The Inuit diet is largely composed of cold-water ocean fish, which provide an essential ingredient called omega-3 fatty acids.  They are found in anchovies, herring, mackerel, salmon, sardines, tuna and white fish.  Epidemiological studies suggest that olive oil is also a great oil for the heart. 

The Phenomenal Role of Exercise in Coronary Health.  Studies show startling results from exercise in those with a history of heart disease.  A 10-year follow up of 4,713 post-coronary patients at the Toronto Rehabilitation Institute who had been following a special exercise program revealed that the death rate from recurrent heart attacks was 60% lower in the exercisers.  Animal studies have shown that regular exercise training is a powerful stimulus for a natural bypass called collateralisation (growth of new coronary artery branches that detour the blood flow around the narrowed segment).  This improves survival after an experimentally induced heart attack.  A one year exercise training using 40 men from the Royal Canadian Air Force showed a 34% reduction in the area of poor blood flow that was causing them angina (heart pain induce by poor blood flow).  Among other things, exercise increases the amount of oxygen your blood can carry and improves the efficiency and blood supply of the heart while at the same time making it more resistance to disease.