Heart healthy diet not just for Heart Month

heartIt’s not just about Valentine’s Day anymore

February is American Heart Month, as in that part of your body that pumps blood.  Heart Month is about heart health.  The only link to Valentine’s Day is chocolate, which has some some antioxidant-type health benefits.  You can participate in Heart Month:

A heart healthy diet is a key component of prevention.  But it’s interesting to review how the definition of ‘heart healthy’ has evolved over the years.  Back in the mid-20th century, when a dietary connection was first suspected, eggs were blamed for heart attacks because:

  1. eggs have cholesterol
  2. arterial plaque is made from cholesterol
  3. people who have heart attacks typically have elevated cholesterol
  4. therefore cholesterol causes heart attacks and eating less of it is a good thing.

Egg consumption plummeted.  Heart disease marched on.  Fat was blamed, particularly saturated fat.  We switched to margarine from saturated-fat butter. Heart disease marched on.  Someone noticed that the trans fats in hydrogenated margarine were linked to heart disease; trans fats were blamed.  Risk factors continued to pile up: excess body weight, sodium, sugar, lack of fiber, low intake of antioxidants and a sedentary lifestyle.

The American Heart Association is the arbiter of official recommendations on a heart healthy diet.  Right now, the recommendations have morphed into a Mediterranean-style diet, plant based, low fat, with little added sugar and extremely low sodium.  There’s also a recommendation to be physically active and maintain a normal weight.

Interestingly, the recommendations have drifted away from recommending or prohibiting specific foods.  There is no recommendation for a cholesterol-lowering diet, heavy on oatmeal, apples, beans and flax seed.  There is no prohibition of eggs.  Rather, the advice is to restrict saturated fat.  And nowhere is there a recommendation to eat more chocolate.

The diet is pretty sensible, but that hasn’t prevented controversy.  The new highly restrictive sodium recommendations are getting a lot of push-back from researchers and medical experts.  The continued obsession with “low fat” is getting a lot of pushback from consumers and medical experts.

Where do I stand on all this?

I think the continued harping on sodium intake misses the mark.  Potassium is extremely important for blood pressure regulation, yet we never hear about it.  Why?  My guess: food manufacturers and supplement makers can’t pump up the potassium in their processed products, so there’s no marketing advantage.  Potassium is naturally high in fruits and vegetables.  When people eat more of those, like they do on the DASH or Mediterranean diet, blood pressure can improve.  Simply telling people to cut back on sodium without increasing potassium-rich foods isn’t very helpful.  But it does give food manufacturers a handy marketing tool: they can reformulate their products and slap a “low sodium” label on them.

The same principle is true for fat.  A Low Fat label is a health halo, even if the product isn’t that healthy.  There’s another major problem with low fat diets: no one can stick to them.  Fat provides satiety and flavor.  I suspect the people pushing back against this recommendation have a point.  In fact, the classic Mediterranean diet is typically much higher fat than the official AHA diet, although the fat is mostly from olive oil.

What about all those supposedly heart-healthy foods like oatmeal?  Yes some of them do help lower blood cholesterol when eaten on a regular basis, but cholesterol isn’t the only risk factor for heart disease.  The only good thing about cholesterol-lowering foods is that, for the most part, they’re healthy anyway.  Including plenty of those in your diet crowds out less nutritious junk foods.  The catch: you eat a few token servings of heart-healthy foods and reward yourself for your healthy behavior with a double cheeseburger and super-sized fries.

What about chocolate.  Yes there’s evidence that the antioxidants in dark chocolate can have a beneficial effect on vascular health, which impacts heart health and stroke risk.  The amount of chocolate you need daily is quite small, and it does have to be dark chocolate.  So if you’re buying chocolate for someone for that other heart day, dark chocolate would be the heart healthiest choice.

You’re in control

Here’s the basic message of Heart Month: you are the person in primary control of your health.  And the way to take control is to stick to a healthier lifestyle for 12 months of the year, not just in February.  Wearing red dresses or red ribbons or sending eCards is fine, but that’s not going to save you from the effects of a junk diet and sedentary lifestyle.

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