FROM THE BOOK FULL-FAT SOLUTION
by Karlene Karst R.D.
Healthful Fats for a Healthy Heart
When you look down the aisles of your neighborhood grocery store, you can see why cardiovascular disease is the top killer in Canada and the United States. Ninety percent of the products on the supermatket shelves are highly processed foods that are rich in unhealthful fats, loaded with sugar, and depleted of fiber. Combine these foods with lifestyles marked by inactivity, sleep deprivation, and stress, and you create a constellation of physiological phenomena that include low levels of good cholesterol (HDL), high levels of harmful triglycerides, and high blood pressure.
Cardiovascular disease (CVD), namely heart disease and stroke— continues to reign as the number one cause of death in Canada and the United States. One in four Canadians has some form of heart disease—about 8 million people. About 60 million Americans suffer from heart disease. Yet this is a "lifestyle disease" that can be largely prevented by not smoking, making healthful choices, increasing physical activity, and maintaining a healthy weight. This means that if we change our environment we can reduce the likelihood of developing disease. So why, if we know we can prevent CVD, as well as type-2 diabetes and obesity, and even certain types of cancers, are they still the top chronic diseases that people are dealing with?
DMA Is Not Destiny
When my husband and I were traveling to Bora Bora for our ten-day honeymoon back in 2006 (where does time go?), I was adamant that all BlackBerrys, laptops, and other modes of communication be left at home so that we could disconnect and enjoy a restful and recharging honeymoon. However, I did say that novels and magazines were allowed. I bought InStyle and an assortment of gossip magazines (my guilty pleasure and escape from reality); my husband bought Time and Discover Magazine. (Yes, you can see the differences in our personalities just from our magazine choices.) Fortunately, the issue of Discover Magazinemy husband picked up had a profound article that demonstrated that DNA is not destiny. Dr. Morello, my husband, has now shared this information with thousands of people at countless lectures, and I know it really hits home for many people. In the article, the author described two distinctly different individuals—one who was taller and larger than the other. These two people also had different facial features. Yes, even though it appeared as if these two were unrelated, the shocking fact was that they were identical twins. Essentially, identical twins are supposed to be carbon copies of each other, yet these two were far from identical. So what happened? When the scientists studied this anomaly, they discovered that these men had been separated at birth and grew up in two very different environments. The foods they ate, the water they drank, the air they breathed, and the nurturing they received were all different—and it was these differences that changed the behavior of their DNA.
DNA Is Not Destiny discussed how the environment can affect the body's ability to read DNA. This may eventually prove that the reason some people develop cancer, heart disease, diabetes, eczema, Alzheimer's disease, and a host of other diseases isn't that they inherited these conditions, but rather that they live in the same environment their parents did and mimic their behavior.
Fats Can Change Our Cells
In chapter 1, I discussed how essential fatty acids are the building blocks of cells and that, essentially, a diet full of bad fats leads to bad cell structures, which in turn can be linked with depression, cardiovascular disease, immune-system impairment, joint pain, diabetes, and obesity—and the list continues.
Of all the areas studied with respect to omega-3s and disease prevention, there is no area that shines brighter than that of healthful fats for a healthy heart.
Cholesterol is the most misunderstood subject in nutrition. Cholesterol for some reason has received the most attention. In fact, it is often a measurement by which people judge their overall health. A conversation goes like this: "So what did the doctor say? How are you?" "Well, my cholesterol is normal, so I am good." Cholesterol is found in the bloodstream and in every cell in your body. Cholesterol is used to form cell membranes and is needed to produce sex hormones, such as estrogen, androgen, and progesterone, and adrenocorticoid hormones, as well as to manufacture vitamin D. Of the cholesterol in the blood, 75 percent is produced by the liver. Most people have a feedback mechanism that moderates their cholesterol levels. For a small group of people, however, their cholesterol-regulating system in the liver is dysfunctional and their cholesterol levels must be maintained by making changes in their diet.
Lousy Cholesterol: LDL
Cholesterol is transported in the blood in various protein components known as lipoproteins, including low-density lipoprotein (LDL), high-density lipoprotein (HDL), intermediate-density lipoprotein (IDL), and very-low-density lipoproteins (VLDL). These transport proteins vary in their effects on the body. If too much LDL cholesterol circulates in the blood, it can slowly build up on the lining of arterial walls. This condition is known as atherosclerosis (hardening of the arteries). A clot that forms near this plaque can block the blood flow to part of the heart muscle and cause a heart attack. This is why LDL cholesterol is called the bad, or lousy, cholesterol. Also, when the LDL particles are small and dense, it can further lead to a heart attack. The American Heart Association recommends that our LDL cholesterol be less than 2.6 mmol/L (100 mg/dL).
How to Lower LDL Levels:
If you are in the moderate-to high-LDL cholesterol range, that is, 3.3 mmol/L (130 mg/dL) or higher and you have coronary heart disease, or 4.9 mmol/L (190 mg/dL) and you do not have coronary heart disease, then medication may be required to initially bring levels down into the safe zone.
Numerous studies show that lifestyle changes such as exercise, smoking cessation, weight loss, and following a heart-healthy diet can reduce cholesterol levels, and thus the risk of heart disease.
Eat heart-healthy foods. These include avocados, almonds, garlic…. oat bran, legumes and beans, onions, fatty cold-water fish, ground flaxseeds, and extra virgin olive oil.
Take natural supplements such as omega-3 fatty acids from fish oil, resveratrol, garlic, beta-glucans, polymethoxylated flavones, vitamin B6, coenzyme Ql0 (CoQlO), and hydroxy citric acid.
Happy Cholesteroh HDL
Research shows that HDL cholesterol tends to carry cholesterol away from the arteries and back to the liver for disposal. HDL acts like a bottom-feeder in a fish tank. It cleans off the walls of the blood vessels, thus removing excess LDL cholesterol. HDL cholesterol is known as "good" cholesterol because a high level of HDL seems to protect against heart attacks. Even small increases in HDL cholesterol reduce the frequency of heart attacks, for each 0.03 mmol/L (1 mg/dL), or 1 percent, increase in HDL cholesterol, there is a 2 to 4 percent reduction in the risk of coronary heart disease.
To Increase HDL Levels:
Regular cardio exercise (aerobic exercise) that burns between 1,200 and 1,500 calories each week can have dramatic results.
By losing ten pounds of excess weight (fat), you will see a significant increase in HDL cholesterol.
If you smoke, quit—cigarettes decrease HDL cholesterol levels. A study published in Preventive Medicine showed that HDL cholesterol levels increased by approximately 4 mg/dL (0.12 mmol/L) following smoking cessation.
Lower your carbohydrate intake (especially processed, refined, white carbs). Avoid everything white: white bread, white rice, white sugar, white flour, white potatoes. Studies prove that HDL levels drop dramatically when blood sugar is spiked by carbohydrates.
[GOOD OLD CHARLES ATLAS [IN HIS COURSE “HEALTH AND STRENGTH” - STILL AVAILABLE - look him up on the internet] TAUGHT THAT AVOID WHITE FLOUR PRODUCTS LIKE THE PLAGUE; IT IS THE WORSE INVENTION BY MAN IN THE FOOD WE EAT - Keith Hunt]
Take natural supplements such as GLA, EPA + DHA (from fish oil), fiber supplements, and tons of antioxidants such as resveratrol and CoQlO.
A news report shows that only 13 percent of US adults have high total cholesterol, which is very interesting, especially since CVD is still the number one killer in the United States, a country where two-thirds of adults are overweight. The reason cited was that so many Americans use cholesterol-lowering drugs, yet if the prevalence of cholesterol has decreased, why are rates of heart disease still so high?
The old "cholesterol hypothesis" suggested that elevated cholesterol in the blood increases the risk of CVD, and that a high intake of saturated fat increases blood cholesterol. This theory is completely outdated and far too simple. In fact, we know that our diet is missing a healthful level of good saturates (short-and medium-chain), and this deficiency is one of the factors related to an increased risk of CVD and metabolic syndrome. It's important to remember that cholesterol is only one of 200 risk factors for heart disease, meaning there are other factors that are far more important to consider. As well, cholesterol-lowering drugs have numerous side effects, decreasing levels of coenzyme Q10 being one of them—this is linked to heart attacks and heart disease, which could be one of the possible explanations for low cholesterol yet high rates of heart disease.
Triglycerides are a storage form of fat. They come from the food we eat and from the fats produced by the body. Fatty acids get stored as triglycerides, as do excess sugars and refined carbohydrates. Our bodies have a limited capacity to use sugar, so once it reaches that capacity, the sugar gets converted into fat and stored as a triglyceride. During the low-fat, no-fat diet craze in the 1980s and 1990s, many people were eating low-fat food products that were loaded with sugar. During this time, triglyceride levels soared. This is why we need to eat only those carbohydrates that can be burned. Elevated triglyceride levels are positively associated with an increased risk of heart disease.
To Lower Your Triglyceride Levels
Cut back on simple sugars such as juice, soda, cookies, and candy, along with table sugar, sweeteners (including artificial sweeteners), honey, and syrups (high-fructose corn syrup).
Reduce carbohydrate-containing foods such as bread, pasta, white rice, and white flour. Instead, think about fibrous carbohydrates only.
[GET RID OF WHITE FLOUR PRODUCTS IN YOUR DIET PERIOD - Keith Hunt]
Obesity is a major cause of high triglycerides. If you are overweight, lose weight and exercise.
Use natural supplements. Fish oils shine with respect to loweting triglycerides. The American Heart Association recommends 2 to 3 grams of omega-3s per day.
Recommended Cholesterol Levels*
Total Cholesterol: Less than 200 mg/dL (5.1 mmol/L)
LDL Cholesterol: Less than 100 mg/dL (2.56 mmol/L)
HDL Cholesterol: Women: Greater than 50 mg/dL (1.3 mmol/L)
Men: Greater than 40 mg/dL (1.0 mmol/L)
Triglycrides: Less than 150 mg/dL (1.7 mmol/L)
*Source: Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults, "Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP)," Journal of the American Medical Association 285 (May 2001)
Obesity and Heart Disease
Carrying excess weight, especially in the abdominal region, is a risk factor for heart disease. (Please see chapter 4 for more on this relationship.) Being overweight increases your risk of high blood pressure. In fact, blood pressure rises as body weight increases. Losing even ten pounds can lower blood pressure, and it has the greatest effect for those who are overweight and already have high blood pressure.
The Nurses' Health Study found that the risk of developing coronary artery disease increased three to four times in women who had a body mass index (BMI) greater than 29. A normal BMI should be between 19 and 24. A Finnish study showed that for every 1-kilogram (2.2 lb.) increase in body weight, the risk of death from coronary artery disease increased by 1 percent. In patients who have already had a heart attack, obesity is associated with an increased likelihood of a second heart attack.
How to Reduce Your Risk of Heart Disease
Dietary and lifestyle interventions are critical to the management of abnormal blood lipids. The following changes should be considered:
Reduce trans fats
Exercise at least thirty minutes per day
Reduce salt in your diet
Increase consumption of antioxidants
Eat fewer simple sugars; focus on fibrous food
Limit alcohol consumption
Use natural supplements, especially omega-3s from fish oil, and take antioxidants such as CoQIO and resveratrol
Fish and its corresponding omega-3s, EPA and DHA, have received much positive attention for their heart-health benefits, which might leave vegetarians feeling as though they are out of luck. However, flaxseed and other plant sources of the omega-3 ALA, such as camelina oil, are extremely beneficial for the heart. The Mediterranean-style diet (rich in olive oil, tomatoes, and fish), which is high in both plant and fish omega-3s, can reduce the incidence of sudden death by 70 percent after two years. A study that compared the cholesterol levels in Crete, Greece, and Zutphen, Netherlands, reported the Cretans had higher concentrations of ALA and lower cholesterol levels than the Dutch. ALA in the Cretan diet comes from purslane, walnuts, and other wild dark green leafy plants.
The National Heart, Lung, and Blood Institute Family Heart Study examined the relationship between ALA-rich omega-3 oils and coronary artery disease. More than 4,500 participants filled out food-frequency questionnaires, and the results of the study showed that a higher intake of ALA and LA had a synergistic effect on the risk of developing coronary artery disease, with higher intakes of ALA and LA corresponding to lower risks.
And one of the most significant landmark studies examining the relationship between dietary ALA and heart disease was the Nurses' Health Study. The dietary habits of more than 120,000 registered nurses were followed for more than ten years. Nurses with the highest dietary intake of ALA experienced 30 percent fewer fatal heart attacks than those who consumed lower amounts of ALA. Regular consumption of ground flaxseeds and/or flaxseed oil would provide similar results.
Chia Seed: Ancient Seed, but Mew Kid on the Block
I have been incorporating ground flaxseeds into my diet for almost fifteen years. The health benefits are enormous. However, I love to have a balanced and varied diet, which is why I was excited to learn of another great plant source of omega-3s, fiber, and protein: chia seed. It's interesting to note that the word "chia" is derived from the word chian, which means "oily." Although not a new seed, it has become known as one of the top superfoods that people should consume.
My first memory of chia is from the TV commercial that had the catchy tune of "cha, cha, cha, cha, cha, cha chia," which went on to advertise the little Chia Pet clay animals with sprouted chia seeds covering their bodies. As a child, I had no idea that those tiny seeds provided such tremendous nutritional value and medicinal properties.
In a small recent study on postmenopausal women, 25 grams/day of ground chia seed over a seven-week period resulted in significant increases in blood levels of ALA and EPA, which offers numerous health benefits for heart health. In another study on individuals with metabolic syndrome, subjects consumed chia seed and saw improvements in their body weight and waist circumference, as well as decreases in their triglyceride and fasting blood sugar levels. Chia seed's abundance of protein, healthful fats, and tons of fiber make it an excellent food choice for those with heart disease, type-2 diabetes, or metabolic syndrome, and those who are overweight.
Recommendation for Plant-Based Heart Health
Consume 2 tablespoons (30 mL) of ground flaxseeds or chia seeds per day. They are very easy to incorporate into all foods, including smoothies, yogurt, soups, cereals, bread, hot dishes, pasta sauce, and almost every other food. Just ensure the flaxseeds and/or chia seeds are ground to receive all the nutrition from the seed, or for a more convenient option, you can buy them already ground.
[FLAXSEED SHOULD BE GROUND; BUT I’VE HEARD OTHER “EXPERTS” SAY THERE IS NO NEED TO GRIND CHAI SEEDS - Keith Hunt]
Fishing for Heart Health
Over the past few decades, an impressive number of studies have shown that fish is good for the heart. Research has shown that omega-3 fatty acids decrease the risk of arrhythmias (abnormal heartbeats), which can lead to sudden death. Omega-3 fatty acids also decrease triglyceride levels, slow the growth rate of atherosclerotic plaque, and lower blood pressure (slightly). In 2000, the American Heart Association (AHA) released dietary guidelines recommending everyone consume at least two servings of fatty fish per week to protect against heart disease. The AHA then updated their guidelines, stating that for patients with coronary artery disease, at least 1 gram of omega-3s per day is recommended. Similarly, for those with elevated triglyceride levels, 2 to 3 grams of omega-3s per day is desirable. This is a major milestone and the first time an organization such as the AHA has endorsed supplement use. The AHA realized the recommended dosages may be greater than what can be readily achieved through diet alone.
Table 1: Potential EPA and DHA Benefits*
Improvements in autonomic function
Decreased platelet aggregation
Decreased blood pressure
Improvements in endothelial function
Reduced free fatty acids and triglyceride
Upreguiated adiponectin synthesis
Reduced collagen deposition
*Source: Carl J. Lavie, Richard V. Milani, Mandeep R. Mehra, and Hector O. Ventura., "Omega-3 Polyunsaturated Fatty Acids and Cardiovascular Diseases,"Journal of the American College of Cardiology 54 (August 2009)
The 1970s' Great Fish Find
In the late 1970s, two Danish scientists, Dyerberg and Bang, were the first to highlight the cardio-protective effect of dietary omega-3 fats found in fatty fish in the Inuit population. Over the past thirty years, the mechanisms by which fish oils improve cardiovascular health have been extensively studied, showing anti-inflammatory, antiarrhythmic, and antiaggregatory effects, as well as improvements in endothelial function.
Fish Oil Lowers Inflammation
We have all heard that an aspirin a day keeps the doctor away, especially for those with heart disease. The aspirin is so effective at preventing heart attack risk has to do with its ability to thin blood, and also its anti-inflammatory benefits. Upon the action of aspirin, EPA and DHA can be converted by the COX and LOX pathways (please see chapter 1) into similar families of resolvins, E and D series, which have tremendous anti-inflammatory benefits for heart health. The role of chronic inflammation in the diseases that modern society is now dealing with has become far-reaching, and the influence of nutrition and dietaty impact serious. Most studies have shown a correlation between diet and markers of inflammation called "C-reactive protein (CRP)," a protein produced by the liver when arteries become inflamed. In a study published in the journal Circulation, women who had the highest CRP levels were two times more likely to have a cardiovascular event. In chapter 4, I discussed the science of high linoleic safflower oil and its ability to reduce CRVP levels by 17.5 percent in women who were obese, post menopausal, and type-2 diabetic.
A traditional Mediterranean diet pattern rich in olive oil, tomatoes, fish, and an abundance of fruit and vegetables, legumes, and grains, can provide tremendous anti-inflammatory benefits.
Because fish oil is rich in omega-3 fatty acids, research has shown its ability to decrease inflammatory markers such as CRP. A study involving 130 people with metabolic syndrome each received 1,000 mg of fish oil daily over a six-month period. These individuals saw a significant reduction in CRP levels, cholesterol, and triglycerides. Omega-3s from fish oil is an important dietary strategy for managing heart disease risk factors caused by excessive inflammation.
Fatty Fish Lowers Cholesterol and Triglycerides
Triglycerides—the blood storage form of fat (which is increased by not just fat, but by too much sugar in our diet as well),— are a major risk factor for heart disease, possibly even greater than high total cholesterol. Luckily, this is where fish oils shine in their ability to reduce triglyceride levels by 30 to 40 percent when using approximately 4 grams of EPA and DHA daily. The results are very effective, even in comparison with some pharmaceutical drugs. The US Food and Drug Administration (FDA) has approved an omega-3 PUFA formula at a dosage of 4 grams/day for the treatment of very high triglyceride levels (500 mg/dL). This dose has been shown to reduce severely elevated triglyceride levels (500 mg/dL) by 45 percent, along with reduction in non-high-density lipoprotein cholesterol by 14 percent with a 9 percent increase in high-density lipoprotein cholesterol. When added to statin therapy in patients with triglyceride levels between 200 and 499 mg/dL, this dosage of omega-3 PUFAs lowers triglyceride levels by close to 30 percent. A dose-dependent relationship exists for fish oil and triglyceride-lowering: The higher the doses used, the greater the reduction in triglyceride levels.
Research shows that as triglyceride (TG) levels increase, so do the number of coronary heart events. The mechanism in which they lower TG is complex; however, we know that they regulate the expression of genes that encode the key proteins controlling the metabolism and formation of very-low-density lipoproteins carrying triglycerides in the liver. Omega-3s also reduce the formation of triglycerides by the liver.
Fish Reduces Heart Palpitations
Arrhythmias (abnormal electrical conductivity of the heart that causes irregular heart beats) is a serious risk factor for heart attacks. There is strong clinical evidence suggesting the cardioprotective role of fish oil, which is significant because there is currently no pharmaceutical drug treatment for arrhythmias. Dr. Alexander Leaf, professor of clinical medicine at Harvard Medical School, commented in the journal Circulation, "Animal studies show that fatty acids from omega-3 fish oils are stored in the cell membranes of heart cells and can prevent sudden cardiac death or fatal arrhythmias." Dr. Leaf said that studies of individual heart cells demonstrate that omega-3s specifically blocked excessive sodium and calcium currents in the heart, which can cause dangerous and erratic changes in heart rhythm. On examining the effects of different toxic agents on heart cells, they observed that adding omega-3s prevented arrhythmias induced in the cells. In a large study of 5,096 men and women, a high fish intake was associated with a lower heart rate and slower atrioventricular conduction. Recent research has started to focus on DHA's role in the prevention of arrhythmia over EPA, with knowledge that there is a greater amount of DHA than EPA in the heart muscle. According to doctors, at least half of all heart attacks are caused by irregular heartbeats.
Fish Oil Reduces Heart Attack Risk
Some of the most impressive research comes from heart studies showing the benefit of fish on reducing sudden cardiac death. We know that the risk of dying from a heart attack goes up exponentially in people who have already suffered one. There have been three large randomized trials that have documented the effects of omega-3s in primary and secondary prevention of coronary heart disease. For example, the Diet and Reinfarction Trial (DART) was the first clinical trial to evaluate the effects of omega-3s on survival. DART included 2,033 men who were recruited in twenty-one British hospitals an average of forty-one days after having a heart attack. The people in this study were divided into groups and given advice to receive either a lower-fat diet, increasing fatty fish intake to at least two fish meals per week (200 to 400 grams of fatty fish per week), or fish-oil capsules and increasing fiber intake. After two years, the group that was advised to increase their fatty fish intake had an impressive 29 percent reduction in deaths from any cause, but mainly due to a reduction in fatal heart attacks. The reduction in heart attacks was particularly impressive in the group who consumed fish-oil capsules as opposed to simply increasing dietary fish consumption.
More recently, two major randomized trials were performed. The infamous GISSI (Gruppo Italiano per lo Studio della Soprawivenza nell'Infarto Miocardico)-Prevenzione study, which divided the 11,323 patients (who had suffered a heart attack within the past three months) into four different groups:
Group 1: Patients received 1 gram of fish oil (containing 85% EPA and DTLA in a ratio of 1.2:1)
Group 2: Patients received 300 mg of vitamin E
Group 3: Patients received a combination offish oil and vitamin E
Group 4: Control group (patients did not receive anything)
The results were very significant for dietary supplementation with omega-3s from fish oil. Treatment with omega-3s resulted in an impressive 45 percent reduction in the risk of having a sudden fatal heart attack, a 30 percent decrease from heart-related death, and a 20 percent reduction in overall death.
In another trial, the JELIS Qapan EPA Lipid Intervention Study) trial, in which 18,645 patients (14,981 in primary prevention, 3,664 in secondary prevention) with high cholesterol (70% women) were divided into groups to receive either statin alone or statin with fish oil containing the high level 1,800 mg/day of EPA. At the end of the five-year study, those in the EPA group had a 19 percent reduction in major cardiovascular events.
Krill Oil Is Good for the Heart
Krill oil first came to my attention in 2004 as the new kid on the block for omega-3s. It has a unique profile in that the omega-3s EPA and DHA are found in their phospholipid structure, which enhances their absorption. Not only that, but krill is known as a super antioxidant from its rich astaxanthins. It has greater antioxidant potential than CoQIO and vitamin E. Krill is also known as "whale food" and is a shrimp-like crustacean with a bright red color (from the rich astaxanthins). However, we don't have to worry about depleting the supply of whale food because there are maximum allowable fishing limits set for krill-catching to ensure it stays sustainable. The majority of krill is caught off the coast of Antarctica.
I have seen many people use krill oil with great success in the area of heart health and PMS. (I have many female friends who found relief from their PMS symptoms with krill over any other natural product they tried.)
There are a few stand-out clinical trials with respect to krill oil. One of them assessed the effects of krill oil on blood lipids, specifically total cholesterol, triglycerides, low-density lipoprotein (LDL), and high-density lipoprotein (HDL). Over a period of three months, 120 patients were given the following:
Group A: Krill oil at a BMI-dependent daily dose of 2 to 3 grams daily
Group B: 1 to 1.5 grams of krill oil daily
Group C: Fish oil containing 180 mg of EPA and 120 mg of DHA per gram of oil at a dose of 3 grams daily
Group D: A placebo
The researchers found that 1 to 3 grams per day of krill was effective for reducing blood sugar, triglycerides, LDL, and HDL compared with both fish oil and placebo. It was significantly more effective than even fish oil for overall blood lipid improvements.
Summary of American Heart Association Recommendations
Eat fatty fish (salmon, mackerel, lake trout, sardines, albacore tuna, and halibut) at least two times per week; 3.5 ounces (100 g) cooked, or about % cup (185 mL) of flaked fish.
Patients with coronary heart disease: 1,000 mg of EPA and DHA per day
Elevated triglycerides: 2,000 to 4,000 mg of EPA and DHA per day
Table 2: Fish Content of EPA and DHA*
*Source-. Carl J. Lavie, Richard V. Milani, Mandeep R. Mehra, and Hector O. Ventura, "Omega-3 Polyunsaturated Fatty Acids and Cardiovascular Diseases,"Journal of the American College of Cardiology 54 (August 2009)
Summary of Food Strategies to improve Heart Health
Limit intake of trans fats and red meat (one to two servings of red meat are suggested per week). Try to cut any excess fat from meat, or choose leaner cuts.
Increase consumption of fatty fish (at least two servings per week).
When choosing culinary oils, use heart-healthy extra virgin olive oil for salad dressings and as a garnish. Use coconut oil, avocado oil, or camelina oil for medium- to high-heat cooking.
Increase consumption of dietary fiber. Fiber helps to mop up extra cholesterol from the blood, helps to balance blood sugar, provides a feeling of fullness, and helps shed extra weight.
Enjoy your food baked or grilled and fry less often (when you do fry, make sure to match your oil with the smoke point and cooking application.
Choose low-sodium seasonings such as spices, herbs, and lemon juice in cooking and at the table.
Increase consumption of antioxidant-rich foods (remember, antioxidants help to deactivate and absorb all the free radicals that damage cellular walls).
Consume foods such as berries, dark green leafy veggies, citrus fruit, green tea, and red wine.
Eat fewer simple sugars; focus on fibrous carbohydrates only.
Limit alcohol consumption (other than the occasional glass of red wine, which is loaded with heart-healthy resveratrol).
Increase consumption of anti-inflammatory foods, especially turmeric.
Exercise at least thirty minutes per day, five days per week.
Use natural supplements such as omega-3s from fish or krill oils.
What You Have Learned in This Chapter
Heart disease is largely preventable with proper diet and lifestyle strategies.
Omega-3 fatty acids from fish oil and krill oil are highly effective strategies for the reduction of total cholesterol and triglyceride levels.
Ground flaxseeds and chia seeds can be easily added to all foods and provide the diet with fiber, omega-3s, and protein, nutrients that are known to improve heart health.