If you have coronary artery disease (CAD), remember these two things: “L” for lousy — as in LDL cholesterol — and the number 60. In a major study, Steven Nissen, MD, chief of cardiovascular medicine at the Cleveland Clinic, showed that if you can get your LDL cholesterol level to 60 or below, the plaque buildup that’s clogging your arteries starts to reverse. In other words, the goal of treatment isn’t to simply make sure your coronary artery disease doesn’t get worse, but to actually reverse the plaque buildup at the root of the problem. Most people can lower their LDL level by 10 to 20 percent through diet alone, Dr. Nissen says. While that’s not enough to reverse CAD in most patients, food plays a major part in the success of treatment, and a heart-healthy diet can help you get powerful results with less medication.
Cut Out the Coronary Culprits
A diagnosis of coronary artery disease usually comes with the direction to cut the saturated fat and trans fat from your diet. The reason: Both raise your LDL cholesterol. The chief sources of saturated fat are red meat, processed meats (think bacon and salami) and full-fat dairy products. Trans fat is found in partially hydrogenated vegetable oil and makes its ugly appearance in many baked goods and fried foods. Aim for 7 percent or less of your calories to come from saturated fat. If you eat a fairly standard American diet, about 16 percent of your calories come from saturated fat, so cut that by roughly half. To get more precise, you’ll have to read Nutrition Facts labels on food packages and do some calculating. (We don’t mean to torture you with flashbacks to math class, but here’s the equation if you’re interested: Look for the number of grams of saturated fat in a serving of anything you eat. Then add your total saturated fat grams for the day. Multiply that number by nine to find out how many calories come from saturated fat. Now divide by the total number of calories you consume. Finally, multiply by 100 to get the saturated fat percentage.) You should also make sure to get your trans fat intake down to zero. Check the labels of packaged foods for even a trace of the stuff, or go to nutritiondata.com, which provides breakdowns for packaged and whole foods, as well as chain restaurant menu items.
If you think heart-healthy eating means deprivation (dry chicken breast, anyone?), take heart: Eating for wellness can mean eating well too. True, you need to ditch those bacon double cheeseburgers, but there’s a world of delicious, cardio-smart eating out there. Many heart experts recommend the Mediterranean diet — rich in fruits, vegetables, whole grains, beans, seafood and heart-healthy fats. In addition to being low in “bad” fat and processed carbs (too many of which can contribute to the development of diabetes and metabolic syndrome, both tied to heart disease), studies show that the Mediterranean’s combination of foods reduces inflammation, which contributes to plaque buildup. Here’s a look at the heart-healthy heroes to welcome in.
Heart-Healthy Hero #1: Beans
Once considered “lowly,” beans are actually out-and-out superfoods. The soluble fiber in LDL-busting legumes (beans, lentils and peas) helps siphon bad cholesterol from your system. In addition, they provide you with lean, plant-based protein to use in place of meat in some of your meals. Plus, they pack a host of heart-helping minerals (including magnesium and potassium, which promote normal blood pressure) and vitamins (B6 and folate, which help control levels of homocysteine, an amino acid linked to heart attack and stroke). And believe it or not, a half-cup of kidney beans delivers more antioxidants than the same amount of blueberries, which have become the antioxidant poster food. All this without a cape! How to serve it up, try a vegetarian chili, a hearty black bean soup or a white bean salad.
Heart-Healthy Hero #2: Fish
As you cut your meat intake, you may wonder what to put on your plate instead. Fish is, of course, a source of lean protein with a lot of flavor. Pick the right ones — particularly salmon — and you’ll do more than reduce your saturated fat intake; you’ll also add the right fats. Salmon is rich in omega-3 fatty acids, as are tuna, halibut and sardines; these good-for-you fats help combat inflammation. Go easy on shrimp, which is high in cholesterol. And stay away from breaded or fried fishes, which pack bad fat and calories. How to serve it up, broil salmon, grill tuna or order some mackerel sushi (really — it’s delicious).
Heart-Healthy Hero #3: Olive Oil
This iconic Mediterranean staple is the mainstay of health-conscious kitchens because its monounsaturated fats help improve the composition of LDL cholesterol. Adding olive oil can also help increase the heart-healthy HDL cholesterol. It’s also the mainstay of gourmet kitchens because it’s delicious. Hello, perfect combination. One study indicates that compounds found in olive oil may help your arteries become more elastic — and if you’re battling plaque-hardened arteries, that’s the sort of flexibility you need. How to serve it up, dress your salad with olive oil and lemon juice (mix one tablespoon of oil with two tablespoons of juice for a four-person salad). You’ll wonder why you ever used those creamy dressings.
Heart-Healthy Hero #4: Nuts
Need to get rid of fatty, fried snacks? Go for a palmful of nuts (unsalted, of course). Crunch on this: Some research suggests that just one serving a day of mixed nuts is associated with lower LDL cholesterol. On top of that, studies show that eating nuts lowers inflammatory molecules in the bloodstream and raises levels of your body’s own anti-inflammatory compounds. Walnuts are one of the best-studied nuts for heart health, but almonds and macadamia nuts are good too. Walnuts are also super-rich in antioxidants, and almonds are high in protein! How to serve it up, sprinkle chopped walnuts over your spinach salad instead of croutons.
Heart-Healthy Hero # 5: Cholesterol Decoys
Phytosterols and stanols are plant-based compounds that mimic cholesterol and block your body from absorbing it. They also help your body to excrete the cholesterol that’s already there. While these compounds are found in bran fiber, nuts and vegetables, you’ll need help getting enough to have an LDL-busting effect. Look for margarine, orange juice and rice milks enriched with phytosterols and stanols to help you get the two grams a day you need. How to serve it up, pour enriched rice milk over your whole-grain cereal; use sterol-enriched and trans-fat-free margarine on your whole-grain toast.
Super Supplements: Niacin and DHA
Along with lowering LDL cholesterol, you should also try to raise your HDL (“good”) cholesterol. HDL (high-density lipoprotein) carts away the LDL. Certain supplements have been shown to have HDL-boosting effects. Talk to your doctor about prescription-strength niacin (one of the B-complex vitamins) — and be sure to follow doctor’s orders. Dr. Nissen says “no-flush” niacin “is completely fraudulent and has no effect on HDL.” DHA, a form of omega-3 oils derived from algae, is another supplement that may raise HDL. To achieve the needed effect, you may need prescription dosages.
Welcome to the “Whole” World
Eating more whole foods and fewer processed ones will benefit your blood pressure and blood sugar. Managing both is critical to overall heart health. How to do it:
- Bite into fruits and vegetables: Besides providing fiber and flavor, produce is loaded with nutritious compounds that fight disease and reduce inflammation. The more different kinds and colors you eat, the wider array of nutrients you’ll get.
- Brown out: Brown rice, whole-grain bread and pastas, quinoa and barley pack in fiber, flavor and nutrients, and they don’t spike your blood sugar the way “white” carbs do.
- Spice it up: Sodium, found in table salt and loaded in many processed foods, drives up blood pressure. Spices bring rich flavor to your food without the sodium. Specific ones, such as turmeric and oregano, have been found to have health-protecting compounds as well.