Cardiovascular diseases (CVDs) encompass all diseases and disorders of the heart and blood vessels. CVDs are the number one killer worldwide for both men and women, most often triggered by the acute result of CVD, either a heart attack or stroke.
While many factors influence CVD risk, research focuses on several major lifestyle changes that can make a big difference – tobacco and excessive alcohol cessation, increase in exercise and produce intake, and reduced salt intake. These changes improve inflammation as well as reduce available cholesterol in the bloodstream, discouraging plaque formation. In fact, research reveals that cholesterol carried on low-density lipoproteins (LDLs), a type of lipid highly correlated with disease risk, can drop as much as 8 - 15 mg/dL (0.2-0.4 mmol/L) with dietary changes alone.
The most important dietary changes (excluding excessive alcohol and tobacco cessation) to make are separated below into two categories – eat more of or eat less of.
1. Eat More Soluble Fiber-Rich Foods
Soluble fiber is a type of fiber that dissolves in liquid to form a gel. These fibers are able to bind to dietary fats within the digestive tract so that they are prepared for excretion via stool rather than converted to cholesterol in the liver and transported into the circulation on lipoproteins. Without adequate soluble fiber, lipoproteins like LDL become saturated with cholesterol, remain in circulation too long and increase cardiovascular disease risk. In other words, soluble fiber helps lower LDL cholesterol.
A review of randomized controlled trials on oat bran intervention for CVD risk found that 3.5g oat bran per day for a median duration of 6 weeks resulted in a 4.2% reduction in LDL cholesterol.
Another study found 5g of psyllium supplement before meals for 3 months significantly lowered total and LDL cholesterol.
Foods rich in soluble fibers include oats, psyllium seed, chia seed, beans, peas, apple with skin, barley, artichokes and wheat bran.
2. Eat More Cruciferous Veggies
Cruciferous vegetables are nutrient powerhouses rich in fiber, carotenoids, vitamins, minerals, and glucosinolates - sulfur-containing chemicals – that all interact to help reduce cancer risk, and improve heart health and inflammation.
A review of two randomized, controlled trials found that broccoli and its glucoraphanin content, a glucosinolate, significantly lowered LDL and total cholesterol levels. Study 2 found that 400g of high glucoraphanin broccoli daily for 12 weeks reduced LDL cholesterol by 5.1% whereas regular broccoli lowered it 2.5%.
Cruciferous vegetables include arugula, broccoli, broccoli sprouts, Bok choy, Brussel sprouts, cabbage, cauliflower, collard greens, kale, horseradish, mustard greens and turnips.
3. Eat More Fish (and Other Omega-3 Sources)
Omega-3 fatty acids are known as anti-inflammatory fats which help to keep chronic inflammation at bay – a driver of cardiovascular disease and other chronic diseases. Omega-3's also help to reduce platelet aggregation so blood flows more smoothly through vessels, reducing the risk of clots.
In addition, a diet rich in omega-3's from fish (250g/day) significantly lowered LDL cholesterol over an 8-week intervention period, whereas fish oil supplementation raised LDL cholesterol. Total cholesterol and HDL cholesterol levels were improved in both groups but a more pronounced effect in the fish group.
Food sources that include the most bioavailable omega-3 sources of EPA and DHA include salmon, sardines, herring, anchovies, trout, and eggs.
4. Eat More Plant Stanols
Plant stanols are bioactive compounds found in plants that help to improve cardiovascular disease risk by reducing cholesterol absorption thus lowering your serum LDL cholesterol. Other names for stanols include phytosterols, plant sterols, and sterol esters.
Research reports that plant stanols in doses of up to 10 grams per day have been shown to reduce LDL cholesterol levels by as much as 7 to 18 percent. More pronounced changes were seen in higher doses, a term called dose-dependence.
Sources of plant stanols include fruits, vegetables, nuts, beans, and some fortified products like yogurt, margarine, and orange juice.
5. Eat Less Red Meat and Butter
Research has been mixed over the last few decades leading to much debate on the ideal fat content in the diet. One case-cohort study looked at data from 9 European countries and reported that saturated fat from specific sources increased coronary heart disease risk but not all sources. Red meat and butter tended to worsen risk, whereas fermented dairy (yogurt and cheese) and fish lowered risk due to their influences on risk factors such as LDL and HDL cholesterol levels.
When reducing your saturated fat intake from meat and butter, swap them for unsaturated fats like avocado, nuts, seeds, fish, eggs, extra virgin olive oil and fermented dairy.
6. Eat/Drink Less Sugar
Dyslipidemia is defined as high LDL cholesterol, high triglycerides and/or low HDL cholesterol, a combination known to increase cardiovascular disease risk.
Sugar, especially in liquid form, is associated with worsened levels of HDL cholesterol, triglycerides, and incidence of dyslipidemia. One study of six thousand participants over a period of twelve years found that more than 1 serving a day of soda, juice, and other sweetened beverages was to blame.
Soluble fiber encourages cholesterol excretion thereby reducing serum cholesterol levels.
Cruciferous veggies contain bioactive compounds called glucosinolates that help reduce serum LDL cholesterol.
Omega 3 fatty acids found primarily in fish reduce inflammation, platelet aggregation and lower LDL cholesterol.
Plant sterols are compounds found in plants that compete for absorption with cholesterol thereby lowering serum LDL cholesterol levels.
Research shows saturated fat obtained from meat and butter tends to increase heart disease risk, whereas other sources do not.
Limit sugar-sweetened beverages as research shows more than 1 drink a day can worsen your cholesterol and heart health.
Both genetic and dietary factors can influence your lipid (cholesterol) levels. While “high cholesterol” is a very common finding especially as you age, it’s important to view cholesterol as just one factor of your heart health. Nevertheless, there are documented heart health benefits to specific dietary changes. Don’t wait until cardiovascular disease has resulted in a cardiac event - such as a heart attack or stroke – before you adjust your lifestyle. Start now with diet changes - as well as exercise, sleep and stress management – to mitigate your risk and improve your quality of life.
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