HEART HEALTH: A SNAPSHOT OF THE BODY

In the United States, heart disease is the leading cause of death for both men and women. One in every four deaths is attributed to heart disease, and every forty seconds, someone in America has a heart attack (I). These statistics are both jarring and disheartening–but, when investigated alongside other health research that we have on the population, the heart disease epidemic illustrates a fascinating picture of the interface between lifestyle and medicine.

The heart and cardiovascular system are an excellent illustration of the unbelievable power of the human body. The heart itself is an organ composed of cardiac muscle and valves that distribute oxygen-rich blood to cells through systemic circulation, and receive oxygen-poor blood through venous return. It’s almost challenging to imagine, but the heart and its network of arteries, capillaries, and veins never stop working for the entirety of a human life. The powerful cardiac muscle works aerobically–meaning, they create energy in the presence of oxygen–to keep every cell of the body nourished and productive, fueling the tedious work of division, repair, growth, remodeling, renewal, protection, and detoxification. That’s a lot of work! 

Because the cardiovascular system is so intertwined with all other processes of the body, the state of the system is a reflection of the state of the body as a whole. And given the current data on heart disease, it’s clear that hundreds of thousands of bodies each year are telling a story of sickness. 

The Heart Tells A Story

If we think of heart health as a river fed by many streams, we can appreciate the many avenues that may affect the health of the river. Cardiovascular wellness is affected by body weight, alcohol, smoking, nutrition, physical activity, stress, metabolic diseases, as well as family history. 

Currently, genetic risk assessments are being created by researchers as they determine which genetic influences are altering things such as fat metabolism, liver function, or reactivity and behavior of blood vessels. Given that the data does indict family history as a risk factor, genetic variants are certainly involved in the development of the disease. However, it also demonstrates that lifestyles run in families as well, and are major actors in the health of the circulatory system. To that end, individuals and families can work with a forward-thinking mentality about how to create health within themselves and their community. 

Systemically, hypertension, high cholesterol, diabetes, obesity, physical inactivity, alcohol, and tobacco can be a devastating tax on the circulatory system. Thankfully, those conditions are more preventable than altering genomes! This is where lifestyle factors and nutrition steal the show. 

Nutrition and Lifestyle Factors You Can Control: Fiber, Sugar, Fat

Overall, research has consistently demonstrated that a diet high in fruits and vegetables–and thus, plant fibers and nutrients–is extremely cardioprotective. The rich fiber matrix found in plant cell walls helps pull cholesterol out of circulation when bile is secreted into the small intestine. It binds to the cholesterol molecules and then carries them to the large intestine for excretion, effectively removing it from the liver’s hepatic portal circulation (the veins and ducts that loop between the liver and the GI tract), and thus, the bloodstream. The additional additive and synergistic benefits of the thousands of nutrients found in fresh plant foods also works in countless ways to aid systemic health and reduce inflammation. This is one reason why multivitamins cannot substitute real, whole, fresh foods. 

A lesser known but equally important dietary factor is to reduce consumption of sugar. A diet low in sugar prevents the cluster of metabolic illnesses that can initiate cardiovascular sickness. A recent 15-year study on added sugar and heart disease discovered that participants who consumed 25% or more of their daily calories from sugar were more than twice as likely to die from heart disease than those whose diets included less than 10% added sugar. Overall, the odds of dying from heart disease rose in tandem with the percentage of sugar in the diet—and that was true regardless of a person’s age, sex, physical activity level, and body-mass index. So even healthy body weight participants had increased risk in equal magnitude to the amount of sugar consumed. That is staggering data–and challenges years of belief systems that dietary fats and body weight are solely to blame.

Another nutritional factor that gets little to no attention is the quality of the fat being consumed by Americans. In fact, fat products known as industrial seed oils have become a major ingredient in the modern diet. They are hidden in salad dressings, mayonnaise, restaurant foods, and almost all processed foods. In 2000, the average consumption of soybean oil skyrocketed to 26 lbs per person per year (Blasbalg et al, 2011), and that’s not even recent data, which presumably is even worse. Industrial seed oils such as soybean oil, canola oil, vegetable oil, safflower oil, sunflower oil, cottonseed oil, and others, are showing to be potent pro-inflammatory molecules in animals. 

“Lipid peroxidation and triglyceride mass in aortas from Soybean oil supplemented mice were dose-dependently and significantly increased. In macrophages from those mice, lipid peroxides were significantly increased and a marked accumulation of cellular triglycerides was found in accordance with enhanced triglyceride biosynthesis rate and overexpression of diacylglycerol acyltransferase1 (DGAT1), the key enzyme in triglyceride biosynthesis.” -Rom et al, 2017

This research suggests that triglyceride mass in aortas is greater in animals as the consumption of soybean oil increased. And when the oils are heated–as they are in restaurant friers, high-temperature cooking, and a lot of processed food production–the effects become even more deleterious. The aortae in the repeatedly heated soybean oil-fed groups showed significantly increased aortic wall thickness, area, and circumferential wall tension. Endothelial function (blood vessel function, including the ability to dilate or constrict) also was significantly disrupted, and overall, prolonged consumption of repeatedly heated soybean oil caused blood pressure elevation, which may be attributed to inflammation involved in atherogenesis (Jaarin et al, 2012).

Overall, the connections between the standard American diet and contributory factors to heart disease are clear. On average, Americans eat over 8% of their calories from soybean oil, over 10-25% of calories consumed come from sugar, and consumption of recommended amounts for vegetables and fruits is sorely lacking–with millions of Americans consuming less than one serving a day. 

The Exercise Prescription

These nutritional hazards do not work alone, however. We also see consistently in data that the average American does not meet daily requirements for physical activity. In fact, they typically don’t even come close! 

The current national guidelines call for 150 minutes per week of moderate-intensity aerobic activity or 75 minutes per week of vigorous aerobic activity, preferably spread throughout the week. Additionally, the guidelines call for adding moderate to high-intensity resistance training at least 2 days per week. Given that many occupations are very sedentary, and less than 1 in 5 Americans meet these standards, it’s fair to deduce that the muscles of the heart and skeleton are far under-utilized, and thus failing to thrive. Endurance and strength training both help muscle cells develop not only strength but also mitochondrial density, which produces more oxygen and allows cells to work more efficiently for longer periods of time. Exercise also directly contributes to the health of heart muscles themselves, and can help the heart increase cardiac output, which optimizes the heart’s efficiency by lowering the threshold of work required to distribute blood to tissue. This efficiency is a key factor in cardiovascular health.

Given all of this eye-opening date on nutrition and exercise–and of course, the known factors of alcohol, smoking, and stress–we can create important action steps to tackle. 

Your Action Steps
  1. Reduce sugar in your diet to as little added sugar as possible. Make it far less than 10% of your caloric intake. 
  2. Dramatically increase your fruit and vegetable consumption. If you cup your two hands together to make a “bowl” consider that one serving of vegetables or fruit. You should be consuming at least five of those per day. 
  3. Reduce as many seed oils in your day as possible. Focus on consuming monounsaturated fats like olive oil and avocado oil, and consume nuts, seeds, and avocados for your other fats. Also take particular care to consume doses of Omega-3 fatty acid sources throughout the week–this primarily comes from fatty cold water fish like salmon or mackerel, or you can consume a high-quality Omega-3 supplement. 
  4. Be sure to exercise for at least 150 minutes per week. If you are strength training once a week, it’s time to increase that amount. Aim for 2-3 strength training days weekly. 
  5. And of course, reduce the other more obvious risk factors by cutting down on alcohol consumption as much as possible. Do not smoke. Maintain a healthy body weight. And always check-in with your doctor about cholesterol panels, blood pressure, and family history.

Additional References:

  1. https://www.cdc.gov/heartdisease/heart_attack.htm 
  2. https://www.heart.org/en/healthy-living/healthy-lifestyle/my-life-check–lifes-simple-7 

HEART HEALTH: A SNAPSHOT OF THE BODY

In the United States, heart disease is the leading cause of death for both men and women. One in every four deaths is attributed to heart disease, and every forty seconds, someone in America has a heart attack (I). These statistics are both jarring and disheartening–but, when investigated alongside other health research that we have on the population, the heart disease epidemic illustrates a fascinating picture of the interface between lifestyle and medicine.

The heart and cardiovascular system are an excellent illustration of the unbelievable power of the human body. The heart itself is an organ composed of cardiac muscle and valves that distribute oxygen-rich blood to cells through systemic circulation, and receive oxygen-poor blood through venous return. It’s almost challenging to imagine, but the heart and its network of arteries, capillaries, and veins never stop working for the entirety of a human life. The powerful cardiac muscle works aerobically–meaning, they create energy in the presence of oxygen–to keep every cell of the body nourished and productive, fueling the tedious work of division, repair, growth, remodeling, renewal, protection, and detoxification. That’s a lot of work! 

Because the cardiovascular system is so intertwined with all other processes of the body, the state of the system is a reflection of the state of the body as a whole. And given the current data on heart disease, it’s clear that hundreds of thousands of bodies each year are telling a story of sickness. 

The Heart Tells A Story

If we think of heart health as a river fed by many streams, we can appreciate the many avenues that may affect the health of the river. Cardiovascular wellness is affected by body weight, alcohol, smoking, nutrition, physical activity, stress, metabolic diseases, as well as family history. 

Currently, genetic risk assessments are being created by researchers as they determine which genetic influences are altering things such as fat metabolism, liver function, or reactivity and behavior of blood vessels. Given that the data does indict family history as a risk factor, genetic variants are certainly involved in the development of the disease. However, it also demonstrates that lifestyles run in families as well, and are major actors in the health of the circulatory system. To that end, individuals and families can work with a forward-thinking mentality about how to create health within themselves and their community. 

Systemically, hypertension, high cholesterol, diabetes, obesity, physical inactivity, alcohol, and tobacco can be a devastating tax on the circulatory system. Thankfully, those conditions are more preventable than altering genomes! This is where lifestyle factors and nutrition steal the show. 

Nutrition and Lifestyle Factors You Can Control: Fiber, Sugar, Fat

Overall, research has consistently demonstrated that a diet high in fruits and vegetables–and thus, plant fibers and nutrients–is extremely cardioprotective. The rich fiber matrix found in plant cell walls helps pull cholesterol out of circulation when bile is secreted into the small intestine. It binds to the cholesterol molecules and then carries them to the large intestine for excretion, effectively removing it from the liver’s hepatic portal circulation (the veins and ducts that loop between the liver and the GI tract), and thus, the bloodstream. The additional additive and synergistic benefits of the thousands of nutrients found in fresh plant foods also works in countless ways to aid systemic health and reduce inflammation. This is one reason why multivitamins cannot substitute real, whole, fresh foods. 

A lesser known but equally important dietary factor is to reduce consumption of sugar. A diet low in sugar prevents the cluster of metabolic illnesses that can initiate cardiovascular sickness. A recent 15-year study on added sugar and heart disease discovered that participants who consumed 25% or more of their daily calories from sugar were more than twice as likely to die from heart disease than those whose diets included less than 10% added sugar. Overall, the odds of dying from heart disease rose in tandem with the percentage of sugar in the diet—and that was true regardless of a person’s age, sex, physical activity level, and body-mass index. So even healthy body weight participants had increased risk in equal magnitude to the amount of sugar consumed. That is staggering data–and challenges years of belief systems that dietary fats and body weight are solely to blame.

Another nutritional factor that gets little to no attention is the quality of the fat being consumed by Americans. In fact, fat products known as industrial seed oils have become a major ingredient in the modern diet. They are hidden in salad dressings, mayonnaise, restaurant foods, and almost all processed foods. In 2000, the average consumption of soybean oil skyrocketed to 26 lbs per person per year (Blasbalg et al, 2011), and that’s not even recent data, which presumably is even worse. Industrial seed oils such as soybean oil, canola oil, vegetable oil, safflower oil, sunflower oil, cottonseed oil, and others, are showing to be potent pro-inflammatory molecules in animals. 

“Lipid peroxidation and triglyceride mass in aortas from Soybean oil supplemented mice were dose-dependently and significantly increased. In macrophages from those mice, lipid peroxides were significantly increased and a marked accumulation of cellular triglycerides was found in accordance with enhanced triglyceride biosynthesis rate and overexpression of diacylglycerol acyltransferase1 (DGAT1), the key enzyme in triglyceride biosynthesis.” -Rom et al, 2017

This research suggests that triglyceride mass in aortas is greater in animals as the consumption of soybean oil increased. And when the oils are heated–as they are in restaurant friers, high-temperature cooking, and a lot of processed food production–the effects become even more deleterious. The aortae in the repeatedly heated soybean oil-fed groups showed significantly increased aortic wall thickness, area, and circumferential wall tension. Endothelial function (blood vessel function, including the ability to dilate or constrict) also was significantly disrupted, and overall, prolonged consumption of repeatedly heated soybean oil caused blood pressure elevation, which may be attributed to inflammation involved in atherogenesis (Jaarin et al, 2012).

Overall, the connections between the standard American diet and contributory factors to heart disease are clear. On average, Americans eat over 8% of their calories from soybean oil, over 10-25% of calories consumed come from sugar, and consumption of recommended amounts for vegetables and fruits is sorely lacking–with millions of Americans consuming less than one serving a day. 

The Exercise Prescription

These nutritional hazards do not work alone, however. We also see consistently in data that the average American does not meet daily requirements for physical activity. In fact, they typically don’t even come close! 

The current national guidelines call for 150 minutes per week of moderate-intensity aerobic activity or 75 minutes per week of vigorous aerobic activity, preferably spread throughout the week. Additionally, the guidelines call for adding moderate to high-intensity resistance training at least 2 days per week. Given that many occupations are very sedentary, and less than 1 in 5 Americans meet these standards, it’s fair to deduce that the muscles of the heart and skeleton are far under-utilized, and thus failing to thrive. Endurance and strength training both help muscle cells develop not only strength but also mitochondrial density, which produces more oxygen and allows cells to work more efficiently for longer periods of time. Exercise also directly contributes to the health of heart muscles themselves, and can help the heart increase cardiac output, which optimizes the heart’s efficiency by lowering the threshold of work required to distribute blood to tissue. This efficiency is a key factor in cardiovascular health.

Given all of this eye-opening date on nutrition and exercise–and of course, the known factors of alcohol, smoking, and stress–we can create important action steps to tackle. 

Your Action Steps
  1. Reduce sugar in your diet to as little added sugar as possible. Make it far less than 10% of your caloric intake. 
  2. Dramatically increase your fruit and vegetable consumption. If you cup your two hands together to make a “bowl” consider that one serving of vegetables or fruit. You should be consuming at least five of those per day. 
  3. Reduce as many seed oils in your day as possible. Focus on consuming monounsaturated fats like olive oil and avocado oil, and consume nuts, seeds, and avocados for your other fats. Also take particular care to consume doses of Omega-3 fatty acid sources throughout the week–this primarily comes from fatty cold water fish like salmon or mackerel, or you can consume a high-quality Omega-3 supplement. 
  4. Be sure to exercise for at least 150 minutes per week. If you are strength training once a week, it’s time to increase that amount. Aim for 2-3 strength training days weekly. 
  5. And of course, reduce the other more obvious risk factors by cutting down on alcohol consumption as much as possible. Do not smoke. Maintain a healthy body weight. And always check-in with your doctor about cholesterol panels, blood pressure, and family history.

Additional References:

  1. https://www.cdc.gov/heartdisease/heart_attack.htm 
  2. https://www.heart.org/en/healthy-living/healthy-lifestyle/my-life-check–lifes-simple-7