Heart disease remains the number one cause of death for men and women in the United States, causing about one in every four deaths. Atherosclerosis (plaque buildup in arterial walls) leads to heart attack or stroke and is the most common type of heart disease, killing 655,000 people in the U.S. annually.

We've mentioned some of the most commonly modifiable (things you can change) risks for cardiovascular disease.

Metabolic disease is considered a precursor to heart disease, and develops over several years.  A combination of three or more of the following symptoms can be considered metabolic disease: 

• Large Waistline
• High Triglycerides
• Low HDL Cholesterol
• High Blood Pressure
• High Fasting Blood Sugar.

Luckily, sweeping changes in lifestyle, diet and exercise can prevent or delay both metabolic disease and the modifiable risk factors for heart disease.

Initial dietary advice focused on avoiding cholesterol- and saturated fat-laden foods with an emphasis on eating complex carbohydrate foods like vegetables, whole grains and fruits. Unfortunately, people have been consuming more simple and refined carbohydrate foods (cereals, pastas, crackers, cookies, cakes and other sugary foods). This has resulted in a shift in dietary advice; reducing the consumption of simple, processed carbohydrates and sweetened foods has taken precedence in the fight against cardiovascular disease over reducing cholesterol and limiting saturated fat.

Triglycerides are an important biomarker for heart disease risk. Intake of simple carbs, including added sugars and fructose (includes high fructose corn syrup), and eating a diet with a high glycemic load are both associated with increased triglycerides levels. Reducing simple carbohydrate intake and restricting fructose all appear to beneficial diet changes for lowering triglycerides as well.

In addition to raising triglyceride levels, a diet high in simple carbs is also associated with insulin resistance, another important factor in heart disease risk. Simple carbs raise blood sugar more so than non-simple or complex carbs, resulting in a matching rise in insulin to bring blood sugar back down. Just as we become tolerant to things like background noise and smells, the body becomes tolerant to the ongoing excessive rise in insulin, requiring more and more insulin to achieve the same blood sugar lowering effect. As a result, fasting blood sugar increases, contributing to yet another factor of metabolic disease.  

While exercise can lower blood sugar without the help of insulin, trying to out-exercise a bad diet is not a good idea. It takes about 5 minutes to eat a 350 calorie piece of chocolate cake, but it would take about an hour of aerobic exercise for the average person to burn it off. Over time, the excess calories and sugar can contribute to metabolic disease, thereby increasing your risk for heart disease.  Instead, make exercise a part of a healthy diet to help you achieve your goals. 

When it comes to eating for a healthy heart, focus not only on eating a healthy, well balanced diet that is moderate in saturated fat and cholesterol, but most importantly it should be low in refined simple carbohydrates and high in vegetables.

Try replacing white bread, pasta, and rice with 100% whole grain breads, pasta, and rice, and reduce portions of these foods at meal time, while increasing vegetables. Skip sugary beverages (soda, juices, energy drinks and even commercial bottled teas) altogether and slowly reduce the amount of sugar you add to your morning coffee. 

Choose fresh, whole fruit or small amounts of dark chocolate instead of sugar laden desserts. And, lastly, don’t rely on exercise to make up for a bad diet. 

References

Liu, Simin, et al. "A prospective study of dietary glycemic load, carbohydrate intake, and risk of coronary heart disease in US women." The American Journal of Clinical Nutrition 71.6 (2000): 1455-1461.

Miller, Michael, et al. "Triglycerides and cardiovascular disease a scientific statement from the American Heart Association." Circulation 123.20 (2011): 2292-2333.