Heart disease is the most common disease and cause of death in American adults.
As with any disease, there are genetic and environmental causes. The one we can control is environmental. We know there are environmental things we can do to prevent heart disease and stroke. Risk factors include nicotine use, low activity, and unhealthy diet. Just as I mentioned in previous blogs, the Standard American Diet (ironically shortened to SAD) is not healthy. It is high in unhealthy things (sugar and animal products), and low in healthy things (plants and fish). This leads to inflammation, fat build up, and high blood pressure in blood vessels. When the blood vessels of the heart gets clogged, it can cause a heart attack. When blood vessels of the brain get clogged, it can cause a stroke.
Unfortunately many children have risk factors for heart disease that start in childhood, and scientists have even found cholesterol plaques in children’s blood vessels and heart. That’s why the American Academy of Pediatrics recommends blood lipid (fat) testing in children around age 9-10, and earlier if risk factors. If children have high blood lipid levels at that young age, we can improve them and decrease their risk down the road. Fortunately high blood lipids can be reversed by a healthy lifestyle. (A book and website I recommend is Undo It by Dr. Ornish) As I have mentioned before, this is not individual family’s fault, this is American society’s fault that makes it easier to live an unhealthy lifestyle.
What are blood lipids?
It is normal to have some fat molecules in your blood. The body stores energy in many forms, and one of the forms is fat. There are different types of fat molecules that the body makes. The 2 main types are cholesterol and trigylcerides. Triglycerides (TG) are a form of fat that transports fat from the gut to the liver, and they are not healthy in high levels. Cholesterol are fatty molecules that are made in the liver. There are different types of cholesterol determined by the type of protein attached to the fat (lipoprotein). Low density lipoprotein (LDL) is a type that can stick to artery walls and cause damage (such as heart disease). LDL in high levels is not healthy to have in the blood. High density lipoprotein (HDL) is a type that “cleans up” cholesterol that built up in tissues and takes it back to the liver. Therefore you want more “cleaner” HDL molecules, so the higher the level the better. When the body has high levels of not healthy fat (LDL cholesterol and triglycerides), and low levels of cleaner HDL, this can lead to fat deposits in the blood vessels, which can lead to heart disease.
Fat molecules can be high for several reasons. If the patient ate within 8 hours of the test, certain levels can be high after meals, so it is harder to figure out if the levels are actually unhealthy. Labs done when fasting (no food for at least 8 hours) are more accurate. If the labs are abnormal when fasting, this can be due to several reasons. There can be genetic (things that run in the family) reasons the labs are abnormal. There also can be environmental causes for abnormal fat in blood. This is the part that we can help improve.
What is a heart healthy lifestyle?
Many factors of the American lifestyle contributes to heart disease. Not dealing with stress in a healthy way causes the body to release chemicals that harm the blood vessels. Not being active causes the body to store energy in fat molecules that stick to blood vessels.
Certain foods cause the liver to make more LDL and decrease HDL. A non-balanced diet which is high in sugar and simple carbohydrates, high in animal products and low in plant products will increase bad fats. Unfortunately the standard American diet is just that, which contributes to heart disease being the most common cause of death in America. In contrast, Japan has the lowest amount of heart disease. And they eat a whole food, plant-based diet with seafood, which is what we should strive for. Below are key points to a heart healthy lifestyle.
1. Reduce simple carbohydrate intake: Simple carbohydrates are things that have white flour in them. The white flour is converted to sugar in the body. When there is too much sugar in the body, one way it reacts is by storing it in the form of fat. Unfortunately the body stores it in the wrong forms, which leads to unhealthy types and levels of fat in the blood. When food is highly processed, it is more likely to be simple carbohydrates. Decreasing the amount of processed foods will decrease the amount of simple carbohydrates. Changing food to less processed and closer to nature forms of food will help you be healthier. Examples of processed simple carbohydrates are pastries, white pasta, white bread, and doughs. Examples of less processed complex carbohydrates are whole oats, whole grain foods, vegetables, fruit, and brown rice.
2. Increase plant food intake: A diet that has more plants than animal products has been shown to prevent and even reverse many diseases. Food from plants has healthy forms of fat, has fiber which helps clean up fat from blood vessels, has vitamins and nutrients, and also has chemicals that decrease inflammation. Whole vegetables such as carrots, broccoli, avocado, beans, leafy greens such as lettuce, spinach and kale are literally the healthiest thing you can eat! It is recommended to eat at least 5 vegetables and fruit servings per day. The goal is at least a vegetable or fruit with every meal and snack, and the more the better!
3. Increase good fat intake: The human body needs fat to function, plus it makes us feel full after eating. The goal is to not eliminate fat, but to focus on improving the fat quality. Your body does different things with different types of fat from food. Omega 3 is a good dietary fat that is turned into the good fat, HDL (remember HDL cleans up the arteries, that is why we treat high fat levels with Omega 3 supplements!). Omega 3 is found in fish, seafood, and plants such as flax, chia, and walnuts. This is why fish and seafood is recommended in a heart healthy diet! Monounsaturated fat is found in things like olive oil, and it is not turned into bad fat in the blood. This is why the mediterranean people are heart healthy! Omega 6 fat is found in processed vegetable oils, such as canola. It is not as healthy as omega 3 fat, so we should try to eat less of it. Unfortunately omega 6 is found in most American processed foods. Saturated fat is the fat found in animal products such as dairy and fatty meat such as red meat, and should be eaten less than monounsaturated and omega 3 fat. Trans fat is something that humans made for processed foods and it causes bad fat and inflammation, so avoid trans fat in processed foods.
4. Start supplements: It can be difficult in America to eat a well balanced diet to make sure the body gets enough good types of fat, vitamin D and other nutrients needed directly from food to decrease the risk of heart disease and other diseases. Therefore, supplements are often used to make sure the body gets what it needs. Supplements are used in addition to a healthy balanced diet, it cannot replace the benefits from a well balanced diet with nutrients from food. Omega 3 supplements can be taken to help supplement good fats in the diet to help increase HDL and clean up arteries.
Find a supplement that your child will take, there are chewable and swallowable forms. Doses can range from 250-1000 mg per day. There is a brand, Nordic Naturals, that has reliable supplements of Omega 3. There are also some multivitamins which contain Omega 3, such as Smarty Pants brand.
5. Get active: 30-40 minutes of activity per day uses energy so less energy is stored as fat. Limiting screen time also increases activity.
6. Reduce stress and/or deal with stress in healthy manner: Stress is natural, but too much or not relieving it causes the body to release a hormone called cortisol that causes problems such as high blood pressure and increased cholesterol. Try to prioritize and decrease things that cause stress. Practice mindfulness techniques daily, such as in this article I wrote on Meditation . There are great apps and youtube videos for kids meditation and yoga. Spend time outside, studies show daily time outdoors in nature boosts mood and decreases blood pressure. Health benefits of nature
In summary: A lifestyle that decreases risk for hyperlipidemia and heart disease means being active, reducing stress, and eating a well-balanced diet. A well-balanced diet means avoiding simple carbohydrates and highly processed foods, eating mostly plants (vegetables, fruit, beans, nuts, whole grains), 2-3 servings of fish and seafood per week, most of fat should be good fats such as olive oil and nuts, limiting high fat animal products (like cheese and red meat). More to come on logistics of improving lifestyle with a whole food, plant based diet…
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