Heart Disease – Change your life now to stave off problems later

* Eat fewer animal products. Eat less meat and more plant foods rich in vitamin C and beta-carotene to reduce heart disease and stroke (Am J Epidemiol, 1995; 142: 1269-78; Epidemiology, 1992; 3: 194-202; BMJ, 1990; 300: 771-3).

* Be sensible with salt. Less salt can substantially lower hypertension (N Engl J Med, 2001; 344: 3-10, 53-4). Combined with eating fruits and vegetables rich in potassium and magnesium, a salt intake of 1-2 mg daily is considered healthy and sufficient (Lancet, 1981; ii: 895-900).

* Increase fibre intake. Water-soluble fibres such as oat bran, apple pectin and psyllium lower both cholesterol and blood pressure (Am J Clin Nutr, 1979; 32: 346-63).

* Find support. California heart specialist Dr Dean Ornish finds that the usual risk factors for heart disease – sedentary lifestyle, smoking, obesity and a high-fat diet – account for only half of all heart disease. The rest is down to a person’s level of isolation (Am J Empidemiol, 1979; 109: 186-204; Am J Epidemiol, 1988; 128: 370-80). Unexpressed emotions are also a factor in premature heart-disease death (Lancet, 1996; 347: 417-21). To deal with isolation, explore your spirituality, express your feelings, make friends, get involved in your local community, own a pet or sponsor a child – it may save your life.

* Limit dairy. Studies suggest an association between dairy and increased heart-disease risk (Air Med Rev, 1998; 4: 281-94). Excess calcium intake also plays a role in atherosclerotic plaque development (Int J Cardiol, 1991; 33: 191-8).

* Quit smoking. How many times do we have to say it?

* Think antioxidants. Wine (in moderation), grape juice, green tea, dark berries and all fresh, brightly coloured fruits and vegetables are rich
in heart-protective flavonoid antioxidants. As flavonoid intake rises, heart disease risk drops significantly (J Nutr, 2000; 130: 53-6). Pycnogenol contains proanthocyanidins and tannins that strengthen capillaries (Bordeaux Med, 1980; 13: 903-7) and reduce venous insufficiency (Ther Rev Med, 1981; 27-28 Sept: 1793-802).

* Wholegrains. Eating at least two-and-a-half servings a day of dark breads, wheat or bran cereals, popcorn, oatmeal, brown rice or other wholegrains can reduce coronary disease risk by 33 per cent (Am J Clin Nutr, 1999; 70: 412-9).

* Lighten up. Losing excess weight can reduce blood pressure (JAMA, 1996; 275: 1549-56).

* Take care of your teeth. Bacterial infection can spread from the mouth via the bloodstream to remote parts of the body. Those with periodontal (gum) disease had three to seven times the risk
of fatal heart disease (J Cardiovasc Risk, 1999; 6: 7-11; BMJ, 1993; 306: 688-91.

* Bacterial and parasitic infections. These can lead to chronic inflammation and disease (BMJ, 1996; 312: 1061-5), even death. Culprits include Chlamydia pneumoniae (Eur Heart J, 1996; 17: 902- 10) and Helicobacter pylori, which causes stomach ulcers (BMJ, 1995; 311: 11-4). Exposure to other ‘poisonous’ substances, such as allergens and environmental pollutants, can also produce heart inflammation and subsequent heart disease (N Engl J Med, 1997; 337: 422-4).

* Exercise. Exercise of any kind, including brisk walking, lowers the risk of heart disease (N Engl J Med, 1999; 341: 650-8), especially when accompanied by a sensible eating regime (J Hypertens, 1996; 14: 779-90).

* Increase good fats. Omega-3 fatty acids, found in fish and flaxseed oils, lower triglycerides and LDL (‘bad’) cholesterol, while increasing HDL (‘good’) cholesterol (Am J Cardiol, 1995; 76: 459-62).

* Good old garlic (Allium sativum) can reduce cholesterol (Ann Intern Med, 1993; 119: 599-605) and the risk of blood clots (J Orthomolec Med, 1987; 36: 766-8), and act as a vasodilator (New Drug Clin, 1996; 45: 456-66; Am J Clin Nutr, 1996; 64: 866-70).

Vitamin E protects blood vessels and prevents blood clots (Int J Vit Nutr Res, 1976; 46: 18-91).

Selenium stops blood clotting (Fed Proc, 1984; 43: 477)

B vitamins help rid the body of heart-damaging homocysteine (JAMA, 1998; 279: 359-64).

Coenzyme Q10 helps to treat various heart conditions (Mol Aspects Med, 1994; 15 [Suppl]: 287-94).

L-Carnitine, a non-essential amino acid, improves exercise tolerance in angina patients (Jpn Heart J, 1984; 25: 587-97; Clin Terap [Ital], 1992; 140: 353-77).

Magnesium reduces cardiovascular spasms and angina (Magnesium, 1985; 4: 226-44) and improves cholesterol levels (Curr Ther Res, 1984; 36: 341-5).

* Oestrogen: There is now no doubt that oestrogen in the Pill or as hormone replacement has no protective effect on the heart (JAMA, 1998; 280: 605-13), and may even increase coronary events by nearly 30 per cent (JAMA, 2002; 288: 321-33, 366-8), and increase heart-damaging triglycerides (Am J Clin Nutr, 2000; 72: 389-94; JAMA, 1995; 273: 199-208) and vascular inflammation (Circulation, 1999; 100: 713-6, 717-22).

* Lowering cholesterol: Ironically, most heart patients have normal cholesterol levels (Lancet, 1994; 344: 1182-6). Evidence shows that high cholesterol does not raise your risk of dying from anything, including heart disease (JAMA, 1994; 272: 1135-40). In fact, high blood-cholesterol levels are associated with longevity and good health in older people (Lancet, 1997; 350: 1119-23). In contrast, lowering cholesterol is associated with higher rates of depression and suicide (BMJ, 1992; 304; 431-3).

* Low-fat diets: Some researchers believe that saturated fats are not linked to heart disease at all (BMJ, 1996; 313: 84-90). Indeed, given all the advice we receive about lowering fat, it is surprising to find that the link between saturated fats and the heart is based on only one major trial (BMJ, 1996; 313: 1258).

* Giving up alcohol: While there are studies that have linked alcohol with high blood pressure (JAMA, 1985; 253: 1567-70), it may not be abstinence, but what you drink that is important. There is strong evidence of the heart-protective effects of red wine (BMJ, 1995; 310: 1165-9). Women, however, are in Catch-22 – moderate alcohol can help the heart but, in some, may raise the risk of breast cancer (N Engl J Med, 1995; 332: 1733-7).