More than 50 percent of Americans have resolved to lose weight and pump up their exercise regimen this year, although that’s pretty much the case every year. And there are good reasons for that.
Diet and physical activity make a dramatic difference in your well-being, physically and psychologically. Getting in shape isn’t just a way to fit into your old pair of skinny jeans (although that’s a nice benefit).
A growing number of nutritional studies are accumulating compelling evidence about the link between diet and health, particularly when it comes to matters like preventing and fighting heart disease.
“Diet is at the basis of everything we do in cardiology because it’s basically the fuel you put into your gas tank,” said cardiologist Dr. Carl Orringer, director of The Preventive Cardiovascular Medicine Program at the University of Miami Health System. “If you consistently put a low-grade fuel into a gas tank, it may run for a while but then it’s going to break down.
Poor diets, not enough exercise
“The biggest enemy that we have in regard to cardiovascular disease is poor eating habits and lack of regular physical activity,” said Orringer, the top lipid expert at UHealth and associate professor of medicine at the Miller School of Medicine. “The wrong fuels increase our risk of obesity, our risk for diabetes, a shorter life span, and in certain cases, the risk for cancers.”
Getting the right fuel, among other positive changes — such as giving up smoking and cutting back on alcohol — may be tough but consider this: Cardiovascular disease remains the No. 1 killer in the United States.
“More than 80 percent of all cardiovascular events are preventable through lifestyle changes, yet we often fall short in terms of implementing these strategies and controlling other risk factors,” said John Hopkins University cardiovascular expert Dr. Roger S. Blumenthal, who was co-chair of the 2019 Primary Prevention of Cardiovascular Disease guidelines from the American College of Cardiology and the American Heart Association.
One of the biggest challenges “is that we see patients after they have an event,” said Dr. Jessen Jacob, cardiologist for Baptist Health’s Miami Cardiac & Vascular Institute. “The focus should be more on prevention and heart health.”
While there are patients who have higher risk factors, “we know that a heart healthy diet and exercise on a regular basis reduces cardiovascular risk long term,” he said.
Watch those drive-throughs
Physicians and dietitians note that grabbing fast food or a sweet treat isn’t insurmountable if it’s an exception rather than your primary diet. But too often, busy families depend on the drive-through or processed foods.
“We know that unfortunately the typical American diet is not heart healthy,” said Candace O’Neill, a registered dietitian at Cleveland Clinic Florida in Weston. “In general, people gravitate toward quick meals, which aren’t always healthy.
“These meals are prepared quickly or we get food on the run with too much salt that tends to be fried and the protein itself is not healthy protein,” said O’Neill. “Eating unhealthy fats can cause high cholesterol, a risk factor for heart disease. Eating too much refined sugar and red meat can increase inflammation in the body, which increases the risk of heart disease.”
Today, there are dozens of diet options offering consumers myriad choices but that also brings confusion. There are low-fat or low-carb diets. Ones inspired by the people of Okinawa or the Mediterranean. Vegan or Carnivore. Some are fads, but there are also variations of healthy diet plans.
“Within the umbrella of healthy diets, there’s not only one diet that’s absolutely the optimal diet. There’s no such thing,” said Teresa Fung, Harvard faculty editor of “The Diet Review: 39 popular nutrition and weight-loss plans and the science (or lack of science) behind them” from Harvard Health Publishing.
Factors to consider when planning your diet regimen include: “What are my goals, what are my nutrient needs, what do I need to eat in order to accomplish these goals, what foods provide what nutrients, what foods lower the risk of diseases,” said Fung. “The general principles are very simple. Eat a variety of foods, as minimally processed as possible. Eat lots of fruits and vegetables, nuts, beans and seeds, and only a small amount of animal protein.”
In recent years, there’s been a movement toward vegan and vegetarian diets, for environmental and animal welfare concerns as well as dietary preference.
A vegan diet is the most restrictive of the plant-based diets, excluding all foods of animal origin — meat, poultry, seafood, eggs, dairy and honey.
‘Plants are hot’
“Well-balanced vegan diets are associated with the lowest risk of heart disease and cancer when it’s done properly, with a good balance of whole grains, fresh vegetables and legumes and foods of that type,” said Orringer.
While there are challenges such as increased prep time, commitment and sustainability, “when an individual is motivated, it’s a terrific way to maximize health,” Orringer said.
Those trying to eliminate or cut back red meat can start by slowly adding meatless meals and increasing the amount. If you have to eat meat, at least make it lean, cardiologists said.
For those who want the benefits of a vegan or vegetarian diet but don’t want a restrictive diet, there are moderate paths to healthy eating, said the experts.
“More patients are asking ‘What are my options?’ “ said Daris Morato, adult cardiac and kidney transplant dietitian at Memorial Healthcare System. “In the last 10 years, there’s been a big shift toward more of a plant-based diet.”
“In case you haven’t noticed, plants are hot,” according to Harvard’s “Diet Review” book. “Plant milk. Plant protein. Vegetarian. Vegan.”
The terms may be plant-based, plant-forward or plant-centric but these diets aren’t interchangeable with a vegan approach. People choosing a plant-based preference may be eating an abundance of vegetables and fruit yet they haven’t eliminated all meat or dairy.
Whole Foods lists “reducetarianism” in its top 10 food projections for food trends for 2022: “Reducing consumption of meat, dairy and eggs without cutting them out completely. When animal products are on the menu, reducetarians make them count, opting for premium grass-fed meat … and pasture-raised eggs.”
Nutritional experts point to a similar approach called a Flexitarian diet.
“We don’t have to go all the way to a vegan or vegetarian diet to be healthy,” Fung said. “One thing to emphasize: It’s not just what you cut out, it’s what you substitute.”
For instance, if you’re cutting out red meat, look at healthy proteins like legumes (beans, lentils and peas) or fatty fish rich in omega 3. Just cutting out meat doesn’t ensure a healthy diet.
“An Oreo is a vegan item,” said Morato. “Vegan food can be great but it has to be the right way.”
The common denominators of a well-balanced diet include eating lots of plants and adequate protein (preferably beans, lentils, soy-based foods, nuts, seeds, fish or seafood instead of red meat) while limiting processed foods, saturated fats, added sugars and sodium.
“People are looking to make changes they can stick with, improve their health and lower their weight,” said O’Neill.
“Beans, lentils, pulses are great plant-based protein options that are high in fiber, very filling and very affordable,” said O’Neill. “With the price of meat going up, people are becoming more open to plant-based meals for reduced savings.”
Mediterranean, DASH diets
Two other diets mentioned as heart healthy alternatives include The Mediterranean Diet and DASH or Dietary Approaches to Stop Hypertension.
“They’re both associated with a reduced risk of heart disease,” said O’Neill.
The Mediterranean Diet features a variety of nutrient-dense foods such as fruits, vegetables, nuts, seeds, whole grains, olive oil and a few servings a week of fish rich in omega-3 fatty acids, which include salmon, sardines, herring, tuna and mackerel.
The DASH diet is also rich in fruits and vegetables with an emphasis on watching sodium, so it’s often followed by people concerned about high blood pressure.
“The real answer in most cases is moderation,” said Orringer. “Try to eat higher quality foods and minimize the negative things. It doesn’t have to be an all or nothing situation.”
How to adopt a healthier diet
Cooking method matters, said Baptist’s Jacob. “”If the fish is fried or has butter sauce that takes away some of the benefits of avoiding red meat.”
Avoid oils high in saturated fats like lard, coconut and palm oil and use olive oil, corn, safflower or soybean oil, he said.
“Alcohol in small amounts, an occasional drink, seems to be reasonable in terms of one’s health,” said University of Miami’s Orringer. “But binge drinking five or more drinks is associated with a lot of adverse health outcomes.
A healthy lifestyle “is a combination of exercise and diet,” said Jacob.
Recommendations call for at least 150 minutes of moderate aerobic activity or 75 minutes of vigorous aerobic activity a week, or a combination. “The bottom line,” said Orringer, “is that sitting over prolonged periods of time on a regular daily basis is associated with increased cardiovascular risk.”