This past week, I was delighted to receive my copy of “Prevention and Treatment of Cardiovascular Disease: Nutritional and Dietary Approaches” an important new book edited by my colleagues Drs. Michael Wilkinson, Michael Garshick and Pam Taub that focuses on lifestyle strategies for optimizing cardiovascular health.
There are numerous excellent contributions encompassing plant-based, Mediterranean and other popular diets, intermittent fasting/restrictive feeding, dietary recommendations for diabetes, metabolic syndrome, heart failure, atrial fibrillation and many other cardiovascular/inflammatory disorders.
Our contribution entitled, “Lifestyle Approaches to Lowering Triglycerides” was led by Dr. Stephen Hankinson (former University of Maryland medicine resident, currently affiliated with Brigham & Women’s Hospital).
Listed below are some of the numerous “pearls” throughout the book. It is a superb resource for anyone interested in evidence-based medicine as it relates to nutrition and cardiovascular risk reduction.
- Overwhelmingly, consumption of whole foods enriched in dietary macronutrients have a more pronounced benefit on heart disease risk factors (such as high blood pressure/ cholesterol) than dietary supplements, for whom minimal if any such evidence exists.
- Inadequate intake of selenium is associated with adverse effects on the cardiovascular system including oxidative stress and inflammation. Excellent sources of selenium include Brazil nuts, oysters and yellowfin tuna.
- Low levels of magnesium may increase aortic valve calcification (due to buildup of calcium within cardiac and smooth muscle cells). Make sure to include green leafy vegetables, legumes, seeds and whole grains in your diet to maintain healthy magnesium levels.
- A review of 50 studies evaluating more than 500,000 men and women found that adherence to a Mediterranean diet correlated with a 31% reduced risk of developing the Metabolic Syndrome over a 6-year period.
- The DASH (Dietary Approaches to Stop Hypertension) is among the most effective non-pharmacologic treatment for high blood pressure with average reductions in systolic pressure (~11 mmHg) and similar to that observed with a single blood pressure medicine.
- When controlled for total caloric intake, a ketogenic diet does not result in greater weight loss than other diets.
- In the REGARDS (REasons for Geographic And Racial Differences in Stroke) study, a primary plant based diet (vegetables, fruits, beans, fish) was associated with a 41% lower likelihood of developing heart failure over an approximate 9 year follow-up period.
- In contrast to popular belief, corn oil has a more profound effect on lowering LDL levels than olive oil (11% vs 4%).
- A mildly caloric restrictive diet (12% reduction in daily calories) was associated with significant weight loss (average, 16.5 lbs) as well as improvement in cholesterol, blood pressure, insulin sensitivity and inflammation over a 2-year period.
- Time restrictive eating (6-10 hour window of eating followed by a 14-18 hour fast) reduces risk of cardiometabolic diseases by promoting weight loss and improving sleep.
- In women with early-stage breast cancer, overnight fasting of 13 (or more) hours was associated with an improved cancer prognosis, longer sleep duration and better glycemic control.
- In men and women with Metabolic Syndrome, 12-weeks of time restrictive eating (10 hour feeding window) resulted in significant reductions in waist circumference, blood pressure and LDL cholesterol.
- In more than 1100 men and women with psoriasis, dietary intervention that included a structured exercise program to promote weight loss resulted in a 75% improvement in psoriatic skin lesion severity.
- In obese men and women with a history of atrial fibrillation, 10% weight loss resulted in a 46% likelihood of sustained normal (sinus) rhythm without medication over ~5 years of follow-up.
Dr. Michael Miller is Professor of Cardiovascular Medicine at the University of Maryland School of Medicine in Baltimore, Maryland and author of multiple books and book chapters related to heart disease prevention and treatment.