Another Plus for DASH Diet: Less Heart Failure

The DASH Diet was recently linked to lower chances of developing heart failure.  DASH stands for Dietary Approaches to Stop Hypertension.  High compliance with the diet reduced heart failure by up to 37% in women. 

At age 40, the lifetime risk of developing heart failure is one in five.  Heart failure causes fatigue, trouble breathing, swollen legs; and it shortens lifespan.  I've written about the causes of heart failure.

The study, published in the Archives of Internal Medicine, was based on nutritional analysis of 36,019 women in the Swedish Mammography Cohort.  During seven years of follow-up, 443 women developed heart failure.  The higher the adherence to the DASH Diet, the lower the risk of heart failure.

Men haven't been studied for this outcome, so we don't know if DASH prevents heart failure in men.  I bet it does.  

Consider lowering your risk of heart failure by adopting the major features of the DASH diet:

• 4-5 servings of fruit daily
• 4-5 servings of vegetables daily
• 2-3 servings of low-fat dairy products daily
• it's low in saturated and total fats (under 25% of total calories)

Hey!  This sounds like it might prevent heart attacks, cancer, and strokes, too!

Additional Resource:  The DASH Diet Eating Plan

-Steve Parker, M.D.

Disclaimer:  All matters regarding your health require supervision by a personal physician or other appropriate health professional familiar with your current health status.  Always consult your personal physician before making any dietary or exercise changes.

Reference:  Levitan, E.B., et al.  Consistency with the DASH Diet and incidence of heart failure.  Archives of Internal Medicine, 169 (2009): 851-857.

Cardiologists Underutilize TLC: Therapeutic Lifestyle Change

If you have coronary heart disease, you can augment the effects of heart pills and procedures with therapeutic lifestyle changes, such as:

• Eat cold-water fatty fish twice weekly.  These include salmon, trout, tuna (white/albacore), sardines, herring, swordfish, halibut, mackerel, and sea bass.
• Eat nuts: three to five 1-ounce servings a week.
• Exercise regularly. 
• Eat legumes twice a week.
• Consider low-glycemic index eating. 

Some of these measures are as potent as drug therapy.

If you or someone you love has coronary heart disease, you need to know that there's more to successful treatment than drug therapy, angioplasty, and open heart surgery. 

It's just a fact that many cardiologists - certainly not all - focus on invasive intervention and drug therapy.  Invasive intervention typically involves threading a small tube into the heart via the groin artery, opening up a blocked artery with a balloon (angioplasty), and leaving a metal frame behind to keep the artery open. 

That's what they are trained to do.  It's easier to prescribe pills and do procedures rather than spend time educating a patient on healthy diet, exercise, weight loss, and mental health.  The educational effort too often seems to fall on deaf ears.     

Let's face it: many heart patients also would rather pop a pill or have a procedure and be done with it.  Or at least think they're done with it.

No doubt about it, pills and invasive procedures save many lives every day.  Therapeutic lifestyle changes also have a role.

-Steve Parker, M.D.

Disclaimer:  All matters regarding your health require supervision by a personal physician or other appropriate health professional familiar with your current health status.  Always consult your personal physician before making any dietary or exercise changes. 

 

Unusual Diet Modifications to Reduce High Blood Pressure

In addition to salt restriction, you can make other diet modifications to lower your blood pressure.  Why would you want to do that?  High blood pressure causes one in six cases of preventable death. 

The following foods were tested mostly in people already diagnosed with elevated blood pressure.

• Vegetarian diet:  Lowers systolic pressure 5 points (mmHg).
• Fiber supplementation:  Increasing daily intake of fiber by 10-12 grams drops pressure only one point usually, although more in people over 40 or with hypertension.
• Increased calcium intake:  insignificant one point drop.
• Increased fish intake:  Daily fish plus loss of excess weight dropped pressures from an average of 133/77 to 119/68 in a 16-week study.  Daily fish??!!
• Fish oil:  3-4 grams a day drops blood pressure two to six points, usually closer to two.
• Potassium supplementation:  40-80 mEq per day seems to lower blood pressure somewhat, but the effect is mostly lost in someone on a reduced-salt diet.
• Cocoa:  Adding cocoa products lowers systolic pressure by 5 points and diastolic by 3, at least in short-term studies.  Chocolate, anyone?   

The numbers above are averages; your mileage may vary.

The combination of regular exercise, loss of excess weight, and salt restriction is a potent approach to lowering your elevated blood pressure or avoiding hypertension "naturally."  Consider some of these other diet modifications, too.

NDs Nutrient Search Tool will help you find foods rich in potassium and fiber.  Search Monica Reinagel's Nutrition Data Blog for information on vegetarianism.

-Steve Parker, M.D.

Disclaimer:  All matters regarding your health require supervision by a personal physician or other appropriate health professional familiar with your current health status.  Always consult your personal physician before making any dietary or exercise changes.

Additional Resource:  UpToDate Patient Information: High blood pressure, diet, and weight

High Blood Pressure and Smoking Cause the Most Preventable Deaths

High blood pressure and smoking cause the most preventable deaths in the U.S., according to a study published last month.  862,000 deaths in 2005, to be precise.  Researchers blame smoking for one in five deaths, and high blood pressure for one in six deaths. 

This is pertinent to the Heart Health Blog because smoking and high blood pressure contribute to coronary heart disease and strokes.  As reported by TheHeart.Org, lead author Goodarz Danaei said, "In the U.S. and many other Western countries, heart disease is not only the number one cause of death, it is the number one preventable cause of death - that's what our results show."

Of course, many of the smoking-related deaths are from lung cancer, emphysema, and chronic obstructive lung disease.

Researchers looked at causes of death registered at the National Center for Health Statistics, and estimated how much individual risk factors increased the risk of death from each disease.  Twelve modifiable risk factors were considered. 

Here's a run-down of the number of deaths attibuted to each risk factor:

• Smoking:                            467,000
• High blood pressure:           395,000
• Overweight/obesity:             216,000
• Physical inactivity:               191,000
• High blood glucose:             190,000
• High LDL cholesterol:           113,000
• High salt intake:                   102,000
• Low omega-3 intake:             84,000
• High dietary trans-fats:          82,000
• Heavy alcohol use:                64,000
• Low fruit/vegetable intake:     58,000
• Low dietary PUFAs                15,000

Did you notice that many of these factors are under our control as individuals?

Note relatively few deaths from high LDL cholesterol. This surprised the investigators. Six times as many deaths were caused by physical inactivity, overweight, and high blood glucose.

Some NutritionData users are fairly compulsive about "eating healthy."  That's great.  Every little bit helps, or might.

But it's important to focus also on some of the heavy hitters above, if you don't already.

-Steve Parker, M.D.

Reference:  Danaei, G. et al.  The preventable causes of death in the Unites States: comparative risk assessment of dietary, lifestyle, and metabolic risk factors.  PLoS Med, April, 2009; DOI:10.1371/journal.pmed.1000058.

Depressed? Angry? Isolated? . . . Beware!

Depression, anger, hostility, stress, and social isolation are linked to increased risk for heart disease, the leading cause of death in Western cultures.

These psychosocial factors may directly damage your arteries or aggravate traditional heart risk factors such as overweight, high blood pressure, and smoking.  

[Back in the 1950s, physicians sometimes recommended smoking as a way to reduce stress!]

The scientific literature on this topic is complex and often inconsistent.  But several patterns stand out:

• Loss of a job, depression, and grieving over the death of a loved one are associated with heart attacks and sudden death.
• In established cases of coronary heart disease, depression is linked to increased risk of cardiac complications, including death.
• In men, those with the highest levels of depression, anger, or social competitiveness have higher risk of coronary heart disease, including heart attack and death.  Especially anger in response to stress.
• In men and women predisposed to coronary heart disease, hostility increases the risk of coronary heart disease.
• Social isolation in women increases risk.
• Submissiveness, especially in women, is protective against heart attacks.  [Don't shoot me!  I'm only the messenger.]

If you suffer from depression, isolation, undue hostility or anger, bereavement, or excessive stress, don't ignore them.  Talk to your spiritual adviser, primary care physician, cardiologist, or a mental health professional.  You don't have to live that way.   

-Steve Parker, M.D.

Disclaimer:  All matters regarding your health require supervision by a personal physician or other appropriate health professional familiar with your current health status.  Always consult your personal physician before making any dietary or exercise changes. 

Analyze your recipes and make them healthier

Nutrition Data can help you see how your favorite recipes stack up nutritionally and how they fit into your overall diet plan.  To analyze your recipes, simply enter the ingredients and quantities and click the orange "save and analyze" button.

You can also use our recipe analysis tool to make your favorite recipes healthier!  Once you've saved a recipe to My Recipes, click on the orange "edit" icon to modify the recipe and see how it affects the nutritional quality of the recipe.

 

Substitute low-fat sour cream for full-fat sour cream to reduce calories, for example. Use olive oil for half of the butter to reduce saturated fat.  Increase the amount of vegetables to add more fiber and nutrients. And so on!

Next Step: Go to My Recipes

Related Content
Help page for My Recipes
Make your recipe analysis more accurate

Go to the Heart Health Resource Center

Give your diet an upgrade

You can use the Better Choices tool on Nutrition Data to give your diet a nutritional upgrade. (And if you're trying to lose weight, Better choices can help with that too!).

For every food you eat, there are likely to be similar foods that are more nutritious. By "more nutritious," we mean that they contain more essential nutrients and/or less saturated fat, cholesterol, and sodium per calorie. We consider these to be Better Choices for Optimum Health.  There are also similar foods that are both more nutritious and will fill you up for fewer calories.  We consider these foods Better Choices for Weight Loss. 

When you track your diet using the My Tracking tool, the analysis report includes a list of all the foods you've eaten that day.  Next to each food you'll find Better Choices links.

For example, yesterday, you might have had some frozen corn with dinner.

If you click on Better Choices for Optimum Health (and then choose the "vegetable" category), you'll find that there are 597 vegetable choices that are more nutritious than corn. Choosing any one of these as a substitute for corn will be a step in the right direction!  For example, you could choose asparagus, kale, or zucchini instead of corn.

If you're trying to lose weight, click the Better Choices for Weight Loss instead for a list of foods that are both more nutritious and more filling per calorie.

Each Better Choice you make will improve the nutritional quality of your diet and can also make it easier to lose weight.

Next Step: Learn more about Better Choices

Go to the Heart Health Resource Center

Track and analyze what you eat

One of the best ways to get a handle on your diet is to analyze the total of all nutrients that you consume over the course of an entire day. This is very easy to do with My Tracking.

More powerful than a simple "calorie counter," My Tracking gives you a detailed analysis of your diet, including information about over 140 nutrients and dietary factors. My Tracking can help you monitor your calories, fats, carbohydrates, glycemic load, inflammation factor, protein quality, fullness factor, nutritional balance, and individual vitamins and minerals.

If you've set your own customized Individual Daily Values in My Preferences, My Tracking will compare your intake against your customized target values and tell you how your diet measures up. (If you haven't customized your nutrient targets, My Tracking will compare your intake against the standard Daily Values.)

   

If you find that you're falling short on a particular nutrient, just click on that nutrient for a list of foods that are good sources.

Share or save your report

At the top of the report, click on the "e-mail a friend" link to send a copy of the report to someone else, such as your dietitian or personal trainer. You can also download the report as a CSV file.

Next Step: Go to My Tracking

Related Content:
How can NutritionData be personalized for your goals?
My Tracking Help Page

Go to the Heart Health Resource Center