Happy (belated) Valentine's Day! I hope everyone had a chance to get out there and spread some love. 

Last week we covered food. I get asked so often if there's something natural people can take to fix the cholesterol or the insulin resistance or the blood pressure. Today we'll go over the three magic bullets to keep your heart healthy. Unfortunately, you have to do some work and they don't come in pill form. Hey, why not stand up while you're reading this? 

1. Stress less.
We have two modes of our nervous system. Our sympathetic mode is our fight-or-flight response when cortisol production ramps up, adrenaline gets going, blood pressure increases, blood sugar increases, and we're prepped for fighting or running for our lives. Except these days, we're fighting traffic, deadlines, grocery lines, etc. This leaves our parasympathetic system (aka your rest-and-digest response) struggling to get your body repaired and fuelled properly. It's hard to repair all of that vascular damage from consistent high blood pressure when, well, you don't get a good change to repair it. 

Signs you're over-stressed: you're reaching for coffee when you're tired, you're reaching for the sleeping pills because you can't sleep, you're slathering the cortisone cream on your eczema, you have IBS, your hair is falling out, your periods are wonky, you're having a smoke at any time... to name just a few. 

Breathe. Don't sweat the small stuff. Practice gratitude. Leave earlier. Ask for help. Quit smoking. 
Sloooooowwww doooowwwnnn.

2. Eat well. Not sugar. 
Sugar, especially fructose, gets metabolized into the bad cholesterol in your liver. This clogs arteries. Sugar is pro-inflammatory. This oxidizes cholesterol in your arteries. This creates a perfect storm for a heart attack and some really bad times. These clogs also create a perfect storm to throw a clot out into your circulation and cause a stroke. Again, really bad times. 

Eat whole, real food. Can you pronounce that ingredient? Is it from a package? Will it go bad? Ask yourself all of these questions when prepping for meals. I get it - you're busy. You're tired. It's been a long day. That's okay. Please know that there are really easy swaps and excellent, tasty choices out there to keep you risk for heart disease low, you just need to know where to look for them. Talk to a nutritionist or a licensed ND about what easy swaps you can make. You don't need to overhaul anything. If you'd like a place to start, eat more fibre by adding an extra 2 servings of fruit or veggies each day.

3. Move your body. 
Sedentary lifestyles put you at a high risk for cardiovascular problems. Set an alarm in your phone to do a lap or two around your office every hour. Get exercising. It doesn't have to be running an hour a day - do something slow and relaxing if you're predisposed to anxiety or stress. Yoga is just as effective as other exercise for reducing cardiovascular risk. Get out the door, walk for 10 minutes, then turn around and come back. Get some buddies on your team and do it together. The point is you just need to move your body. 

Did you stand up while you read this? High five to you! 

I know these seem quite obvious and we've all heard them a thousand times. Unfortunately, there's no lazy way around these 3 magic bullets, but they are proven to work again and again. Now get out there, take some deep breaths, grab an apple, and move! 

References:
Yang Q, Zhang Z, Gregg EW, Flanders WD, Merritt R, Hu FB. Added Sugar Intake and Cardiovascular Diseases Mortality Among US Adults. JAMA Intern Med. 2014;174(4):516-524.


Xiao Q, Keadle SK, Hollenbeck AR, Matthews CE. Sleep duration and total and cause-specific mortality in a large US cohort: interrelationships with physical activity, sedentary behavior, and body mass index. Am J Epidemiol. 2014 Nov 15;180(10):997-1006.

Xiao Q, Keadle SK, Hollenbeck AR, Matthews CE. Sleep duration and total and cause-specific mortality in a large US cohort: interrelationships with physical activity, sedentary behavior, and body mass index. Am J Epidemiol. 2014 Nov 15;180(10):997-1006.

Chu P, Gotink RA, Yeh GY, Goldie SJ, Hunink MM. The effectiveness of yoga in modifying risk factors for cardiovascular disease and metabolic syndrome: A systematic review and meta-analysis of randomized controlled trials. Eur J Prev Cardiol. 2014 Dec 15.

Eaton RJ, Bradley G, Morrissey S. Positive predispositions, quality of life and chronic illness. Psychol Health Med. 2014;19(4):473-89.

There's tons of information out there when it comes to what to eat and when. Is butter good? Saturated fat? Egg yolks? If you're still stuck on the egg-white omelettes, read on. 

When it comes to heart health and researched diets, the Mediterranean Diet is king, but its buddy, the DASH diet, is also a winner. Let's go over the best stuff to eat for keeping your heart happy!

The Mediterranean Diet  
Breakdown:

• Lots of fruits and veggies, olive oil, whole grains (WHOLE, not refined), beans, nuts, legumes. 
  
• Moderate amounts of fish and seafood.
  
• Little bit of poultry, eggs, and dairy.
  
• A wee bit of occasional red meat.
  
• Red wine with dinner. Not the whole bottle though, just one glass.

What it does:

• Significant reduction in your risk for cardiovascular disease and major cardiovascular events including stroke and heart attack. The studies vary here but up to around 40% seems to be estimated. 
• The better adherence to the diet, the lower the risk for cardiovascular disease. So don't keep sneaking meat in there and don't skip the veggies!
• Has the best ability to detect early changes in risk markers. This means your doctor will be SO impressed with your follow-up labs in a short amount of time. Yes! 

The DASH Diet
Breakdown:

• Similar to the Mediterranean Diet, this menu has you eating lots of fruits and veggies, nuts and seeds, with a focus on low-fat dairy and really watching salt intake (limits vary from 1500 mg - 2300 mg each day). 
• Includes more meat, poultry, fish, and dairy.
• Limit sweets to 5/week max. 

What it does:

• One study found a 13% reduction on the Framingham Risk Score. This is what we use to determine where your cholesterol levels should be to prevent problems. 
• Significant reduction in blood pressure, total cholesterol, and LDL (the bad stuff). 

Busting the Myths:
Please, don't waste those egg yolks! 

• We know that dietary cholesterol has no effect on cardiovascular events. Egg yolks are also full of fat-soluble vitamins and also choline which helps to emulsify fat to break it up. Plus, yolks just make an omelette taste waaaaaay better.

Adding a pat of butter is fine. 

• So long as you're not adding an entire brick on your plate, butter is fine. The connection of saturated fat with heart disease is starting to look quite weak. Given the alternative that most people use (I personally think margarine shouldn't have ever been invented. Food, in general, should never be 'invented'), definitely opt for the butter. 

Cholesterol and sugar are connected. Strongly. Minimize your sugar.

• Fructose especially is under fire here. High-fructose corn syrup (HFCS) found in so many processed foods, pop, and a zillion other products has awful effects on obesity, blood sugar (which we know from last week raises your heart disease risk), blood pressure, and triglycerides. 
• Note: a lot of people started using agave a while ago as a 'healthy' alternative to sugar. The composition of agave is quite similar to that of HFCS and it's so highly processed. Skip it. 

So, now we cheers with our one glass of red wine to these amazing, risk-reducing, delicious-tasting menus! 

References:
Turati F, et al. Glycemic load and coronary heart disease in a Mediterranean population: The EPIC Greek cohort study. Nutr Metab Cardiovasc Dis. 2014 Dec 11

Sofi F, Macchi C, Abbate R, Genuine GF, Casini A. Mediterranean diet and health status: an updated meta-analysis and a proposal for a literature-based adherence score. Public Health Nutr. 2014 Dec;17(12):2769-82.

Alkerwi A, et al. Cross-comparison of diet quality indices for predicting chronic disease risk: findings from the Observation of Cardiovascular Risk Factors in Luxembourg (ORISCAV-LUX) study. Br J Nutr. 2014 Dec 5:1-11.

Martinez-Gonzalez MA, et al. Empirically-derived food patterns and the risk of total mortality and cardiovascular events in the PREDIMED study. Clin Nutr. 2014 Sep 16.

Siervo M, et al. Effects of the Dietary Approach to Stop Hypertension (DASH) diet on cardiovascular risk factors: a systematic review and meta-analysis. Br J Nutr. 2014 Nov 28:1-15. 

Saneei P, Salehi-Abargouei A, Esmaillzadeh A, Azadbakht L. Influence of Dietary Approaches to Stop Hypertension (DASH) diet on blood pressure: a systematic review and meta-analysis on randomized controlled trials. Nutr Metab Cardiovasc Dis. 2014 Dec;24(12):1253-61.

Stradling C, Hamid M, Taheri S, Thomas GN. A review of dietary influences on cardiovascular health: part 2: dietary patterns. Cardiovasc Hematol Disord Drug Targets. 2014;14(1):50-63.

Kelishadi R, Mansourian M, Heidari-Beni M. Association of fructose consumption and components of metabolic syndrome in human studies: a systematic review and meta-analysis. Nutrition. 2014 May;30(5):503-10.

It’s always the right time to give your ticker a little TLC. From hemp hearts to happiness, this month I’ll be giving you some weekly tips on the best ways to keep your cardiovascular system healthy. 

I would say at least half of my patients over 40 are on at least one medication for a cardiovascular-related health concern: blood pressure and cholesterol are the biggest ones. There are some great herbs and supplements with lots of research behind them that can help these meds to work best and support the rest of the cardio system, but we won’t discuss those here since it’s quite individualized. Plus, if you’re on meds, talk to a licensed ND who will make sure there’s no contraindications.

Beyond meds and supplements, what else can be done? LOTS! First, review your risk factors for heart disease to see where you can make some best-bang-for-your-buck changes. Here’s the biggest, changeable factors according to the Heart and Stroke Foundation:

• High blood pressure. High pressure on the walls of your arteries can prevent blood from flowing smoothly. This can increase your risk of damage to the arteries which can result in a blood clot and subsequent stroke.
• High cholesterol. This causes a problem when it gets oxidized and gets stuck in the walls of the arteries (called atherosclerosis) which can eventually cause a heart attack.
• Diabetes or impaired blood sugar regulation. High blood sugar can damage nerves and blood vessels, and also feeds the pathway in your liver which keeps your body making cholesterol at a fast pace. 
• Obesity or being overweight, particularly around the middle. Central obesity in particular drastically increases your risk for heart disease and diabetes. Not cool. Weight loss is one of the first-line treatments to reduce your risk by a whole lot! See how your weight measures up here. *Note: if you’re an athlete, the BMI isn’t the best measure of your risk. 
• Excessive alcohol. A couple of drinks here and there is not a bad thing. Ladies, keep it to 10 drinks per week, and gentlemen keep it to 15 per week. Not all in one night - binge drinking is consistently shown to not be a healthy idea. We’re talking about 2 drinks per day maximum. As I’m writing this, a study popped up in my email about exceeding 2 drinks per day doubles your risk for stroke. How’s that for serendipitous timing! Also, never, ever, ever drink and drive, and do not drink if you’re preggers. Just to clarify…
• Couch potatoness (aka physical inactivity). Your heart needs exercise! It’s a pump and is happiest when it’s pumping efficiently! 20-30 minutes each day of physical activity decreases your bad cholesterol, increases your good cholesterol, decreases overall blood pressure, decreases stress, increases happiness, decreases weight… need I go on? 
• Smoking. Increases your risk factors for everything from blood clots to cholesterol plugs to cancer to wrinkles. Everything!
• Stress. Oh this is a doozy because it’s so much easier said than done to ‘stress less’. We’ll chat about strategies for this a bit later. It’s a big topic.

If you’re not sure how these all add up for your individual risk, they here's the HSF's handy dandy calculator for you. How easy is that to take control of your health?!

There certainly are some things that we can’t do much about: genetics and health history are two of them but they certainly aren’t a guarantee. If you have a strong family history of heart disease, there’s lots you can do to change your fate. 


Stay tuned: up next week, we'll go over the best foods for your heart. Hint: they're (unfortunately) not cinnamon hearts.