Heart Disease Road

Heart disease is the #1 killer in America. There seems to be a cloud of misleading myths circulating around the disease. It used to be the common belief that heart disease was a process of aging; your blood pressure and cholesterol naturally went up as you got older. This is no longer commonly accepted, and personal trainers are in a unique position to help steer clients with risk factors towards healthier lifestyles, which includes a plant-based diet.  

Nowadays, the pervasive myth is that cholesterol accounts for only a minority of the risk and that many people have heart attacks without risk factors. This gives people the impression that there is not much they can do about heart disease prevention. Instead of it being a fact of aging, we accept it as a fact of life.

In this article, we’re going to consider different ways to shift the common perspectives of how blood pressure is impacted by diets, especially “plant-based” and the DASH diet, to better help our clients tackle their dietary and fitness goals. 

Blood Pressure

Whether it’s study-based research or commercials advertising medication to help lower blood pressure, the term hypertension is thrown around a lot. Unless someone is battling high blood pressure, people may not understand that hypertension and blood pressure mean the same but that hypertension is defined as having 140/90 mmHg reading or higher. Hypertension is indeed a risk factor for heart disease.

Healthy blood pressure is 120/80 or lower. This is the magic number those battling high blood pressure are trying to reach.

In order to help our clients get there, we first have to consider how people have a rise in blood pressure if diet and exercise are the keys to lowering it.  

Let’s take a moment to consider the Paleo diet, a popular diet based on the types of foods presumed to have been consumed by early humans. It mainly consists of meat, fish, vegetables, and fruit. It excludes dairy, grain, and processed foods. This is not a diet generally recommended to someone managing hypertension/high blood pressure.

A study published in the European Journal of Clinical Nutrition indicated that the Paleo diet increased TMAO (Trimethylamine N-oxide: small colorless amine oxide generated by choline, betaine, and carnitine by gut microbial metabolism) levels which are associated with heart disease. The paleo subjects had an increase in cholesterol, fat, and saturated fats which increased the amount of gut bacteria species linked to heart disease and inflammation.

This study on the Paleo diet does include vegetables and fruits. However, if the subjects were consuming higher quantities of fruits & vegetables it would likely balance out the gut bacteria. A more plant-based Paleo diet approach may actually reduce the increased heart disease risk observed in this study.

Understanding “Plant-Based”

Today the term “plant-based” is used indiscriminately to explain healthier eating or a healthy lifestyle as a whole where vegetable consumption is central. The general public might assume that when we talk about plant-based diets we are trying to convince them that they should consider being a vegetarian or vegan.

In actuality, “plant-based” simply refers to decreasing the consumption of meat and while increasing the consumption of fruits, vegetables, whole grains, and legumes. It’s up to the consumer to determine how a plant-based diet looks for them. This is intuitive eating at it’s best. 

Those struggling with hypertension/high blood pressure, high cholesterol, heart disease, or Type 2 diabetes do not need to feel limited in their diet but find abundance in what specifically works for them. They can find so many fruits, vegetables, and whole grains available to suit their taste buds. Increasing the portions and/or portion size of their fruits, vegetables, and whole grains while decreasing that of meat can have a measurable impact at varying degrees.

Any movement on the scale of plant-based eating will increase health by lowering the risks of heart disease through decreasing hypertension/high blood pressure and high cholesterol. There are studies that demonstrate the benefits of a vegetarian diet vs. a vegan diet but, again, it’s up to the consumer to define what is best for them. 

Studies on Plant-Based Diets

There are studies dating back to the 1920s that report a correlation between the rise in blood pressure with an increase in the consumption of meat and dairy. There is also data collected from studies on rural populations in Africa and China which consumed a plant-based diet. These rural populations had virtually no incidences of high blood pressure and no cases of heart disease. These are not the only places in the world where this occurs.

Blue Zones®, founded by Dan Buetter, discovered there are five (5) regions in the world where people live the longest and healthiest by avoiding junk foods and eating fruits, vegetables, and whole grains.

These Blue Zones are:

  1. Okinawa, Japan
  2. Sardinia, Italy
  3. Nicoya, Costa Rica
  4. Ikaria, Greece
  5. Loma Linda, California

A study published in the Journal of the American Heart Association compared four dietary patterns among middle-aged adults and tracked mortality rates. Results indicated that healthful, plant-based diets (meaning high in nutrient-dense plant foods & low in refined carbs) and animal foods were associated with a lower risk of cardiovascular disease and mortality. 

In another study of 89,000 people managing hypertension; it was found that those who ate a meat-free diet lowered their blood pressure by 55% but those who ate a meat-free, dairy-free, egg-free diet lowered their blood pressure by 75%. 

In addition, eating a strictly plant-based diet provided additional protection against cardiovascular disease, some cancers, obesity, hypertension, Type 2 diabetes, and cardiovascular mortality.

A study published in Nutrition, researchers in Montreal, Canada asked at-risk participants from a 12-week nutrition education program to increase their consumption of plant-based foods and tracked the dietary effects on cardiovascular disease. The participants lost an average of 10.5 lbs, reduced their waist circumference, and lowered their LDL.

None of these studies is a mandate to the public that they must be vegan or vegetarian to be healthy. They simply point out that the more fruits, vegetables, and whole grains consumed and the less meat and dairy in the diet the better chance they have of lowering their blood pressure and reduce their risk of heart disease. 

Medication and High Blood Pressure

An INTERHEART study showed that diet, exercise, and smoking accounted for more than 90% of the proportion of the risk of having a heart attack. Men who made healthy lifestyle changes over time reduced their risk of a heart attack by 90% while women who made healthy lifestyle changes over time reduced their risk of heart attack by 92%.

If someone is only using medication to manage their risk of heart disease, they’re only reducing the risk by 20%-30%. Harvard Health Professionals follow-up study reported that those on medication and making healthy lifestyle adjustments further decreased their risk of suffering a heart attack by 78%.

The decision to decrease the use of medication in managing hypertension/high blood pressure is a very personal decision that should be monitored by a physician along with working with fitness and nutrition coaches to help achieve that goal. 

The DASH Diet

The DASH diet stands for Dietary Approaches to Stop Hypertension. It was designed by the American Heart Association to help people lower their blood pressure/hypertension through a diet that utilizes the benefits of a vegetarian diet but allow for the consumption of some meat and dairy. 

The American Heart Association’s term for why they allow for the consumption of meat and dairy is palatability. They felt that the general public would not be willing to accept a vegetarian diet without specifically allowing for some meat & dairy consumption. 

For purposes of this article, discussing the specific risks of dairy consumption will be left for another entry. Suffice it to say, dairy is included in the DASH diet again because of palatability and to supply additional calcium and protein. 

However, dairy products are not easily digested and are the leading source of saturated fat in the diet. Late in childhood or early adulthood, most people lose the enzymes (lactase) that digest the lactose sugar in milk and other dairy products. This is why we have the term lactose-intolerant. It is not a disease but a human condition. 

Fitness and Nutrition Coaches

The ideal health and wellness of an individual will vary from person to person. Although people may struggle with similar circumstances, they may be different in how they choose to manage those circumstances and why. 

Our clients who come to us needing help in managing their hypertension, high blood pressure, high cholesterol, or type 2 diabetes come to us for specialized guidance. They are usually well aware of their need to exercise and eat right, but are trying to determine what the exercise and dietary plan should look like for them. 

There is a huge benefit to helping our at-risk clients eat plant-based diets. Whether it’s utilizing the DASH diet or helping them design a plant-based diet based on their unique needs. Food serves more of a purpose than just sustenance. We rely on food for comfort and routine, for communing and celebrating. When a complete overhaul is called for to improve health it may feel like your client’s whole world is turned upside down, and for a second time after receiving their diagnosis. 

This is not an easy journey for them. Introduce them to the multitude of tasty food options available to them, and ways to exercise that they find enjoyable. Our work is to shift their mindset from one of scarcity and fear to one of abundance and happiness through adopting a healthy lifestyle. 

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References:

www.nutritionfacts.org/video/how-not-to-die-from-high-blood-pressure

www.nutritionfacts.org/video/the-weight-loss-program-that-got-better-with-time

www.bluezones.com/about/history/

https://www.ahajournals.org/doi/pdf/10.1161/JAHA.119.012865

https://www.pcrm.org/news/health-nutrition/paleo-diet-increases-risk-heart-disease

https://www.pcrm.org/news/news-releases/doctors-group-tells-dietary-guidelines-advisory-committee-ditch-dairy