February is American Heart Month, a reminder for all of us to focus on cardiovascular health. Professor and Ruby Winslow Linn Endowed Chair of the Simmons' Nutrition Department Elizabeth Metallinos-Katsaras shares what specific nutritional and lifestyle modifications can help people, and especially women, who are at risk for heart disease and other related comorbidities.
Heart disease, which may manifest in the form of arrhythmia, stroke, heart failure, heart attack, or other serious conditions, is dangerous and startlingly prevalent. As Dr. M-K says, "cardiovascular disease is the number one cause of death for most women in the United States, followed by cancer."
Dr. M-K explains that in addition to race, ethnicity, culture, genetics, and socioeconomic factors all play a role in people's susceptibility to serious heart conditions. For instance, African American women and White women are at higher risk than Asian, Pacific Islander, and Latinx women. However, "only about 56% of women recognize they have risk factors," she notes. Older, postmenopausal women are especially vulnerable.
In general, people with a lower socioeconomic status will have less access to good healthcare, preventative screenings, and healthy food. Dr. M-K draws attention to cultural factors that may interfere with quality healthcare. "Non-White populations don't often have providers from their same culture," she explains. "I am of Greek descent, and I know older Greek women who speak mostly Greek, and they are much more comfortable with a Greek provider. This way, they share more information, and the providers can give them more culturally appropriate care."
Patients with high blood pressure, high LDL cholesterol, and those who smoke are especially at risk for adverse cardiovascular events. However, good nutrition can help manage some of these issues. Maintaining a healthy weight is also vital for heart health.
"By having a high weight, I am referring specifically to the presence of high adipose tissue, or body fat," says Dr. M-K. "In other words, if you are a muscular athlete with a high BMI, that is fine. But people need to be careful of carrying too much body fat. If a person is overweight in terms of fat content and adipose tissue, the risk of heart disease, high blood pressure, and diabetes all go up."
Dr. M-K is a proponent of the Mediterranean diet, which draws inspiration from the cuisines of Greece, Italy, and other surrounding regions. This diet is rich in plant-based foods, lean proteins, healthy fats, and whole grains. "The Mediterranean diet has a lot of research behind it, and it is associated with a lower risk of a number of diseases, including heart disease and cancer," she explains. "Fruits and vegetables have an anti-inflammatory effect on your body. This effect can help prevent the development of plaque in your vessels." While she does not necessarily advocate vegetarian or vegan regimens, she recommends that people begin by eating one additional vegetable and fruit per day.
Certain fats and protein sources are also beneficial, such as nuts, fish, leaner meats, and poultry. By contrast, saturated fats will increase cholesterol for many people, especially if they have a family history of high cholesterol. Dr. M-K advises us to avoid processed meats, excess sugar, and excess sodium; the latter two are high in processed foods in general. Whole grains also promote heart health.
Dr. M-K warns her students of the dubious claims of fad diets. "While these diets might promote short-term weight loss, they are not sustainable or healthy in the long-term. For instance, the Atkins and Ketogenic diets are deficient in many vitamins and minerals," she explains. "When we teach our introductory nutrition class, we try to teach our students to recognize quackery and misinformation, including the promotion of supplements. When you see that someone is making money off of a claim, that should be a red flag right there," she says.
She is also an advocate of movement and exercise. The American Heart Association recommends 150 minutes of moderate physical activity per week, or 75 minutes of vigorous physical activity per week. "The key here is to find something you like and that makes you happy. If you find something you love, then exercise is not a chore, and it can actually improve your mood as well," she advises, also warning against a sedentary lifestyle. "Movement makes your heart stronger and your muscles stronger. It's just so good for you, and many scientists believe that physical activity is at least as important as a healthy diet."
Education is key, and women should take sudden, unexplained symptoms seriously. Some women may experience severe gastrointestinal symptoms, rather than classic chest pain, before a heart attack. "If you have any severe symptoms, go to the emergency room," she recommends.
Dr. M-K teaches her students that many health complications, including cardiovascular disease, are "multi-factorial." As she explains, "there can be many causes of a disease, and this complicates things. But with healthy diet and exercise, people can prevent heart disease before they develop hypertension and high cholesterol. Prevention is essential: adopting lifestyle modifications can be very helpful in promoting heart health and overall longevity."