Heart Attack (Holistic)

Dietary fat independently affects heart attack risk. The Nurses’ Health Study found that eating foods high in saturated fats (meat and dairy fat) and trans fatty acids (margarine, hydrogenated vegetable oils, and many processed foods containing hydrogenated vegetable oils) was directly associated with many nonfatal heart attacks and deaths from coronary heart disease. Consuming foods high in monounsaturated fat, such as olive oil, and polyunsaturated fat, as found in nuts and most vegetable oils, is linked to a decreased risk. This same study revealed that margarine increased the incidence of heart attack, particularly among women who had eaten margarine consistently for more than a decade. Other studies report a direct association between frequent consumption of meat and butter and heart attack occurrence.

Many doctors tell people trying to reduce their risk of heart disease to avoid all meat, margarine, and other processed foods containing hydrogenated oils and dairy fat. Fish are often suggested instead of meat; nuts instead of snack foods containing hydrogenated oils; olive oil instead of butter; nonfat yogurt, milk, and even cheese instead of full or reduced fat versions of the same foods; and oatmeal instead of eggs for breakfast.

People who eat diets high in alpha-linolenic acid (ALA), which is found in canola and flaxseed oils, have higher blood levels of omega-3 fatty acids than those consuming lower amounts, which may confer some protection against atherosclerosis. In 1994, researchers conducted a study in people with a history of heart disease, using what they called the “Mediterranean” diet. The diet was significantly different from what people from Mediterranean countries actually eat, in that it contained little olive oil. Instead, the diet included a special margarine high in ALA. Those people assigned to the Mediterranean diet had a remarkable 70% reduced risk of dying from heart disease compared with the control group during the first 27 months. Similar results were also confirmed after almost four years. The diet was high in beans and peas, fish, fruit, vegetables, bread, and cereals; and low in meat, dairy fat, and eggs. Although the authors believe that the high ALA content of the diet was partly responsible for the surprising outcome, other aspects of the diet may have been partially or even totally responsible for decreased death rates. Therefore, the success of the Mediterranean diet does not prove that ALA protects against heart disease.

Several trials report that eating fish decreases heart attack deaths and reduces the size of the infarct, though some researchers have not confirmed these findings. The link between fish eating and heart attack prevention is supported by research showing that fish oil supplements help reverse atherosclerosis.

A high-fiber diet, particularly water-soluble fiber (high in oats, psyllium seeds, fruit, vegetables, and legumes), is associated with decreased risk of both fatal and nonfatal heart attacks, probably because these fibers are known to lower cholesterol. However, large trials separately studying men and women who were followed for years, have linked the greatest protection to water-insoluble fiber (from cereals), though scientists have yet to understand why. Until the details are better understood, doctors often recommend increasing intake of fruit, vegetables, beans, oats, and whole grains. In a preliminary study, the total number of deaths from cardiovascular disease was found to be significantly lower among men with high fruit consumption.

Research consistently shows that people who frequently eat nuts have a dramatically reduced risk of heart disease; this could be because nut consumption lowers cholesterol levels. Of nuts commonly consumed, almonds and walnuts may be most effective at lowering cholesterol, and macadamia nuts may be least beneficial.Hazelnuts and pistachio nuts may also help lower cholesterol.

Nuts contain many nutrients that could be responsible for protection against heart disease, including fiber, vitamin E, alpha-linolenic acid (found primarily in walnuts), oleic acid, magnesium, and arginine. Therefore, exactly how nuts lower cholesterol or lower the risk of heart disease remains somewhat unclear. Some doctors even believe that nuts may not be directly protective. Rather, people who eat nuts may not eat as much dairy, eggs, or trans fatty acids from margarine and processed food, the avoidance of which would reduce both cholesterol levels and the risk of heart disease. Nonetheless, the remarkable consistency of research outcomes strongly suggests that nuts directly protect against heart disease. Although nuts are loaded with calories, a recent preliminary study reported that adding hundreds of calories per day from nuts for six months did not increase body weight in humans—an outcome supported by several other reports. Even when increasing nut consumption has led to weight gain, the amount of added weight has been remarkably less than would be expected given the number of calories added to the diet.

Eating a diet high in refined carbohydrates (e.g., white flour, white rice, simple sugars) appears to increase the risk of coronary heart disease, and thus of heart attacks, especially in overweight women.

Preliminary research conducted several decades ago suggested that high sugar consumption increased heart attack risk. Some researchers at that time disagreed and others have subsequently been unable to find a link. Nevertheless, sugar has been associated with reduced HDL (“good”) cholesterol, increased triglycerides, as well as an increase in other risk factors linked to heart attacks. As a result, many doctors recommend that people reduce their intake of sugar despite the fact that high sugar intake leads to only slightly higher risks of heart disease in most reports.

Recent preliminary evidence has implicated salt consumption as a risk factor for heart disease and death from heart disease in overweight people. Among overweight persons, an increase in salt consumption of 2.3 grams per day was associated with a 44% increase in coronary heart disease mortality, a 61% increase in cardiovascular disease mortality, and a 39% increase in mortality from all causes. Blinded, intervention trials are still needed to confirm these preliminary observations.

Making positive dietary changes immediately following a heart attack is likely to decrease the chance of a second heart attack. In one study, individuals began eating more vegetables and fruits, and substituted fish, nuts, and legumes for meat and eggs 24–48 hours after a heart attack. Six weeks later, the diet group had significantly fewer fatal and nonfatal heart attacks than a similar group who did not make these dietary changes. This trend continued for an additional six weeks.

Most studies confirm that light to moderate alcohol consumption (one to three drinks per day) significantly reduces both fatal and nonfatal heart attack risk compared to heavy or no drinking, though a few reports find the link to protection both weak and statistically insignificant. In France, abundant red wine drinking was assumed to be responsible for the country’s remarkably low incidence of heart disease. However, a lower intake of animal fats in the French diet now appears to be the primary reason for what has been called the French paradox. However, as animal fat intake continues to increase in France, a trend that began in the 1970s, researchers now speculate that heart disease and heart attacks will also increase.

Although red wine has been branded best for heart disease in a few reports, all types of alcoholic beverages appear to be beneficial. Whether red wine has a clear advantage over other forms of alcohol remains unclear. Alcohol reduces the risk for heart attacks because it increases HDL (“good”) cholesterol and acts as a blood thinner. High levels of another risk factor for heart attacks, lipoprotein(a), have also been reported to be lowered by drinking alcohol.

Despite this healthful effect, alcohol consumption can cause liver disease (e.g., cirrhosis), cancer, high blood pressure, alcoholism, and, at high intake, even an increased risk of heart attack. As a result, some doctors never recommend alcohol, even for people at risk for heart attack. Nevertheless, because limited intake of alcohol lowers heart attack risk, some people at high risk for heart attack who are not alcoholics, have healthy livers and normal blood pressure, and are not at an especially high risk for cancer, may benefit from light drinking. In fact, since heart disease is the leading cause of death in the United States, and alcohol reduces that risk, most studies report that light drinkers live slightly longer on average than teetotalers. In an analysis of 16 trials, men who drank less than two drinks per day and women who averaged less than one drink per day were likely to slightly outlive those who did not drink at all. In the same report, however, people who drank beyond these moderate levels in men and low levels in women were more likely to die sooner than were nondrinkers. In deciding whether light drinking might do more good than harm, people at high risk for heart attack should consult a doctor.

Drinking five cups of coffee or more per day has been shown to increase the risk of nonfatal heart attack in both men and women. Though many studies find such links, many others do not. Nevertheless, heavy coffee drinking should be avoided. This disparity may result in part from the fact that paper-filtered coffee does not raise cholesterol but percolated, boiled, or French press coffees do. Several recent studies have linked coffee drinking to increased blood levels of homocysteine, another risk factor for heart disease. In this regard, research has yet to absolve paper-filtered coffee, because these studies have not examined separate effects for coffee prepared by different methods.

Dietary fat independently affects heart attack risk. The Nurses’ Health Study found that eating foods high in saturated fats (meat and dairy fat) and trans fatty acids (margarine, hydrogenated vegetable oils, and many processed foods containing hydrogenated vegetable oils) was directly associated with many nonfatal heart attacks and deaths from coronary heart disease. Consuming foods high in monounsaturated fat, such as olive oil, and polyunsaturated fat, as found in nuts and most vegetable oils, is linked to a decreased risk. This same study revealed that margarine increased the incidence of heart attack, particularly among women who had eaten margarine consistently for more than a decade. Other studies report a direct association between frequent consumption of meat and butter and heart attack occurrence.

Many doctors tell people trying to reduce their risk of heart disease to avoid all meat, margarine, and other processed foods containing hydrogenated oils and dairy fat. Fish are often suggested instead of meat; nuts instead of snack foods containing hydrogenated oils; olive oil instead of butter; nonfat yogurt, milk, and even cheese instead of full or reduced fat versions of the same foods; and oatmeal instead of eggs for breakfast.

Eating eggs may increase heart attack risk. People who consume eggs have been reported to be more likely to die from all types of heart disease, including heart attack, in some, although not all, research. Increased oxidation, a state associated with heart attack risk, may be the key. Cooking or exposure to air oxidizes the cholesterol in eggs. Eating eggs enhances LDL (“bad”) cholesterol oxidation, which may in turn contribute to heart attack risk.