How to eat your way to cardiovascular wellness

Weight
Carrying too much weight is linked to elevated cholesterol levels and high blood pressure, among other factors that increase the risk of coronary heart disease. An eight-year study of more than 110,000 American women aged 30 to 55, for example, revealed that those who were as little as 5% overweight were 30% more likely than their lean counterparts to develop heart disease. That risk increased to 80% in women who were moderately overweight, while those who were obese were more than 300% more likely to develop heart disease. On the other side of this coin, data show that maintaining an ideal body weight, as compared with being obese, can reduce the risk of coronary disease by 35% to 55%.

The National Institutes of Health recommends using the Body Mass Index (BMI) reproduced on pages 24–25. Find your height and weight on the chart and the corresponding BMI. Then assess your BMI in light of the guidelines on page 26.

BMI                    Condition                     Risk Classification
19 to 24.9        Healthy weight           Desirable
25 to 29.9        Overweight                Borderline high
30 to 39.9        Obese                       High
40 to 54           Very obese                Very high

The link between heart disease and overweight is particularly strong if the excess weight is carried around the middle. Says Dr. William Castelli, former director of the Framingham Heart Study, “People with wide hips and flat bellies may seem overweight, but the extra weight does not seem to increase their cardiac risk as much as that of people with narrow hips and potbellies. Abdominal obesity, which is more a male problem, is predictive of coronary disease.” (See also page 34.)

Striking a balance between calories in and calories out is the key to managing weight. It’s that simple. If you want to lose weight, take in fewer calories and exercise a little more. Some tested principles for managing caloric intake include:

• Don’t diet! Crash dieting is a game for fools. The only thing lost in the long run is money. Smart dietary decisions are based on the question “How do I want to eat for a lifetime?”
• Do not skip meals.
• Do a kitchen makeover. If your refrigerator and cupboard shelves are filled with all kinds of junk food, that’s what you’ll eat. Clean out the high-calorie snacks and restock your kitchen with healthier choices.
• Cut your normal portion size by a third and watch out for supersizing in restaurants.
• Reduce high-calorie foods rich in fat and low-fiber carbohydrates. Eat protein-rich snacks to curb hunger.
• Drink eight glasses of water daily, or other healthy fluids.
  Aim for 60 to 90 minutes of exercise on most days to lose weight, and 30 to 60 minutes to maintain weight loss.

Blood Pressure
Blood pressure is the force needed to move blood through the vascular system against the resistance of artery walls. High blood pressure, or hypertension, occurs when blood pressure exceeds an upper limit for an extended period of time. This condition can take place when arteries become narrow and hardened, often the result of atherosclerosis. Then additional resistance is created, increasing the pressure needed to move blood through the system and making the heart work harder than normal. Over time, this added strain can cause injury to coronary artery walls and result in inflammation. According to the Framingham Heart Study, people with high blood pressure have five times the risk of a heart attack as those with normal blood pressure. Unfortunately, the percentage of people with high blood pressure has been steadily increasing in recent years, particularly in females, African Americans and Mexican Americans.

“The view of blood pressure is changing,” says Dr. Paul Wheaton of Tulane University Health Sciences Center. “Doctors used to consider high blood pressure a disease people either had or did not have. But today we understand that the risk of dying from heart complications caused by high blood pressure is a graded risk. The higher the blood pressure, the higher the risk. The more you can take that pressure down, the more you can get the risk back down.”

Blood pressure is measured when the heart beats (systolic pressure) and then rests (diastolic pressure) and is expressed as two numbers representing millimeters of mercury (mm Hg). A systolic pressure of 120 and a diastolic pressure of 80 are typically expressed as 120/80, or “120 over 80.” “Normal” systolic pressure is below 120; “normal” diastolic pressure is below 80. High blood pressure is defined as any reading above 140/90. In recent years, however, readings between 120/80 and 139/89 have been labeled indications of a condition called prehypertension. The standards below, established by the National Heart, Lung and Blood Institute, reflect the debilitating effect of blood pressure even at lower levels. New science suggests that the risk of heart disease starts to rise with readings as low as 115/75 and doubles for each increase of 20/10.

Blood Pressure Reading
Systolic           Diastolic         Risk Classification
Below 120       Below 80        Optimal
120 to 139      80 to 89         Prehypertension
140 to 159      90 to 99         Stage 1 hypertension
Above 160      Above 100       Stage 2 hypertension

As Americans get older and fatter, the number of adults with high blood pressure has climbed to almost one in three. Fortunately, healthy eating can have a very positive impact on blood pressure.

One study found that overweight people lowered their blood pressure by one point for every kilogram (2.2 pounds) of body weight they were able to lose.

Suggested dietary actions include:

• Use portion control to moderate caloric intake (along with increased physical activity) to shed excess pounds, if necessary.
• Eat less salt and sodium.
• Emphasize potassium-rich foods (such as white beans, tomato paste, yogurt, bananas, apricots, avocados, sweet potatoes, lima beans, tuna, cantaloupe, winter squash and spinach). Cut down on foods low in potassium (such as white bread, doughnuts, soft drinks and junk food).
• Limit alcohol and caffeine.
• Eat foods rich in antioxidants (fruits, vegetables and nuts).

Regular exercise, along with not smoking and stress management, can also help.

Excerpted from “The Road to a Healthy Heart Runs Through the Kitchen” by Joseph C. Piscatella. Copyright © 2005, Joseph C. Piscatella. All rights reserved. Published by Workman Publishing. No part of this excerpt can be used without permission of the publisher.

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