February is National Heart Month , so we’re going to take a short break from talking about runner specific food to talk about eating to prevent heart disease, the number one killer of Americans. I know, as a runner or endurance athlete – you may think, “I’m healthy, I’ll never have to worry about heart disease.” And hopefully that is the case. But, with stats like “1 of every 3 people in America are affected by heart disease,” it’s likely you at least know someone who is at risk for or is already dealing with the consequences of heart disease. If that’s not enough to convince you, heart conditions costs Americans an estimated $44 BILLION in health care and lost economic productivity. That’s a lot of money! By taking part in the fight against heart disease, whether it is changing your habits or encouraging someone else change theirs, you will not only be improving someone’s health and quality of life, but helping to cut unnecessary health care costs that this country faces.
To raise awareness about heart disease and decrease the number of people affected by it, the Centers for Disease Control (CDC)and Centers for Medicare and Medicaid Services (CMMS) have created the Million Hearts Program , with a goal of preventing 1 million heart attacks and strokes over the next 5 years.
While we cannot do anything to control our genetics and some people are more likely to have high cholesterol and blood pressure (2 major risk factors for heart disease), we cancontrol our diet and activity level, both of which play a large role in our risk for heart disease.
The CDC and American Heart Association (AHA) recommend the following 7 steps to reducing your risk for heart disease.
Do not smoke and if you do, get help to quit
Maintain a healthy weight
Eat a healthy diet full of fruits, vegetables, whole grains, lean meats (or other protein), low-fat dairy, legumes, and nuts. Limit foods high in saturated and trans fats; cholesterol; added sugars; and sodium.
Exercise regularly (minimum of 150 minute of moderate or 75 minutes of vigorous activity per week)
Keep blood pressure in control
Maintain healthy blood sugar levels
Did you notice that 6 of the 7 recommendations are related to diet and exercise? As a runner you are already hitting #4 (likely way above it, which is great!). And I hope you are not smoking, but I will leave it at that. If you focus on eating to fuel your body, rather than running to eat whatever you want, you’re probably already eating a relatively heart healthy diet and maintaining a healthy weight along with cholesterol, blood pressure, and blood sugar. If not, a few simple ways to reduce your risk for heart disease with diet is to increase your intake of fruits, vegetables, whole grains (especially oats), beans, nuts, and seeds. Also, choose low-fat dairy and lean protein (see below for more on this).
Not surprisingly, there is a lot of confusion surrounding the topic of dietary fats and it’s relation to heart health so I thought I’d provide some insight into 2 of the questions that I hear most often.
What’s the story with omega-3 fatty acids and why is everyone talking about them?
Omega-3 fatty acids are essential (meaning our body cannot make them so we need to get them from food) polyunsaturated fatty acids (PUFAs) . Omega-3s are found in fatty fish like salmon, tuna, and mackerel, as well as in walnuts, flax seed, and some fortified foods such as eggs. PUFAs may reduce your LDL (bad cholesterol), and therefore reduce your risk of heart disease. It is also thought that Omega-3s can reduce inflammation throughout the body, which can be positive for the heart and blood vessels. They may also improve blood pressure, and some research shows a correlation between Omega-3s and reduced risk of dying from heart disease. Omega-3s also play an important role in brain development and may improve the outcome of other chronic diseases. However, much of the excitement over Omega-3s has stemmed from their relation to heart health.
Another reason they have received so much press is that people who eat Western diet are often deficient in Omega-3s and over consume Omega-6 fatty acids (another type of essential PUFAs found in vegetable oils like soybean and safflower oil, and nuts), leading to an unbalanced ratio of omega-6’s to omega-3s, which may play a role in the progression of heart disease (among other chronic diseases).
Should I eat a low-fat diet to improve heart health?
The American Heart Association recommends that fat make up about 25-35% of your total caloric intake. If you are eating a 2,000-calorie diet, that means 500-700 of your daily calorie intake should come from fat (or 55-77g of fat per day).
The majority of this fat should be from mono and polyunsaturated fats (from plant sources) such as those from olive oil, nuts, seeds, avocados, and fatty fish. What you do want to limit is the amount of saturated fat (animal sources) in your diet which is found in meat and dairy products. Thus, the AHA recommends eating low-fat dairy (such as 1% or skim milk, reduced fat cheese and yogurt), and lean protein (fish, chicken, tofu, beans, etc) and limiting full fat dairy (whole milk) and red meats with high saturated fat. It’s also recommended to avoid all trans fats (usually coming from partially hydrogenated oils). Luckily most food companies and restaurants are removing trans fats from their food, if they haven’t already.
Eating a low-fat diet (one in which fewer than 20% of your calories come from fats) can actually lead to negative health effects. This is because carbohydrates often replace the fat, which can cause blood triglyceride levels to increase, a risk factor for heart disease. In addition, many food companies reduce the fat in products by replacing it with sugar (have you ever noticed that low-fat products like cookies and crackers are often not that much lower in calories?), leading to more added refined sugars to your diet, which can increase blood glucose. Unless your on a long run (where you need straight sugar to fuel your muscles), you want to minimize the amount of added sugars in your diet to keep your blood glucose stable and at a healthy range. High triglyceride levels are associated with higher LDL cholesterol as well. Therefore it’s best to just focus on choosing the right the type of fatrather reducing fat overall. If you do choose a low-fat diet, make sure you’re replacing your fat intake with healthy carbohydrates like fruits, vegetables, beans, and whole grains.
In addition, fat is digested more slowly than carbohydrates, which can help with satiety. Therefore eating some fat is helpful for weight management.
Remember though, fat, whether the good or bad kind, is calorie dense (9 calories per gram vs. 4 calories per gram for carbs and protein). Therefore, for the same amount of calories, you need to eat less volume. So, watch portion sizes. If you’re replacing butter with olive oil when cooking (great, easy switch), don’t forget that even though you’re replacing the saturated fat with health monounsaturated fats, portion size and calorie content still count! Snacking on almonds or other nuts is a great way to up your unsaturated fat intake, but measure out your 1oz portion size before you dig in!
More questions on eating for heart health? Post them in a comment below and I will answer them!
What are you doing to keep your heart happy? Do you include healthy fats in your diet?
(Sarah is a 2nd year grad student pursuing her MS in Nutrition Communication at Tufts University Friedman School in Boston. She is also completing the requirements to become a registered dietitian and will begin her dietetic internship in 2012. Sarah is a certified spin instructor and an avid runner and regularly participates in road races from 5k to a 1/2 marathons. Follow her on Twitter @SpinnerSarah and at her personal blog Food and Fitness Friend .)