Diets For Heart Disease and Diabetes

Best Diet for Heart Health, Heart Disease and Diabetes

Top NJ Cardiologist: A Vegan Diet is good for heart disease patients 

In this article, we will discuss:

• Is a plant-based diet good for heart disease patients?
• Do vegans get heart disease?
• Can plant-based diets reverse clogged arteries?
• Will a vegan diet reverse heart disease?
• Do cardiologists recommend a vegan diet?
• What diet do cardiologists recommend?

UNHEALTHY DIETS FOR HEART DISEASE PATIENTS

• Diabetic diet: What is a diabetic diet?
• Diabetes and Heart Disease: What is the best diet for diabetics?
• Best diet after heart attack and stents

Diet after Heart Attack: Best diet for heart disease and diabetes

Diet plan for someone with heart disease

Try to avoid bad fat, unnecessary fat, unnecessary carbs and sugars. I don’t recommend a no carb diet. Either go with a low sugar, low carb diet or you can go with a low-fat diet.

They both work well and improve your strength, stamina, and energy levels. It improves cholesterol levels as well as weight reduction. Those are the diets that I typically recommend to my cardiovascular patients with a history of heart disease.

Post heart attack diet

• Avoid having fat, especially saturated fat.
• Excess of carbs and excess of sugar is bad for everyone.

[READ]: 15 diabetes apps to manage your health

Is the keto diet good for heart disease patients?

The keto diet is something new. The jury is still out on seeing how much long-term benefit we are going to see from this. It is a tough diet to stick to. Many people try it but then they give up on it because it is difficult to stick to.

How much of an effect does exercise have on preventing diet related ailments such as heart disease and type 2 diabetes?

There are multiple studies showing the benefits of exercise in reducing heart disease and type 2 diabetes by up to 30%, but in most of those studies, the subjects who were exercising were also eating ‘healthy.’ Often, exercise alone leads to high energy expenditure and calorie loss, but people can consume a lot of those calories back by eating junk in a brief time span.

For example, a lot of the benefit of 45 minutes of high-intensity exercise is lost with just two sugary sodas.

Whereas studies have shown that a proper diet is more (approximately 75%) responsible for weight-loss compared to exercise, there are certainly other benefits of exercise that outweighs one’s weight. There have been a number of studies looking at ‘Fitness’ vs. “Fatness’ and a recent meta-analysis of all these studies have concluded that compared to normal weight -fit individual, unfit individuals had twice the risk of mortality regardless of their weights (BMI). Overweight and obese-fit individuals had the same risk of mortality as normal weight fit individuals.

As far as cardiac disease and lifespan is compared, it is better to be ‘fat and fit’ than unfit with any weight. 

It’s the combination of ‘good habits’ (preferably – great habits!) including moderate exercise of at least 30 minutes/day, healthy diet (along with reducing stress in life and avoiding smoking) has shown 75-80 percent lower risk of developing any chronic disease, including a 93 percent lower risk of getting type 2 Diabetes, an 81 percent reduced risk of a heart attack, a 50 percent lower risk of a stroke and a 36 percent reduction in all forms of cancer.

Are there diet changes patients can make to decrease their risk of heart disease or stroke?

Change in diet is the key factor along with regular exercise and proper attention to sleep. Mindfulness and meditation are also known to decrease the risk of heart disease and stroke.

Knowing that food is healthy is only one part of being healthy. It first requires a commitment to being healthy. Once you’re committed – you need not only cognitive but emotional mastery over this – so you form healthy habits and associations and take pride in making those choices. This includes regular exercise, avoiding inflammatory, processed food and going for healthier options, especially if you have type two diabetes.

Diets for lowering your cholesterol

Diet is a tricky thing, especially for a heart disease patient. It is one of those controversial subjects because so much has been done and yet so much more needs to be done.

As far as cardiovascular disease goes, there’s only one diet which has shown true improvement in cardiovascular outcomes, which is the Mediterranean diet. It is high in good cholesterol. It has a lot of nuts and olive oil.

Every other type of diet is probably good, but the commonly recommended diets are low fat diet, low cholesterol diet, low sugar diet, keto diet. All of those diets have a lot of proponents of these different types of diets.

Unfortunately, none of them have demonstrated long-term benefits for cardiovascular disease. There is no particular diet except for the Mediterranean diet, which has shown that the future risk of heart attack or stroke is reduced.

There are other benefits that specific heart healthy diets have such as weight reduction. Certain diets will lower your cholesterol, which hopefully will translate into reducing heart attack and stroke. As far as diet goes, we know that it is important to stick to something.

Heart Disease and Inflammation

When working with patients who have heart disease or are at risk for heart disease and stroke, you want to pay close attention to diet. Is inflammation the real cause of heart attacks?

A recent study showed that avoiding inflammatory foods can lower risk for heart disease and stroke.

People with unhealthy dietary habits, including inflammatory food, are at a much higher risk of heart disease and stroke. In clinical practice, we see a pattern. Some people who have not developed healthy habits and have not paid attention to their diet and nutrition.

Unfortunately, these are often the same group of people who also don’t exercise and have poorly controlled blood pressure, cholesterol and diabetes profiles, which puts them at risk of heart disease and stroke.

Poor diet habits compound their risk of heart attack and stroke by not only direct impact on the vascular endothelium (inner lining of blood vessels that get inflamed) but also higher risk of diabetes and cholesterol.

Have you encountered at-risk patients who have changed their diet to eliminate inflammatory foods and have successfully improved their blood profile and cardiac test results?

Once someone (typically an at-risk patient) decides to focus on their health, they can work on changing their diet, reduce inflammatory food etc. This has been shown to improve their blood profile by improving LDL and triglyceride levels (bad lipids) and also by controlling their blood pressure.

Once people choose to have a healthy lifestyle by better (less inflammatory) diet and exercise, we see tremendous results on their cardiac tests showing a reduction in plaque content.

There are many studies that show that a healthy lifestyle causes reduction in atherosclerosis (plaque building) confirmed via Carotid Intima media thickness (CIMT) and coronary calcium score (Coronary CT scan) – which are surrogates for overall atherosclerosis (plaque building) burden.

Which foods are inflammatory?

Processed foods are very inflammatory. Red meat and anything with refined sugar tends to be very inflammatory. A lot of beverages with sugar also tend to be very inflammatory.

Does adding anti-inflammatory foods to the diet help to improve risk levels? 

Adding anti-inflammatory food helps improve risk levels. Antioxidants like berries, green tea are great. There are other sources like chili peppers, turmeric with curcumin and cocoa can be great too. Also, food with long-chain omega-3 fatty acids EPA, DHA like fatty fish can be very healthy. Overall, the Mediterranean diet is considered to be the best cardiovascular diet due to food high in the above content.

PLANT-BASED DIETS

• Vegan diet heart disease reversal
• Is a vegan diet good for heart disease?

NJ Cardiologist shares why new study is a myth and the #1 reason you should keep eating plant-based foods

There has been a lot of controversy about what is a better diet – a “vegetarian/vegan diet” vs. a predominantly meat-based diet. Intuitively, most people would think that the plant-based vegetarian diet is better for cardiovascular health, but lately, there have been some publications and news articles talking about how a plant-based diet could lead to a higher risk of stroke.

This comes from one research study that was performed at Oxford University, where they looked at 48,000 patients in an ‘observational’ fashion. They followed these patients and looked at those with vegetarian diets (not plant-based diets) vs. fish and meat-based diets and what they found was that people who had vegetarian diets were ‘associated’ with a significantly lower risk of ischemic heart disease (cardiac blockages) but it was also associated with a higher risk of stroke.

Overall, for every 1,000 patients who followed a vegetarian diet, on average, 10 would have a lower risk of heart attacks, but 3 would have a higher risk of stroke. This information has now been extrapolated into some news media – thinking that ‘vegetarian’ (and later extrapolated to saying ‘plant-based’ diet) is not that safe.

I have several issues with this. When we look at the study, they are talking about ‘hemorrhagic stroke’ (a stroke caused by bleeding in the brain) that is truly driving this higher association; but not stroke related to blockages (ischemic).

When you combine total cardiovascular risks (heart attacks, strokes combined), vegetarian diets were still associated with lower risks. But this is just the tip of the iceberg in terms of flaws with the fundamental extrapolation being made about the diets.

They collected patients for the study between 1993 to 2001 who said they were vegetarian and followed them over 18 years and later published the study in July 2019. It is important to note that the ‘vegetarian’ diet has significantly changed over many years. There are vegetarian diets that are not that healthy.

Second, there are multiple factors that could play a role in the risk of stroke etc., namely high blood pressure, diabetes, high cholesterol etc. and there’s no objective measurement of these other risk factors between the groups in this study, but rather they relied only on subjective information provided by the people in the study.

However, there is no obvious confirmed theory why this would be the case. The only known deficiency most vegetarians may have is vitamin B12, but vitamin B12 deficiency is never proven to increase risks of intracranial bleeding.

This stems from the limitation of an observational study since an observational study can only point towards ‘association’ and not ‘causation’ and we know that ‘association is not causation’.

Time and time again in medicine, we have seen that there are observations showing one thing, but when we look at the purest form of research called randomized controlled trial (RCT), those ‘associations’ don’t stand the test of the RCT’s.

The biggest example of this is ‘Hormone Replacement therapy’ (HRT). In the early 2000s, HRT was routinely recommended in postmenopausal women based on observational study evidence. But in 2002, the results of a randomized controlled trial on more than 1600 women in menopause, assigned to HRT vs. placebo, showed that HRT led to increased risk of coronary disease, mammary tumor, blood clots and strokes.

These discrepancies can be explained considering that several confounding factors like exercise, smoking, education or income – in fact correlated to the outcome – were not included in the observational studies.

Plant Based Diets and Heart Disease

Is a vegan diet good for heart disease?

We know that the Mediterranean diet has the best cardiovascular health benefits. It is the only diet that is what we call randomized control data supporting that it actually helps with it. Everything else has a benefit in terms of weight loss. We know on animal models that the plant-based diet has significant results that cause less atherosclerosis.

A lot of people recommend a vegan diet because of that. Lately, there has been a bit of controversy around it. They looked at in the United Kingdom and there were marginally higher incidences of stroke in people who are vegetarian and vegan, which created a big uproar.

But then you have to look at the results and the statistics and studies and it turned out, it’s what we call association and not causation. It’s just like one of those random statistical outliers that came out. As far as cardiac health is concerned, that diet was better. That’s why diet is one of those things that continues to change.

Does the Mediterranean diet include fish? Or is it mostly just straight vegetarian?

Fish, poultry, beans, eggs are all part of the Mediterranean diet. Whole grains, vegetables, fruits. A moderate portion of dairy products. There are not a lot of dairy products in the Mediterranean diet and a limited intake of red meat.

Should you stop eating plant-based diets?

There is no need to stop eating a plant-based diet. Until a true randomized controlled trial is run comparing various diets, it is not wise to extrapolate the results of the said recent study.  I tell my patients to eat healthy no matter what. There are plenty of benefits of plant-based diets and there is no proven risk of stroke associated with plant-based diets.

As Mark Twain said, “There are three kinds of lies: lies, damned lies, and statistics.”

Whenever I look at statistics and the poor inference for popular media – it reminds me of how important it is to look at data and properly interpret it.

I wouldn’t jump to throw away your plant-based diet for steak quite yet.

Our ever-increasing rate of obesity in the United States continues to increase. Here is how we combat it.  

Obesity leads to many cardiovascular issues because it is an underlying root problem. If you trace that back, there is a large genetic component.

There is a famous saying that genes run in the family. So do recipes! 

People will say, my parents used to be overweight and my grandparents used to be overweight, so I’m overweight too.

Sure. But they also probably made some mistakes.

• They had a certain kind of diet.
• They didn’t exercise.
• They ignored it.

Those are the things you can change. Paying attention to your diet and living a healthy lifestyle with frequent exercise is very important.

PREVENTING HEART DISEASE: CHANGE HAS TO BE MADE

It should be stylish and sexy to eat healthy and be healthy. That should be mainstream conversation.

When we talk about access to health care and the disparities in access to health care, a large portion of that is also access to healthy food. At the government policy level, change has to be made. At the industry level, the food industry has to own up to it. These conversations have to become mainstream.

It’s shocking that even now, if somebody wants to be healthy and have a salad for lunch, it would cost them fifteen dollars to get a salad versus a Mac burger for two dollars. The food industry is playing a big role in the obesity epidemic in the US. 

Diet itself is not a diet. Diet is your culture.

Culturally, you are raised in a particular way. If we want to change people’s diets and the population, first we have to collectively act and change the deep-rooted cultural beliefs around diet, recipes and food. We have to change the way people and families are raised and what family values are specifically as it pertains to diet.

The government and regulation agencies have to come and make a change because healthier food traditionally is more expensive. The fundamental shift has to come in until the food becomes cheaper, the healthier food, the salads, not costing you 15 dollars. You can’t change that. Instead, you can change your mentality and say, “You know what, I am committed to my health, even if it means I’m going to have $15 for lunch every day. That’s okay.” That’s where the integration comes in.

Your belief system has to change. You have to be committed to being healthy.

Can an Unhealthy Diet Catch Up to You If You Work Out? 

Yes. A healthy diet, regular exercise and stress reduction are the three pillars of a more robust, longer life.  Balancing all three are essential for wellness and dare I say, a more fulfilled life. Maintaining fitness is vital and has benefits beyond one’s weight, but having an unhealthy diet can lead to serious issues, even if a person works out regularly.

A diet that is high in sugar and bad fat can lead to plaque building in various arteries in the body and can lead to a chronic inflammatory state. At some point, the damage from this will catch up, leading to reducing one’s ability to exercise and by causing actual physical limitations to exercise.

How much does your diet matter if you exercise often? Can you outrun a poor diet?

Diet does matter and it’s difficult to outrun a bad diet because it’s the combination of exercise and proper diet which has been demonstrated to show all the benefits. A sedentary lifestyle increases chronic inflammation and hence exercise reduces the risks of chronic inflammation, leading to the benefits in cutting premature death rates by 20-30% and adding an additional 3 to 10 years in people’s life spans when compared to a controlled group who didn’t exercise.

The typical American diet high in animal protein, sugar and bad fat can lead to increased production of interleukin (blood chemicals that promote chronic inflammatory state). Therefore, it’s unlikely that one can simply outrun a poor diet.

ZIP CODE HEALTH

“Awareness is important regardless of where you live in America.”

Your zip code determines more than your genetic code. Where you live plays a huge role in your health care treatment. There are certain parts of this country where I think it comes down to everything but access to health care. I have an office in Irvington, New Jersey. These are very urban areas and good luck trying to find a healthy meal if you live there and you want to get a healthy meal.

It’s so difficult to find healthy options versus if you live in the West Village in Manhattan and you want to find a healthy meal there, every corner has seven options. Where you live plays a big role in access to health care and healthy meal choices.

Creating Healthy Habits Through Diet, Discipline, and Exercise

Diet is one of those things that is always changing. What we thought was perfect 20 years ago we cringe at today. People used to think, no carb diet and then no fat diet, and then no sugar diet came and then keto diet became hot. It’s very difficult because what we have to look at is not short term, a lot of things in the short term immediately give tremendous, beautiful, great results, and especially weight loss.

Focus on what is going to build a healthy habit because you can go from zero to 60 to 200 very quickly and lose a lot of weight. Unfortunately, I’ve seen so many people that gain that weight back.

Do not go on a health sprint. Health is not a sprint, it’s a marathon.

Look at something that brings great long-term health results. This is where science is still struggling to find out what was one of the most perfect, greatest diet, and what is something that people can stick with? That requires motivation, but that also requires your palette to be trained.

• What do you actually believe in?
• What are your values you believe in?
• Vegan diet or not?
• Plant-based diet or not?

Something that is long-term that can give you long-term health benefits.

Creating Healthy Habits Through Diet, Discipline, and Exercise

Everything in moderation

“A filet itself is not bad, it’s the side dishes like the potatoes and the extra butter that will go on that you have to worry about.”

Best Food For Heart Attack Patients:

If somebody is disciplined enough they have their one cheat day. I have a lot of patients with open heart surgery that come to me for follow up and love seeing me because I take a prescription pad I write down, “Cheat day number one in 30 days” and they love it. If you allow them to have a cheat day once a month and I give them a prescription for that. I also give a prescription of smiles and hugs and they just love it.

Heart Heathy Food List & Foods To Avoid With Heart Disease:

If you’re hypertensive, your blood pressure is running high. Your cheat day cannot be like something super salty, like Chinese food. Then your pressure is going to go up.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Healthy eating. Eat smart. Healthy food for your heart.

Apex can help you with managing your diabetes. Prevent and reverse heart disease. Need a custom plan for a diet to reverse heart disease? We can help you create the best diet for heart disease and diabetes meal plans. If you have Peripheral Artery Disease we can create a custom Heart Healthy Diet for you.

 

RESOURCES:

Plant‐Based Diets Are Associated with a Lower Risk of Incident Cardiovascular Disease, Cardiovascular Disease Mortality, and All‐Cause Mortality in a General Population of Middle‐Aged Adults

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

Studies published recently in the Journal of the American Heart Association and JAMA Internal Medicine found that diets high in plant-based foods can decrease your risk of dying of heart attack, stroke, or heart failure by 32 percent, and developing type 2 diabetes by 30 percent.

 

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