I'm back with more provocative statistics. It's actually surprisingly hard to get a handle on just how many deaths happen due to heart disease here in Canada. If we estimate based on what data they do provide, it's still so shocking just thinking that it's killing roughly 12 Canadians every hour, meaning roughly 288 people every day, meaning roughly 105,120 people will die of this preventable disease every year (source Canada.ca).
In the US, they blatantly tell you that someone is dying every 36 seconds from this preventable disease. That's roughly 655,000 every year, or 1 in 4 Americans that will die of this preventable disease. Not only that, but roughly every 40 seconds someone in the United States has a heart attack (whether they know it or not, as 1 in 5 are silent) (source: cdc.gov).
In his book, "How Not to Die", Dr. Michael Greger wittingly opens the chapter on heart disease by asking what would happen if a terrorist organization released a biological weapon that killed thousands of people in a matter of days. There would be no end to the work to stop the spread of this disease, stop the terrorists, and prevent deaths. Sound familiar?
Think about the worldwide response to Covid-19. Every day, the news covers the death toll from Covid-19 here in Canada. As of today, the stats sit around 22,300 deaths from Covid-19 in all of Canada over the last year. The United States sit around 528,000 today. That is rapidly approaching the death rate for cardiovascular disease (655,000), but though I hate to say it, most people who die of covid-19 have some sort of comorbidity like heart disease that already had them at risk for death. In Alberta alone, it's roughly 85% of Covid-19 deaths where hypertension was a comorbidity and 53% of deaths where cardiovascular disease was one.
These numbers are so horrifying and yet we've become numb to them, haven't we? Who hasn't heard that heart disease is the number 1 killer in America, number 2 in Canada? Who doesn't know someone who has unfortunately died too early of a heart attack (my grandpa), stroke, heart failure, or other condition made more severe in those with heart disease (Covid-19).
Well, I'm not numb. I am so very deeply saddened that so much death is occurring from heart disease when we know how to treat and even reverse this condition. Aren't you?
What's even more saddening is the way modern medicine goes about treatment for this disease. It's all "here's another prescription" and "oh, by the way, maybe try eating less beef and more chicken and fish". Medical schools are recommended to implement 25 hours of nutrition, but few schools meet this requirement, and very few doctors learn how to translate this knowledge into practical steps to help their patients. Sadly, your doctor may be getting his nutrition education from the same checkout aisle magazines where your diet-crazed Aunt Betty is getting hers.
Why is it so important that doctors get a better understanding of nutrition? Because aside from accidents and suicide, nutrition has a major role in all of our top killers in North America, from heart disease to cancer to Alzheimer's to even pneumonia. Don't even get me started on how much proper nutrition can help protect you from severe Covid-19 infections.
Back to heart disease, what is it? And how does nutrition impact this deadly assassin of the North American population?
Coronary artery disease, responsible for heart attacks, is caused by a buildup of fatty plaque, which inserts itself in the lining of your coronary (heart) arteries. The cholesterol-rich junk builds up over years, slowly restricting the pathway for blood. Eventually, some of the plaque may break loose and cause blockages in these areas of restricted flow and cause circulation (and especially oxygen) to be cut off from your heart. These blockages may be happening all over your body causing damage to your peripheral vascular system or lungs (deep vein thrombosis or pulmonary embolism), or your brain (stroke). Some people have this damage happening and don't even know it (ever heard of a silent heart attack?). Others have issues like impotence or varicose veins and think it has nothing to do with their cardiovascular health... but oh how they are wrong.
What causes these plaque's to form? According to one Dr. Roberts of the American Journal of Cardiology, "It's the Cholesterol, Stupid!". There are entire populations around the world where cardiovascular disease is nearly non-existent. What do they have in common? Extremely low blood cholesterol levels.
The recommended cholesterol levels in the United States are under 200 mg/dL of total cholesterol, which equates to <100 mg/dL of "bad" LDL cholesterol. However, these guidelines are not actually protective against heart disease. If you want to protect against heart disease, it's better if you aim for <70 mg/dL LDL, which equates to <150 mg/dL of total cholesterol (source: How Not to Die).
What raises our cholesterol level?
#1: Dietary Cholesterol found in foods like eggs, cheese, poultry, and other meat. Only foods of animal origin contain cholesterol as it is produced by these living organisms as a normal part of their body functioning. However, our body produces just the right amount of cholesterol for our own functioning, and therefore any excess from these foods just damages our bodies. Wondering if plant-foods contain cholesterol? They have their own version called phytosterols, which help human bodies by actually binding to cholesterol receptors and preventing them from being absorbed.
#2: Saturated Fat: the mechanism may not be as clear, but the link is crystal. Saturated fat in our diets may lead to fat buildup in the liver, which prevents cholesterol from being handled as it should. Our bodies are naturally trying to heal themselves on a daily basis. There is a type of cholesterol called HDL whose sole job is to go and clear cholesterol from places it shouldn't be. It brings it back to the liver, which then has mechanisms to dump the excess cholesterol into our GI tract. Hopefully, there is a lot of fiber in the gut to bind that cholesterol and keep it from being reabsorbed. A lack of fiber may lead to that cholesterol just being reabsorbed and sent back to the liver. What foods have saturated fat? Foods of animal origin like dairy, eggs, and meat, along with processed foods, fried foods, and solid plant oils like coconut and palm.
#3: Sugar: Sugar can raise your cholesterol by causing more LDL to be synthesized, lowering your HDL, and raising triglycerides. Excess sugar leads to excess weight and insulin resistance which are also risk factors for heart disease. What foods have sugar in them? Well, you probably don't need my help with that one, but some of the tricker to identify foods rich in refined sugar are whole wheat or brown bread, yogurt, granola bars, coffee drinks, salad dressing, canned fruit, ready-to-eat cereal, flavored oatmeal, iced tea, peanut butter, condiments, and pasta sauce (source: Cleveland Clinic)
What lowers our cholesterol level, and our overall risk for heart disease?
In my own words, "It's the Fiber, Stupid!"
Fiber is key to reducing the amount of cholesterol we have circulating through our bodies, especially soluble fiber. Soluble fiber is the kind that forms a gel-like substance which acts as a sponge for cholesterol. It soaks it up in the GI tract and out it comes without ever interacting with your blood. This is a primary method for you to prevent dietary cholesterol from being absorbed, but also help your body by binding the excess cholesterol sent to the GI tract by the liver.
Foods with soluble fiber: oats (maybe you should try my chocolate blueberry oatmeal?), barley, beans, lentils, chia, other nuts and seeds, citrus fruit, strawberries, and several type of vegetables.
It's important to note the value of insoluble fiber here too. Roughage from plants, aka the parts of fiber that provide structure to the plants, acts as a broom that keeps things moving through the GI tract. The faster it moves through, the less likely things like fat and cholesterol will be absorbed, especially if they are bound by soluble fiber.
"It's Also the Plants, Stupid!"
Plants are naturally low in cholesterol (remember they even have phytosterols which are beneficial), saturated fat, sugar, and sometimes overall calories (except the nuts and avocados mind you). Not only that, but they have phytochemicals, vitamins, and minerals that aid your body in naturally healing/protecting itself from disease.
Phytochemicals definitely deserve their own article, but here are a few of the highlights as to how they may help you stay protected from all forms of disease, but especially heart disease. These tips come from Harvard Health where you can find an extensive list of phytochemicals and how they help fight disease:
"Anthocyanins in berries and red wine are associated with lower blood pressure."
Proanthocyanidins and flavanols in grapes, apples, cocoa, and red wine may also improve arterial function/blood pressure.
"Sulfides and thiols in onions, garlic, leeks, olives, and scallions may help decrease "bad" LDL cholesterol."
Cruciferous vegetable intake and red/orange vegetable intake are associated with lower cardiovascular disease.
Need I say it again? Following a more plant-forward lifestyle can lead to much better health outcomes, and prevent against cardiovascular disease.
BUT THAT'S NOT ALL: HEART DISEASE IS REVERSIBLE
According to research by Dr. Caldwell B. Esselstyn and Dr. Dean Ornish in the 80's, 90's, and early 2000's, patients were able to see a reversal of severe coronary artery disease (improved blood flow, reduction of blockages) following a low-fat plant-based diet along with stress management, exercise, and a support network.
I find this incredibly encouraging! Yet, how many people live with the idea that "heart disease is just in my genes" and "there's nothing I can do about it but take my medications".
Now, I know "Extreme" diet change isn't for everyone, but in his famous words, Dr. Caldwell Esselstyn said this:
If someone you know is suffering from cardiovascular disease, even of the minutest kind (just a little high blood pressure is all), then encourage them to get a handle on it now before it leads to worse outcomes.
For an unfortunate amount of people, their first symptom of heart disease is also their last.
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