Food Cures (22 page)

The naturally occurring compound called
allicin
is the active part of garlic that seems to help lower cholesterol. It acts as a powerful antioxidant, and may also affect the way LDL cholesterol is used in the body and reduce triglycerides. There is some evidence that garlic may also lower homocysteine and reduce blood pressure. Although most studies of garlic use garlic supplements, some have shown similar good results for raw garlic. Unfortunately a great many of my clients don’t like or can’t tolerate raw garlic. Either they don’t like the taste or it upsets their stomachs. Still, I recommend adding garlic to your cooking—as much as you like, as often as your family and friends can stand. Gently sauté the garlic separately from other foods to avoid burning it, or bake it and enjoy it as a rich, nutty-flavored paste. Garlic can act as a blood thinner, so if you are already taking aspirin or warfarin, please make your doctor aware that you’ve added garlic to your diet. (See the Supplements section, Chapter 7, for more information about garlic supplements.)

PLANT STEROLS OR STANOLS

Sterols and stanols are natural substances found in small amounts in the cell membrane of plants, including fruits, vegetables, legumes, nuts, and seeds. Sterols are found in relatively high amounts in pistachio nuts, sunflower seeds, sesame seeds, and wheat germ. In terms of their effects on the human body, plant sterols and stanols are virtually the same.

Sterols and stanols have a structure similar to cholesterol, and they compete with cholesterol for access to receptors in the small intestines. (Imagine 15 people all hoping to get a ride in their friend’s Volkswagen Beetle—not everyone is going to be riding in the car.) Sterols/stanols compete with cholesterol, effectively blocking its access. Research has shown that sterols and stanols have been shown to cut the amount of cholesterol absorbed by the small intestines by about 50 percent, and to reduce LDL cholesterol levels by between 5 and 14 percent.

You can reap these cardiovascular benefits with just 2 grams of sterol/stanol per day, though you can’t get that much eating fruits and vegetables alone. Sterols and stanols have been added to certain heart-healthy spreads that taste and cook just like margarine, including Take Control and Benecol spreads. These spreads have been found to be safe, with very few side effects (although some people complained of upset stomach). That said, they’re only for those with cholesterol problems, who should consume no more than the amounts recommended: 2 to 3 tablespoons per day (each tablespoon provides 1 gram of sterol/stanol). You can use it on whole grain bread, melt it on heart-healthy vegetables, or use it in cooking. I recommend trying the
light
versions of these spreads to save yourself 30 calories per tablespoon. If you’re not a bread eater, please don’t start just to have a vehicle for these spreads! Instead, consider the plant stanol/sterol supplements. (See the Supplements section, Chapter 7, for more information about nonfood sources of plant sterol/stanols.)

ALCOHOL

The benefits of alcohol depend, in part, on exactly what your cardiovascular risk factors are. If your problem is high triglycerides, alcohol should be considered a rare treat, if you indulge at all. Even small amounts of alcohol can increase triglyceride levels dramatically.

For other risk factors, research suggests that one or two servings of alcohol per day may be good for your heart—that’s no more than one serving per day for women, and no more than two servings per day for men. Studies have shown that drinking moderate amounts of alcohol reduces the risk of coronary artery disease by about 25 percent, and reduces the risk of death from heart disease by about 12 percent. Alcohol seems to increase the good HDL cholesterol and prevent clots.

There are right ways and wrong ways to use alcohol for heart health. The right ways are to drink moderately, and with a meal. The optimal amount of alcohol is one or two drinks per day (one serving is 12 ounces of beer; 5 ounces of wine; or one shot of hard alcohol). Although all alcohol has heart-healthy benefits, red wine also contains antioxidants called
flavonoids
and
resveratrol
—an extra boost of nutrition. Studies show that people who drink these moderate amounts of alcohol have a lower risk of disease than abstainers…although I can’t recommend starting to drink if you’re a teetotaler.

The wrong way to use alcohol is to drink heavily. People who regularly drink five or more servings of alcohol per day have a higher risk of disease than people who drink moderately or who abstain completely. Even three or more drinks per day raises blood pressure and increases triglycerides. The worst risks are for binge drinkers—people who occasionally consume large amounts of alcohol. Women who have five or more drinks and men who have nine or more drinks in a single drinking episode put themselves at risk of what scientists call
major coronary events
—heart attacks, strokes, and death. No one wants to see a big celebration—a Super Bowl or bachelorette party—end that way. If your team makes it to the Super Bowl and loses, it’s a bummer, but it doesn’t have to be fatal.

If you are currently taking medication for lowering blood pressure or cholesterol, or if you have diabetes,
always
talk with your doctor about whether drinking alcohol makes sense for you. There are some questions about whether alcohol might interact with medications, or complicate potential liver problems.

MULTIPLE CHANGES, MEGA BENEFITS

I saved my client story for this point in the chapter because I’m guessing you’re probably feeling a little overwhelmed right now. Take heart…as Sean did.

Sean was 36 years old, and about 35 pounds overweight. He had high blood pressure, LDL cholesterol of 170, HDL cholesterol of 48, and triglycerides of about 300. His internist was also a cardiologist, and wanted to put Sean on medication before he developed serious heart disease. Sean couldn’t stand the thought of going on medication, so he made a deal with his doctor—if he didn’t get his numbers down within two months, he would fill his prescription.

When Sean came to see me, his diet was a mess. He ate and partied like he was still in college. Weekends were orgies of buffalo wings, beer, pizza, and ice cream, all things he was loathe to give up…but he did. We made a game of his deal with the doctor—Beat the Medication. Sean did everything in this program. He stopped smoking. He started walking every evening with his wife and baby. He took fish oil capsules and plant stanol supplements. And he started eating only heart-healthy foods, including those with plenty of calcium and magnesium. He cut out salt and fruit juice and even stopped drinking beer. That was the hardest part, and it was a real struggle for Sean, but he was playing for keeps.

After two months, Sean had lost 17 pounds. His LDL cholesterol dropped 30 points to 140, his HDLs stayed the same, and his triglycerides—slashed by more than half—were down to 120. His doctor was thrilled and gave him another two months to get his LDLs closer to 100.

For the next two months, Sean continued the program and dropped another 16 pounds. At the end of four months, he got all his risk factors under control. His blood pressure was normal, his HDL was the same, his LDL was down to 124, and his triglycerides fell to 105. He did it! He beat the medication. Even better, he felt fabulous, energetic, and empowered. Ultimately, his doctor and I would love to see his LDL cholesterol come down even more, and I am optimistic it will happen.

Want to be like Sean? It is never too late to make these healthy changes. Study after study has shown that the more heart-healthy living you do, the greater the benefits. With cardiovascular disease, you don’t want to wait. don’t forget we’re talking about stroke, heart attack, and the possibility of sudden death. Be like Sean. Do it all. You may be able to heal yourself. But even if you need to take medications, that doesn’t diminish the good that you’re doing for yourself. Some people need medication, even if they do everything right, and that group includes two of my own relatives! Even then, this program is important.

BONUS POINTS

• Know all your numbers.
  Don’t rely on your doctor to keep track of your blood pressure, triglycerides, and cholesterol levels—they don’t do much good sitting in a medical file drawer. Every time you have your blood tested, write down your numbers, and track your progress. Most doctors recommend follow-up blood work every year or every six months, depending on your individual health concerns. There’s nothing more motivating than results—in this case seeing your numbers drop steadily lower and lower. Work with your doctor to set goals for each of the following tests: Blood pressure, LDL cholesterol, HDL cholesterol, cholesterol ratio (total cholesterol divided by HDL cholesterol), triglycerides, homocysteine, and C-reactive protein.
  
• Ask about iron and thyroid.
  Heart disease risk can be affected by elevated ferritin (a measure of iron), and high cholesterol can be a side effect of low levels of thyroid hormones. Talk with your doctor about whether you need to have these additional tests.
  
• If you smoke, quit.
  Smoking causes inflammation, not just in your lungs, but throughout your body. Inflammation can contribute to atherosclerosis, blood clots, and risk of heart attack. Smoking makes all heart health indicators worse. If you have high cholesterol, high triglycerides, or high blood pressure, smoking magnifies the danger.
  
• If you are overweight, focus on losing weight.
  Body fat produces and secretes hormones and other types of biochemicals, including inflammatory chemicals. People who are overweight have higher levels of C-reactive protein, a marker for inflammation. And as already discussed, inflammation contributes to atherosclerosis and heart attacks. In addition, being overweight increases blood pressure and decreases HDL cholesterol. In 2006, researchers found that the more overweight you are, the greater your risk of death…not just from heart disease, but from all causes. Even if you have normal blood pressure, normal cholesterol and don’t smoke, being overweight increases the risk of death from heart disease by more than 40 percent. You don’t have to return to your high school weight to see a benefit—every little bit helps. Research has shown that losing just 10 pounds can reduce LDL cholesterol by 5 to 8 percent. (See Weight Loss on Chapter 3 for more information on how to lose weight while following this heart-healthy program.)
  
• Become more physically active.
  Even moderate exercise can help improve cholesterol, triglycerides, and blood pressure. Aerobic exercise seems to be able to stop the sharp rise of triglycerides after eating, perhaps because of a decrease in the amount of triglyceride released by the liver, or because active muscle clears triglycerides out of the blood stream more quickly than inactive muscle. If you haven’t exercised regularly (or at all) for years, I recommend starting slowly, by walking at an easy pace for 15 minutes a day, five days a week. Then, as you feel comfortable, increase the amount of time by five minutes each day. Strive to work up to 45 minutes each day. (Always get clearance from your doctor before beginning an exercise program.) If you are relatively healthy and are cleared for exercise, research shows that you might get optimal heart benefit from moderate-intensity exercise that burns about 500 calories or more. This means brisk walking for about 90 minutes, three to five times per week. I know it sounds like a lot, but your life may depend on it.
  
• If you also have diabetes, control your blood sugar.
  Uncontrolled blood sugar can increase your risk of coronary artery disease, heart attack, and stroke. Part of your heart care is diabetes care. (For more information about nutritional advice for diabetes, see Type 2 Diabetes on Chapter 9.)
  
• Manage stress.
  High blood pressure has been linked to emotional stress and anxiety. It is so common that the phrase
  white-coat hypertension
  has been used to describe the spike in blood pressure some people experience in the stressful setting of the doctor’s office. The best stress reducers are meditation (especially Transcendental Meditation), going to church or temple, biofeedback, guided relaxation, and cognitive-behavioral therapy. Taking time to play with or pet a dog or cat also seems to help. (In case you’re wondering, watching TV does not work as a stress reliever—scientists actually checked.) Research has shown that reducing stress can reduce blood pressure by as much as 10 percent. It may not seem like much, but it’s not bad for a few minutes of meditation or quiet relaxation every day.
  
• If you have hypertension, avoid hot tubs.
  Well, not just hot tubs, but also saunas, steam rooms, hot baths, and other activities that relax your body with heat. They can raise your heart rate and cause dizziness, while raising blood pressure even higher.
  
• Get enough sleep.
  Research shows that people who get six to eight hours of sleep per night have less risk of developing hypertension than people who got five hours or less per night. It could be that people who sleep too little have a lot of stress, and their lack of rest may make them too tired to follow through on healthy diet and exercise plans. When you make time for sleep, you may also find that it’s easier to make time for everything else, too.