Are you eating your way to a heart attack?
Abhay Singh, a marketing and sales professional from Ahmedabad, suffered his first heart attack in 2001, at age 29. It was shocking for him and his family since there was no family history of heart disease; in fact, his father suffered a heart attack 11 years after Singh did.
Singh’s lifestyle was not perfect. He smoked heavily, didn’t exercise enough and was overweight. He also drank occasionally. In 2011, he had a second heart attack, followed by a third in 2013. Eventually, after a failed bypass surgery, he underwent a heart transplant in August last year.
Today, Singh, 46, leads a normal life but he can do so only because he keeps a close check on his lipid profile, has cut back on his salt intake, minimized drinking and smoking, and exercises every day. Over the last one year, he has lost around 32kg. He was 93kg at the time of his first heart attack, then shot up to 115kg before the transplant, and is now 83kg.
Singh says the one lesson he has learnt is that always listen to your body. At 29, he thought he was too young for a cardiac failure and mistook his first heart attack for indigestion. By the time he saw a doctor, 12 hours had elapsed, and the delay extensively damaged his heart.
Kenneth Thorpe, chairman, Partnership to Fight Chronic Disease (PFCD), says, “Heart disease needs urgent intervention. And that intervention, it is increasingly getting clear, has to be a lifestyle and diet makeover.” PFCD is a global organization with an office in India, committed to raising awareness about non-communicable diseases (NCDs).
Another concern is the average age of patients today. “There has been, without doubt, a marked increase in the number of young patients suffering from heart attacks,” says Ajeet Arulkumar, interventional cardiologist at Frontier Lifeline Hospital, Chennai.
Thorpe says statistics suggest that NCDs are estimated to cause almost 60% of 9.8 million deaths annually in India. Cardiovascular diseases alone account for nearly half of NCD mortalities.
Manage lifestyle and diet
Timely diagnosis, lifestyle modifications, and availability of advanced treatment management protocols are needed to curb the growing incidence of cardiovascular diseases, says Thorpe. Research supports this. A study published in the Journal Of The American Medical Association (JAMA) in March shows that a large percentage of deaths due to cardiovascular disease and diabetes are linked to poor diet.
According to the study, 10 foods/nutrients associated with cardiometabolic diseases are fruits, vegetables, nuts/seeds, whole grains, unprocessed red meats, processed meats (refined oils, hydrogenated fats, etc.), sugar-sweetened beverages (SSBs), polyunsaturated fats (PUFA), seafood omega-3 fats and sodium. Excess sodium intake was connected to the highest proportion of heart disease (it was associated in 9.5% of deaths). Other top-of-the-list dietary patterns affecting heart health were low intake of nuts and seeds (8.5%), high intake of processed meats (8.2%) and low fruit and vegetable intake (7.6 and 7.5%, respectively).
Say no to salt
According to Sundeep Mishra, professor of cardiology, All India Institute of Medical Sciences (AIIMS), New Delhi, high-salt diets increase blood pressure and the risk of heart disease extensively-. “Most of us consume more than 10 times the amount of salt we need to meet our sodium requirements (salt contains sodium and chloride),” he says. High salt intake was found to be associated with a doubled risk of heart failure in another 12-year study presented in August at the France-based European Society of Cardiology. Researchers found that people who consumed more than 13.7g of salt daily had a two times higher risk of heart failure compared to those who consumed less than 6.8g. “The World Health Organization recommends a maximum of 5g per day,” says Dr Mishra.
Use heart-healthy fats
“Paying attention to what you eat is one of the most important preventative measures you can take,” says Simmi Manocha, head of department, non-invasive cardiology, Asian Institute of Medical Sciences, Faridabad, near Delhi. The kind of fat we eat is of paramount importance. “Saturated and trans fats increase blood cholesterol and heart attack rates. PUFA and monounsaturated (MUFA) fats lower the risk of heart attacks,” says Dr Manocha. Omega-3, a type of PUFA, is greatly beneficial for heart health.
A study done by Tufts University, US, researchers has found that both plant-based and seafood-based omega-3 lower the risk of fatal heart attacks by about 10%. Fish, walnuts and flaxseed oil are the best sources of omega-3.
The vegan advantage
A well-planned vegan diet may be potentially useful in preventing heart ailments as it is higher in fibre and lower in saturated fats, says Priti Rishi Lal, assistant professor, food and nutrition, Lady Irwin College, Delhi. A study on how a vegan diet affects the lipid profile of patients with cardiovascular diseases (CVDs) was undertaken by Max Super Speciality Hospital, Saket and Lady Irwin College, New Delhi, in April. “The results of this yet unpublished study showcased that a vegan diet effectively brought about significant improvements in patient lipid profiles,” says Roopa Salwan, senior director, myocardial infarction programme, and senior consultant (cardiology), Max Super Speciality Hospital, Saket, Delhi. Dr Lal adds, “Vegans, however, must look out for deficiencies in certain key nutrients such as vitamin B-12 and iron.”
A poor diet in itself is bad for heart. It can lead to weight gain, which also raises the risk of heart attack by more than a quarter, even if you are otherwise healthy.
Researchers at Imperial College London and the University of Cambridge have found that being overweight or obese increases a person’s risk of coronary heart disease (CHD) by up to 28% compared to those with a healthy bodyweight, even if they have healthy blood pressure, blood sugar and cholesterol levels. This study was published in August in the European Heart Journal.
According to Dr Manocha, a person who carries the bulk of their body fat around their stomach (an “apple” shaped body) is at greater risk of heart disease than someone whose body fat tends to settle around their bottom, hips and thighs (a “pear” shaped body).
Follow some golden rules
Nutrition advice is always changing, but some golden rules should always be followed, says Dr Arulkumar. “Packaged food is never healthy, no matter what the labels claim,” he says. “Stick to natural, minimal processed foods, be it fruits or nuts,” he adds.
The way to a healthy heart lies in what you eat, so get smart about what you put on your plate.