Heart disease is a leading cause of death among women. But did you know that prior to menopause we are somewhat protected against the development of cardiovascular disease when compared to men.
Menopause and an increased risk of heart problems. What’s the connection?
It is important to recognise that women lose the protective effect of oestrogen post-menopause, making it the biggest cause of death of women worldwide – five times more so than breast cancer.
This is because oestrogen has a number of protective effects on the cardiovascular system:
Oestrogen positively affects blood triglyceride and cholesterol levels, reducing the build up of plaque and blockages in the arteries, that can cause heart attacks and strokes.
Oestrogen helps to maintain blood vessel function, reduce inflammation, protect against oxidative stress, and lower blood pressure
Oestrogen positively impacts carbohydrate metabolism which can help reduce the risk of metabolic syndrome which is a common cause of weight gain, insulin resistance and diabetes (all of which are risk factors for cardiovascular disease)
In addition, some of the big risk factors (outside of smoking and drinking in excess), include being diabetic, having high cholesterol and being overweight – all of these conditions become more prevalent in women during menopause.
How can what you eat help?
What I want to talk to you about today is which dietary changes you might start to make from today, to protect your health and that of your loved ones. There’s fantastic news in this regard because a number of huge studies point to diet and lifestyle change being crucial when it comes to prevention.
The INTERHEART study, published in the Lancet in 2004, followed 30,000 people in 52 countries. Researchers found that lifestyle changes could prevent at least 90 percent of all heart disease.
This was another big one: the EPIC study in 2009 looked at how 23,000 people adhered to 4 simple behaviours: not smoking, exercising 3.5 hours a week, eating a healthy diet, and maintaining a healthy weight. Sticking to these four behaviours alone seemed to prevent 93% of cases of diabetes, 81% of cases of heart attacks, 50% of cases of strokes, and 36% of cases of all cancers.
A simple strategy for good heart health:
Of course, everyone is individual, and there is no official ‘single diet’ that all humans should eat. But if there were, this would be it because it handles what the essence of the problem is – being overweight and a highly inflammatory internal environment.
Before I dive in with some of the answers, I want to say a little something about fat because chances are, if you’ve heard one thing about staving off a heart attack, it’s ‘cut back on fat’ (and especially the saturated kind).
The success of some low-fat dietary models in weight loss is thought to be more likely due to the simultaneous reduction of sugar, refined carbohydrates and processed foods.
Dietary fat actually turns off fat production in your liver. Unlike carbohydrates and protein, dietary fat does not trigger your pancreas to secrete insulin.
There is one type of fat everyone should avoid, and it’s trans fats, a kind of Frankenstein fat added to food to improve shelf life and mouthfeel of products. One study actually found that the risk of coronary heart disease doubled with each 2 percent increase in calories from trans fats (Iqbal, 2014). Another researcher even concluded: “On a per-calorie basis, trans fats appear to increase the risk of CHD more than any other micronutrient.” (Mozaffarian et al., 2006).
Foods to avoid….
The real villains in the piece are refined grains and sugar. During processing, refined grains are stripped of the bran and germ, two parts of the grain kernel that contain a wealth of nutrients. The final product is starch with next to no nutritional value, providing little more than carbohydrates and calories. Refined carbohydrates can be found in a wide variety of foods, including white bread, pasta and rice, muffins, cakes, cookies, crackers, and bagels. Unfortunately, these foods make up a pretty good chunk of the modern Western diet and may be linked to a higher risk of heart disease. One study from China found that a higher carbohydrate intake, mainly from refined grains, was associated with an increased risk of coronary heart disease among 117,366 adults (Yu et al., 2013).
Sugar is one of the main culprits of heart disease. Added sugars from foods like sweets, desserts, juice and soft drinks can spike blood sugar levels, damaging the blood vessels, overloading the liver and increasing the risk of heart disease.
Interestingly, a study from Harvard School of Public Health actually found that participants who drank the highest amount of sugar-sweetened beverages had a 20 percent higher relative risk of developing coronary heart disease than those who drank the lowest amount (de Koning et al., 2012).
Foods to focus on….
A lower carbohydrate diet is recommended to balance blood sugar and therefore reduce insulin and blood glucose levels. Elevated insulin is a major risk factor for heart disease and promotes inflammation. You’re also likely will lose weight on a blood sugar balancing diet, and that in itself will reduce the risk for many chronic diseases, including heart disease and high blood pressure.
PROTEIN Eat a source of protein at every meal and snack. This can be any fish/ seafood, poultry, meat, nuts, seeds, tofu, eggs. Given you probably eat enough meat already and many people don’t eat nearly enough vegetable protein, see if you can bring in more fish and more vegetable sources of protein over the week. Ideally, eat two to three vegetable-based protein meals weekly. Replace animal-based protein meals with lentils, legumes, tofu, quinoa or nuts and seeds, for example. If you’re a fish eater, get in wild-caught fish, which are rich in omega-3 fatty acids, twice a week.
FRUIT & VEG Get plenty of fruit and veg but focus specifically on eating veg that grow above the ground and fruit that can be grown in this country. These foods naturally contain either less natural sugar or lower amounts of carbohydrates, which have an impact on hormones. At each meal, have this cover at least half of your plate. The aim is 7 a day and ideally 5 from veg. Over the course of a week, aim to eat all different colours - span the rainbow to enjoy a diverse intake of nutrients. Enjoy berries, citrus fruit, peppers and leafy greens.
FIBRE is a great addition, the soluble kind you’ll find in oats, lentils, split peas, flaxseed, citrus fruits and apples. All of those are heart-healthy choices. From the insoluble category, eat nuts and whole grains.
FAT Some fats are healthy, and let’s not forget that fat is actually essential for life. Get your fat from avocados, oily fish, nuts and seeds.
CARBS Think carefully about the quality (what kind) and the quantity (how much) of starchy carbs like bread, pasta, cereals, potato, rice. Focus on wholemeal over white, sweet potato over regular white potato, basmati or brown rice over long grain. You can also try throwing in a few ‘faux carbs’ like cauliflower or broccoli rice, courgetti (courgette spiralised into noodle shapes), butternut squash waffles, and so on.
PROCESSED MEAT In recent years, there have been numerous studies connecting processed meats, like hot dogs, salami and tinned meat, to a range of adverse effects on health. Not surprisingly, processed meats can also negatively affect heart health, so best to give them a wide berth.
VEGETABLE OILS can be very damaging for heart health. Recent studies show that oils like rapeseed are not helpful (even though the supermarkets are brimming with these options). In fact, the linoleic acid they contain has been linked to cardiovascular disease and cancer.
SUGAR Remove as much sugar as you can from your diet as this is the real villain in the tale. That means saving sugary treats for high days and holidays and, most of the time, ditching breakfast cereals, cakes, cookies, pastries, and so on, and checking the label of jarred sauces, where sugar often lurks.
FIZZY POP Avoid fizzy soft drinks. Eliminating soft drinks is one of the best things that everyone can do for their heart. Besides being laden with controversial chemicals and unhealthy ingredients, soft drinks are also brimming with added sugars.
Do you notice a trend in my diet tips? The focus is on real food. What you would benefit from decreasing is the processed stuff most people tell themselves is OK for them to eat. Truly, your body doesn't know what’s going on when you eat heavily processed or chemically altered foods.
Eating this way - sometimes referred to as a low GL (glycaemic load) diet - will also help, providing your body with a steady supply of energy through the day, rather than a rollercoaster of energy spikes and troughs.
Making dietary changes as well as committing to regularly de-stress, move your body and prioritise sleep is not always easy to do on your own. It is always helpful to have someone – like me – in the wings helping you fit what you already know about eating well into your life and keeping you motivated to follow your plan for long enough that you really see a shift in your health.
I warmly invite you to book a free Health and Energy Review call with me so that we can talk about what you need and I can let you know how I can help. You can do that HERE
A side note on salt
Salt has long been considered a major contributor to high blood pressure, and the high salt content of processed foods and junk food has been given at least some of the blame for the high incidence of hypertension and heart disease. However, even this recommendation has recently come under scrutiny and may change in the future.
Recent research has cast doubt on the role of salt intake in hypertension (DiNicolantonio, Lucan et al., 2014). However, the WHO and most countries still recommend less than 2g sodium/day, equivalent to <5g/day salt in adults, which is equivalent to 1 teaspoon. Until this changes, we should stick to the guidelines. But we also need to recognise that other factors also contribute to high blood pressure (such as sugars). Salty snacks like potato chips, pretzels and microwave popcorn are full of added ingredients as well as salt, that can take a serious toll on heart health – and are best avoided. Where possible choose natural sea salt, which is rich in trace minerals. The healthiest forms of sea salt are the least refined with no added preservatives. Pink Himalayan salt is widely regarded as the ultimate mineral-rich seasoning and the purest of the natural salt family. Regarding health benefits, sea salt is plentiful in trace minerals due to its marine derivation, delivering many of the same nutritional compounds that make superfood seaweed so nutritious. The healthiest forms of sea salt are the least refined with no added preservatives (which can mean clumping in the fine variety).
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