By Dr. Mercola
Heart disease claims the lives of about one million Americans every year, making it the leading cause of death for both men and women. One in every three deaths in the US is attributed to cardiovascular disease.
This year alone, 920,000 Americans will have a heart attack, and nearly half will occur suddenly and without warning.1 Remember the most common symptom of heart disease is actually sudden death.
A heart attack occurs when part of your heart muscle begins to die, and even if you survive, the resulting scarring can cause severe health problems down the road, such as increased risk for sudden cardiac arrest.2 How much of your cardiac risk is under your control? Quite a bit, according to the latest studies.
Six Choices That Can Make or Break Your Heart
According to new research published in the Journal of the American College of Cardiology,3 young women who follow six lifestyle guidelines can all but "heart attack-proof" themselves.
The study, which followed nurses over the course of two decades, starting around age 37, identified the six lifestyle factors of greatest impact on heart health.4
Women who adhered to all six guidelines lowered their heart disease risk by 92 percent. Based on that, researchers estimated that more than 70 percent of heart attacks could be prevented by implementing the following:
1. Healthy diet
2. Normal BMI (body fat % is actually more accurate)
3. Getting at least 2.5 hours of exercise each week
4. Watching television seven or fewer hours per week
5. Not smoking
6. Limiting alcohol intake to one drink or less per day
None of these factors should come as a surprise, but the impact they collectively have on your cardiac risk is impressive. The results of this study echo the results of a 2014 study5 concluding that essentially the same health habits could prevent nearly 80 percent of first-time heart attacks in men.
With respect to BMI, it should be noted that your waist-to-hip ratio is a more reliable risk predictor because it reflects visceral fat. And more reliable still would be an accurate assessment of body fat percentage.
What if the Real Cause of Heart Attacks Is Not What We Thought?
The conventional view holds that the primary problem with heart disease occurs in your arteries—related to blockage from the buildup of plaque. But what if this premise is false?
Most experts believe that the majority of heart attacks result from a blockage in one of your four major coronary arteries, but Thomas S. Cowan, MD challenges this notion in an article we featured in December 2014.
Dr. Cowan makes a strong argument that heart attacks are caused by a malfunction in your central nervous system (CNS)—specifically, an imbalance between your sympathetic and parasympathetic branches—rather than by clogged arteries and compromised blood flow.
I encourage you to read his article, but in short, he presents compelling evidence that arteries more than 90 percent blocked, in almost all cases, compensate for that blockage by forming a collateral blood supply.
In other words, your body naturally performs it's own natural "bypass" if a vessel becomes significantly blocked. This explains why the majority of angioplasty and bypass surgeries provide only minimal benefit for most people.
According to Dr. Cowan, most heart attacks happen as a result of the following mechanism: A person experiences decreased healing activity of his or her parasympathetic nervous system over time, typically from chronic stress.
Then a strong emotional stressor activates a sympathetic response—but there is no parasympathetic response to compensate.
This causes an uncontrolled release of adrenalin, which breaks down the myocardial cells and interferes with their metabolism, depriving the heart of its normal fuel sources. This in turn impairs the heart's ability to contract and a heart attack occurs.
According to Dr. Cowan, heart attacks typically occur without any disruption in blood flow. So it's the heart muscle itself that experiences the problem—not the arteries. If Dr. Cowan's theory is correct, the implications are enormous with respect to the effects of unmanaged stress on your heart.
Is Stress Making You a 'Heart Attack Waiting to Happen?'
Not only does stress increase inflammation, but it activates your sympathetic nervous system (the "fight or flight" response) and suppresses your parasympathetic.
If heart attacks result from a suppressed parasympathetic nervous system, then preventing them obviously requires nurturing and protecting this part of your CNS—which means keeping your stress level under control. It's well known that stress can trigger heart attacks, but stress may be even MORE deadly if you're a woman.
A Yale study6, 7 found that young and middle aged women have a harder time recovering after a heart attack than men, potentially due to the stress of multiple roles between family and work. Women are also twice as likely as men to die within the first two weeks following a heart attack.8
Research9,10 has also linked having a bout of intense anger with an 8.5-fold higher risk of experiencing a heart attack in the following two hours. Stress and pain also often go together, and a number of pain medications, including aspirin,11 ibuprofen and Celebrex can heighten your heart attack risk.12
A study from Brown University13 examined whether having something called "dispositional mindfulness"—which they define as being very aware and attentive to what you're thinking and feeling at any given moment—is important for heart health.
They found that people with high mindfulness scores had an 83 percent greater prevalence of good cardiovascular health. Being mindful doesn't necessarily mean that you're regularly practicing mindfulness exercises like meditation but is more about having mind-body awareness.
People with higher mindfulness may be more aware of the impact their lifestyle choices have on their bodies, and be more likely to change their habits. For some people, being present is a natural part of their personality, but for others, it must be learned. By being more mindful, you will likely make better lifestyle choices for yourself and your family. Another recent study found that optimism can cut your heart attack risk in half, but the tendency to always expect the worst is linked to a 25 percent higher risk of dying before age 65.
Conventional Wisdom Is NOT So Wise About Cholesterol
Cholesterol has been blamed for just about every case of heart disease for the last 30+ years, but in reality, you need cholesterol in order to be healthy. Your body uses cholesterol for cell membranes, hormones, neurotransmitters, and overall nerve function. This is important to understand before discussing what constitutes a heart-healthy diet. High cholesterol does not cause heart disease, but insulin resistance and leptin resistance are major players.
These metabolic problems are caused by modern lifestyle factors, including a diet high in processed carbohydrates, refined sugars/processed fructose, and industrial seed oils, as well as insufficient exercise, chronic sleep deprivation, environmental toxins, and poor gut health. Your total cholesterol number is not a good indicator for cardiac risk, but a test called NMR lipoprofile can be quite useful as it measures LDL particle number and other markers related to insulin and leptin resistance. To learn more, please listen to my interview with Chris Kresser, L.Ac, above.
What Constitutes a Heart-Healthy Diet?
In addition to stress management, proper diet and exercise are your best allies in reducing your risk for heart disease. When it comes to "proper diet," keep in mind that many of the conventional dietary recommendations are highly flawed. The recommendation to limit sodium is one. While the American Heart Association recommends limiting sodium to 1,500 mg per day, recent research14 found no benefit at all among elderly people with low sodium consumption. They also found no indication of harm among those who consumed higher levels. Also, in addition to what you eat, an equally important consideration is when you eat. Intermittent fasting, which can rapidly normalize insulin resistance, also has a number of other health benefits, including improved cardiovascular health, reduced cancer risk, gene repair, and increased longevity.
More than half of the American population is insulin resistant, and intermittent fasting can be tremendously helpful for normalizing this condition and help your body remember how to burn fat for fuel. It's not something you have to continue for life, however. Nor is it necessary if you're not struggling with insulin resistance or symptoms thereof, such as high blood pressure, diabetes, heart disease, or excess weight for example. Recent studies show that when your body begins burning fat instead of sugar as its primary fuel, your risk for all kinds of chronic disease will drop. Several basic nutritional guidelines are outlined in the table below. For more comprehensive information about what constitutes a truly heart-healthy diet, I suggest reviewing my Optimized Nutrition Plan.
✓ Limit or eliminate all processed foods, and focus your diet on fresh whole foods
✓ Limit fructose to less than 25 grams per day, from all sources, including whole fruits. If you have insulin resistance, diabetes, hypertension or heart disease, strive to keep your fructose consumption below 15 grams per day
✓ Avoid artificial sweeteners of any kind
✓ Eliminate gluten and other highly allergenic foods from your diet
✓ Eat organic foods whenever possible to avoid exposure to harmful agricultural chemicals such as glyphosate
✓ Eat at least one-third of your food uncooked (raw)
✓ Increase your consumption of fresh vegetables
✓ Incorporate naturally fermented foods into your diet, such as cultured vegetables and dairy, which help build healthy gut flora
✓ Swap all trans fats (vegetable oils, margarine etc.) for healthy fats like avocado, raw butter, and coconut oil
✓ To rebalance your omega-3 to omega-6 ratio, take a high-quality omega-3 supplement such as krill oil, and reduce your consumption of processed omega-6 fats from vegetable oils
✓ Drink plenty of pure water
Your Heart Needs the Right Kind of Exercise
Exercising is extremely important for every aspect of your health, including your heart and blood vessels, but in order to maximize your benefit, it has to be the right kind of exercise. Recent research has given us a much better understanding of exercise physiology, and many of our past notions have been turned upside-down, in terms of how long and how hard you can push yourself without doing damage. Research shows that overdoing endurance training can actually do more harm than good--especially if you have a history of heart disease.
High-endurance training, such as running for an hour at a time, puts extraordinary stress on your heart. And while stressing a muscle usually makes it stronger, extremely high stress can have the opposite effect—and when it comes to your heart muscle, this is bad news. To strengthen as well as protect your heart, focus on high intensity interval exercise instead of endurance training. Short bursts of intense activity are safer and more effective than conventional cardio—for your heart, general health, weight, and overall fitness. For optimal benefits, make sure you allow your body plenty of recovery time between sessions.
Excessive Sitting Raises Your Cardiac Risk—Even if You Go to the Gym
Sitting is the new smoking, raising your risk for lung cancer by more than 54 percent. It's actually worse for you than secondhand smoke! Prolonged sitting has significant negative impacts on your cardiovascular and metabolic function. The combination of prolonged sitting and inadequate exercise has been shown to double men's risk of heart failure. Studies show that these risks hold true no matter how much you exercise. In one recent study, six hours of uninterrupted sitting was found to negate the positive health benefits of one hour of exercise.
This means intermittent movement may be even MORE important than spending time at the gym. Standing up as much as possible and moving more throughout the day have been shown to help prevent the damage done by sitting. Ideally you want to sit less than three hours a day. If that happened in the US, life expectancy would increase by three years. Additionally walking 7,000 to 10,000 steps per day can be another powerful tool. This is in addition to, not in place of, your exercise program. This goal may be easier to achieve with a fitness tracker. And try to do some of that walking outdoors!
Low Vitamin D Levels Raise Your Heart Attack Risk by 50 Percent
Cholesterol, sulfur, and vitamin D from sun exposure all work together to protect your heart, brain, and blood vessels, so it's important that you have sufficient amounts of all three. Vitamin D reduces your risk for hypertension, atherosclerosis, heart attack, and stroke. One recent study found that postmenopausal women with higher vitamin D levels had higher levels of HDL and lower levels of LDL and triglycerides.
According to longtime vitamin D researcher Dr. Michael Holick, vitamin D deficiency can increase your risk of heart attack by 50 percent, and if you have a heart attack while you're vitamin D deficient, your odds of dying from that heart attack creeps up toward 100 percent. The best source of vitamin D is from exposing your skin to the sun so that your body will produce much-needed cholesterol sulfate. That said, newer research shows that many foods that were previously thought to be devoid of vitamin D actually do contain it, so sun exposure, food, and supplements are all viable sources.
The only way to determine whether or not your vitamin D level is sufficient is to have regular blood tests. I recommend getting your vitamin D level tested at least once a year, when your levels are likely to be lowest, which is typically January or February if you live in the northern hemisphere. To benefit from vitamin D, you need a level of at least 40 ng/ml, and to get there, you may need around 5,000-6,000 IUs or more of vitamin D3 per day, from all sources. Ideally, strive to maintain a level between 50-70 ng/ml for optimal health.
Grounding Benefits Your Heart and Blood
As you can see, there are many simple and inexpensive ways to prevent becoming a heart attack statistic. Last but not least, pioneering cardiologist Stephen T. Sinatra, MD, and coauthor of the book Earthing: The Most Important Health Discovery Ever? has extolled the benefits of grounding as a tool for heart health, as well as overall health and vitality. When you walk barefoot, free electrons are transferred from the earth into your body, and this grounding effect is one of the most potent antioxidants known. Grounding also helps thin your blood by improving its zeta potential, which means it improves the energy between your red blood cells.
Grounding is a powerful way to reduce inflammation throughout your body. Inflammation thrives when your blood is thick and you have excess free radicals and excess positive charges in your body. Grounding alleviates inflammation because it thins your blood and infuses you with negatively charged ions, which enter through the soles of your feet. Surfaces that allow for proper grounding include sand and grass, bare dirt, and untreated concrete or brick. Leather-soled shoes also allow you to ground while walking, whereas rubber-soled shoes disconnect you from the earth and block this beneficial electron flow.