Heart disease or cardiovascular disease, is often a preventable disease. In India, non-communicable diseases (NCD’s) account for the majority of deaths (59.1%), with most loss taking place during the productive years of life. And in India, cardiovascular disease accounts for about 53.7% of NCD mortality. Cardiovascular disease remains to be one of the leading causes of death worldwide. And therefore, to understand how to prevent and manage cardiovascular disease is very important and should be a priority in relation to public health.
According to the World Health Organisation (WHO), CVDs are the number 1 cause of death globally, taking an estimated 17.9 million lives each year. CVDs are a group of disorders of the heart and blood vessels and include coronary heart disease, cerebrovascular disease, rheumatic heart disease and other conditions.
Coronary heart disease – disease of the blood vessels supplying the heart muscle;
Cerebrovascular disease – disease of the blood vessels supplying the brain;
Peripheral arterial disease – disease of blood vessels supplying the arms and legs;
Rheumatic heart disease – damage to the heart muscle and heart valves from rheumatic fever, caused by streptococcal bacteria;
Congenital heart disease – malformations of heart structure existing at birth;
Deep vein thrombosis and pulmonary embolism – blood clots in the leg veins, which can dislodge and move to the heart and lungs.
Coronary Artery disease
Do you know what coronary artery disease is? Well, CAD or coronary artery disease causes dangerous thickening and narrowing of coronary arteries. You must wonder why it is dangerous. We all know that blood travels through blood vessels in our body. Now imagine those blood vessels becoming narrower day after day. A time will come when the arteries will become completely blocked by thickening and narrowing. In such cases, the blood will not be able to pass through that segment of the artery. This will lead to oxygen deprivation to the part of the body to which blood is not able to reach. In such conditions, the heart has to work more to pump blood with much more force. The artery may become completely blocked or it may become prone to clotting.
This disrupts the flow of blood carrying oxygen and nutrients to the heart, causing serious problems such as angina (chest pain), myocardial infarction, arrhythmias (irregular heartbeat) and possible heart failure. The symptoms depend on the stage of illness. The commonly noticed first indication is shortness of breath or chest pain or exertion.
You must wonder how to prevent such conditions? So, such conditions develop over a long period of time, slowly and usually over decades. Looking at the time frame, you might have understood that there is a great possibility to prevent heart disease. The best way to prevent heart disease is through eating habits and lifestyle modifications.
Risk factors
Let’s briefly discuss the risk factors to prevent heart disease
| Major risk factors | Additional risk factors | Non-traditional risk-factors |
| Advanced age | Obesity, abdominal obesity | High Lipoprotein (a) |
| High total cholesterol | Family history of hyperlipidaemia | High clotting factors |
| High non-HDL-C | PCOS | High inflammatory markers |
| High LDL-C | Metabolic syndrome | High uric acid |
| Low HDL-C | High Apolipoprotein B | High homocysteine |
| Diabetes mellitus | ||
| Hypertension | ||
| Chronic kidney disease | ||
| Cigarette smoking | ||
| Family history of CVD |
As we can see in the table, few of the risk factors are modifiable and few are non-modifiable. For example, you cannot modify advancing age or your genetics. But you can surely modify your lipid profile, manage your diabetes or obesity or kidney disease. It is very important to understand the risk factors as they tell us a lot about the condition.
If we talk about the diagnosis of heart disease to prevent heart disease, then the markers such as blood pressure, lipid profile, blood glucose as well as family history of the disease are commonly used. One can also go for tests such as electrocardiogram (ECG), inflammatory marker tests such as high sensitivity C-reactive protein, or chest angiography or thallium test, depending on the symptoms suffered by the individual.
What is lipid profile? And Why is it so important in reference to heart health?
Lipids are bound to protein as lipoprotein for transportation in blood. Lipids consist of total cholesterol, low density lipoprotein (LDL) and high density lipoprotein (HDL).
We all are aware of HDL being the good cholesterol and LDL being the bad cholesterol. To understand cholesterol better give a read to A comprehensive guide on different types of cholesterol.
Importance of lipid profile in relation to heart disease is that it is one of the most basic factors leading to the development of heart disease. You cannot see or feel it, and therefore, it is important to get it checked. Once checked, you get to know your numbers which becomes easy to prevent heart disease. You must be aware of the fact that LDL contributes to the fatty build-ups in arteries which causes atherosclerosis. This raises the risk of heart attack, stroke and other heart-related conditions. On the other hand, HDL acts as a scavenger, carrying LDL away from the arteries and back to the liver for disposal.
Triglycerides
Apart from cholesterol, triglycerides are of utmost importance. Triglycerides are the most common type of fat in the body which stores excess energy. A high triglyceride level with low HDL and high LDL level is linked with fatty build-ups in artery walls. It is observed that many people with heart disease or diabetes have high triglyceride levels. It can also elevate as a result of obesity, physical inactivity, smoking, excess alcohol consumption, or a diet which is very high in carbohydrates. Well, to make it easier to understand, all these conditions can easily be monitored with a better diet and good lifestyle habits.
By reading this you must have got an idea of how diabetes or obesity is related to heat diseases. A high level of triglycerides in both of these conditions may cause the development of heart related conditions. You must also be aware of the fact that heart diseases are one of the manifestations or complications of diabetes and obesity in the long term.
Can we really prevent heart diseases?
Yes, we can prevent heart disease for sure. All you need is extra care and attention towards your lifestyle habits and what goes into your body. If you are able to make mindful eating choices and modify your lifestyle in such a way that you are physically active, practising meditation, and losing excess weight, then the chances of developing heart disease becomes significantly low. In fact, a person suffering from any heart condition should also try to follow a lifestyle which promotes heart health.
For example, if you’re taking care of your diet, eating healthy and in moderation. Along with diet, you’re able to follow a physical activity routine, then the levels of your deranged lipid profile will surely start becoming normal and you’ll see the levels coming in optimal ranges. All it takes is a little bit of motivation and focus!
How can we prevent heart diseases?
The following should be the goals of prevention:
- Eating a heart healthy diet
- Being physically active
- Shedding extra weight (if overweight or obese)
- Smoking cessation
- Moderate alcohol consumption
- Focusing on electrolyte balance
- Practicing mindful eating and focusing on portion control.
Diet:
Diet is one of the most important parts of our lives. We always look forward to having our meals of the day. And therefore, one can never keep diet aside. It is very important to plan your diet according to your health status. All of the food and beverages choices that you make in your daily life matter. The amount of calories consumed, what kind of fat goes into your body, are there adequate nutrients in the diet. Each and every choice matters. If a person is overweight, the amount of calories to lose and maintain weight will matter.
Diet patterns to follow:
Mediterranean diet pattern: this diet pattern focuses on the consumption of whole foods as compared to refined foods. A diet rich in fruits and vegetables with low fat milk and milk products and lean meats. It focuses on healthy fats such as oil, nuts and seeds. This diet pattern is considered to be healthy because it includes around 5-6 servings of fruits and vegetables with whole grains, nuts, beans and seeds. The Mediterranean diet is also rich in fibre.
DASH diet pattern: DASH diet stands for Dietary Approaches to Stop Hypertension. This diet pattern focuses on vegetables, fruits, low fat dairy, whole grains, and fish. It is low in saturated fats and trans fats and rich in minerals and vitamins such as potassium, calcium, magnesium, protein and fibre.
To know more about the DASH diet and how it helps in hypertension management, you can give a read to the DASH diet and its role in hypertension.
The healthy vegetarian eating pattern: this diet pattern majorly focuses on the vegetarian choices available in the diet such as pulses, legumes, soy products, nuts and seeds. This pattern also includes dairy and whole grains. People may or may not include eggs in their diet in such a pattern.
What does a heart healthy eating pattern include?
1 cup= 250 ml
- Fruit- 1-2 no.
- Vegetables: 2.5 cups/day (include green, red, orange and other colours)
- Grains: 3+ servings of whole grains and <3 of refined grains
- Dairy low fat: 2-3 cups/day (milk, curd, buttermilk, paneer)
- Protein rich food options:
– Meat, poultry, eggs- 100g/day
– Dals, pulses, legumes
– Nuts, seeds: 8-12g/day
- Oil: 20-25g/day
Dietary fats and heart disease:
The association between LDL cholesterol and saturated fatty acids (SFA) to heart disease is not only very strong but also important to understand. Do you know that 1% increase in SFA consumption equals 2.7 mg increase in serum cholesterol. Furthermore, low intake of SFA replaced with polyunsaturated fat (PUFA) which contains vegetable oils, may prevent heart disease risk by 30%. So therefore, it is a wise choice to reduce SFA and trans fat from your daily diet and replace them with PUFA or MUFA (monounsaturated fats).
Both MUFA and PUFA may be used to replace SFA, with PUFA having a greater cholesterol-lowering effect. Examples of PUFA include sunflower and corn oil and oils high in MUFA are olive oil, canola oil, peanut oil and gingelly oil.
Dietary cholesterol <200 mg/day. dietary cholesterol is present only in animal foods and the richest sources are organ meats and egg yolk.
Exercise and physical activity
In addition to the dietary recommendations, adults and children of all ages should meet the physical activity guidelines for health promotion. Achieving a healthy body weight by appropriate control of the diet and level of physical activity holds the key to a healthy lifestyle.
For adults, it is generally advised to do a least 150 minutes of moderate-intensity aerobic physical activity per week or around 75 minutes of vigorous physical activity per week. If all days of the week are not possible, then you should at least aim for 5 days/week. Both aerobic and non-aerobic exercises are beneficial.
You can carry out a simple activity to keep your heart healthy, and that is going for a brisk walk. Make sure to get your heart moving!
Shedding extra weight:
Weight gain and heart disease are related to each other. Obesity is associated with an increased risk of CVD. Furthermore, high levels of triglycerides along with changes in body composition are one of the most critical reasons. Weight loss is also associated with an increase in HDL cholesterol and decrease in LDL cholesterol.
Therefore, it is important to reduce those extra kilos! Achieve your healthy weight goal and try to maintain it with the help of a diet and physical activity regime.
Alcohol consumption
Consumption of alcohol in high amounts can cause cardiomyopathy and high blood pressure in some people. Furthermore, moderate consumption has few adverse effects. Moreover, alcohol should not exceed 30-60 ml of ethanol per day.
Bottom line:
Heart diseases are preventable with not only the help of right diet but also with good lifestyle habits. The prevalence of heart disease is increasing in India and even worldwide. Moreover, it is very important to follow a heart-healthy lifestyle to keep the disease conditions at bay.
Make sure to keep your heart healthy and beating by making a few changes in your lifestyle slowly and steadily. For example, it is better to take stairs than elevators, better to avoid fried and oily food and have whole foods, better to have alcohol in moderation than over-consumption. These small choices everyday can really make a difference.
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