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Nutrition Counseling and Cardiac Health

Author: Erica Drost, MS, RDN, LDN
Published: October 17, 2023

Heart disease is the leading cause of death in the United States, and accounts for 1 in 4 deaths. Every 37 seconds one person dies of heart disease in America, for a total of 670,000 deaths per year. A disproportionate number of the statistics fall on racial and ethnic minorities. Many minorities have higher rates of heart disease and its risk factors than white Americans. These statistics make it all the more imperative for one to seek nutrition care from dietitians for cardiac health.

What is Heart Disease?

Heart disease (also known as cardiovascular disease) is an umbrella term that includes a number of different conditions.

  1. Blood vessel diseases

Blood vessel diseases generally involve the narrowing or hardening of the arteries and veins. A common example of this would be coronary artery disease (CAD). CAD is a result of plaque buildup in the coronary arteries causing the arteries to become narrow, blocking blood flow to the heart. This is the most common type of heart disease and can eventually lead to angina (chest pain), myocardial infarction (heart attack) and stroke.

  1. Heart arrhythmias

Arrhythmia simply means having an irregular heart rhythm. So if you have some type of heart arrhythmia, your heart beats too slow (bradycardia), too fast (tachycardia), or in a disordered way. Treatment for heart arrhythmias include pacemakers, medications, and possibly surgery.

  1. Structural heart diseases 

Structural heart diseases concern abnormalities in the heart’s structure (valves, walls, muscle, or blood vessels). Structural defects can occur at birth (such as congenital heart disease) or after birth as a result of infection, or wear and tear. Other examples of structural heart conditions include cardiomyopathy (disease of the heart muscle that reduces its ability to pump blood), endocarditis (heart infection), and damage to heart valves.

  1. Heart failure 

Heart failure (which comes in many forms, such as congestive heart failure, diastolic heart failure and systolic heart failure) occurs when the heart becomes weakened or damaged. Different types of heart failure affect different areas of the heart; for instance, diastolic heart failure specifically affects the functioning of the left ventricle. The heart is not strong enough to pump blood around like it should and can lead to the congestion of fluid in the lungs. The two most common causes of heart failure are heart attack and hypertension (high blood pressure).

Despite the myriad conditions that fall under the ‘heart disease’ category, most of them can be prevented through lifestyle changes and nutrition counseling. Making healthy food choices, engaging in nutrition counseling, staying active and improving cardiovascular endurance, and stopping smoking are the best things you can do to decrease your risk of developing heart disease. As nutritionists for cardiac health, we know that diet can help prevent heart disease development because it plays a role in decreasing the progress of atherosclerosis, one of the main underlying causes of heart disease.

What is atherosclerosis? 

Atherosclerosis is the buildup of fatty plaque along the walls of the arteries. If this plaque buildup occurs near the heart, or begins to interfere with heart function, it becomes coronary artery disease (CAD). Atherosclerosis is the most common type of heart diseases, but how does this plaque accumulate in the arteries to become such a problem?

The progression of atherosclerosis begins when cells on the walls of arteries called endothelial cells become damaged. Endothelial cells can be damaged because of hypertension (high blood pressure), smoking, hyperglycemia (high blood glucose), and hypercholesterolemia (increased number of LDL cholesterol -bad cholesterol- in the blood).

As a result, more LDL cholesterol is able to permeate into the innermost layer of the artery. In addition, white blood cells attach to damaged endothelial cells and move from their normal place in the bloodstream, into that inner layer.

There is a cascade of events that occurs in the tunica intima that involves white blood cells producing free radicals which oxidize LDL particles which attracts more white blood cells. This positive feedback loop leads to an accumulation of white blood cells and modified LDL particles near endothelial cell damage.

White blood cells engulf these LDL particles over and over again creating what’s called a foam cell. Eventually these cells burst releasing their lipid contents. The accumulating lipids and dead foam cells begin to form a hardened lipid plaque on the arterial wall. Otherwise known as atherosclerosis.

How can my diet impact heart health? 

What we eat greatly influences our risk of developing heart disease. We know that hypertension, hyperglycemia, and hypercholesterolemia all contribute to progression of atherosclerosis, and thus the development of CAD, myocardial infarction, stroke, and heart failure. All of these ‘hyper-’ conditions can be controlled by diet to some degree. So what should I eat if I have heart disease or if I am trying to prevent heart disease?

Most dietitians for cardiac health would say that a diet for heart health includes plenty of fruits, vegetables, whole grains, nuts, legumes, and low fat protein and dairy options. Increased amounts of saturated fat in the diet have been shown to increase risk of heart disease so limited saturated fat consumption is advised. Sources of saturated fat include red meat, poultry, and full fat dairy products such as milk, cream, and cheese. Limited salt and refined sugar intake is also recommended.

Many heart specialists would also advocate for the DASH diet, or Dietary Approaches to Stop Hypertension. The word ‘diet’ may deter some people, but really DASH is an approach to focus on heart health. DASH encourages increased consumption of fruits, vegetables, and whole grains, over saturated fat, refined sugar, and salt. If you are interested in learning more about DASH you can find a DASH plan here. If the DASH plan sounds like a good fit for you, our nutritionists for cardiac health would love to work with you on nutrition counseling for improving your heart health.

How can working with a dietitian for cardiac health help me?

If you have just been diagnosed with heart disease having a dietitian on your health care team will be a real asset to you. Dietitians are experts in all things food and nutrition, areas that other medical professionals lack. Dietitians can work with you one-on-one to address your individual needs. Creating heart healthy diet changes can be challenging, and working with a Health Loft nutritionist or cardiac health can help you navigate these new habits. We will be there to support you and help you achieve your nutrition related goals.

If you have a history of heart disease in your family, or you are working to prevent developing heart disease, seeking out a dietitian and beginning nutrition counseling is a great place to start. Prevention really is the key when it comes to heart disease. Putting in effort towards eating right now can save on medical expenses to treat heart disease in the future such as hospital bills, medications, or other surgerys/procedures. Staying physically active and improving your cardiovascular endurance is also essential to preventing and mitigating heart disease.

To learn more about how your diet can affect your heart, you can talk to a Health Loft dietitian in Chicago, IL (virtually via our telehealth platform or in person) by calling us at (312) 374-5399 or by scheduling an appointment online. For more tips and fun facts to also check out our Facebook, Instagram, and Twitter pages for more fun facts and articles on nutrition, physical therapy, and exercise!

 

Written by Erica Drost
Edited by Alexander Franz
Reviewed by Morgan Murdock, RD.

REFERENCES

1. Fantuzzi, Giamila. “Cardiovascular disease.” Genetic, Cellular, and Molecular Mechanisms of Chronic Diseases, 30, October 2019, University of Illinois at Chicago, Applied Health Science Building, Chicago, IL. Lecture.

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