Heart disease, stroke & aging
Christopher Thomas
Slow aging is about prevention (of disease) and proactive health behaviors. It means you don’t stick your head in the sand hoping that you’ll be saved from any nasties such as the common diseases causing death. In our book Fast Living, Slow Ageing we provide a raft of options so you are proactive and prevent diseases such as heart disease and stroke.
Here we provide an extract from the book, written by one of the authors Christopher Thomas (Chapter 5 – Avoiding Heartache):
Every cell in our body depends on the flow of blood for survival. If this is compromised, even for a brief period, the cells and tissues downstream suffer and eventually die. When this occurs in the heart, it is called a heart attack or myocardial infarction (MI). When a severe reduction in blood flow occurs to the brain, it is called a stroke or cerebrovascular accident (CVA). Together, heart attacks and strokes are the major killers in the Western world. Quality of life for survivors is also greatly reduced. Finding ways to prevent or reverse this process are an integral part of any slow aging strategy.
Think of the arteries of the heart and brain as a major freeway that handles heavy traffic. Over time, a number changes occur under the surface, causing it to thicken and soften. Still the traffic drives over the road, but the pressure of the heavy trucks makes more a difference, as the sub-structures are less resilient. Years may go by and the sub-structure gets weaker and weaker. It may start to bulge a little bit, but still the seal remains intact and the traffic flows. Then one fateful day, usually after a large stress, the surface cracks and erodes, and a pothole occurs. The next car hits the hole and flips. The car behind it hits the first car and a major pileup ensues, completely blocking the road. This is what happens when we have a heart attack or stroke. In at least half of men and women, this is the first sign of problems with their blood vessels. For many, it is also their last. If the blockage is not quickly cleared, everything downstream eventually dies. The cells of the heart and brain cannot grow back.
Any loss of cells means some permanent loss of function. But if blood flow can be rapidly restored, the traffic flow can return to normal, at least until the next pothole forms in the weakened surface. However, repeated small surface erosions and ruptures eventually lead to narrowing of the road. This scenario is a preventable on a number of levels. The best prevention begins early with the choices we make in our lifestyle, diet and other areas. The combination of these measures will reduce the chance of crashing in a pothole and keep us safely on the road for many years to come.
Options to help prevent heart attacks and strokes
Increase physical activity – increasing your physical activity has a range of positive effects on the body, reducing stress on arteries, preventing clogging, improving glucose and blood pressure control, and helping us maintain a healthy weight. A combination of cardio and weight bearing exercise is best. At the start, aim for 30 minutes daily achieving a minimum heart rate of 65% of your maximum (see chapter 18 in Fast Living, Slow Ageing)
- Have a fitness assessment and find out what you really need to do to meet your goals
- Find an exercise buddy to work out or walk with
- Buy a pedometer and join the 10,000 steps program (www.10000steps.org.au)
- Find out about classes run at your local community center. Aerobics, yoga or dancing may be options
- Try karate or another martial art
Reduce calorie intake
- See a dietician or nutritionist for a dietary program that suits your needs
- Clear out your pantry – bin all the lollies, chips, snacks, biscuits and ‘empty calorie’ foods
- Figure out your caloric intake needs and then reduce by 20%. If you are unsure what your caloric needs are see a nutritionist or dietician to guide you
Prevent diabetes
Excessive levels of sugar damage blood vessels, like the baking sun causes a road’s surface to become brittle and damage more easily when exposed to stress. The presence of diabetes at least doubles the risk of heart disease. Measures to prevent diabetes are more effective than anything else in reducing heart disease.
- Eat more fiber by increasing wholegrains and eating 3 serves of fruit and 5 serves of vegies each day
- Reduce your total fat and saturated intake by trimming meat, choosing lean cuts and substituting full fat dairy with low fat alternatives
- Avoid trans fats by reducing fried foods, use olive or rice bran oil for cooking and avoiding processed and packaged foods
- Increase resistance exercises (see chapter 18). Try including weights in your program
Stop smoking
- Call Quitline, contactable on 131 848 or 13 7848
- Get a buddy – when about to reach for a cigarette call them
- Visit non-smoking venues such as cinemas, museums, libraries and cafes
- Make a change in your routine – get up earlier and go for a walk
- Chew gum
- Have a pen and paper handy to you can doodle when you have time on your hands and nothing to do!
Lower your LDL cholesterol levels
LDL cholesterol is the bad cholesterol that deposits its cargo under the surface of blood vessels. If we reduce our LDL cholesterol, our risk of death from a heart attack or stroke risk is also reduced. We can reduce our LDL cholesterol through exercise and choosing foods that low in saturated fat and cholesterol.
- Reduce your intake of saturated fats from dairy products (especially whole milk, cream cheese and ice cream), coconut, palm oils, fatty meat
- Include phytosterols/stanols in your diet that reduce cholesterol absorption
- Include soy, nuts and whole grain on a daily basis. Use them to replace other calories (like dessert) not to add even more energy to our diet, and more fat to our waists. ¼ cup(30g)nuts or seeds is a perfect snack size
- Get help from your doctor if your cholesterol levels are too high (LDL > 3.5mmol/L) or your risk of heart disease is too great (high blood pressure, diabetes, family history, etc)
Lower your blood pressure
Blood pressure is the stress placed on our arteries. If we can find ways to lower it and keep it low, just like reducing the number of heavy vehicles, it will keep a road in better shape for longer. For every 1 mm Hg decrease in systolic blood pressure, the long-term risk of a heart attack is reduced by 2% to 3%. Regular exercise, staying in a healthy weight range and eating a diet low in salt (<6g/day) and fat can reduce systolic blood pressure by 10-20mm Hg and therefore the risk of heart attack or stroke by 20% to 50%.
- Start with 10 minutes walking per day of exercise and slowly build up to half an hour
- Try resistance training with a Thera-band. An exercise physiologist can write you a home program
- Reduce your intake of meat and thereby saturated fat by increasing portion sizes of vegetables, rice and dry beans in meals
- Try casseroles or stir-fry dishes, which have less meat, more vegetables and beans
- Include two or more meat-free or vegetarian-type meals in your weekly diet.
- Use herbs and spices to flavor food rather than salt
- Limit the amount of salt used in cooking, and do not add salt to food at the table
- Choose foods labeled ‘no added salt’
- Avoid canned, fast and processed foods as much as possible as they tend to be higher in salt
Increase your antioxidant defences
Ooxidative stress is bad for blood vessels and their function. You can increase your antioxidant defenses by choosing foods that are naturally high in antioxidants, especially the richly colored (rainbow) foods (see chapter 8). The more naturally colored fresh fruit and vegetables the better. Other useful sources of antioxidants with a range of bonus benefits include:
- Red wine – contains the antioxidant resveratrol, as well as a host of other useful compounds
- Green tea – contains catechins; epigallocatechin gallate (EGCG) is one of the most efficient antioxidants
- Garlic – has many positive effects on the heart including lowering blood pressure and cholesterol levels, blood thinning, as well as antioxidant effects
- Turmeric – is both antioxidant and anti-inflammatory. It also lowers LDL cholesterol. Team it up with your antioxidant vegetables, like brassicas and legumes; a quarter of a teaspoon a day
Increase your omega 3 fats
Omega 3s can reduce cardiovascular disease, partly by reducing cholesterol and inflammation, as well as thinning the blood. Eat cold-water oily fish (such as salmon, herring, mackerel, anchovies, sardines and tuna) three times a week or meat from grass eating animals, such as lamb or kangaroo. Chose fruit and vegetables high in omega 3 fat like flax seed (linseed), purslane, kiwifruit, lignon berries and walnuts
Consider omega-3 supplements (fish oils, flax or linseed oil); about a gram per day of combined EPA and DH or 4-5 grams of alpha linolenic acid
Other things to consider
- Include half a handful (1/4 cup) of nuts and seeds in your diet daily. Eat them raw, avoiding salted and roasted varieties
- Eat more whole grains and dietary fiber – aim for 30g of fiber each day. Substitute refined products with wholegrain equivalents. Substitute fiber for animal protein. Consider fiber-rich legumes instead of steak mince
- Use wholegrain pasta, bread and brown or wild rice
- Have 5 serves of vegetables per day
- Include legumes such as red kidney beans, lima beans, broad beans or lentils in your diet 2 – 3 times a week
Check your risk factors regularly:
- Systolic blood pressure
- Bad (LDL) pressure cholesterol
- Good (HDL) cholesterol
- Triglycerides
- Homocysteine
- Waist circumference
- Markers of inflammation including hsCRP and fibrinogen
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