The Heart of the Matter

Last week we briefly discussed inflammation and provided an overview of arthritis. If you never have to deal with OA, gout, or other forms of arthritis, consider yourself lucky! Arthritis is all too common for so many. This week, we’ll dive a little deeper and talk about the “heart and soul” of inflammation.

As previously mentioned, heart disease is still killing too many of us. According to the CDC, 1 person dies in the US every 36 seconds of cardiovascular disease and 18.2 million adults aged 20 and up have some form of coronary artery disease (CAD). Someone who’s 20 years old is still considered a pediatric patient! CAD costs the healthcare system close to 220 billion dollars annually.¹

Knowing your family history, lipid profile and other risk factors including blood pressure and diabetes risk is also important in preventing heart disease as is not smoking and getting regular exercise. Diet is one of the most controllable risk factors for heart disease. We can quit smoking, but we can’t quit eating!Diet impacts the risk of heart disease in a number of ways. Most of us understand that saturated fat from animal foods (beef, butter, bacon, lard, and full-fat dairy) as well as trans-fat (from processed crackers, pastries, and other snacks), raise LDL (lousy) cholesterol.But oxidative stress and inflammation are two big factors that also raise the risk of heart disease.² Polyunsaturated fatty acids (PUFA), when oxidized due to stress from free radicals, create products of oxidation. Evidence suggests that oxidized lipids accelerate an inflammatory response by communicating with immune cells (like macrophages and endothelial cells), leading to arterial damage.  Reducing oxidized cholesterol esters (such as LDL) as well as phospholipids that impact inflammation is of particular interest to researchers.³Taming the flameReducing inflammation is not only a matter of cutting back on foods that raise LDL cholesterol, it also involves decreasing free radical production. Free radicals are unstable compounds in the blood that are made through exposure to pollution, smoking, radiation, metabolism of drugs as well as food. Antioxidants are elements that prevent oxidation and combat free radicals. ⁴When considering foods highest in antioxidant content, berries, green leafy vegetables, and vegetables from the cabbage family (broccoli, Brussels sprouts, cabbage, cauliflower) come to mind.  Antioxidants are also present in bananas, mango, papaya, pineapple, and other tropical fruit. Polyphenols, quercetin, carotenoids, vitamin C, and epigallocatechin (found also in green tea) protect red blood cells and fat cells from the stress of oxidation. ⁵Despite the popularity of low carb diets, it’s important not to discount the importance of grains in the prevention of heart disease. Cereal grains including wheat, corn, rice, barley, rye, sorghum, oat, and millet are high in phenolic compounds as well as flavonoids and anthocyanins. These possess high antioxidant activity and have been found to reduce LDL oxidation.⁶ Antioxidants for all!The way to amp your antioxidant intake and aid in heart disease prevention is through produce.

Forget the vitamin C pills and gummy fruit and vegetable supplements.

Here are tips to “put your plants on” and make the most of your meals.

• Encourage a variety of whole grains beyond wheat and oats. Add barley to soup or try millet in your next grain bowl.
• Make it zesty- include citrus zest in marinades and sauces. Did you know orange zest contains over 250 different phytochemicals? ⁷
• Pile on the greens- add spinach to sandwiches, pasta, and rice dishes, soups, and chilis. Roast kale or sneak it into salads and soup.
• Try different tropical fruit- papaya, passion fruit, mangoes, and more.
• Keep frozen berries on hand to add to oats, yogurt, smoothies, or cereal.

Lisa Andrews, Med, RD, LDReferences:

1. https://www.cdc.gov/heartdisease/facts.htm
2. Clifton PM, Keogh JB. A systematic review of the effect of dietary saturated and polyunsaturated fat on heart disease. Nutr Metab Cardiovasc Dis. 2017 Dec;27(12):1060-1080.
3. Zhong S, Li L, Shen X, Li Q, Xu W, Wang X, Tao Y, Yin H. An update on lipid oxidation and inflammation in cardiovascular diseases. Free Radic Biol Med. 2019 Nov 20;144:266-278.
4. Neha K, Haider MR, Pathak A, Yar MS. Medicinal prospects of antioxidants: A review. Eur J Med Chem. 2019 Sep 15;178:687-704.
5. Septembre-Malaterre A, Stanislas G, Douraguia E, Gonthier MP. Evaluation of nutritional and antioxidant properties of the tropical fruits banana, litchi, mango, papaya, passion fruit and pineapple cultivated in Réunion French Island. Food Chem. 2016 Dec 1;212:225-33
6. Van Hung P. Phenolic Compounds of Cereals and Their Antioxidant Capacity. Crit Rev Food Sci Nutr. 2016;56(1):25-35.
7. Wang F, Chen L, Chen H, Chen S, Liu Y. Analysis of Flavonoid Metabolites in Citrus Peels (Citrus reticulata"Dahongpao") Using UPLC-ESI-MS/MS. Molecules. 2019 Jul 24;24(15):2680.

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