Atheroschlerosis commonly known as “hardening of the arteries” is the root cause of all heart disease including high blood pressure, heart attack and stroke. This gradual narrowing of the blood vessels is a complex process with many factors. Think of your blood vessels as rivers whose banks are constantly changing based on what is surging through. Everything we eat is digested into the basic components of carbohydrate, protein, fat, vitamins and minerals which flow through this river. When a large load of saturated fat (like from a double cheeseburger and fries) is sent through the system, the levels of “bad” LDL cholesterol rise, and a thickening of the blood vessel wall occurs. The “good” HDL cholesterol then tries to remove or lower the amount of thickening which is why we call them “good”. So, bad cholesterol increases the blocking of blood vessels and good cholesterol removes those blockages. The problem is that most of us have more bad than good which over time makes for a losing battle.
So the strategy to reduce our risk of atherosclerosis and the resulting heart disease is to avoid foods that raise our bad cholesterol and to increase our activity to raise our good cholesterol. The next chapter in this unfolding story is that there are several foods to include that either improve our ratio of bad to good cholesterol or in some other way in this complex process reduce the formation of atheroschlerosis.
It is thought that chronic inflammation plays an important part in initiating the thickening in the vessel walls. Some foods are pro-inflammatory meaning that they promote inflammation. Others are anti-inflammatory. To reduce systemic inflammation, we focus on consuming anti-inflammatory foods and limiting pro-inflammatory foods. This also involves serving size because we are looking for balance in the ratio of these different types of foods.
Carbohydrate is a broad category that includes sweets, starches, vegetables, milk and fruits. All sweets are pro-inflammatory; candies, pastries, sodas, etc. Limit sweets to special occasions. High fiber starches like beans, peas, corn, brown rice and whole grains are anti-inflammatory while the refined grains; white bread, processed cereals, white rice, etc. are pro-inflammatory. Limit starch serving size to one quarter of the plate. Non starchy vegetables are anti-inflammatory. This is one reason why tomatoes for example reduce our risk of heart disease. Dairy products are essential for the nutrients they provide. Choosing low-fat or skim dairy foods most of the time delivers the benefit without the inflammatory saturated fat. Fruits are valuable carbs for the fiber and nutrients they provide. Choose fresh fruit daily.
Lean protein foods are our best anti-inflammatory choices. Avoid fatty meats and focus on lean modest portions (3-5 ounces for most people). Plant proteins like beans, peas, lentils and soy foods are excellent anti-inflammatory choices that also deliver other heart healthy benefits such as lowering our bad cholesterol. Fish including salmon, tuna, and sardines are good choices because of the anti-inflammatory oils they contain. This is the basis for the American Heart Association recommendation to eat fish twice a week to reduce our risk.
Fats can be pro or anti-inflammatory depending on their type. Saturated fats in meats and dairy foods and trans-fats in margarine, shortening and hydrogenated oils increase inflammation. We find shortening (trans-fat) in a lot of snack foods like crackers, cookies, donuts, etc. and in restaurant deep fried foods like chicken and french fries. Make careful choices when dining out and look for trans-fat on package labels. In the ingredients, look for the term “hydrogenated” or “partially hydrogenated” oils. Mono-unsaturated fats in olive oil, canola oil, avocados and nuts are anti-inflammatory.
It is important to note that anti-inflammatory foods have many health benefits beyond their role in reducing heart disease risk. While it is interesting to explore the science behind health recommendations, it is somehow comforting to realize that our grandparents had it right all along. Eat your vegetables!
Tim Scallon is a registered dietitian nutritionist with St. Luke’s Health. In cooperation with Sodexo Food Service, The Polk Education Center and the City of Lufkin, Tim Scallon hosts the nationally viewed TV series Memorial Cooking Innovations. The popular cooking show celebrates the joy of fresh food and healthy eating and can be seen on cable in 62 cities and online at https://www.chistlukeshealthmemorial.org. On the website find healthy recipes, past cooking shows and sound nutrition information.