Heart Attacks, Strokes, and Dementia: Reducing the Risk With Every Meal

What is a safe, effective, and inexpensive way to reduce the risk of heart attacks, strokes, and dementia? What we eat is a key part of the answer.

In this podcast, David T. Nash, MD, discusses the role of diet and exercise in cardiovascular disease prevention. Dr Nash is Clinical Professor of Medicine at Upstate Medical Center in Syracuse, New York. The author of more than 250 peer-reviewed clinical articles, Dr Nash has practiced cardiology in Syracuse for over 50 years. He is a Fellow of the National Lipid Association. Here, Dr Nash offers simple specific guidelines that may be helpful to your patient.

Here is a brief summary:

Key components of a dietary program:
• Decrease saturated fat intake (ie, beef, full-fat cheeses, baked goods, palm oils)
• Add more soluble fiber to your diet (ie, with products containing psillium), including:

  • Bran Bud cereals, Kashi Go Lean (yellow box has 4 g per serving) (for every 1 g of soluble fiber you eat, you can reduce LDL levels by about 1%)
   • Fruits, including apple, oranges; beans; brown rice; guar gum; pectin
   • Plant stanol ester found in Benecol Margarine
   • Nuts, including almonds, pistachios, and walnuts
   • Soy products (eg, tofu)

Heart Attacks, Strokes, and Dementia

The Protocol Diet From Dr Jenkins in Canada
This diet is appropriate for motivated patients, those who have had adverse reactions to drug therapy, and individuals who prefer a non-drug approach. One study showed that the Protocol Diet lowered LDL as much as a 20-mg dose of lovastatin.

1.2 g of plant sterols
8 g of soluble fiber
16 g almonds (1/2 oz)
16 g of soy protein

Other approaches to cardiovascular health
• Lower blood pressure with dark chocolate
• Use grapeseed oil to raise HDL levels (about 1 to 2 oz/d in salads, cooking, etc)

Nondietary measures
• Exercise daily, 30 to 60 minutes, to help lower high blood pressure and reduce lipid levels and obesity

Suggested readings
• Foley DJ, White LR. Dietary intake of antioxidants and risk of Alzheimer disease: food for thought. JAMA. 2002;287:3261-3263.
• Jenkins DJ, Kendall CW, Marchie A, et al. Effects of a dietary portfolio of cholesterol-lowering foods vs lovastatin on serum lipids and C-reactive protein. JAMA. 2003;290:502-510.
• Milles EJ, Rachlis B, Wu P, et al. Primary prevention of cardiovascular mortality and events with statin treatments: a network meta-analysis involving more than 65,000 patients. J Am Coll Cardiol. 2008;52:1769-1781.
• Ornish D, Brown SE, Scherwitz LW, et al. Can lifestyle changes reverse coronary heart disease? The Lifestyle Heart Trial. Lancet. 1990;336:129-133.
• Taubert D, Berkels R, Roesen R, Klaus W. Chocolate and blood pressure in elderly individuals with isolated systolic hypertension. JAMA. 2003;290:1029-1030.