Proper nutrition -- including a low fat, high fiber diet -- is considered so important to heart health that just about every set of guidelines touches on what you should eat, what you shouldn't eat, how you should eat it, and when you should eat it.
In fact, government guidelines for treating blood pressure, cholesterol, and obesity -- three top risk factors for heart disease -- all emphasize diet as a means of getting your numbers where they belong. And don’t forget that in addition to a healthy diet, getting regular physical activity contributes to heart health, weight management, and a host of other benefits.
"There is no question that nutrition is the single most important factor in the prevention of coronary artery disease," says Thomas Barringer, MD, the medical director of the Center for Cardiovascular Health at the Carolinas Medical Center in Charlotte, N.C. "It definitely comes down to nutrition."
Making More Magnesium Mandatory
"Some researchers say that, as a nation, we could cut our rate of heart disease by one-half if we took more magnesium," says City Island, N.Y.-based Carolyn Dean, MD, ND, author of The Miracle of Magnesium. "Magnesium is the body's natural calcium channel blocker. It balances out the excess calcium that is associated with the heart going into muscle spasm, which equals a heart attack."
Dark, leafy green vegetables are rich in magnesium, and whole grains and nuts also are good sources.
"Cooked and processed foods also lose a lot of magnesium, making it a very deficient mineral." That's why Dean suggests taking 300 mg two to three times a day of magnesium oxide, magnesium citrate, or magnesium glycinate.
Although doctors may recommend higher doses of magnesium supplementation for specific conditions, the Institute of Medicine states that the upper intake of supplemental magnesium for healthy adults is 350 mg. There isn’t an upper limit tied to dietary magnesium. Make sure to talk to your doctor about using supplements as they can interfere with some drugs and be unsafe in people with certain conditions or taking certain medications.
Data from the Nurses' Health Study and the Harvard School of Public Health back up Dean's claims. A higher intake of magnesium may reduce the risk of developing type 2 diabetes. Research has shown that low levels of magnesium may impair insulin sensitivity or function. Consuming adequate levels of magnesium may help insulin function properly in the body, which may prevent type 2 diabetes.
The American Heart Association (AHA) lists diabetes as one of the six major risk factors for cardiovascular disease. In fact, adults with diabetes are two to four times more likely to have heart disease or a stroke than adults without diabetes.
Not Fooling With Folic Acid
"High levels of homocysteine can lead to heart disease, and the way to combat high homocysteine is to take folic acid," says Michael Poon, MD, chief of cardiology at Cabrini Medical Center in New York. Aim for 1 milligram or 1,000 micrograms a day, he says.
Homocysteine may damage the blood vessel walls and promote blood clots, and although studies have consistently shown that high levels are associated with an increased risk of heart disease, researchers are still not sure whether lowering the level of homocysteine reduces heart disease risk.
But homocysteine levels are strongly influenced by diet, and several studies have shown that higher blood levels of B vitamins -- specifically folic acid -- are related, at least partly, to lower concentrations of homocysteine. Today, cereals, breads, and other grains like rice are fortified with extra folic acid. Fruits and vegetables like spinach, strawberries, oranges, and broccoli have high levels of folic acid.
But don't forget the other Bs, says Nancy Kennedy, MS, RD, a nutritionist at the Ministrelli Women's Heart Center at Beaumont Hospital in Royal Oak, Mich. Vitamins B-6 and B-12 are also important in lowering homocysteine. "Many clinicians emphasize folic acid, but actually all three B vitamins are involved in the metabolism of homocysteine, and B-6 is one of the vitamins that is typically very low in the American diet," she says. Beef liver, baked potatoes, watermelon, and banana are rich in B-6, while milk, meats (beef, pork, lamb, veal, fish, poultry), eggs, and cheese are replete with B-12.
Nixing Your Heart Risks With Niacin
Niacin (another B vitamin) helps increase HDL or "good" cholesterol levels. It comes in over-the-counter preparations and as dietary supplements. It's also found in dairy products, poultry, fish, lean meats, nuts, and eggs. Legumes and enriched breads and cereals may also contain niacin. Poon recommends that people with low HDL levels take 500 mg of niacin each day, building up to 1,000 mg.
But, he cautions, this should be monitored by a doctor because each person is different. "It can have some side effects and is not for everybody, particularly people who already have high HDL levels," he tells WebMD. Flushing, itching, and nausea and vomiting can occur.
Pumping Up Your Potassium
Potassium helps regulate blood pressure levels, and high blood pressure, or hypertension, is a major risk factor for heart disease. Normal blood pressure is less than 120 systolic, the upper number in a blood pressure reading, and less than 80 diastolic pressure, the lower number in a blood pressure reading.
For adequate potassium, "I suggest five to nine servings of fruits and vegetables each day," says Kennedy. Potassium-rich foods include dairy, bananas, potatoes, peaches, and apricots. In fact, the National High Blood Pressure Education Program recommends that people who do not suffer from hypertension consume at least 3,500 mg of dietary potassium daily.
Kennedy prefers whole foods to supplements when it comes to potassium. "Fruits and vegetables are also high in fiber, and you also need fiber to lower cholesterol levels, which won't come from potassium supplements," she tells WebMD. One medium-sized baked potato with skin has 850 mg of potassium; 10 halves of dry apricots contain 407 mg; 1 cup of raisins has 1,099 mg, and one cup of winter squash has 896 mg.
Counting on Calcium
"A lot of people think of calcium as for the bones, but it's also good for the heart," Kennedy says. "It helps weight management, which indirectly affects heart disease risk." It also helps regulates blood pressure along with magnesium and potassium.
"I recommend that everyone get two to three servings of calcium-rich food a day," she says. "You can eat almonds or broccoli, but it takes three cups of broccoli to get the calcium in one glass of milk, so I really push dairy or soy foods.
The 2005 U.S. Dietary Guidelines recommend adults consume three servings of calcium-rich low- or nonfat dairy each day.
"For people who are lactose intolerant or don't like the taste of milk, I suggest including soy cheese and soy milk because they are rich in calcium and also help lower cholesterol," she says. One cup of milk has 290 to 300 mg of calcium, and 1 oz of Swiss cheese has 250 to 270 mg. Dietary supplements are another option to make sure you are meeting your daily needs.