Page 8 of 9

Page 9


Tobacco and Cardiovascular Disease

Physical Activity and Cardiovascular Disease

Diet and Cardiovascular Disease


heart bar
    Diet and CVD


  • *The connection between diet and cardiovascular disease has been well established in numerous studies.
  • *Over consumption of calories, total fat, and saturated fat seems to increase the risk of cardiovascular disease.
  • *Certain people seem especially "salt sensitive." Restricting sodium in their diets can produce significant drops in blood pressure.
  • *Reducing the intake of saturated fats, primarily from high fat meats and dairy products, can help to lower LDL cholesterol levels.
  • * Reducing the intake of saturated fats seems to have more impact on lowering serum cholesterol than reducing the intake of cholesterol itself in foods.
  • *If a person is overweight or obese, losing weight often results in a drop in blood pressure, blood glucose (if a person has diabetes), and serum triglycerides. The amount of weight needed to produce these changes is relatively small.
  • *Weight loss methods have been studied extensively. Almost any system of calorie restriction and/or increased exercise will result in weight loss. The evidence about weight maintenance, however, is not as promising. Most people who lose weight regain the lost weight over the first two years.
  • *Changing lifestyle habits, such as what you eat and how much physical activity you get, is not very simple. People need education, assistance, and support from professionals, families, and coworkers to be successful in changing lifestyles.


MYTHS : If I stop drinking whole milk, I won't get enough calcium, and if I eat less red meat, I won't get enough protein and iron.

Low fat dairy products contain as much calcium as their higher fat, higher calorie counterparts. Most Americans eat two to three times the protein they need. Healthy protein is found in vegetables, grains, beans, low fat dairy products and leaner meats as well. Iron is more available from red meat, but learning to eat a wide variety of foods at meals can help with iron absorption from non-meat sources.

Rapid weight loss is widely regarded as a sign that a new diet or weight management regimen really works, when the opposite is actually true. Slow but steady weight loss is much more likely to result in permanent changes that will help in maintenance. The weight loss industry, including the manufacture and sale of liquids and pills, herbs, and vitamins, has convinced many persons that by using supplements they can continue to eat anything they want and still control weight. Finally, unrealistic goals for weight get in the way of healthy changes. The loss of five to ten percent of body weight can make a large difference in blood pressure and blood glucose, thereby reducing CVD risk.

I buy cookies, cereal, and bread made with oats and this will help.

Studies show that soluble fibers, such as those found in oats, barley, carrots, parsnips, citrus fruits, berries, apples, and grapes can help to lower blood cholesterol of foods. The effect is best seen when consumed in conjunction with a low fat diet. When oats are baked into cookies and other desserts, the cholesterol lowering effects may be lost because of the added fats and other ingredients.

I am on a very low fat diet -- less than 10 grams of fat per day. This will solve both my overweight and cholesterol problems.

Some fat in the diet is necessary for us to absorb certain vitamins. Fat also contributes to "satiety" or the feeling of fullness that keeps us from being hungry all the time. If you are successful in eliminating nearly all sources of fat, you will be cutting out all forms of meats, most grains and beans, even some fruits and vegetables. Such a diet would be very unhealthy because it would eliminate some very important nutrients. Most people who start out on very low fat diets eventually "break over" or go off the diet. When this happens, they become convinced that they can never lose weight or control blood fats. It is better to reduce the known sources of saturated fat (meats, cheeses, and high fat dairy products), use small amounts of monounsaturated fat (olive and canola oils) for flavoring, and increase use of fruits, vegetables, beans and grains, which are generally low in fat and calories. Be cautious in using low fat products because they often are high in calories.

Margarine is better than butter.

Butter contains large amounts of saturated fat and raises blood cholesterol more than any other fat. For this reason, it is not the best choice for general use in cooking and for spreads. Margarines are made by partially hardening (or hydrogenating) liquid vegetable oils so that they have a spreading consistency that is pleasant to use. The process used in manufacturing causes those formerly healthy oils to become somewhat more saturated and also creates a "new" kind of fatty acid, the trans fatty acid found in the margarine. Trans fatty acids may also increase the LDL, or harmful form of cholesterol, in the blood. A sensible way to deal with this dilemma might be the following: Use liquid vegetable oils, such as olive or canola oil, for cooking, baking, and salad dressings. Avoid using butter for cooking and spreading, except for the very few recipes where its taste is important to you. Choose a margarine spread that is made primarily from liquid vegetable oils and is low in saturated fat. Then try to limit your use of spreads, or try the "diet" spreads that have water as the first ingredient on the label.

Garlic pills and antioxidants lessen the problem.

Continuing research will give us much more information about substances in foods that are health giving. For the present, we know that there have been studies that seem to show that garlic and antioxidants may be protective of the heart and blood vessels. What we don't know is whether the protection is from the garlic or vitamins alone or if it is from eating a diet rich in foods containing those substances. Many scientists think there is a "synergistic" effect, that is, that there are other substances in the foods that cause the vitamins to be helpful. The most sensible (and cheapest!)

advice is to eat more plant foods and smaller servings of animal foods. This will result in cutting down on saturated fats and increasing fibers and natural oxidants in foods. Season with garlic and other herbs as you learn to cut down on fats and salt.

I believe in the "French paradox"--why drinking wine will reduce heart disease risk.

Many people seem eager to adopt the custom of drinking wine at meals not just because it might prevent heart disease, but because it can be a pleasant custom. There is ongoing research to try and isolate substances in wine that might be protective. When likely substances are found, they can be tested in pill form to help determine if this might be true. In the meantime, remember that there are several large differences in the way the French and most Americans eat. Much longer and more relaxing mealtimes with attention to skillful food preparation using herbs and fine cooking techniques are characteristic of French cuisine. The French eat a wide variety of vegetables and fruits not found in American fast food restaurants or, unfortunately, on most tables in American homes. Finally, drinking wine with meals adds calories and is a very real problem for the estimated one in ten American adults who are victims of alcohol abuse. If it is otherwise safe for you to use wine at meals, limiting this to no more than two drinks per day is probably a good idea.

I switched to turkey bacon and turkey ham--that's enough.

Again, the best way to lower cholesterol in the blood is to reduce consumption of all animal products. Read the labels since some sources of turkey ham and bacon can be higher in fat than the original products.

Some people won't benefit from a change to a low fat, low saturated fat diet.

Because genetic factors influence the way our bodies use, reuse, and dispose of cholesterol and fats, not all persons will see significant changes in serum cholesterol, HDL cholesterol, and triglycerides by changing what they eat. By consuming more fruits, vegetables, whole grains, and low fat dairy products, however, even persons who continue to experience hyperlipidemia may be reducing their risks of diverticulosis, cancer of the bowel, constipation, osteoporosis, and other diseases of nutritional origin. By reducing consumption of fatty foods, people are likely to experience modest success in weight management, especially when combined with increased exercise.

Healthy eating costs more.

No special diet foods are necessary for a healthy diet. Fresh fruits and vegetables should be bought when they are in season. Frozen vegetables and drained canned vegetables can be used. Meat prices reflect the amount of lean meat per pound, with the most expensive yielding the most edible lean meat. By reducing the amount of meat purchased per person and by using only the leanest cuts, most consumers will be able to afford a lower fat diet. Meat substitutes, such as dried beans, are much cheaper than meat and are helpful in treating many conditions. Special dietetic foods are expensive and also unnecessary in most cases. Soda pop, snack foods, and prepared meats and dinners are expensive items. By using fewer of these products, consumers should be able to buy more fruits, vegetables, beans, and other healthy foods.

Community Strategies

Communities can play a leadership role in CVD prevention. Research shows us that one of the most effective ways to have measurable impact on our communities is to target all levels of social structure with behavioral and environmental change strategies. The purpose of this section is to help guide the choice of community changes that your group will seek in each relevant sector of the community. To address the mission of reducing risks for CVD, your group programs, policies, and practices within schools, health care settings, worksites, or the broader community. Awareness strategies focus on informing the public about health issues, concerns, and/or solutions. Knowledge and skill-based strategies educate the public about causes, symptoms, strategies, etc., of public health issues.

Providing opportunities and supportive environments promotes and encourages healthy behavior.

Policy and regulation means establishing mandates that promote healthy behaviors.


Schools are a key intervention channel for influencing healthier behaviors in a positive way. Elementary and secondary schools provide a structured opportunity to reach youth with interventions and health messages that can set the stage for a healthy lifestyle now and in the future.

Health care settings have the unique opportunity to promote positive lifestyle behaviors. Role modeling of positive lifestyle behaviors could perhaps be the most influential role a provider can have on clients.

The worksite channel is composed of those activities through which employers, unions, and insurers try to influence the health of workers in a positive fashion.

All these "channels" together are parts of the broader community. The community as an entity can, in turn, promote health for all its members. The above listed channels are only a few examples of channels for which interventions can take place.

HeartTop | Page 7 | To Page 9 | Home

Published July 1997
For questions concerning page content, see contact information on the Contents page.
Navigation updated 02/05/01