February is Heart Month. This year there is a lot of focus on learning CPR, but lifestyle changes that prevent heart disease are still emphasized by most public health organizations. The idea that specific foods and nutrients will prevent heart disease have been around since the mid-20th Century, if not before. Over the years, vitamin C, vitamin E, and fiber have been touted for heart health benefits. Meanwhile eggs, dairy foods and red meat were blamed for heart attacks. Despite all this advice, according to the CDC, heart disease is the leading cause of death in the U.S. That’s not counting the debilitating impact of living with heart disease.
For the average person, lifestyle changes remain the most significant intervention. These include exercise, quitting smoking, and diet. Myths persist about foods that will allegedly help lower risk for heart disease. How do those myths stack up against the evidence?
Soy foods (tofu, edamame, tempeh, cooked soy beans) have been touted for heart health for decades, based on an association between soy food consumption and heart disease risk. One classic study found that people who ate the equivalent of 1-1/2 pounds of tofu every day had lower LDL cholesterol. Think about that: 1-1/2 pounds of tofu every single day, day after day. If someone is eating that much tofu, they are not eating other foods (processed meats, etc.). In fact, they’re probably eating a completely different diet. So is it just the soy, or is it the whole diet?
Nothing wrong with soy. Tofu is a great convenient, affordable and versatile protein source. It’s been a staple in Asian cuisine for centuries. Soy foods can be part of a heart healthy diet, but they won’t miraculously prevent heart disease on their own.
There’s plenty of evidence that a Mediterranean Diet, rich in olive oil, is good for heart health. But is it just about the olive oil? Olive oil, particularly extra virgin, certainly has many unique nutritional properties. Using olive oil for home food preparation is a good idea. But adding token bits of olive oil to a diet of highly processed foods isn’t likely to benefit your health. The traditional Mediterranean Diet emphasizes vegetables, nuts, grains and legumes, all of which promote heart health.
The research on chocolate and heart health is complicated. Studies are small and short duration. The type of chocolate used is all over the map, from candy bars to capsules of cocoa flavanols. Study subjects might eat chocolate 3 times a month, 3 times a week, every day, or they might be taking capsules every day. All sorts of things are measured to try to identify a benefit: atrial fibrillation, blood pressure, peripheral artery disease, HDL, LDL, etc. At best we can say there might be some minor benefit from regular consumption of dark chocolate. If you like chocolate, enjoy it in small amounts. Don’t expect miraculous health benefits.
Omega 3 fats
These uniquely shaped fatty acids are nutritionally important and have many known health benefits. They play a critical role in immune, brain and eye function. Food sources of omega-3 fats are linked to more benefit for heart health than supplements. That means eating high fat fish, like salmon, sardines, mackerel or herring, a couple of times a week.
What could be better? Enjoy red wine and improve heart health at the same time? There is some evidence that moderate wine consumption has some benefit. Research focuses mostly on components of the wine, particularly a polyphenol called resveratrol. Study results are mixed; resveratrol may reduce inflammation and lower LDL cholesterol. Since many of the studies use resveratrol supplements rather than actual wine, it’s unclear how beneficial a glass of red wine would be. By the way, other foods have resveratrol: peanuts, blueberries, cranberries and fresh grapes.
Oats and oatmeal are rich in a fiber called beta-glucan, which help slow digestion and modestly lower LDL cholesterol. The cholesterol angle has been used to market oatmeal as a heart healthy food for many years. The benefit is modest, but there’s nothing wrong with eating oatmeal, as long as it isn’t loaded up with sweeteners. Ready-to-eat cereals made with oat flour or oat fiber are another matter entirely. Some may have just a smidgen of oat content, to justify a health claim. If you want to take advantage of oat fiber, eat real oatmeal.
Other foods, nutrients and supplements are promoted for heart health, but these are some of the more significant and enduring examples. Alone they aren’t likely to make much difference. Eaten as part of a whole-foods, mostly unprocessed diet loaded with vegetables, legumes and whole grains, these foods could help reduce your risk of developing heart disease.