Fibre As well as the minerals contained within beans, legumes and pulses, these foods offer a variety of fibre sources. As with most aspects of health, your gut microbes have a significant role in cardiovascular disease and there is a clear ‘gut-heart’ connection.63 Inflammation is an important contributor to the mechanism of cardiovascular disease and nurturing a robust gut population with plenty of fibre sources reduces inflammation and can prevent damage to arteries that can cause heart attacks and strokes. In addition to pulses and legumes, chicory, garlic, onion and leeks are fantastic fibre sources that will encourage a healthy microbiota.
+ Good-quality fats These have been shown to have positive effects on the expression of your genes, which create a more favourable cholesterol profile and improve fat distribution around your body.49 The fats to focus on are those from whole plant sources: concentrate on the least refined types. These include walnuts, pistachios, almonds, oily fish, cold-pressed virgin oils (like avocado, rapeseed and olive) and seeds. These tend to have higher amounts of unsaturated versus saturated fats, but I’d rather you pay attention to foods rather than the biochemical profiles of ingredients. I’ve found in clinical practice that it’s a waste of mental energy to try and entertain the different arguments for and against certain fats. The reality is, all fats contain both unsaturated and saturated categories in varying proportions and subtypes. It doesn’t make any sense to suggest we should remove all saturated fats from your diet when every fat you can think of will contain some amount of saturated fat. Trust me on this one: your heart will thank you for focusing on plentiful whole, largely plant-based fats and enjoying fats from animal products like meat and dairy on occasion.
LIFESTYLE 360
Diet is just one of the many strategies to positively impact metabolism, genetic expression, body-fat distribution and many more processes that benefit your heart.64 Now consider the extra medicinal benefit of complementing delicious food with lifestyle modifications. As a starting point, the recommendations of smoking cessation, alcohol moderation and exercise are essential, but this is not where lifestyle advice stops. Over and above these well-known factors are other extensively studied recommendations that I’ve outlined below.
+ Sleep If there was one thing I could change about my patients’ habits, from the perspective of improving heart function, it would be to get more sleep. Sleep deprivation is correlated with higher blood pressure, higher measures of inflammation and worsening cholesterol profiles, all of which contribute to heart disease.65 Findings from multiple studies demonstrate that a lack of sleep causes raised stress hormone levels and activation of your ‘fight or flight’ system which leads to changes in your mental ability as well as causing strain on your heart. In addition to the direct impact, after a poor night’s kip your brain sends signals to make you hungrier, making you more likely to crave that sugary croissant or salty fried snack, which will compound the detrimental impact.66 As with most things in medicine it’s not about quantity but quality. Seven to nine hours a night is a general rule of thumb, but try measuring how long you sleep at the weekend without an alarm waking you the next day and being aware of how refreshed you feel. This will give you a personal indication of generally how much sleep you should be aiming for during the working week, too.
+ Stress-relieving techniques As an adjunct to improving stress hormone levels and reducing inflammation, stress-relieving techniques and mind–body interventions including deep breathing exercises, meditation and yoga can have positive effects on heart health. It may seem slightly leftfield for a conventionally trained doctor to be recommending this, but actually mental stress has been shown in many studies to be a significant contributing factor to heart disease.67, 68 Stress activates the immune system to create an inflammatory environment as it perceives the body is ‘under attack’ and this can lead to oxidative stress that damages and weakens blood vessels. These same stress hormones can increase sugars in your bloodstream, which can impact fat production by the liver as well as cholesterol ratios. There are robust clinical reasons behind why one of the most effective lifestyle programmes for heart disease, the Dr. Ornish Program for Reversing Heart Disease, has an intense focus on stress-relieving techniques. We would all benefit from one of these in our daily routine and you can check the website www.thedoctorskitchen.com.
+ When we eat The timing of when we eat has been shown to have a significant impact on our blood sugar, cholesterol ratios and the overall impact on our heart health.69 It is an unfortunate and well-recognised fact that shift workers who experience regular disruption to their circadian rhythm (the rough 24-hour cycle that all our cells are aligned to) have a greater risk of heart disease, obesity, dementia and generally live shorter lives.70 However, there are certain practices that even shift workers can employ to mitigate the effect of cycle interference. Studying this population of workers has led to some interesting recommendations that even those who are lucky enough not to have to do odd working patterns can employ. As a guide, it has been suggested that night-shift workers should eat at the start of their shift (dinner) and at the end (breakfast) to minimise the negative impact of eating when their bodies should be asleep. This practice of ‘defining periods of eating’ to a rough 10–12-hour window (during hours that you are awake) has also been shown to have favourable effects on markers of disease risk.71–73 As a general rule of thumb, this practice allows cells of your liver, pancreas and gut to better tolerate the food you ingest so that it is less likely to cause blood sugar spikes and cholesterol imbalances which can affect your heart. It’s a simple guide that not only gives your gut a rest (allowing it to perform the numerous other functions it needs to do) and minimises disturbance to your important rhythms, but also it also discourages mindless snacking in the late evenings that most of us do out of boredom.
These simple diet and lifestyle practices are incredibly powerful and accessible to the entire population. Combining these with the other chapters that demonstrate how to improve your immune system, balance inflammation and relieve stress produces a collective medicinal package that is so powerful in the fight against the biggest killer in the UK today. Our food and lifestyle are powerful tools that I encourage you to use, whatever your age for the optimal functioning of this principal organ.
It’s amazing how many times I see ‘inflammation’ as a concept coming up in different medical specialities as one of the potential causes of disease. It has almost become a unifying theory that links conditions of the modern world to our lifestyles. You might think I’m just talking just about the swollen ankle that happens after an injury, or the redness that surrounds a cut on the skin, but high blood pressure, heart disease, dementia, diabetes and mental health problems all have links to an imbalance of inflammation in the body at a cellular level.75
WHAT IS IT?
I see many products being labelled as ‘anti-inflammatory’ and I think there is a lot of misunderstanding about what inflammation
