Family History of Heart Disease? (Eat This, Not That)

Transcript:

TERESA: Welcome to Dishing Up Nutrition, brought to you by Nutritional Weight and Wellness. We are a small, family owned company with a big goal of spreading the real food message through life changing nutrition education and counseling.

I'm Teresa Wagner, a Registered and Licensed Dietitian, and I'm here today with my cohost, Leah Kleinschrodt, who is also a Registered and Licensed Dietitian. As we close out the month of February, we knew we needed to do at least one show around the topic of heart health since February is the American Heart Month.

So today is the day. The title of our show today is “Family History of Heart Disease? (Eat This, Not That)”. How many of you listening out there know that heart disease is likely lurking somewhere in the depths of your genetic code? Have you ever thought to yourself, boy, I better make some changes now to take care of my heart so I don't end up like Uncle Bob or Grandpa Joe?

Or maybe you've already had a few warning lights go off on your dashboard. You've been put on a high blood pressure medication. You've had to do an EKG or a stress test for some unexplained chest pains. Or your blood sugar levels have danced in the prediabetic range for the last five years. Today, we want to shed some light on what real food can do to help mitigate some of that underlying risk.

LEAH: Yeah, that's great. And this is a topic near and dear to my heart. So totally pun intended there. But I know for me, I have heart and vascular issues coming at me on both sides of the family. And this ranges from high blood pressure and high cholesterol to actual heart attacks, strokes, bypass surgeries and more.

And Teresa, you and I, we've met with many clients who are in that same boat. I can just think about clients that I've sat down with who they start listing off the family members who have had heart attacks in there, even in their forties or sometimes even late thirties. And it makes you almost feel like you're staring down the barrel of a loaded gun and wondering if and when it's going to go off.

And I mean, rightfully so; heart disease is the number one killer of people in the United States, and it's also the number one killer of people in the world. So it is a real thing to be aware of. And unfortunately, it is kind of a sobering reality in that sense.

But you better believe that I'm doing what I can right now to keep my heart strong, to keep my inflammation levels low, and to keep the plumbing clear. And I said this on one of our “Ask a Nutritionist” episodes a few weeks ago, but I think it just bears repeating, that we may have been handed a less than ideal genetic blueprint, you know, we might have some missing bits and pieces here and there, but we don't have to build our house;

And in this case, the house is like our bodies and our systems, we don't have to build that house according to that exact blueprint that we were given. We as humans are very smart and resourceful. And we have the ability to modify and fine tune our blueprints so that our bodies still can work in the best ways possible.

The importance of keeping the heart AND blood vessels healthy

TERESA: That's so true. And I just want to briefly emphasize a point that you have just mentioned. When we talk about heart health, it's not just about keeping the heart muscle itself functioning and strong. Heart health also means that we have healthy, flexible, clear blood vessels, the arteries and the veins. That's the plumbing part I think you were referring to.

LEAH: Yep.

TERESA: I've sometimes referred to it as our highway system. You know, things are coming and going like traffic through our blood vessels.

LEAH: Mm hmm. Yep. And that's a major way that we get things delivered where they need to go in the body. And that is a super great point to make people aware of that when we talk heart health, we're talking about healthy heart and healthy blood vessels.

Avoid processed, convenience foods for heart health

So let's backtrack just for a moment to the statement I made about what am I currently doing and what I help my clients do now to take care of our heart and our blood vessels. So what are some of those big factors that I think about? And to just start the conversation off, to start broadly, I look at where can we make a switch from more ultra processed and convenience foods to real whole foods or like foods that our great grandma would recognize as being a food.

So oftentimes we're looking at things like, can we make a switch from breaded and fried chicken nuggets to using actual real chicken or chicken thighs, chicken breasts in a delicious chicken wild rice soup? Can we upgrade to avocado oil or butter from canola oil or vegetable oils when we're cooking breakfast?

Can we roast a few sweet potatoes on a sheet pan and put another sheet pan of broccoli in the oven? Have that with some steak instead of baking up a few slices of frozen garlic bread? When we're looking for peanut butter, can we choose the peanut butter that has one or two ingredients in it instead of eight or nine different ingredients?

So when we can look at it through that lens and we can change the source of our food from factory to farm, not only do we decrease the chemicals and the iffy additives we're getting in our diet, but we're also increasing the nutrients that we're getting from our food.

TERESA: I do the same thing with my clients. We work hard to make sure that the foundation of their diet comes from quality proteins like beef, pork, turkey, chicken, eggs, fish, seafood, and dairy products. Then we pair that protein with real food carbohydrates, like you were talking about with that sheet pan meal, the broccoli and the sweet potatoes.

So we want to make real food carbohydrates or eat real food carbohydrates, vegetables, fruits and various starches like potatoes, squash, beets, beans, brown and wild rice, rolled oats, and quinoa. Then we round out their meal with a source of natural fats like olive oil, butter, avocado oil, avocados, nuts, seeds, nut butter, canned coconut milk, and more.

I promise you are not going to go hungry eating this way. That is actually a part of the magic. When you feel full and are truly nourished on a biochemical level, most of the cravings for the ultra processed foods just go away.

LEAH: Yeah, and that is so important for being able to eat this way for the long haul. I've talked with many many clients who have these amazing long term health goals like avoiding heart disease or avoiding a heart attack like their uncle had at age 40 or clients who have seen their parents degenerate from Alzheimer's disease or clients who want to avoid a joint replacement or they just even want to have energy to keep up with their grandkids or maintain their independence into their 80s, 90s and 100 years old.

So we have these great goals, but then when we get a little more short term, we tend to stumble when we have to live our everyday lives, when we're faced with Friday night pizza, when we're faced with candy bowl in the break room, when we're faced with the sheet cake at graduation and happy hour with friends.

It is totally human nature to prioritize the short term, to prioritize some of these indulgences versus some of those longer term payoffs. Part of that challenge is having a strategy or just knowing what your options are when it comes to navigating some of these situations.

But another big part of it is when we have those cravings that rear up and you are trying to say no when every other cell in your body is saying, yes, eat the thing. So if we can turn that dial down on the cravings piece; and then we work to just layer in some strategies on, again, how do we navigate through some of these usually social types of situations with food?

Now, all of a sudden, we can truly actually start to feel like, oh, this is actually doable. I can kind of see those stepping stones between what I'm doing now and those long term goals that I have, those future oriented goals.

TERESA: Such a good point. It's such a good point. I mean, I just feel like we're, human nature is so much what I want right now in this moment. I try to like, you know, keep it light with my clients that we all have this toddler living in us.

LEAH: Yes, I love that analogy.

TERESA: I want what I want, and I want it right now.

LEAH: Yep.

TERESA: And we're just these adults, hopefully mature adults, with these toddler brains. So when we can create some distance between us and those ultra processed foods and fill that gap with delicious, balanced meals and snacks, we start to rewrite that blueprint that we mentioned earlier.

So, instead of that Friday night pizza where one slice of pizza might give us eight teaspoons of sugar and the crust is made with refined flour and canola oil, I might ask my client if they'd be willing to try maybe making our meat and veggie sheet pan pizza, or making a pizza with a meat crust instead of a dough crust.

Instead of raiding the break room for something sweet mid-afternoon, we'll plan a few balanced snack options, like a few protein peanut butter balls, or making a small yogurt parfait with plain yogurt, berries, and some nuts on top for crunch. And if there's an occasion that calls for cake, perhaps that client can offer to contribute a dessert dish to the menu and still do something tasty but lower in sugar, like the blueberry nut freezer bars or the pumpkin cheesecake bars or the chocolate fat bombs that are on our website.

LEAH: Yeah, it is I think, and that was something actually that came up in the Nutrition for Weight Loss class that I taught this last week of, you know, yes, we eat real food, but of course, there's always going to be social situations or things that we do where food is a celebration. It's part of what we're doing there.

And a lot of times we celebrate with sweet things, or we celebrate with dessert types of things. So what can we do when we're looking at that real food perspective, what can we still do to celebrate and be a part of that and still kind of hold true to our goals or still eat lower sugar? And some of those recipes are that great example of okay, we can still feel like we can have a treat or something sweet and still be a part of that celebration and that event without blowing things out of the water.

TERESA: Yeah. And sometimes it's okay to indulge. It's just, what does that do to your, what happens next? And those are strategies that we talk about too, when you're talking about strategies is, okay, so if I indulged, then what? Do I feel bad about it? And then just eat all the things or do I rebound and just get right back on track?

LEAH: Yep. Exactly. And Nikki, one of our other dietitians, has mentioned before, too, that's always something that's always stuck with me, too, is if you've kind of gone a while without sugar and then had some sugar, in your brain, just kind of be ready for a three day battle, like that you might have some of those lingering sugar cravings for a few days after you have something a little sweeter or a little more sugary.

But if you kind of know it's coming, you can prepare and you can be like, okay, I know this is temporary and I know that this will last forever. I just kind of need to get through these couple of days and balanced eating and I know it'll get better after a couple of days.

TERESA: Yeah. And then that's where the recipes for those peanut butter balls or those fat bombs come in handy.

LEAH: Absolutely.

TERESA: Because while they taste a little bit sweet, they shouldn't be triggering.

LEAH: Yep, exactly. Yeah. So those are all really great ideas. And I know it doesn't seem like it right now, but graduation season is coming up. We're in February. So we've got graduations coming up in May and June for most people.

Balanced blood sugar reduces cravings & supports heart health

So going back to the components of a balanced meal or a balanced snack, you gave some great protein ideas before, some great real food carbohydrate ideas and some healthy fat ideas in there. Another really key piece why we have clients eat this way and nourish themselves this way is that it keeps our blood sugar level in check.

When we have more rolling hills blood sugar, so gentle ups and downs instead of a roller coaster of blood sugars; when we're swinging way up and way down, usually we do a little bit better. Things seem a little bit more manageable day to day. It is those big swings in blood sugar that create more cravings for the sugar and the refined carbohydrates.

So think the breads and the crackers, the cookies, the ice cream. So we have more of those cravings in the short term, but then thinking longer term or over time when we are constantly going too high in blood sugar, having those really high swings, it can lead to more insulin resistance or eventually lead to prediabetes or type two diabetes.

When we think about that from a heart health perspective, when we consistently run high in blood sugar, so we, again, on, in that plumbing or in, on those highways, when we have a lot of sugar that is on that system, that sugar scratches up and damages the lining of those blood vessels, and then those blood vessels become inflamed, and then they don't work quite as well.

So kind of to your point earlier, Teresa, is one ice cream cone going to clog your arteries and cause you to have a heart attack? No, it's not just one of anything that's really going to do it. But if we get into this routine where we start our morning with cereal and orange juice, which is just a lot of carbohydrates, which turns into a lot of sugar in the body;

Then we follow that up with a sandwich and chips for lunch, more carbohydrates, more sugar. And then we have a spaghetti dinner at the end of the day. And then we do that on repeat for five to 10 to 20 years. Then yes, you will be creating more inflammation and just more damage in those tiny little blood vessels.

Prediabetes & diabetes: risk factor for heart disease

TERESA: Yes, prediabetes and diabetes are well known risk factors for heart disease. But let's talk more about that on the other side of break.

LEAH: Yeah. Great. So you are listening to Dishing Up Nutrition brought to you by Nutritional Weight and Wellness. I am Leah Kleinschrodt, along with Teresa Wagner, and we are your hosts for this episode talking about the nutrition connection to lowering your risk of heart disease. We'll be back in a moment.

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TERESA: All right, we are back to Dishing Up Nutrition, and we are continuing our topic today. It's “Family History of Heart Disease? (Eat This, Not That)”. And when we left off, we were talking about prediabetes and diabetes being a well known risk for heart disease. And as Leah was explaining earlier, all that sugar, it acts like sandpaper on the inside of our blood vessels.

And the tiny blood vessels in our heart, our kidneys, our eyes, our fingers and toes, are especially vulnerable to damage. So when we lead classes and counsel clients, we are teaching the same formula. Choose a protein, choose a cup or two of vegetables, and a half a cup of starch or fruit. And then choose some healthy fat to go along with it. Most people need to eat something every three to five hours, so we don't dip in blood sugar, which creates a lot of internal stress and cravings.

LEAH: Mm hmm. Yeah, so you're, we're trying to stay away from those extreme ends of blood sugar, so we don't want blood sugars that are too high, but we also don't want blood sugars that are too low. As you mentioned, Teresa, that's where that low blood sugar really does create that internal stress. And when we're actively trying to get rid of cravings, that is one thing that will absolutely throw someone back into those cravings for the processed carbs or the sugars or whatever they're working against. Absolutely.

TERESA: That's like the Goldilocks, right?

LEAH: Yeah.

TERESA: Not too high, not too low. Just right.

Testing blood sugars with a glucometer can be insightful

LEAH: That's right. And I want to just take a moment and share a story from a client that I saw recently. This client had had some lab work done about two months ago. I think it was back in December and it showed a hemoglobin A1C of 5.8. Now, just a little bit of background: hemoglobin A1C, it is a longer term measure of blood sugar control.

And so less than 5.6 is ideal. If we start looking at 5.7 or higher, we're in that prediabetes range. If we're at 6.5 or higher, now we're talking about type 2 diabetes. So we know that this client in particular was in that prediabetic range, so we had to start doing some digging. Where are we spiking with that blood sugar? Where, what are things that are contributing to those higher blood sugars for this person?

And this guy, he's a data driven and very “techy” guy. So we use that to our advantage. He was willing to wear a continuous glucose monitor to get a better sense of what his blood sugar patterns were on a day-to-day basis. And he also ended up giving me access to an app where he was uploading photos of what he was eating so I could see what his meals and snacks were.

And then on the right-hand side of that app, there was a graph of what his blood sugar did over the next two to three hours. So, very cool stuff. And one thing that we kind of identified, one thing that he was doing consistently was he was having a coffee with oat milk and MCT oil pretty much every day, sometimes even multiple times a day.

One thing that we noticed was that coffee drink was creating a blood sugar spike for him. So, he was consistently ending up in the 150s to 160s for his blood sugar, even though he was also adding some fat into that coffee. So that was a switch we identified for him that we thought would be really helpful.

We said, let's switch out that oat milk for some unsweetened almond milk or unsweetened coconut milk from the carton. But actually he even landed on, I'd rather just do some regular canned coconut milk. So a little bit more creamy, a little bit thicker. So we are getting some of that healthy fat, but without any carbohydrates coming along for the ride also.

So, so I will follow up with him in a couple of weeks. I don't have a, report on what that exactly looks like for him, but I'm just going to be really interested to see how his blood sugar responds to that new combination. And one other thing we found that he was doing on a fairly frequent basis was eating, he's eating this really great soup, but it was a quinoa vegetable soup and that was also creating a blood sugar spike for him.

There was hardly any protein in there. There wasn't any fat in there either. So that was another one of his homework items was to try them soup with a little bit of meat and trying and also layering in perhaps some fat. So maybe a few slices of avocado, either in the soup or on the side. So we're adding in those protein and fat anchors for the blood sugar, and again, I'll be just really curious how his blood sugar responds with those changes.

TERESA: Yeah, that'll be really interesting. And those are some really great examples of just a few small tweaks that can actually make a big difference. So he's already making that lovely soup, adding a little bit of protein to it and some avocado; easy.

Making these small tweaks actually can make a huge difference, especially if this is something that they're doing every day, like you were talking about with the coffee that day after day, and you wouldn't think, honestly, even just looking at that, I probably would not have expected his blood sugar to react that way considering the MCT oil.

LEAH: Yep.

TERESA: So I think those continuous glucose monitors are great if you are able to access one, but even doing some basic blood sugar testing with a regular inexpensive glucometer can be really insightful. If someone is interested in doing some blood sugar testing, I'll have them check their fasting glucose number right away when they wake up in the morning and maybe one to two hours after a meal or two during the day.

A fasting glucose number should be under 100 milligrams per deciliter, but ideally, even under 95. Two hours after a meal, blood sugar should be under 120 milligrams per deciliter.

LEAH: Yeah. I love glucometers. I think they can be really helpful. It does have to kind of be the right person that's willing to do some of that testing. I had to do a lot of blood sugar testing during my second pregnancy. So I know firsthand how onerous it can be to prick your finger multiple times per day. Most of the time, if I'm recommending that for a client or if I do have a client who's interested in just doing some testing, we're just coaching it as this is a short term thing that we're doing.

It's not something that you have to do forever and ever, but it's something short term. We're just going to gather some data. We're going to test how your body responds to maybe to certain carbs or certain combinations of things. And then we know going forward just more than likely how your blood sugar is going to respond.

And like, for me, I really noticed for my blood sugar, I, my blood sugar barely moved at all when I would eat fruit. But if I ate some of the grain-based carbs, so if I was doing something more like rice or quinoa, that would cause a bigger blood sugar spike for me, even within the context of a balanced meal.

Nutrients critical to the heart & blood vessels

So, blood sugar, it is something we definitely have to consider. It's something that we talk a lot about on Dishing Up Nutrition, but I do want to transition off of the blood sugar topic and start winding down our episode with some nutrients that are critical to our heart and our blood vessels. We mentioned earlier when we fill our plates with more real whole foods that we get less junk, but we also get more nutrients.

The importance of magnesium for heart health & more

So, what are some of those important nutrients? I'm going to start us off with magnesium, my favorite mineral, just because, you know, as dietitians, we have favorite minerals like that.

TERESA: Yeah, same. Magnesium is at the top of my list also; such a simple nutrient that can make a big impact. Magnesium is involved in hundreds of different chemical reactions in the body, but it's mostly known as the relaxation mineral. It helps relax the brain and the muscles in the body, including our heart, which is a muscle. And that's a good thing.

If you know you're prone to charley horses, foot cramps, eye twitches, or tight back or neck muscles, you may be low in magnesium. Magnesium is also a great first line of defense for sleep troubles, stress, chocolate cravings or high blood pressure. Why high blood pressure?

Well, the tubing of our blood vessels actually has several layers to it. One of the layers is a layer of smooth muscle. So those little muscles, like any other muscle, can get tight and restricted. When this happens, those blood vessels can't expand to let blood pass through efficiently. Our heart ends up having to work harder to push the blood through those blood vessels and over time, the pressure in those vessels start to rise.

LEAH: Yeah, that makes so much sense. And you realize that one of those layers in the blood vessels is a muscle. And just like any other muscle, tight muscles just don't work the way that they should. So I, I just love magnesium. I know most of us that work here at Nutritional Weight and Wellness love magnesium as well.

And so let's go back to those real foods. We get the most magnesium from our leafy greens. So think spinach, Swiss chard, kale, and there's a lot of other ones out there. But we also get magnesium from some of our different nuts and seeds like almonds and cashews and pumpkin seeds. We get some magnesium from beans and avocados, and we even find a little magnesium in animal proteins like beef and fish, especially if those animals were out on pasture more and they were eating the greens, the grass and all that stuff.

Now the RDA for magnesium is 400 milligrams per day for men and 300 milligrams per day for women. So that's just the recommended daily allowance or like the recommended amounts for people. But in our experience, these levels are more the bare minimum. Oftentimes, we work with our clients to get them eating some of those great magnesium rich, real foods, but then sometimes to dig out of that magnesium deficiency hole, we need to go to a supplement, something like 300 to 400 milligrams of a well absorbed form of magnesium.

Usually, I roll with Magnesium Glycinate to just help some of those pesky symptoms go away and also to bring that added benefit of improving the function of both the heart and those blood vessels.

TERESA: I agree. Real food lays the foundation and a magnesium supplement is there as an added layer of protection. Magnesium is certainly one of the top nutrients I think about for heart and blood vessel health.

Omega-3 fatty acids: great for heart health

But two others are also at the top of my list. They are omega-3 fatty acids and CoQ10. So let's talk about omega 3s first. I think of omega-3s first and foremost as an anti-inflammatory molecule. Chronic, low level inflammation is at the crux of all chronic disease, including heart disease.

So anything we can do to help tip the body in favor of less inflammation is going to be beneficial. Again, fewer chemicals in our food and stable blood sugars will also help lower inflammation. And adding in some wonderful omega-3s is another helpful strategy. There are a few different omega-3 fatty acids in the body, but the EPA fatty acid is thought to be the most responsible for the anti-inflammatory response, followed by DHA. Both EPA and DHA are found in the highest amounts in fatty fish. Think about the SMASH fish: sardines, mackerel, anchovies, salmon, and herring.

LEAH: Yes. And I know, gosh, when I think about that list, as you list that off, I'm like, there's maybe one of those that I would eat. I know a lot of clients or a lot of people listening and fish might not be necessarily at the top of your list of tasty foods to eat every day.

Some of you love fish, which is great. I love you for that. But I'd also don't blame you if you fall into the camp of like, what else can I eat besides some fatty fish? So, if eating salmon cakes or a can of sardines or a jar of pickled herring isn't your jam, then maybe we have to think about a high quality fish oil or omega-3 supplement. That may be more of your style.

Now, a four-ounce serving of salmon will net you in the ballpark of 2,000 milligrams of omega-3s. And then when I think about omega-3 supplement recommendations, I'm usually aiming around that same ballpark: 2,000 to 3,000, sometimes even 4,000 milligrams of omega-3 fatty acids per day as part of a great heart supporting protocol.

Now we also get some omega-3s through some other foods like, some of our nuts and seeds like walnuts or chia seeds. Again, small amounts of omega-3s compared to those fatty fish, but some omega-3s nonetheless. Those types of omega-3s come from a different, we mentioned EPA and DHA before. The type of omega-3s that are coming from more of our plant foods is an omega-3 called ALA.

That one, it can be converted into EPA and DHA, but not really efficiently. So, usually, again, when people are looking at a lot of inflammation or we are thinking about heart health, usually steering people towards more of a fish oil or eating some of those fatty fish to get more of a bang for your buck from some of those omega-threes.

TERESA: Yeah. And both approaches are solid options. And of course it's great. I always consider those omega-3s from the plant sources more as bonus.

LEAH: Yeah, absolutely.

TERESA: Yeah, you get them, it's a bonus.

LEAH: That's a great way to think about it.

TERESA: I'm going to look at these omega-3s from fish and fish oil supplements as my primary. And then, yeah, all the omega-3s we can get is wonderful.

CoQ10: important nutrient for heart health

TERESA: Lastly, I want to talk a little bit about CoQ10. CoQ10: it's an important nutrient for energy production in the mitochondria of our cells and it's also a powerful antioxidant. In other words, CoQ10 fights off molecules that damage our cells.

CoQ10 is found in the highest concentration in our high energy demanding organs, like the heart, the kidneys, the lungs, the liver and the adrenal glands. It makes sense. These organs need a lot of energy, and they also need a lot of protection, so they need the highest amount of troops to fend off the bad guys.

And as we age, CoQ10 levels naturally go down, which means some of those organs may be prone to get weaker. So, we do our best to eat foods with some CoQ10 in them, like chicken hearts or chicken livers, meats like beef and chicken and some nuts and seeds like peanuts, pistachios, and sesame seeds. For reference, three ounces of beef provides two to three milligrams of CoQ10, so it's not a lot.

Supplementing with CoQ10 may have some benefits for people with high blood pressure, heart failure, or for people who have had bypass surgery, or heart valve surgery. If we're working with a client who has heart disease or is at higher risk of heart disease, we may recommend 200 milligrams of CoQ10 per day. But know that some studies have used doses of 3,000 milligrams per day for months at a time to help support a struggling heart muscle.

LEAH: Yeah, CoQ10 is one of those kind of like vitamin D. Like we do get little bits here and there in the food supply, but if we're really looking for a more therapeutic benefits, we oftentimes need to turn to supplements for that.

So we hope this information and the examples in this show have been helpful and doable, but also just, we wanted to provide a sense of empowerment when it comes to lowering your risk of heart disease. It is easy to feel a lack of control and helplessness when you start looking at all the, those branches in your family tree, but just know that research points, but just know that research points to 90 to 94 percent of our heart disease risk is attributed to lifestyle factors that we have control over and not surprisingly, choosing nutritious food really transcends across us all of those lifestyle factors; pretty much all the factors except maybe the smoking part.

So if you're ready to learn more or you think you need more strategies that pertain to your specific situation, we are here to listen and to guide. So you can connect with us on our website, which is www.weightandwellness.com or give us a call at any of our offices. And the number is 651-699-3438.

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TERESA: Our goal at Nutritional Weight and Wellness is to provide each and every person with practical, real life solutions for everyday health through eating real food. It's a simple, yet powerful message. Eating real food is life changing. Thank you for listening, and if you've enjoyed this show, please head over to your favorite podcast platform and leave us a rating and review.