• Michelle Routhenstein, MS RD CDE CDN

What is cardiovascular disease, and am I at risk?

Updated: Jan 10

Cardiovascular disease (CVD) is the number-one cause of death and disability worldwide, resulting in more than 17.9 million deaths each year. In the United States alone, CVD is responsible for one in every three deaths, with 85% of these due to heart attacks and strokes. Alarmingly, one-third of these occur prematurely in people under 70 years of age.


What is cardiovascular disease?


CVD involves multiple diseases affecting the heart and blood vessels. It includes coronary heart disease, also referred to as coronary artery disease or ischemic heart disease, cerebrovascular disease or stroke, and peripheral arterial disease. Similar processes underly each of these three groups of conditions, which affect the heart, the brain, and periphery arteries.




One of the main mechanisms thought to cause CVD is atherosclerosis, where the arteries become clogged by plaque. When the arteries are completely blocked or when blood flow is restricted by a narrowed artery, limiting the amount of blood and oxygen delivered to organs or tissue, CVD occurs. 


Arteries may naturally become harder and narrower with age, although this process may be accelerated by factors such as diet, a sedentary lifestyle, obesity, ethnicity, smoking, high cholesterol, and high blood pressure. 


Another cause of CVD is unstable plaque rupturing. It is thought that unstable plaque activates an inflammatory response in the body that causes the structure of this plaque to weaken and rupture, leading to the formation of blood clots.


Research shows that both the incidence and mortality from CVD is largely due to unhealthy diets and physical inactivity. Nutrition can influence the development of these diseases by modifying the underlying processes that cause or exacerbate the condition. 


What are the risk factors for heart disease?


The term ‘risk factor’ is used to describe physical and biochemical attributes, as well as features of lifestyle and behavior, which predict an increased likelihood of developing CVD.

Millions of people worldwide struggle to control the risk factors that lead to CVD, while many others remain unaware that they are at high risk. 80% of heart attacks and strokes can be prevented by controlling major risk factors through dietary and lifestyle interventions. 


The risk factors for CVD include behavioral factors, such as an unhealthy diet, smoking, harmful use of alcohol and inadequate physical activity. The effects of these risk factors may show up as hypertension, or high blood pressure, high blood cholesterol, raised blood glucose or lipids, and overweight and obesity. All these physiological factors indicate an increased risk of developing a heart attack, stroke, heart failure and other complications.


What are the major risk factors for CVD that are modifiable?

  • High blood LDL cholesterol

  • Low blood HDL cholesterol

  • High blood pressure (hypertension)

  • Diabetes, hyperglycemia, and insulin resistance

  • Obesity (especially abdominal obesity)

  • An ‘atherogenic’ diet (high in saturated fats and low in vegetables, fruits, nuts and whole grains)

  • Physical inactivity

  • Cigarette smoking

  • Dyslipidemia

  • High levels of inflammatory markers

  • High levels of homocysteine


The good news is, that risk factors related to diet and lifestyle are modifiable, so paying attention to what you eat is not only one of the most important measures you can take, it’s completely within your control.


How can I prevent heart disease?


As we know, food is directly involved in many of the risk factors for CVD, and a vast amount of research shows that CVD can easily be prevented with the correct dietary choices. A balanced diet, in terms of both quantity and quality is a key factor for optimal prevention, as well as improving your prognosis after. 


Here are a few practical recommendations for a heart-healthy diet:*


1. Increase consumption of fruit and vegetables. A high consumption of fruits and vegetables abundant in antioxidants, potassium, nitric oxide, B group vitamins and fiber positively impact blood flow and blood vessel function.


2. Increase consumption of whole grains. The consumption of whole grains adds fiber and important nutrients, such as folate, thiamine and niacin, that are cardioprotective.


3. Increase food sources of omega-3 fatty acids. Omega-3 consumption is associated with a lower incidence of CVD and stroke by reducing inflammation, as well as lowering triglyceride levels, blood pressure and resting heart rate. 4. Increase probiotic and prebiotic rich foods. An imbalance of our gut microbiome is now recognized as a risk factor for CVD, showing links to hypertension, hyperlipidemia and associated cardiac illnesses. Pre and probiotics have been found to rebalance our gut microbiota and significantly reduce LDL and total cholesterol, as well as improving other CVD risk factors, such as inflammation and arterial function.


5. Reduce calories. By reducing consumption of excess ‘empty’ calories, we add nutrient dense foods instead to help you feel satiated and help to control your weight.


6. Limit the consumption of added sugar and sugar-sweetened beverages. Sugar has no nutritional value and can actually increase inflammation in the body, which contributes to weight gain, diabetes, fatty liver disease, metabolic syndrome and heart disease.

7. Reduce consumption of fresh and processed meat. Diets rich in meat, especially processed meats, have been associated with an increased risk of developing CVD and stroke because of their high TMAO, sodium, nitrate and saturated fat content, which are known to clog arteries.

8. Replace saturated and trans fats with unsaturated fats. Avoiding animal fats (as well as coconut and palm oils) and including extra virgin cold pressed olive oil, avocado oil and nuts, significantly reduces total and LDL cholesterol, as well as the risk of CVD and death.

9. Limit sodium intake. The main reason for limiting sodium intake is its effect on blood pressure, but it also has serious implications for kidney and blood vessel health as well. Try to limit your intake to 1.5g per day.


*It’s important to note that nutritional supplements do not show the same benefits to health as nutrients found in food. In fact, they can reduce the body’s ability to store and utilize these nutrients, in addition to causing possible side effects from their interaction with medications.


Why do I need personalized nutrition?


A one-size-fits-all approach to preventing or treating CVD is inadequate. Dietary requirements differ not only between the different types of CVD, but also between different individuals. A personalized and tailored approach will provide you with far greater benefits, taking into account your individual makeup, cultural factors, personal preferences, the presence of various cardiovascular risk factors, comorbidities and special needs related to each specific cardiovascular disorder. 


What should I do now?


A healthy diet is not only key to preventing and improving CVD risk, it’s necessary for a long and healthy life. However, changing your diet can be extremely challenging, and the correct instruction and counselling are critical for success. Following a heart-healthy diet that is personalized to you can require major lifestyle changes, so it’s crucial to find a registered dietitian who specializes in preventive cardiology. 


With my background as a preventive cardiology dietitian, registered dietitian nutritionist, and certified diabetes educator, my passion lies in creating comprehensive and personalized lifestyle plans to enhance your well-being and quality of life. 


Are you ready to improve your health and take charge in 2020? I’m offering a limited number of FREE calls in the next week and would love to show you how. Click here to book now.


** This article is for informational purposes only and not a substitute for individualized medical advice or treatment. Always seek the advice of a qualified health professional with any questions you may have regarding your health. 


References

Atherosclerosis. (2020). Retrieved 7 January 2020, from https://www.nhlbi.nih.gov/health-topics/atherosclerosis


Calabrese, V., Cornelius, C., Trovato-Salinaro, A., Cambria, M., Locascio, M., & Rienzo, L. et al. (2010). The Hormetic Role of Dietary Antioxidants in Free Radical-Related Diseases. Current Pharmaceutical Design, 16(7), 877-883. doi: 10.2174/138161210790883615


Cardiovascular Disease Risk Factors. (2020). Retrieved 7 January 2020, from https://ada.com/cardiovascular-disease-risk-factors/


Cardiovascular diseases (CVDs). (2017). Retrieved 7 January 2020, from https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)


Dinu, M., Pagliai, G., & Sofi, F. (2017). A Heart-Healthy Diet: Recent Insights and Practical Recommendations. Current Cardiology Reports, 19(10). doi: 10.1007/s11886-017-0908-0


DiRienzo, D. (2013). Effect of probiotics on biomarkers of cardiovascular disease: implications for heart-healthy diets. Nutrition Reviews, 72(1), 18-29. doi: 10.1111/nure.12084


Mann, J., & Truswell, A. (2017). Essentials of human nutrition (5th ed.). United Kingdom: Oxford University Press.


Ravera, A., Carubelli, V., Sciatti, E., Bonadei, I., Gorga, E., & Cani, D. et al. (2016). Nutrition and Cardiovascular Disease: Finding the Perfect Recipe for Cardiovascular Health. Nutrients, 8(6), 363. doi: 10.3390/nu8060363


Spagnoli, L., Bonanno, E., Sangiorgi, G., & Mauriello, A. (2007). Role of Inflammation in Atherosclerosis. Journal Of Nuclear Medicine, 48(11), 1800-1815. doi: 10.2967/jnumed.107.038661


Whitney, E., Rolfes, S., Crowe, T., & Walsh, A. (2017). Understanding Nutrition (3rd ed., pp. 654-662). Victoria: Cengage Learning Australia.


Willet, W., Koplan, J., Nugent, R., Dusenbury, C., Puska, P., & Gaziano, T. (2006). Prevention of Chronic Disease by Means of Diet and Lifestyle Changes. In D. Jamison, J. Breman & A. Measham, Disease Control Priorities in Developing Countries (2nd ed., pp. 833-850). New York: Oxford University Press.


World Health Organization. (2007). Prevention of cardiovascular disease: Guideline for assessment and management of cardiovascular risk. Geneva: WHO Press.

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