Cardiovascular diseases | Nutritional Advice El Mondo

Cardiovascular disease is a class of diseases that involves the heart or blood vessels (arteries, capillaries and veins). Cardiovascular diseases are TIA, heart attack, stroke and vascular disease of the large vessels, such as claudication. Cardiovascular diseases are currently number 1 cause of death in the Western world.

The main causes of cardiovascular diseases are:

Arteriosclerosis (a thickening and hardening of arteries)
Type 2 diabetes
High blood pressure
High cholesterol levels
High homocysteine levels
Obesity

Rules of thumb:

% reduction of cholesterol = % risk reduction of cardiovascular disease.
Per kg weight loss = 1 mmHg blood pressure reduction. So from 130 to 120 mmHg would practically mean 10 kg weight loss.
Each gram of salt above 6 grams of salt per day will increase the blood pressure by 1 mmHg.

Daily intake of 3 grams of plant sterols or stanols during 2-3 weeks reduces the LDL cholesterol level by 11.3%. However, avoiding dietary cholesterol is not the solution to a high cholesterol level. The solution is to choose products with maximum 30 En% fat, and maximum 7 En% saturated fat.

It is very difficult to decrease the cholesterol level by 15% by diet only.

A cholesterol lowering diet contains:

Products with maximum 30 En% fat
Products with maximum 7 En% saturated fat
Products with maximum 15 En% protein
Up to 200 grams of cholesterol per day
Products with at least 1.5 grams of fiber per 100 kcal

Heredity also plays a role in cardiovascular diseases. The inherited forms of cardiovascular disease are:

Hypertrophic cardiomyopathy (=a heart disease in which the heart muscle is thickened)
Dilated cardiomyopathy (=a heart disease in which the heart muscle is dilated)
Long-QT syndrome
Catecholaminergic polymorphic ventricular tachycardia (CPVT)
Brugada syndrome
Arrhythmogenic right ventricular dysplasia (ARVD)
Familial hypercholesterolemia (FH)

Symptoms of myocardial infarction in men and women are not the same.

Symptoms of myocardial infarction in men are chest pressure, sweating and pain radiating to the arms and jaw.

Symptoms that may indicate a heart attack in women are:

Palpitations (pounding heart)
Sudden dizziness, a feeling of weakness
Insomnia
An uncomfortable feeling in the stomach, possibly with nausea
A sudden onset of extreme fatigue
Shortness of breath
Burning sensation below the sternum
Unpleasant clamping or tightness in the chest
Unpleasant sensation or pain between the shoulder blades, pain in the neck

Dietary guidelines for cardiovascular disease prevention:

Choose products with maximum 30-35 En% fat, products with maximum 7-10 En% saturated fat, products with maximum 0.1 gram of sodium per 100 g (100 ml) product, products with minimum 1.5 grams of fiber per 100 kcal and for fish which provides at least 1000 mg of EPA and DHA per day.
Stop smoking because smoking causes atherosclerosis.
Aim for a healthy weight. A healthy weight has a BMI of 18.5-25. BMI is weight divided by height squared (weight (kg)/height² (m)).
Spend at least 60-90 minutes of physical exercises per day or at least 10000 steps per day.
Eat at least 2 times (100-150 g fish per time) a week oily fish. Oily fishes are sardines, herring, salmon, anchovies, eel and mackerel.
Eat 250 mg omega-3 fatty acids per day. Omega-3 fatty acids are alpha-linolenic acid, EPA and DHA.
Eat 300 grams of vegetables and five servings of fruit per day or 30 grams of fiber per day.
30 grams of fiber per dag corresponds to a daily diet of minimum 1.5 grams of fiber per 100 kcal.
10 to 30 grams of fiber a day decreases the LDL cholesterol levels.
Eat plenty of whole grains (brown bread, brown rice and oats) and legumes.
Limit alcohol consumption to 2 glasses for men and 1 glass for women per day.
Eat no more than 6 grams of salt per day, corresponding to 2400 mg of sodium.
Eat no more than 200 grams of cholesterol per day at an elevated LDL-cholesterol level.
Eat no more than 19 grams of saturated fat per day at 2500 calories diet and 15 grams of saturated fat at 2000 kcal diet. The WHO advises 2000 kcal per day for women and 2500 kcal for men.
Take 500 micrograms of folic acid per day at a high homocysteine level.
Do not take antioxidant supplements. They do more harm than good!
Consult your doctor or a dietician when taking dietary supplements!

Target values for a healthy heart:
Measurement	Reference values
Total cholesterol level	< 4.5 mmol/l
HDL cholesterol level for men	> 0.9 mmol/l
HDL cholesterol level for women	> 1.1 mmol/l
LDL cholesterol level	< 2.5 mmol/l
Triglycerides (blood fats) level	< 2.5 mmol/l
Fasting blood sugar level	< 6 mmol/l
HbA1c	< 7%
Homocysteine level	< 12 micromol/l
Blood pressure	120/80 mmHg. 120 is systolic blood pressure & 80 is diastolic blood pressure
Blood pressure in people over 60 years	140/90 mmHg

Lifestyle measures for the treatment and prevention of high blood pressure
Lifestyle changes	Recommendation	Reduction of systolic blood pressure
Weight loss	A healthy weight has a BMI of 18.5-25 kg/m²	5-20 mmHg
Salt reduction	Up to 6 grams of salt a day or 2400 mg of sodium per day	2-8 mmHg
Potassium intake	Per every increment of 0.6 gram	1 mmHg
Physical activities	30-60 minutes of physical activity per day	4-9 mmHg
Alcohol consumption	Maximum 2 glasses for men & 1 glass for women	2-4 mmHg
DASH diet	Nutritional pattern rich in fruits, vegetables and low-fat products	8-14 mmHg
This table shows that the best way to prevent high blood pressure is to maintain a healthy weight

Scientific studies on the relationship between diet/nutrients and cardiovascular diseases.
Review articles of randomized, placebo-controlled double-blind clinical trials (RCTs) will answer the following question:
"Is taking dietary supplements make sense?". Yes at a positive conclusion and no at a negative conclusion.

Review articles of cohort studies or case-control studies will answer the following question:
"Should I change my diet?".

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