Environmental Nutrition

Eating habits play a pivotal role in promoting a healthy heart. But if you have a family history of heart disease, does healthy eating still matter? Indeed, for most people with such a family history, lifestyle makes a major difference in whether an inherited tendency actually leads to heart disease, according to Sekar Kathiresan, M.D., a cardiologist and human geneticist, who is director of the Center for Genomic Medicine at Massachusetts General Hospital, and director of Preventive Cardiology at its Heart Center.

In his presentation at the latest American Heart Association Scientific Sessions, Kathiresan shared research showing that although some people are at high risk from a single gene, most inherited heart disease risk stems from a combination of multiple genes. Among these people, a healthy lifestyle cut risk of events, such as heart attack or death, by nearly 50 percent.

Based on the latest heart health research presented at the AHA conference, here are four steps you can take to eat to protect your heart.

1. Cut sodium.

The AHA and 10 other major health groups recommend creating heart-healthy eating habits now. Just cutting 1,000 milligrams of sodium per day lowers heart risk. And results are magnified by adopting a DASH (Dietary Approaches to Stop Hypertension) style diet. This means boosting vegetables, fruits, low-fat dairy products, whole grains, poultry, fish and nuts, as well as reducing saturated fat, red meat, sweets and sugar-sweetened beverages. Look beyond the saltshaker, since most sodium comes from processed foods.

Tips:

--Make your own soup with low-sodium bouillon or no-salt-added tomatoes, or select reduced-sodium soup and add your own additional flavors.

--Season unflavored rice and grains with herbs and spices, skipping sodium-laden seasoning packets included in products.

--Use raw veggies -- pepper strips, celery, cauliflower -- for dipping, instead of chips or crackers.

2. Maintain a healthy weight.

Among people with overweight or obesity, 20 percent to over 50 percent have Nonalcoholic Fatty Liver Disease (NAFLD). In his presentation, Raul Santos, M.D., Ph.D., director of the Lipid Clinic of the Heart Institute of the University of Sao Paulo, Brazil, emphasized, "Liver fat increases insulin resistance and unhealthy blood sugars, low-grade inflammation, and blood triglycerides."

But Santos offered good news. "Robust evidence shows that weight loss of five percent or more reduces NAFLD, with even greater impact from a 10 percent or greater weight loss." So, instead of aiming for a target that can seem overwhelming, aiming to lose even 10 pounds and keeping it off can reduce risk of heart disease. Cutting just 200 to 400 calories a day and adding a short walk can accomplish this over time.

Tips:

--Drink more water, and swap sparkling water, unsweetened tea, or coffee for sugar-sweetened drinks.

--Serve up portions about three-quarters of the usual size for most foods other than vegetables. Wait and go back for more only if you're truly hungry.

--Take time for a brief walk or other activity, and you'll burn calories, and decrease liver fat and insulin resistance.

3. Limit added sugar.

Sugar-sweetened drinks and snacks are often identified as "empty calories" that should be limited to reach and maintain a healthy weight. But excess added sugars, especially in sugar-sweetened beverages, may increase risk of Type 2 diabetes even beyond the effects on weight. Evidence also suggests that high consumption of added sugars can raise blood pressure and blood triglycerides, and is linked with increased risk of stroke and heart disease.

How much is too much? The Dietary Guidelines for Americans 2015-2020 recommend less than 10 percent of calories from added sugars (200 calories or 50 grams per day for the average person). The AHA recommends even lower limits of no more than 100 calories (25 grams) per day for women and 150 calories (36 grams) for men.

Tips:

--Since nearly half the added sugars in an average American diet come from beverages, reducing sugar-sweetened soft drinks is the top strategy.

--Skip sweets and opt for nutrient-rich snacks that provide sustained fuel, like fruit, vegetables, whole grains, nuts, and seeds.

4. Choose quality carbs and fats.

LDL ("bad") cholesterol is the primary risk factor when looking at blood lipids. But studies show that at equal LDL levels, blood triglycerides also identify heart risk, according to Aruna Pradhan, M.D., M.P.H., of the Center for Cardiovascular Disease Prevention at Brigham and Women's Hospital, Boston. To control triglycerides, look beyond limiting LDL-raising saturated and trans fats, and aim for other factors in diet quality, too.

Tips:

--Limit sweets and refined grains, favoring foods with more dietary fiber that raise blood sugar more gradually.

--Mediterranean-style eating patterns, which include moderate amounts of fat from healthy oils, nuts and seafood, help reduce elevated triglycerides.

--Limit alcohol to no more than one drink per day for women (one serving of wine is five ounces) or two for men, reducing further if triglycerides remain high.

(Environmental Nutrition is the award-winning independent newsletter written by nutrition experts dedicated to providing readers up-to-date, accurate information about health and nutrition in clear, concise English. For more information, visit www.environmentalnutrition.com.)