Due to medical advancements, death rates from heart disease are falling. Nevertheless, it was reported in 2019 that cardiovascular disease accounted for 27% of all deaths in the United Kingdom. However, the WHO (World Health Organization) have estimated that more than ‘80% of premature heart attacks and strokes are preventable’, with a healthy diet and other lifestyle factors being central to this.
Cardiovascular disease (CVD) is an umbrella term for all the diseases of the heart and circulation including angina, congenital heart disease, coronary heart disease, heart attack and stroke. Coronary heart disease and stroke may be caused by the same problem – atherosclerosis. This is when the arteries become narrowed due to damage and thickening of the blood vessel wall with increased deposits of substances such as cholesterol and calcium which form atherosclerotic plaques.
In this blog we are going to discuss the nutrients that are considered to be essential for the ongoing health of your heart; why they are so important and how to include them in your diet.
Nutrients Essential for Heart Health
In suitable quantities omega-3 fatty acids bestow a wide range of health benefits and this includes supporting the normal function of the heart.
Within the omega-3 family, EPA and DHA are important for heart health by helping to lower blood triglycerides, maintain the elasticity of artery walls, prevent blood clotting, reduce blood pressure and stabilise heart rhythm.
EPA and DHA are also considered to have anti-inflammatory and membrane-stabilising effects. Many diseases, such as heart disease and arthritis, are related to an inflammatory process, and it may be this ability to downregulate such inflammation that helps EPA and DHA prevent certain chronic diseases or positively affect other conditions.
The primary food source of omega-3 fatty acids is fish and especially oily fish such as mackerel and sardines. Unfortunately the substantial fall in our consumption of fish over recent decades has led to reduced intake of omega-3 fatty acids. This has conversely resulted in a substantial rise in sales of omega-3 supplements including fish and krill oils.
The issue of dietary fats in relation to health has generated much confusion over the last few decades; for more information on beneficial fats to include in the diet and which to avoid see our previous blog – Official guidelines on fat intake: Are we in need of a ‘major overhaul’?
Coenzyme Q10 (CoQ10) is a fat soluble compound synthesised in all the tissues in the body; and this endogenous synthesis is the main source of CoQ10 in humans. Synthesis involves a complex process requiring the amino acid tyrosine and a number of vitamin and trace mineral cofactors. Inadequate tyrosine or cofactors impairs endogenous formation. In addition, levels naturally decline with age and statin medications deplete levels.
CoQ10 functions as a coenzyme in the energy producing mitochondrial pathways, specifically in the electron transport chain where it is involved in electron transfer. Thus it is an integral part of energy metabolism inside our cells and required by every cell in the body to produce the energy we need to live. It has been shown to increase the level of energy in muscles and is especially important for cardiac function. In addition, CoQ10 has antioxidant activity inhibiting lipid peroxidation in both cell membranes and low density lipoproteins as well as protecting DNA and proteins from oxidative damage.
CoQ10 is found in small quantities in foods such as red meats, especially organ meat, and fish; it is also found in most fruit and vegetables, albeit at lower levels. Although it is widely available in food the amounts are too small to produce any significant clinical benefit and we rely mainly on synthesis within the body to maintain adequate levels.
Vitamin K is an important vitamin for the maintenance of normal bones, blood clotting and the cardiovascular system; it is essential for the prevention of calcification of the arteries. This is because vitamin K ensures calcium is deposited in bones rather than in soft tissues such as arteries. Excess calcium in the arteries results in atherosclerosis and increased risk of coronary heart disease and stroke.
Vitamin K is most commonly found in two forms – K1 and K2. K1 is found in green vegetables and excellent sources are ‘greens’ like spinach, kale, broccoli and brussel sprouts. Vitamin K1 has been recognised as being important in maintaining a healthy blood clotting system.
Vitamin K2 is less widely available in food – fermented foods such as natto and sauerkraut are the best food sources of K2. Our intestinal bacteria also produce Vitamin K2. Vitamin K2 is the form important for calcium regulation.
Magnesium is a mineral that is often low in Western diets. It is a contributing cofactor for over 300 enzyme systems and is required for any reaction involving ATP. One of the main roles of magnesium, together with calcium, is to control the contraction and relaxation of muscles; calcium contracts and magnesium relaxes. Thus magnesium helps to maintain low blood pressure by relaxing the muscles surrounding the blood vessels and improves coronary blood flow.
Low blood levels of magnesium are associated with an increased risk of heart attack and stroke. Good food sources include dark, green leafy vegetables, nuts and seeds and wholefoods. Magnesium levels are low in refined foods.
B vitamins help maintain low levels of a substance called homocysteine. Homocysteine is an intermediary in an important metabolic cycle called the methylation cycle. As part of this cycle homocysteine is recycled back to methionine provided there is sufficient vitamin B6, B12 and folate. Other nutrients that can help this recycling include zinc and betaine.
If, due to lack of B vitamins, homocysteine builds up it can cause damage to arteries starting the process that eventually leads to atherosclerosis and cardiovascular disease. Homocysteine levels rise with age and B vitamins help to prevent this. In particular, adequate levels of B12, B6 and methylfolate (folate) are needed. These can be found in dark green leafy vegetables, nuts/seeds, eggs, meat/fish and wholegrains.
Vitamin D is mostly made in our skin by exposure to sunlight. Hence Vitamin D is termed ‘the sunshine vitamin’ and if we do not get enough sunshine, we will not get enough Vitamin D.
Indeed, the report published last week by the Scientific Advisory Committee (see article on the BBC Website) on Nutrition is now advising that everyone should take a vitamin D supplement during the winter and autumn months and for ‘at risk’ groups, such as the young, elderly, pregnant women and people with dark skin, vitamin D should be taken all year round.
Most of the foods we eat contain very little vitamin D, natural sources include oily fish such as salmon, mackerel, tuna and sardines; milk; eggs, beef; liver and Swiss cheese.
Vitamin D is most commonly associated with assisting the maintenance of strong bones and teeth, helping support the functions of the immune system and contributing toward normal muscle functions and normal blood calcium levels. Less widely known is its role in relation to cardiovascular health and that a deficiency has been linked to hypertension, atherosclerosis and diabetes – all of which are relevant for cardiovascular disease. Epidemiological data and mechanistic studies have provided strong support for a potential cardio-protective effect of vitamin D.
A naturally occurring sugar that is vital for energy production as it is the main building block for ATP (adenosine triphosphate) and therefore important for maintaining normal ATP levels in the body. ATP is the body’s energy currency produced in the cell’s mitochondria.
Ribose is naturally present in small amounts in foods and is also synthesised in every cell in the body but only slowly and to varying degrees depending on the tissue. Patients with heart disease are energy depleted. Therefore, Stephen Sinatra, MD, a US cardiologist suggests considering D-ribose for cardiovascular diseases including coronary artery disease, angina, arrhythmia and congestive heart failure.
If you have any questions regarding the topics that have been raised, or any other health matters please do contact me (Amanda) by phone or email at any time.
firstname.lastname@example.org, 01684 310099
Amanda Williams and the Cytoplan Editorial Team: Joseph Forsyth, Emma Williams, Simon Holdcroft, Clare Daley and Helen Drake
Last updated on 20th January 2020 by cytoffice