Preventing another heart attack

EAT

• Whole, unprocessed, organic foods grown locally and in season.

• A Mediterranean diet – rich in fruit, vegetables, fish, nuts and olive oil, with some meat – can reduce heart disease risk by 30 per cent;1 and all heart-related deaths by more than 70 per cent, when compared with the typical “prudent diet” for cardiac patients.2

• A low-carb diet can reduce inflammation after six months;3 low-sugar, rather than low-fat,is the most heart-protective,4 so avoid the white stuff: high-GI (glycaemic index) foods like white bread, potatoes, freshly made pastas, biscuits and cakes.

• Fish, but avoid fish from the North Sea or deep-water fish, which are high in contaminants like mercury and dioxins, and farmed fish, which are fed inappropriately with grains.

• Organic eggs – they contain eight times more of the enzyme lecithin-cholesterol acyltransferase (LCAT), which lowers the risk of cardiovascular disease.5

• Heart-healthy nuts. Eating walnuts three times a week can almost halve your chances of dying from heart disease,6 and nut oils help to maintain strong blood vessels.7 Ditto pecans, high in vitamin E, which lower LDL cholesterol, improve arterial health and reduce inflammation.8 Almonds lower blood pressure and improve blood flow.9

• Legumes like lentils and kidney beans; four or more servings a week significantly lower heart-disease risk. 10

• A square or two of dark chocolate daily, which lowers your risk of a future fatal heart attack.11

• Nothing, occasionally; a day-long fast with drinking only water raises levels of adiponectin, a protein that dilates blood vessels and reduces inflammation. 12

• Green tea – up to seven cups a day appears to lower cholesterol and blood pressure, and prevent blood clots.13

• Coffee in moderation; in one study drinking four or more cups a day lowered the risk of heart rhythm disturbances by one-fifth.14

• Red wine in moderation; upping alcohol intake from less than a glass to one or two glasses a day can ‘significantly’ reduce your risk of dying from a heart attack by increasing levels of HDL cholesterol,15 but make it red wine, which contains anti-inflammatory resveratrol.16

• No homogenized or low-fat dairy products, which increase the risk of chronic heart failure.17

PRAY (&PLAY)

• Enjoy your life. Change your job or any other part of your life you don’t like.

• Exercise, ideally for 20 minutes a day; in a London trial pitting heart drugs against regular exercise in 57 trials, only diuretics, or ‘water pills’, helped patients with heart failure live longer than they would have with just exercise alone.25

• Engage in any regular relaxation exercise proven to lower blood pressure and calm the heart, such as Transcendental Meditation (TM), biofeedback and meditation.

• End being isolated from your own feelings, from other people or from a higher power. Make friends, take care of a pet, pray or develop your own spirituality.

• Express yourself. Bottling it up your feelings is also lethal for your heart.

• Love and be loved – it’s your heart’s best medicine.

LIVE

• Keep a healthy body weight. Ignore recommendations to calculate your ideal weight using the body mass index (BMI), a clumsy method of calculating your weight status with no relation to heart health.

• Don’t smoke.

• Avoid sugar, hydrogenated margarines, and all other hydrogenated oils and trans fats, but not saturated fats.

• Get seven hours of sleep a night – the optimal amount for heart health.

• Expose uncovered skin without sunscreen to the sun for about 15 minutes early in the day.

AND TAKE…

• A good-quality multivitamin/mineral supplement.

• Omega-3 fatty acids (1,000-1,500 mg/day as fish oil), known to be heart-protective by markedly reducing ‘bad’ cholesterol and triglycerides, while increasing ‘good’ HDL.18

• Antioxidant vitamins like A (up to 25,000 IU/day as beta-carotene or 10,000 IU/day as retinol), C (1-3 g/day or more) and E (1-3 g/day or up to 600 IU/day as tocotrienols, as well as zinc (10-50 mg/day) and selenium (200 mcg/day).

• Coenzyme Q10 (600-100 mg/day or higher with supervision), to prevent heartbeat irregularities, and cell and tissue damage usually seen after a heart attack.19 Opt for one containing ubiquinol, which is more readily taken up by the body.

• l-Carnitine (250-750 mg/day), made in the body from amino acids; high doses delivered intravenously can reduce ventricular arrhythmias after a heart attack,20 and oral doses, improve exercise capacity and preserve heart function.21

• A high-quality probiotic supplement (most good ones are sold refrigerated).

• Vitamin D (600-1,000 IU/day) if you can’t get daily sunshine.

• Chromium (100 mcg/day) and magnesium (200-600 mg/day). Both diminish with age, but are necessary for heart health; magnesium lowers blood pressure too.22

• B vitamins, especially B6 (100 mg/day), B1 (50 mg/day) and B3 (50 mg/day). Consider higher levels of vitamin B6 (but only with medical supervision) to protect your heart against further damage. Thiamine (B1) supplements taken indefinitely after a heart attack (same dosages as above) can improve ventricular (pumping) function.23

• Magnesium(intravenous infusions). Given soon after a heart attack, these can work as well as thrombolysis or antiplatelet therapy.24

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