No More SAD Hearts

Walking away from the Standard American Diet
By Adam Swenson

“Progress,” says futurist-physician Richard A. Swenson, MD, “is a one-way street. It thrives on differentiation, giving us more and more of everything, faster and faster.”

In many ways, progress has been good to us. As much as we might be nostalgic for that ‘69 Camaro, the new Chevys are much more reliable, safer, quieter, more efficient, and so on. We now have iPads and Kindles and vast online music libraries that allow us to listen to anything in seconds. The progress just in the field of computing is stunning.

But progress has a dirty underbelly: it gives us what we want in greater and greater quantities and a cursory glance through the last century of American culinary history shows we don’t always act in our own best interest. (Cheese in a can? How great is that! Jamba Juice Chocolate “Smoothie” with 900 calories and 166 grams of sugar? Check.)

This trend toward manufacturing food instead of simply growing it has resulted in a diet with the intentionally pejorative acronym, SAD. William Sears, MD, (aka Dr. Sears) characterizes the Standard American Diet as being “High in animal fats, high in unhealthy fats (saturated, hydrogenated), low in fiber, high in processed foods, low in complex carbohydrates, and low in plant-based foods.”

Any cardiologist worth their salt (pun intended) would tell you that if you set out to create a diet worse for cancer, for our hearts, for our blood sugar, and for our waistlines, you’d be hard pressed to do it. (We’ve also been more sedentary than any other people group in recorded history, which hasn’t helped.) And indeed, our waistlines and arteries have reaped what our bent toward gluttony and convenience has sown.

Food author Michael Pollan writes about what he calls the American Paradox: The more we worry about nutrition, the less healthy we seem to become. “What an extraordinary achievement for a civilization: to have developed the one diet that reliably makes its people sick!”

Consequences of the Standard American Diet

The University of Minnesota penned a paper titled, “Why Is the Obesity Rate So Low in Japan and High in the US? Some Possible Economic Explanations.” In it they noted that 32 percent of Americans are obese (BMI over 30), whereas only 3.6 percent of Japanese are. And an even two-thirds of us are overweight (BMI over 25), but only 25 percent of Japanese are—and that number was far lower before McDonalds migrated east.

(The short answer: Japanese people eat 200 fewer calories per day than Americans, eat far more “whole foods,” and walk more because it is expensive to drive.)

Being fat is one thing: the health implications are another thing entirely. The Journal of Applied Physiology notes that “Recent data from the Centers for Disease Control document that cardiovascular diseases, various forms of cancer, and diabetes combine to make up roughly 70 percent of all deaths in the United States.” They also noted that obesity, diabetes, and metabolic syndrome are now common in children.

(A quick side note about fixing the healthcare system: 75 percent of health care spending is on managing chronic—i.e., preventable—diseases. If we could chip away at that, we’d be chipping away at $1.5 trillion in our $2 trillion in annual health care spending.)

Enough’s enough. Heart disease claimed 600,000 lives in 2009. If these are the unintended consequences of “progress” on our food supply, we need to get seriously regressive with our food choices. “We all want progress,” wrote British thinker CS Lewis, “but if you’re on the wrong road, progress means doing an about-turn and walking back to the right road; in that case, the man who turns back soonest is the most progressive.”

Eating for heart health

The Pritikin Longevity Center in Florida exists to help people fight heart disease through exercise and nutrition, and they’ve had excellent results over the years. Gayl J. Canfield, PhD, RD, LD, is the nutrition director there.

I asked her what food group she would unilaterally cut out of the American diet if she could, and the answer was unambiguous. “Processed foods! Virtually all processed foods are lower in fiber and have added sugars, sodium, and fats.” (It’s worth noting that there are many healthy fats, but the fats found in processed foods are overwhelmingly not.)

If she could boost consumption of any food group, her answer was “Produce! Increasing fruit and vegetable consumption is one of the most important changes a person can make toward becoming healthier … High water/high fiber foods provide more nutrition and satiety per calorie dollar.”

Many of our younger-to-middle-aged readers may have fairly healthy cardiovascular systems, and thus are starting from a good baseline. If someone in that demographic was looking to have a pristine cardiovascular system sans medical intervention well into their twilight years, I asked what her dietary guidelines would be. “Increase consumption of fruits and vegetables (eight to nine-plus servings per day); eat whole, unrefined, unprocessed foods; significantly decrease animal protein consumption (less beef, chicken, lamb, pork, veal), and eat modest amounts of cold-water fish high in omega-3 fatty acids; and be mindful of added sodium, sugar, and/or fats/oils in your food.”

There are certainly nutritionists who would vary on the point of animal protein, but the evidence leaves no doubt as to the merit of the overall Pritikin approach. Research shows that within one month of adopting the Pritikin program/diet, 83 percent of hypertensive patients got off their medications and had blood pressures lower than before they had started, when they were still taking medication. Clearly, there’s something to be said for addressing heart health through diet and exercise and turning to medication only as a last resort.

What Canfield is essentially saying is to eat as though progress left food alone. And the Pritikin approach certainly works, but you don’t have to make it complicated. Michael Pollan put it another way: shop around the edges of the supermarket and skip the center section where you’ll find food in boxes and cans. Real food tends to be at the back of the store near the loading docks where it can be changed out for fresh food should it go bad. If food is incapable of spoiling, it isn’t food in the truest sense.

The “why” behind the whole foods argument

We’ve looked at what to eat, and the concepts there are quite simple. Now here’s why you should eat that way. In his paper, “The Role of Nutrition, Nutraceuticals, Vitamins, Antioxidants, and Minerals in the Prevention and Treatment of Hypertension,” Mark

Houston, MD, MS, wrote that “Oxidative stress, inflammation, and autoimmune dysfunction of the vascular system are the primary patho-physiological and functional mechanisms that induce vascular disease.” The vascular disease he is referring to is high blood pressure and atherosclerosis, hardening of the arteries caused by the buildup of plaques and fats on the arterial wall.

Let’s examine the heart for a moment: a fist-sized lump of muscle, it pumps continually from one month after conception until death, circulating blood around an extraordinarily long and complex network of arteries and veins. In one day the blood in your body travels 12,000 miles through a venous structure that would circle the earth two and a half times if laid end to end. Grab a tennis ball and squeeze it as hard as you can—that’s how hard the heart works with each contraction. It will do this three billion times consecutively over the course of a normal lifespan. The heart never gets a break. If it does get a break … well, that’s the end of the line. You can see, then, how it’s in your best interest to take excellent care of this amazing muscle.

The cardiovascular system is finely-tuned and incredibly complex. Like any system of this nature, when the user abuses it, things go wrong. Atherosclerosis and high blood pressure are the two main culprits here and are intimately related, as we’ll explore in a moment.

Blood pressure is simple to understand. When any liquid (blood) flows through a tube (arteries and veins) it will encounter resistance due to gravity and due to friction from the walls of the tube. Blood pressure comes with two numbers: systolic and diastolic. Systolic pressure is the highest and occurs just after the beat: 120 mmHg or less is considered in the healthy range. Diastolic pressure is the resting pressure: 80 mmHg or less is considered healthy here.

Hypertension is simply medicalese for high blood pressure. Prehypertension is 120-139/80-89, stage 1 is 140-159/90-99, stage 2 is over 160/over 100. (Readings over 140/90 are seen in 69 percent of people who have their first heart attack, 77 percent with first stroke, and 74 percent with congestive heart failure.)

Hypertension causes constriction of the arterioles, making the heart work harder; damages and weakens the heart muscle itself; causes the blood vessel walls to thicken (to withstand the pressure), thereby constricting blood flow; contributes to coronary artery disease (the coronary arteries are the ones that feed the heart); can cause kidney damage; and can cause blood vessels in the brain to weaken and rupture, resulting in a stroke. There’s more, but you get the idea.

And here are the risk factors for hypertension: family history, excess weight, smoking, stress, overconsumption of alcohol, and last but certainly not least, the SAD.

Atherosclerosis and hypertension seem to have something of a symbiotic relationship. Atherosclerosis occurs when deposits (plaque and fats) build up on the arterial walls. Mostly this occurs due to oxidation and inflammation when LDL-B particles invade a damaged, delicate single-cell membrane on the inside of the arterial wall called the endothelium. The body launches an attack to neutralize this new threat, resulting in an inflammatory cascade.

Buildup on the walls of the artery creates high blood pressure. Think of it this way: imagine you are in your backyard, watering the garden with a hose. When the end is left open, the water just burbles out in a rather tranquil manner. But when you need to really spray it, you put your thumb over the end, and make the opening smaller. The pressure builds in order to force that same water through, and you better believe that the water pump’s job just got a lot harder. Presto, high pressure.

But, unlike that garden hose, your arterial walls expand and contract to help keep the blood moving along. Higher pressures mean the walls will expand and contract with a larger, more violent motion, damaging the delicate endothelium and making it more susceptible to invasion by LDL-B particles, creating another inflammatory cascade and further deposits. Atherosclerosis and hypertension are two sides of one very sinister coin.

So, if “oxidative stress, inflammation, and autoimmune dysfunction of the vascular system” are the main contributors to heart disease, a heart-healthy diet means eating food that fights—or at the very least, doesn’t contribute to—oxidative stress, inflammation, and autoimmune dysfunction. Inflammation and oxidation are caused in large part by out-of-control blood sugar levels and the insulin resistance that comes with eating sugar and processed foods.

Want to keep your heart healthy into your 80s and beyond? It has everything to do with turning back the clock on your eating habits.


How do I know if I have high blood pressure?

It’s not as simple as you might think. Informed readers should resist jumping to the conclusion of high blood pressure based on a single reading in a doctor’s office. Blood pressure rises and falls throughout the day in response to stress, dehydration, caffeine consumption, exercise, and other factors.

“White Coat Syndrome” is a spike in blood pressure caused by the stress of simply being in a doctor’s office. Health writer Mark Sisson related an incident in which he got a checkup and his blood pressure reading was 140/101. He didn’t believe it, so he bought a home tester and tested himself in 10 different sessions, five times each session, over the next week. He never got back to 140/100 (the highest reading was 133/92) and his after-dinner blood pressures were 108/66.

He summed up the experience well: “One solitary reading is about as useful for diagnosing hypertension as one piano note is for identifying a song.”

Moral of the story: get a home reader, test yourself repeatedly. If you see a pattern of high blood pressure, change your diet and lifestyle first.


Supplement Options

Nutritionists have mixed feelings on the role of supplementation. There are those (like Gayl Canfield) who believe that a properly balanced diet will give you everything you need, with the possible exception of vitamin D. That said, a diet missing key nutrients can spell trouble. If you want to cover your bases, here are a few of the essentials for heart health.

• Fiber

• Tea (green and black)

• Vitamins B6, C, and D

• Flavonoids (resveratrol, found in red wine)

• Lycopene (tomatoes, guava, pink grapefruit, watermelon, apricots, papaya)

• Co-Q10 (found mostly in red meats – best to supplement)

• Alpha-lipoic acid

• L-arginine

• Taurine and cysteine (choose NAC or use a non-denatured [cold-processed] whey protein)