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American Heart Month
Women and Heart Disease

by Traci Kaufman, R.D.

 

Since February is American Heart Month, which is sponsored by The American Heart Association, I would like to take the opportunity to introduce some important dietary steps to reduce the risk of heart disease in women. By addressing the dietary factors I hope I can enlighten readers on the difference between fat and dietary cholesterol in the diet.

American Heart Month Traditionally considered a "male" condition, heart disease is a serious health threat to women as well. Heart disease is the leading cause of death in women today (as well as men). Every year more than half a million women die from cardiovascular disease (CVD). The death rate from heart disease is 69% higher in African American women than white women. Women are twice as likely to die from heart disease than all cancers combined. Women's risk for heart disease begins 10-12 years later than in men. This is due in part to the protective effect of estrogen. This may be why women who go through menopause early, without estrogen replacement, are at higher risk for coronary heart disease.

The following information lists the risk factors for Coronary Heart Disease (CHD) released by the Adult Treatment Panel of the National Cholesterol Program:

  • HDL cholesterol less than 35 mg/dl
  • Hypertension (high blood pressure)
  • Cigarette smoking
  • Diabetes
  • Family history of myocardial infarction (heart attack) or sudden death before age 55 in a male parent or sibling, or before age 65 in a female parent or sibling
  • Male older than or equal to 45 years of age
  • Female older than or equal to 55 years of age (or premature menopause without estrogen replacement)
  • Subtract 1 risk factor if HDL cholesterol is lower than or equal to 60 mg/dl

Other risk factors include physical inactivity and overweight problems. In fact most studies suggest that active women have 50% less risk in developing heart disease. As listed above, diabetes is a contributing risk factor in women than in men. If women develop diabetes before menopause, it counteracts the protective effects of estrogen.

Women should take the following steps to reduce their risk of heart disease and stroke:

Follow a blood cholesterol reducing diet that includes the following dietary recommendations:

Eat a low-saturated-fat diet: The amount of cholesterol found in foods is not as important as the amount of saturated fat. Of all the fats, saturated fat is the most potent determinant of blood cholesterol levels. Saturated fats stimulate the production of LDL cholesterol ("bad" cholesterol) and therefore increase blood cholesterol levels and the risk of heart disease. The amount of fats that you eat has a much greater effect on your blood cholesterol than does the amount of dietary cholesterol you consume. For example, eggs are loaded with cholesterol, but recent medical research shows that eating 2 eggs a day does not raise blood cholesterol for most people. Saturated fats are usually solid or almost solid at room temperature. All animal fats, such as those in meat, poultry, and dairy products are saturated. Processed and fast foods tend to be saturated. Vegetable oils also can be saturated; palm, palm kernel and coconut oils are saturated vegetable oils. Fats containing mostly unsaturated fat can be made more saturated through a process called "hydrogenation."

Substitute monounsaturated fat for saturated fats: Monounsaturated fat lowers total blood cholesterol by lowering LDL cholesterol (bad cholesterol) without lowering HDL cholesterol (good cholesterol). These fats are found in vegetable oils such as olive oil, peanut oil and canola oil. Too much of any fat will increase dietary fat intake, and excess body fat may increase cholesterol levels and the potential to increase body fat.

Vitamin E supplementation: 100-250 IU per day: A major study published in the New England Journal of Medicine found that women who get lots of vitamin E-rich food cut their chance of heart disease by almost two-thirds. Sources of vitamin E include almonds, wheat germ, peanut butter, corn oil, sunflower seeds, pecans, safflower oil, peanuts, soybean oil, cod-liver-oil, lobster, salmon, whole-grain cereals, legumes, nuts, seeds, green leafy vegetables and eggs. It may be difficult to get enough vitamin E alone from foods, since many are high in fat. Therefore, vitamin E supplementation may be beneficial.

Daily consumption of 31 to 47 grams of soy protein: Soy protein and its isoflavones provide many health benefits. Soy protein lowers cholesterol levels and prevents against heart disease. 30-40 mg of soy protein a day was shown to significantly reduce levels of harmful LDL cholesterol while leaving beneficial HDL cholesterol levels unchanged. Textured soy protein or textured vegetable protein (TVP) is an excellent source of soy protein and isoflavones. Other sources of soy protein include soy beverages, soy flour, tofu, soynuts, soy milk, tempeh, and isolated soy protein products.

Daily consumption of 400 mg of folic acid: The scientific studies have shown that an elevated homocysteine level increases the risk of heart attacks, strokes and other vascular problems. Deficiencies of certain B vitamins, folate in particular, are strongly associated with elevation of homocysteine. Folate-containing foods include strawberries, citrus fruits, lentils, soybeans, green leafy vegetables such as turnip greens, spinach, and butterhead lettuce. Other folate rich sources include enriched grain products, kidney beans, navy beans, pinto beans, black beans, black-eyed peas, split peas, green peas, lima beans, organ meats, meat, seafood, brewer's yeast, asparagus, and broccoli.

Increase intake of omega 3 fatty acids: It has been repeatedly noted in population studies that people who consume more fish (omega-3's) consistently have a lower incidence of heart disease. Omega-3ís discourage many processes involved in heart disease. They make blood clotting more difficult thereby preventing the attack itself. They change how the walls of the blood vessels interact with different cells in the blood. That relaxes our arteries, helps them from becoming clogged and improves blood circulation in the heart. I recommend eating 2-3 servings of fish a week, averaging 30-60 grams/day or use one to two grams/day of fish oil supplement. Try mackerel, herring, kipper, pilchards, sardines, salmon or trout.

  • Don't smoke.
  • Have your blood pressure checked.
  • Be physically active.
  • Speak to your physician about hormone replacement therapy if you are past menopause.

It is important for women to understand the causes and effects of cardiovascular disease so they can take the steps necessary to reduce their risk of this deadly but preventable disease. Of course, food alone cannot overcome the ill effects of smoking, high blood pressure, overweight and lack of exercise. But it just may help us live longer.

The following recipes try to include the dietary advice given above. They taste as good as they are good for you!

 

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Traci Kaufman, Registered Dietitian, received her bachelor's degree in dietetics and nutrition from the University of Wisconsin-Madison. She has worked as a clinical nutritionist at UCI Medical Center-Irvine in Orange California, and served as team nutritionist for the Los Angeles Rams. Traci is an active member of the American Dietetic Association and two Dietetic Practice Groups: Sports, Cardiovascular, and Wellness Nutritionist (SCAN), and Dietitians in General Clinical Practice. Traci resides in Southern California.

 

This page created 1999

This page modified October 2006

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