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ALERT for patients on Hormone Replacement Therapy:

Please be aware that as of August 1, 2010, all female patients that elect to have their Hormone Replacement Therapy prescribed through our office will be required to maintain their annual exams (pelvic/pap, breast exam, etc.) and mammograms directly through our office.

Make Heart-healthy Choices
10 Super Foods for a Happy Heart

Make Yourself Heart Attack Proof

The single most important step you can take for heart health starts with what you put on your plate.
By Anne Underwood

With heart disease the number one killer of both men and women in this country, you would think a cure that could dramatically reduce these deaths would be big news. And yet the most effective remedy is so simple that most people can't seem to believe it works. "In traditional societies, where people don't eat processed foods, heart disease is rare," says cardiologist Arthur Agatston, MD, author of The South Beach Wake-Up Call. "If you start with a healthy diet in childhood, heart attacks are almost completely preventable."

Studies have shown that up to 70% of heart disease can be averted with the right regimen, according to Walter Willett, MD, chair of nutrition at Harvard School of Public Health. But is diet alone as powerful as drugs? "Oh, no, it's much more powerful," says Dr. Willett. "Statins, the most effective single medications for reducing heart disease, only cut risk by 25 to 30%."

In fact, you would need a cabinet full of prescription drugs to bestow all the benefits of a serious heart-healthy meal plan. There's nothing a drug can do for your heart health that foods can't do, too.

In that spirit, here are nine top foods for the heart. But this list is only a beginning. A truly healthy diet features a broad range of fruits, vegetables, nuts, and legumes--not a select few. Hippocrates understood the concept more than 2,000 years ago: "Let your food be your medicine, and your medicine be your food."

Oranges
Rx Effect: Reduce blood pressure, cholesterol and heart failure

THE EVIDENCE: Oranges contain a pharmacy's worth of salves for the heart. The soluble fiber pectin acts like a giant sponge, sopping up cholesterol in food and blocking its absorption--just like a class of drugs known as bile acid sequestrants. And the potassium in oranges helps counterbalance salt, keeping blood pressure under control.

But new research shows something even more startling: Citrus pectin helps neutralize a protein called galectin-3 that causes scarring of heart tissue, leading to congestive heart failure--a condition that is often difficult to treat with drugs. "Twenty percent of Americans over 50 have high galectin-3," says Pieter Muntendam, MD, CEO of BG Medicine in Waltham, MA. "A 2009 study showed that a diet high in fruits and vegetables decreased the risk of heart failure by 37%."

TRY: Pectin is contained in the pulp and pith. You'll get more of it in juice with pulp. Or better yet, eat your oranges.


Kale
Rx Effect: Prevents atherosclerosis

THE EVIDENCE: Your mom was right: You need to consume your dark leafy greens. "Kale has everything you would want in a superfood," says Joel Fuhrman, MD, the author of the bestseller Eat to Live, who uses diet and exercise to help patients reverse their cardiovascular disease. For starters, kale boasts a bumper crop of heart-healthy antioxidants, omega-3 fatty acids, fiber, folate, potassium, and vitamin E. It's also rich in lutein, which correlated in the Los Angeles Atherosclerosis Study with protection against early atherosclerosis. Kale even contains an unusual compound, glucoraphanin, that activates a special protective protein called Nrf2. "It creates a sort of Teflon coating in your arteries to keep plaque from adhering," says Dr. Fuhrman.


Garlic
Rx Effect: Reduces blood pressure and plaque

THE EVIDENCE: Research suggests that, much like the ACE inhibitor drugs that fight high blood pressure, garlic ratchets down an enzyme called angiotensin, which constricts blood vessels. Though the effect is modest compared with medications, garlic seems to have a significant impact on the buildup of plaque. In three randomized trials, Matthew Budoff, MD, professor of medicine at UCLA, found that plaque progression slowed by more than 50% in people taking garlic extract, compared with the non?vampire slayers--"and the nongarlic group was on standard drugs," he says.

TRY: The trials used 250 mg tablets of Kyolic aged garlic extract to standardize the dose. "But it's always better to eat the real food," says Gayl Canfield, PhD, RD, director of nutrition at Pritikin Longevity Center in Miami.


Red wine
Rx Effect: Boosts HDL, reduces unwanted clotting

THE EVIDENCE: Any alcohol nudges up HDL, the "good" cholesterol that helps prevent plaque. But red wine may offer additional benefits, says John Folts, PhD, professor emeritus of cardiovascular medicine and nutrition at the University of Wisconsin?Madison. "The key is not resveratrol--you would need 16 bottles a day," he says. Instead, compounds called polyphenols help keep blood vessels flexible and reduce the risk of unwanted clotting. "They're nearly as effective as aspirin," he claims. But note: More than one glass of vino a day ups the risk of breast cancer for women, and chronic heavy drinking damages the heart, so this is a case where more is not better.

TRY: Dark beer such as Guinness stout delivers many of the same beneficial polyphenols.


Dark chocolate
Rx Effect: Reduces blood pressure

THE EVIDENCE: The Kuna Indians off the coast of Panama have enviably low blood pressure--and unlike the rest of us, they don't develop hypertension as they age. When Harvard cardiologist Norman Hollenberg, MD, set out to unravel their secret, he assumed they carried some rare genetic trait. Instead he found they drink enormous quantities of minimally processed cocoa. It's rich in compounds called flavanols, which improve blood vessel flexibility. We can all get them from chocolate--a few squares a day. Dark chocolate is likely to have more, because it starts with a higher cocoa content--but that's no guarantee, since different processing methods can destroy them.


Sardines
Rx Effect: Lower triglycerides, raise HDL

THE EVIDENCE: The omega-3 fatty acids in cold-water fish are crucial for heart health, and sardines have among the highest levels. These "good fats" lower harmful triglycerides, raise protective HDL, reduce potentially fatal heart arrhythmias, and tamp down inflammation. It's inflammation that ultimately destabilizes plaque, causing it to rupture and produce a heart-attack-inducing clot. Though you can get omega-3s from plant sources such as flaxseed, the "long chain" omega-3s in fish are far more powerful. A large Danish study last year in the American Journal of Clinical Nutrition found a 38% reduction in ischemic heart disease among women who consumed the most.


Lentils
Rx Effect: Reduce blood pressure

THE EVIDENCE: One international study followed 12,763 people in the United States, Japan, and six European countries for 25 years. When the results were tallied, legumes--such as lentils--were associated with an 82% reduction in the risk of death from heart disease. The reasons include not only lean vegetable protein and fiber but also folate, magnesium, and potassium. George Mateljan, the author of The World's Healthiest Foods, calls magnesium "nature's own calcium channel blocker"--a type of drug that fights hypertension. And by counterbalancing salt, potassium is crucial for keeping blood pressure under control.


Almonds

Rx Effect: Reduce LDL and fatal arrhythmias

THE EVIDENCE: "You don't have to be miserable to bring your cholesterol down," says David Jenkins, MD, PhD, professor of medicine and nutritional sciences at the University of Toronto. The plant sterols in almonds reduce the absorption of cholesterol from the diet, while the unsaturated oils encourage the liver to make less LDL and more "good" HDL. When Dr. Jenkins gave patients a vegetarian diet including almonds (along with other cholesterol-lowering foods, such as lentils, eggplant, and soy) for a month, he found LDL reductions of 28.6%--comparable to those on 20 mg of lovastatin (Mevacor). Just 22 almonds a day will do. Another study found major declines in fatal arrhythmias with 2 servings of nuts a week.

TRY: Don't limit yourself to almonds. Walnuts, pistachios, and peanuts are also great.


Pomegranates
Rx Effect: Reduce atherosclerosis

THE EVIDENCE: Bringing down LDL is important, but so is preventing the oxidation of that cholesterol. When LDL is oxidized, it tends to get stuck in arterial walls, initiating the formation of plaque. But Michael Aviram, DSc, professor of biochemistry at the Technion-Israel Institute of Technology in Haifa, found that pomegranate juice, with its unique antioxidants, not only blocked the progression of plaque, but actually reversed some of the buildup when patients drank 8 ounces a day for a year. How does it do this? In later studies, Dr. Aviram learned that pomegranates activate an enzyme that breaks down oxidized cholesterol.

Soy

Soy may lower cholesterol, and since it is low in saturated fat, it's still a great source of lean protein in a heart-healthy diet.

Look for natural sources of soy, like edamame, tempeh, or organic silken tofu. And soy milk is a great addition to a bowl of oatmeal or whole-grain cereal. But watch the amount of salt in your soy: some processed varieties like soy dogs can contain added sodium, which boosts blood pressure.

No Half-Hearted Measures
Unfortunately, you won't disease-proof your heart by simply adding chocolate, wine, and nuts to a diet full of doughnuts and bacon. Groundbreaking new studies explain why.

For years, government panels told us that the main villain in heart disease was the saturated fat in meat and dairy. We did the logical thing and cut down on total fat while upping refined carbs.

Bad move. Research now shows that the sugar and refined flour in our bagels, pizzas, cookies, and sodas are even more problematic. Stripped of fiber (and other nutrients), these unhealthy carbs zip-line through the digestive tract and into the bloodstream, where they deliver a triple dose of heart damage--raising harmful triglycerides, lowering protective HDL, and raising blood pressure.

But saturated fat isn't off the hook. Some studies have appeared to exonerate it--but only because people in these studies replaced the bad fat in their diets with harmful carbs. "When you eat good fats instead of bad ones, cardiac risk goes down," says Harvard's Walter Willett, MD. So treat cheese as dessert, not the main course, and favor lean meat such as grass-fed bison.
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