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If you care about your heart health 


Anahite Afshar


Cardiovascular disease accounts for nearly one-third of all deaths in Canada, more than any other disease (1).

In Canada, 80% of heart disease could be prevented with a healthy lifestyle (2).


Since prevention is the best cure, here are 7 lucky heart-healthy tips:
1. Eat a variety of fruits and vegetables every day

It's no surprise that eating fruits and vegetables has long been known to have a protective effect on cardiovascular health (3).

But why?

It is assumed that it is the many nutrients found in fruits and vegetables, such as dietary fiber, potassium, vitamins and especially antioxidants that help reduce atherosclerosis in the blood vessels. However, when these elements are isolated to validate their protective effect, the same results are not obtained as with the consumption of fruits and vegetables. The health benefits of fruits and vegetables would therefore come more from the synergistic effect of the combination of these different phytochemicals (4).

Some fruits and vegetables are becoming fashionable because of their health benefits and antioxidant power. However, targeting specific foods, whether kale or goji berries, will have little effect on our health if the rest of our diet is not well diversified. In fact, variety is the key to success.

2. Increase dietary fiber intake
Dietary fiber intake is associated with a low risk of coronary heart disease (5). Fiber works at different levels and has positive effects on our overall health. For heart health, we are looking to consume more soluble fibre specifically. Soluble fibre helps to reduce blood sugar and cholesterol levels, two cardiovascular risk factors (6).

All fruits, vegetables, whole grain products, nuts, seeds and legumes are foods that contain both soluble and insoluble fibre and should be consumed in adequate amounts. However, some foods are higher in soluble fibre. These include barley, oats, psyllium, flaxseeds, chia seeds, avocado, figs, black beans, lima beans, etc.

3. Eat more "good fats
The popular belief is that fat is bad for our heart because it will "clog" the arteries and that a low-fat diet is recommended.

However, according to a recent meta-analysis (7), there is probably no direct relationship between the amount of fat consumed and the risk of coronary heart disease. Current recommendations now emphasize fat quality rather than quantity (8). According to another meta-analysis (9), there is not even significant evidence to conclude that saturated fat, considered the "bad fat", is associated with an increased risk of cardiovascular disease.

However, the consumption of monounsaturated and polyunsaturated fats, the "good fats", would be protective of heart health.

We generally associate monounsaturated fats, i.e. omega-9, found in olive oil with the Mediterranean diet. This diet reduces the risk of developing cardiovascular disease in people at risk (10).

As for polyunsaturated fats, there are omega-6 and omega-3.

Omega-6s are the basis of several pro-inflammatory molecules. Due to the inflammatory component of cardiovascular disease, one might think that a reduction in omega-6 consumption would be recommended to protect the heart. However, the consumption of omega-6 polyunsaturated fats is, on the contrary, associated with a decrease in cardiovascular risk (11).

Omega-3 fats have an anti-inflammatory effect. However, according to a recent meta-analysis, supplementation with omega-3 is not associated with a reduction in cardiovascular risk (12). It is best to consume omega-3 rich foods such as oily fish, seaweed, flaxseed, chia seeds, and walnuts to get a good intake of omega-3. In fact, it is not so much the total amount that is important, but rather the ratio of omega-6 to omega-3. While the average ratio of omega-6 to omega-3 consumed in Western countries is 15:1, it is thought that a ratio of 3:1 would actually be ideal. A lower ratio of omega-6 to omega-3 fatty acids is therefore desired to reduce the risk of many chronic diseases, including cardiovascular disease (13).

The case of cholesterol
Cholesterol has had a bad reputation for a long time, without really being justified. Cholesterol is an essential element for the proper functioning of the body. It circulates in the blood in carriers called HDL, nicknamed "good cholesterol", and LDL, nicknamed "bad cholesterol". About 10-20% of blood cholesterol comes from dietary cholesterol, the majority is produced by the body. Since dietary cholesterol has very little effect on blood cholesterol, there is no need to ban it from our diet.

However, if you are at risk and want to reduce your blood cholesterol, it is better to choose plant-based foods, since dietary cholesterol comes only from animal products.

4. Reduce the consumption of free sugars
Free sugars" are added simple sugars (white sugar, honey, maple syrup, etc.) but also those in fruit juices.

Excessive sugar consumption is associated with heart disease, stroke, obesity, diabetes, high cholesterol, cancer and dental caries (14).

The WHO recommends limiting the amount of free sugar consumed per day to no more than 10% of total calories, and ideally aim for less than 5%. For an average diet of 2,000 calories per day, 10% is equivalent to about 50 grams (about 12 teaspoons) of sugar and 5% is equivalent to about 25g (about 6 teaspoons) (15). For example, a can of pop contains about 10 teaspoons of free sugars, which is 85% of the recommended maximum intake.

5. Reduce sodium intake
The results of a food consumption survey revealed that the usual sodium intake of Quebec adults was approximately 3299 mg per day (16). This is not only well above the recommended intake of 1500 mg per day, but also well above the tolerable upper intake level of 2300 mg!

Most of the sodium consumed does not come from table salt added in cooking or on the plate, but from processed foods. To reduce sodium consumption, simply pay attention to the nutrition label and choose basic, minimally processed products.

6. Moderate alcohol consumption
It is obvious that excessive alcohol consumption is harmful to health. However, moderate alcohol consumption is associated with a reduced risk of cardiovascular disease (17). Moderate consumption implies 1 to 2 drinks per day maximum and not to drink every day. Beyond that, the beneficial effect is cancelled and the risk is increased.

However, people who do not consume alcohol initially should not start using it if they did not consume it before.

7. Move more
Being physically active is important to prevent heart disease. To improve overall cardiovascular health, it is recommended that you get at least 150 minutes of moderate exercise per week or 75 minutes per week of vigorous exercise or a combination of moderate and vigorous activity (18).


Anahite Afshar, Registered Dietitian-Nutritionist Dt.P
1. Statistics Canada:

2. Heart and Stroke Foundation:

3. Ness A R and Powles J W. (1997). Fruit and vegetables, and cardiovascular disease: A

review. International Journal of Epidemiology. 26: 1-13.

4. Liu RH. (2003). Health benefits of fruit and vegetables are from additive and synergistic

combinations of phytochemicals. The American journal of clinical nutrition.


5. Pereira MA et al (2004). Dietary Fiber and Risk of Coronary Heart Disease A Pooled

Analysis of Cohort Studies. Arch Intern Med.164:370-376

6. Institute of Medicine. Food and Nutrition Board. Dietary Reference Intakes for Energy,

Carbohydrate, Fiber, Fatty Acids, Cholesterol, Protein, and Amino acids

(Macronutrients). Chapter 7: Dietary, functional, and total fiber. Washington, DC:

National Academy Press, 2005.

7. Murray Skeaff C, Miller J. (2009). Dietary Fat and Coronary Heart Disease: Summary of

Evidence from Prospective Cohort and Randomised Controlled Trials. Ann Nutr Metab.


8. American Heart Association:

9. Siri-Tarino PW, Sun Q, Hu FB, Krauss RM. (2010) Meta-analysis of prospective cohort

studies evaluating association of saturated fat with cardiovascular disease. AJCN.


10. Estruch R et al (2013). Primary Prevention of Cardiovascular Disease with a

Mediterranean Diet. N Engl J Med. 368:1279-1290

11. Harris, WS et al. (2009). Omega-6 Fatty Acids and Risk for Cardiovascular Disease. AHA


12. Rizos EC, Ntzani EE, Bika E, Kostapanos MS, Elisaf MS.(2012). Association Between

Omega-3 Fatty Acid Supplementation and Risk of Major Cardiovascular Disease Events A

Systematic Review and Meta-analysis. JAMA.  308(10):1024-1033.

13. Simopoulos AP. (2008). The Importance of the Omega-6/Omega- 3 Fatty Acid Ratio in

Cardiovascular Disease and Other Chronic Diseases. Experimental Biology and Medicine.

Vol 233, Issue 6, pp. 674 - 688

14. Heart and Stroke Foundation:

15. WHO:

16. Institut national de santé publique du Québec. Blanchet C., Plante C. and Rochette L.

(2009). Food consumption and nutritional intakes of Quebec adults.

Retrieved from

17. Educalcool:

18. American Heart Association :