Episode Transcript<\/p>\n
Transcript<\/p>\n
Dr. Mendez:\u00a0We know eating better and healthier lifestyle really m- adds up over time, but there\u2019s no age that\u2019s too late to change. You can always try to get your blood pressure down, even if you\u2019re older and develop high blood pressure. [upbeat music]\u00a0<\/p>\n
Courtney:\u00a0Welcome to Health Matters, your biweekly dose of the latest in health and wellness from NewYork-Presbyterian. I\u2019m Courtney Allison.<\/p>\n
Courtney:\u00a0This season on Health Matters, we\u2019re covering your health from A to Z, asking our experts to break down the health topics and wellness trends we\u2019re all curious about. Today, we\u2019re at the letter D, focusing on diet, specifically how what we eat can impact our heart health. To explore the connection between diet and the heart, we spoke to Dr. Sean Mendez, a cardiologist at NewYork-Presbyterian, Brooklyn Methodist Hospital. He explains what our cholesterol and blood pressure numbers really mean and how our diet could help improve them. He also breaks down heart-healthy diets like the DASH diet and the Mediterranean diet, offering tips on how we can best eat to protect our heart.\u00a0<\/p>\n
Courtney:\u00a0Dr. Mendez, thank you so much for joining me today.\u00a0<\/p>\n
Dr. Mendez:\u00a0Thank you. It\u2019s great to be here.\u00a0<\/p>\n
Courtney:\u00a0So today we\u2019re going to talk about the relationship between diet and heart health, and how what we eat can maybe lower blood pressure and cholesterol. But before we get into these questions, I\u2019d love to break down all these numbers we see when we get our blood work done. What do we actually mean by heart health numbers like cholesterol, blood pressure, blood sugar, and ApoB?\u00a0<\/p>\n
Dr. Mendez:\u00a0All of those mentioned, whether it\u2019s your blood pressure, your cholesterol, specifically your LDL cholesterol and, and triglycerides, are all markers of either various disease states: high cholesterol, high blood pressure, diabetes. But also, before we technically call it a disease, they\u2019re markers that you can be of in- increased risk for that. And so when we get these numbers, really what we\u2019re trying to do is get a little more data to help try to figure out the best way to either prevent or treat heart disease or any cardiovascular disease.\u00a0<\/p>\n
Courtney:\u00a0So let\u2019s start with blood pressure, which measures the force of blood against your artery walls. What is a healthy blood pressure range?\u00a0<\/p>\n
Dr. Mendez:\u00a0I think the kind of ideal blood pressure is about one twenty over seventy. Anything above one thirty over eighty starts to be in the hypertensive range.\u00a0<\/p>\n
Courtney:\u00a0So how about cholesterol? What\u2019s a safe or healthy range of cholesterol numbers for people?\u00a0<\/p>\n
Dr. Mendez:\u00a0When we think about cholesterol, primarily we\u2019re thinking about the LDL cholesterol. The LDL cholesterol is the most associated with adverse cardiovascular disease, and so in general, an ideal LDL cholesterol goal is about less than one hundred milligrams per deciliter for everybody. Also, we think about other things like your triglycerides, which are a secondary marker. It\u2019s less strongly associated, but the higher it is, the increased risk of heart disease, and then we know the higher the HDL is associated with a lower risk of heart disease. Most of your atherogenic or heart disease-causing molecules are in LDL cholesterol, but there\u2019s some that\u2019s not picked up in your standard lipid panel. All of them have this molecule, apolipoprotein B, which is a newer molecule being tested, and so the apolipoprotein B is a measurement of all atherogenic molecules. Higher ApoB is more correlating with the risk of heart disease.\u00a0<\/p>\n
Courtney:\u00a0Could we talk about what we eat and how that can really improve our heart health?\u00a0<\/p>\n
Dr. Mendez:\u00a0All of our numbers can be impacted in a negative and positive way with our lifestyle choices. On average, in the studies with dietary changes alone, blood pressure drops about five to seven points of the top number, the systolic, and about three of the diastolic. It doesn\u2019t sound dramatic, especially when people have very high blood pressure, but it certainly makes a big difference. In general, when we\u2019re thinking about what are we saying when we lower the cholesterol, and we\u2019re talking about the LDL cholesterol, and that\u2019s about three to fifteen percent, depending on the study, just with dietary changes alone. Certainly, the foods that we eat impact in very multifactorial ways, meaning that some foods can raise your blood pressure. We know some people are very salt sensitive. Some can have a salty meal, and their blood pressure is sky-high later that day or the next day. Same with cholesterol. We know some clear associations with things that affect the LDL cholesterol. There\u2019s good evidence that saturated fats elevate the LDL cholesterol. Certainly, a lot of processed foods, refined grains, sugar products, all of that can impact it as well.\u00a0<\/p>\n
Courtney:\u00a0And so I wonder, how quickly can diet changes affect lab results? Just from my own personal experience, when you get a number you don\u2019t like, you\u2019re like, \u201cI want to fix it right away!\u201d But what\u2019s realistic if you\u2019re going to try to make changes for it to show up in your blood?\u00a0<\/p>\n
Dr. Mendez:\u00a0Yeah, I mean, I think most of the studies that we\u2019ve done have kind of been in the range of one to three months for that, for-\u00a0<\/p>\n
Courtney:\u00a0Mm-hmm.<\/p>\n
Dr. Mendez:\u00a0\u2026 we put on this diet, and let\u2019s see the change. And, you know, it\u2019s usually recommended if we either put you on a medication for cholesterol or you\u2019re making lifestyle changes to kind of check that in that same time frame. It also depends on how much you\u2019re changing. If you\u2019re kind of gradually incorporating different lifestyle changes, then it may take a little longer. The full effect, uh, might not be seen for six months, a year or so.\u00a0<\/p>\n
Courtney:\u00a0That\u2019s great. Lifestyle changes, I imagine not smoking, reducing alcohol, exercising, all that good stuff?\u00a0<\/p>\n
Dr. Mendez:\u00a0Yep, yep, all that good stuff. Um, also always forgotten, sleep and stress management are kind of two cor- cornerstones of, of cardiovascular prevention.\u00a0<\/p>\n
Courtney:\u00a0You mentioned some foods are better to lower LDL cholesterol. Do you have any specific examples of what someone should be looking for? If they\u2019re looking to lower their LDL cholesterol, what should they be grabbing at the grocery store?<\/p>\n
Dr. Mendez:\u00a0Yeah, in general, things with soluble fiber, so oats, barley, psyllium, those are fibers known to lower LDL cholesterol. Fiber basically works in the gut. Your gallbladder makes bile, which is made up of cholesterol from the liver, and that when you eat fatty foods or foods with fat in it, the bile is secreted into your gut. What fiber does is bind up with that bile and takes it out. Healthy fats are what we call, you know, the monounsaturated and polyunsaturated fats-\u00a0<\/p>\n
Courtney:\u00a0Mm-hmm.<\/p>\n
Dr. Mendez:\u00a0\u2026 which kind of speak to their structure at a molecular level. But the monounsaturated fats are like olive oil, mixed nuts, avocados, and the polyunsaturated fats, omega-6s, things that are seen in, like, walnuts or omega-3s, which are the seafood-related\u2026. fats. We have seen that replacing saturated fats with these, especially polyunsaturated fats, the omega-6s, omega-3s, reduces your risk of heart disease. And there\u2019s no age that\u2019s too late to really start. The younger you are, the better, because it\u2019s really like compounding interest. Eating better, healthier lifestyle really adds up over time, but there\u2019s no age that\u2019s too late to change. You can always try to get your blood pressure down, even if you\u2019re older and develop high blood pressure.<\/p>\n
Courtney:\u00a0So let\u2019s talk about the DASH diet.\u00a0<\/p>\n
Dr. Mendez:\u00a0Mm-hmm.<\/p>\n
Courtney:\u00a0How is it helpful?\u00a0<\/p>\n
Dr. Mendez:\u00a0Yeah, so the DASH diet is essentially a focused diet. It\u2019s got pretty clear rules about what you can and can\u2019t eat. Really, the emphasis is on eating more fruits and vegetables, a few servings of low-fat dairy, avoiding red meat, and also incorporated it with a low-sodium component. And so the DASH diet has been best studied in the context of high blood pressure. Multiple studies showing evidence that the DASH diet can lower your blood pressure in that range that I, I alluded to before. And so the DASH diet is a nice diet for someone who\u2019s dealing with hypertension. It is also associated with lowering cholesterol, some weight loss as well, but the focus is really on: What can I do to lower the blood pressure? And a big part of that is both sodium restriction and, and an increase in foods that contain potassium, calcium, magnesium. Higher potassium intake is associated with lowering blood pressure. There\u2019s some evidence that it may also even mitigate high salt intake, so I don\u2019t say eat a banana every time you eat a bag of chips, but higher potassium intake can lower blood pressure.\u00a0<\/p>\n
Courtney:\u00a0What about the Mediterranean diet? That\u2019s one we hear a lot about.\u00a0<\/p>\n
Dr. Mendez:\u00a0So the Mediterranean diet is really focused on high consumption of vegetables, fruits, legumes, whole grains, nuts, olive oil, with an emphasis on that, oily fish, so salmon, things rich in omega-3s, really low-fat or fat-free dairy, and f- fish, poultry, eggs in low, moderate amounts, and really low processed foods.\u00a0<\/p>\n
Courtney:\u00a0Mm-hmm.<\/p>\n
Dr. Mendez:\u00a0So the differences are the DASH diet\u2019s the best one studied for hypertension.\u00a0<\/p>\n
Courtney:\u00a0Mm-hmm.<\/p>\n
Dr. Mendez:\u00a0Um, and the biggest trials for the Mediterranean diet, they show that it reduced overall cardiovascular risk in people at either at elevated or high risk for cardiovascular disease. So the DASH diet lowers your blood pressure, but the Mediterranean diet in general has been shown much more to lower your risk of cardiovascular disease.\u00a0<\/p>\n
Courtney:\u00a0Right. The Mediterranean diet has always seemed more like a way of life and a bit more flexible.\u00a0<\/p>\n
Dr. Mendez:\u00a0Yeah, it can be flexible in a good way or a bad way, right? If you\u2019re like, \u201cI\u2019m going to eat pastries all the time,\u201d you know- [laughs] \u2026 certainly, you\u2019re probably not getting the benefits of that, uh-\u00a0<\/p>\n
Courtney:\u00a0Right. Right. Are cannolis part of the Mediterranean diet? [laughs]\u00a0<\/p>\n
Dr. Mendez:\u00a0Yeah. Yeah, yeah, exactly.\u00a0<\/p>\n
Courtney:\u00a0[laughs]<\/p>\n
Dr. Mendez:\u00a0So I think that for someone trying to figure out, like, \u201cI gotta get my blood pressure under control,\u201d often the DASH diet, it\u2019s a little easier because it\u2019s straightforward to follow, especially like incorporating\u2013 there\u2019s diet plans or cookbooks out there which you can really just follow.\u00a0<\/p>\n
Courtney:\u00a0What tips do you tell people who want to start changing their eating habits or adopt these diets? If they\u2019re in your office, and they\u2019re like, \u201cOkay, I want to try to make some changes here,\u201d where do you start?\u00a0<\/p>\n
Dr. Mendez:\u00a0I think first defining what I mean by diet. What kind of foods are you eating? \u201cOh, I eat some vegetables,\u201d but it\u2019s a couple pieces of broccoli next to, you know, mostly a fried piece of meat. I think trying to define that is good, and I think often having patients, like, write down what they ate for a week, and often that\u2019s enough to just look back and say, \u201cOh, when I wrote it down, that kind of puts out what I actually ate, um, versus what I think I eat,\u201d like.\u00a0<\/p>\n
Courtney:\u00a0Yeah, it\u2019s probably enlightening, I imagine.\u00a0<\/p>\n
Dr. Mendez:\u00a0Yeah, I think it\u2019s like that for anything, whether you\u2019re watching your blood pressure at home or, you know, trying to figure out your diet or how much you exercise. I think keeping a log of things for at least a short time period and reflecting on it often can put some insights and see what it is. And I think the second thing to think about is what we kind of talked about before: What are your risk factors? Are we doing this purely to prevent development? Are we doing this to treat something? So trying to figure out, what are you actually eating? And, and second, what are your underlying issues, and, and what are your goals for the diet? And to try to figure out the best approach.\u00a0<\/p>\n
Courtney:\u00a0Are there any easy food swaps you recommend that can make a difference?\u00a0<\/p>\n
Dr. Mendez:\u00a0Often, snacking can be the biggest one. People can often eat well for their meals, but the snacks in between can cause a problem, so trying to figure that out and taking it step by step. Maybe you have an afternoon snack, and you replace that with something a little more heart healthy, less processed, can be the first steps for that. And, and another big thing is, are you drinking sugary beverages? Can you replace that with water or some tea, something else with a little less negative impact?\u00a0<\/p>\n
Courtney:\u00a0Is there anything you find misunderstood about eating for heart health?\u00a0<\/p>\n
Dr. Mendez:\u00a0Yeah, I think it\u2019s two [exhales] things, one of which is that it\u2019s for everybody, right? Everybody should be focused on trying to incorporate a heart-healthy diet, not only if you have a medical problem, but you want to prevent one from coming on in the future. The second thing is food, exercise, sleep, stress, all of that is important, no matter what medications you\u2019re on. If even if your blood pressure\u2019s perfect because we have you on medication, all of these factors still matter and are still associated with decreasing your overall risk.\u00a0<\/p>\n
Courtney:\u00a0Dr. Mendez, thank you so much for joining us today and giving us all these actionable tips for people looking to take care of their heart health.\u00a0<\/p>\n
Dr. Mendez:\u00a0Thanks. It\u2019s been a pleasure. I really appreciate you having me. [upbeat music]\u00a0<\/p>\n
Courtney:\u00a0Our many thanks to Dr. Sean Mendez. I\u2019m Courtney Allison. Health Matters is a production of NewYork-Presbyterian. The views shared on this podcast solely reflect the expertise and experience of our guests. To learn more about Dr. Mendez\u2019s work with patients, check out the show notes. Join us next time when we discuss what to know about endocrine disruptors and the role of hormones in our body. That\u2019s in two weeks, right here on Health Matters. So you don\u2019t miss it, be sure to follow and subscribe on Apple Podcasts, Spotify, or wherever you get podcasts. [upbeat music]<\/p>\n","protected":false},"excerpt":{"rendered":"Episode Transcript Transcript Dr. Mendez:\u00a0We know eating better and healthier lifestyle really m- adds up over time, but…\n","protected":false},"author":2,"featured_media":501251,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[10],"tags":[200266,8431,49,48,32111,31793,2771,408,84,2376,23112,3656,200267],"class_list":{"0":"post-501250","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-health","8":"tag-apob","9":"tag-blood-pressure","10":"tag-ca","11":"tag-canada","12":"tag-cholesterol","13":"tag-dash-diet","14":"tag-diet","15":"tag-exercise","16":"tag-health","17":"tag-heart-health","18":"tag-mediterranean-diet","19":"tag-omega-3","20":"tag-omega-6"},"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/posts\/501250","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/comments?post=501250"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/posts\/501250\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/media\/501251"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/media?parent=501250"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/categories?post=501250"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/tags?post=501250"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}