For the majority of people, diet and lifestyle remain the cornerstones of the prevention of cardiovascular disease. Laying the groundwork for our heart health starts in our teens and twenties.
There is very clear evidence that a Mediterranean-style, plant-based diet is one of the best diets for cardiovascular disease prevention and even reversal of disease. The PREDIMED study published in the New England Journal of Medicine in 2013 and looked at the effects of the Mediterranean Diet on cardiovascular health and was re-analysed in 2018.
The Mediterranean Diet recommends that the majority of your diet should be from plants, including plant-based protein sources; that you limit your consumption of processed red meat; and only have a small to moderate consumption of foods like dairy and eggs. Simplified, this means you should mostly eat fruits, vegetables and wholegrains.
Interestingly, recent meta-analyses have found that people who drink coffee live longer. When we drink more than a few cups a day it can affect both our heart rate and our ability to sleep at night, as well as stress our adrenals, but it has not been associated with many adverse cardiovascular outcomes. I'm more concerned about the things that are consumed with the typical Australian coffee - that extra pastry or even too much milk in the coffee.
In middle age our level of cardiovascular fitness is prognostic, meaning the fitter we are the longer we are going to live. That remains true for whatever risk factors you may already have. Being fit should be part of everyone's program for preventing heart disease. It also aids in the prevention of cognitive decline
Australian recommendations for physical activity are 150 minutes per week of moderate physical activity, or 75 minutes of vigorous activity where you're getting your heart rate between 70-85% of its maximum (usually defined as 220 - your age).
It would be remiss of me not to talk about sleep as well, with studies this year showing an adequate amount of sleep of around seven-to-eight hours per night can help prevent coronary atherosclerosis. People at a high risk of heart disease will still need medication, as well as the assistance of a doctor to decide on the best course of action, but maintaining a good diet and lifestyle remains important.
Finding credible health information
There is a lot of confusion about diet in the public arena, and my recommendation is to seek out where the evidence lies in what the best diet is for what is going on with them personally. Not all diets are appropriate for all people.
It's very important that people get their information from clinical sources, such as website from large healthcare organisations such as the Heart Foundation, the Mayo Clinic, or the Cleveland Clinic.
A good resource is the book The Blue Zones by Dan Buettner, which looks at the living habits of the world's longest-living people. They have a lot of common diet and lifestyle habits such as not indulging too much in processed red meat or drinking alcohol in excess, they keep fit and active as they get older, and cultivate relationships with friends and family - there is a strong emphasis on community engagement and relationships.
You can find a specialist near you using the health tool below.