VEGETARIAN DIET – WHAT ARE THE OPTIONS AVAILABLE?

What are the main drivers?

Have you ever thought of adding more vegetables, fruits, whole grains, legumes, nuts and seeds to your meals? What will be the main drivers for you to consume more of these foods? How about asking the same question to people around you who are already adopting a vegetarian diet? 

Reasons are varied, here, we broadly list out few thinking points for you:

1. Religious dietary requirements
2. Health reasons and/or conscious
3. Environmental concerns, i.e. climate change, global warming, pollution, deforestation, etc.
4. Animal welfare
5. Losing weight
6. Food intolerances or food sensitivity 
7. Trending

No doubt reasons for practising a vegetarian diet can be varied, depending on the choice of an individual. But, it is an undeniable fact that fruits and vegetables, whole grains, legumes, nuts and seeds are essential elements in order to keep our heart healthy. They should always be part of our diets regardless of the reasons. 

How many vegetarian diets do you know? 

What is your first thought when you think about a vegetarian diet? Like many others, we think about a vegetarian diet is a diet excludes meat. And, probably to certain extent no eggs and no dairy products including foods that contain these products! Does such thinking scare you away? 

 

BUT, when we discover there are four broad types of vegetarian diet. Each of them include and exclude certain foods.

• Vegan. People who only eat plant-based foods and avoid meat, poultry, seafood, eggs, and dairy products including foods that contain these products.
• Ovo-Vegetarian. People who eat plant-based foods including eggs. But, their diets still exclude meat, poultry, seafood and dairy products. 
• Lacto-Vegetarian. People who eat plant-based foods as well as consume dairy products, such as cheese, milk, butter and yogurt. However, they avoid meat, fish, poultry and eggs, as well as foods that contain them.  
• Lacto-ovo Vegetarian. People who eat plant-based foods as well as eggs and dairy products. Their diets exclude meat, fish and poultry. 

Obviously, they share one thing in common - they avoid meat, poultry and seafood. Nevertheless, you will also see eggs and dairy products have their rooms in vegetarian diet too! We also come across another two less stringent vegetarian diets, namely Pescatarian and Flexitarian or Semi-vegetarian. 

Pescatarian diet is very closed to vegetarian diet of which is a plant-based food oriented and exclude meat and poultry. However, Pescatarian diet includes fish and other seafood as well as dairy products and eggs. Meanwhile, Flexitarian diet encourages plant-based food while allowing meat and seafood in small quantities. They seem "friendlier" to you? Because, you can still at least enjoy certain animal products, fish and seafood. So, now will you rethink a vegetarian diet?

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Disclaimer: Healthy Heart 231 information aims to help readers understand heart health, and encourage them adopting a whole food plant-based diet. It does not replace care provided by medical practitioners and other qualified health professionals. 

Heart Disease and Cardiovascular Diseases – KNOW THE DIFFERENCES

As when we embark on this Healthy Heart 231’s journey, we come across the use of “heart disease”, and “cardiovascular disease” interchangeably in articles, reports and journals. So, we wonder does one different from another? How can we differentiate them? And, we decided to take a closer look at these two. 

 

Heart disease refers to a range of conditions that affect the structure or function of your heart. These conditions include^[1][2]:

 

1.     Blood vessel disease, such as coronary artery disease (also known as coronary heart disease).

2.     Heart rhythm problems (arrhythmias)

3.     Heart defects you’re born with (congenital heart defects)

4.     Heart valve disease

5.     Disease of the heart muscle 

6.     Heart infection 

 

Although there are different types of heart disease, the most common among them is Coronary Artery Disease. Therefore, when people talk about “heart disease” they often mean coronary heart disease which is another term for coronary artery disease. 

 

On the other hand, we have “cardiovascular diseases (CVDs)” which sometimes is used along with certain heart health conditions. In fact, cardiovascular diseases include all heart conditions as well as the arteries distribute blood to the brain, legs, and everywhere in between^[3]. CVDs are all about diseases that affecting your heart and blood vessels, and these can be^[4]:

1.     Coronary heart disease. Disease of the blood vessels supplying the heart muscle.

2.   Cerebrovascular disease. Disease of the blood vessels supplying the brain and the most commonly known is Stroke.

3.     Peripheral arterial disease. Disease of blood vessels supplying the arms and legs.

4.   Deep vein thrombosis and pulmonary embolism. A condition when blood clots in the leg veins which can dislodge and move to the heart and lungs.

5.  Congenital heart disease. A malformation of the heart structure from birth affecting the normal development and functioning of the heart. A birth defects.

6.    Rheumatic heart disease. A damage caused by streptococcal bacteria to the heart muscle and heart valves. It most commonly occurs in childhood, and can lead to death or life-long disability^[5].

 

That's say all heart diseases are cardiovascular diseases, but not all cardiovascular diseases are heart disease. Nonetheless, both diseases have commonality in lifestyle risk factors namely (1) the unhealthy diet; (2) physical inactivity; (3) tobacco use; and (4) excessive alcohol use. In fact, these are the most important lifestyle risk factors for developing coronary heart disease and stroke. The effects from the unhealthy diet and physical inactivity in particularly will show up in individuals as raised blood pressure, raised blood glucose, raised blood cholesterol, and overweight and obesity. 

Heart diseases and cardiovascular diseases can be prevented or treated with healthy lifestyle choices. Of course, there are exceptional cases such as heart defects but it should not stop you from practicing a healthy lifestyle. Protect yourself from heart disease and stroke because they are preventable and it is doable, simple and straightforward in your daily living. 

Sources:

1.     Heart disease. https://www.mayoclinic.org/diseases-conditions/heart-disease/symptoms-causes/syc-20353118 (Accessed on 4 August 2021) 

2.     Types of heart disease. https://www.heartandstroke.ca/heart-disease/what-is-heart-disease/types-of-heart-disease(Accessed on 4 August 2021)

3.     Heart disease. https://www.hsph.harvard.edu/nutritionsource/disease-prevention/cardiovascular-disease/#definition(Accessed on 19 July 2021)

4.     Cardiovascular diseases (CVDs). 2021. https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)(Accessed on 5 August 2021) 

5.     Rheumatic heart disease. 2020. https://www.who.int/news-room/fact-sheets/detail/rheumatic-heart-disease (Accessed on 5 August 2021)

Disclaimer: Healthy Heart 231 information aims to help readers understand heart health, and encourage them adopting a whole food plant-based diet. It does not replace care provided by medical practitioners and other qualified health professionals. 

DIETARY FIBRE – An ESSENTIAL for a HEALTHY HEART

Why is it important for keeping your heart healthy?

Heart disease is the leading cause of death globally for both men and women. Globally, of all deaths due cardiovascular disease, 85% were due to heart attack and stroke. In the United States, heart disease is the leading cause of death of which about 655,000 Americans die from heart disease each year¹. Although heart disease is the second leading cause of death in Canada there are about 2.4 million Canadian adults (age 20 and over) are living with diagnosed heart disease². Asia country like Malaysia, every day there are about 50 persons die from heart disease³.

 

Unhealthy diet, physical inactivity, tobacco use and harmful use of alcohol are harmful to your heart. An unhealthy diet by itself can cause high blood pressure, high blood glucose, high blood cholesterol and overweight and obesity. And, they all are key risk factors for heart disease. 

 

Healthy lifestyle choices can help you prevent and reduce your risk of developing heart disease, yet heart disease still the number one global health threat. The question is how making a change in return for a healthy heart? 

 

How about start the change by eating more fibre-rich foods?

High blood cholesterol, high blood glucose and overweight and obesity can increase your risk of developing heart disease. Eating more fruits and vegetables not only they are low in calorie and zero cholesterol they contain fibre – a crucial nutrient of heart healthy diet. Besides, whole grains and legumes are also good sources of fibre for your consideration.

We know that fibre comes in two varieties, namely soluble and insoluble fibres. You need both because they are beneficial to your heart health. Let’s take a look how fibre helps in regulating the key risk factors for heart disease:

1.     Lowering blood cholesterol 

Fibre has cholesterol-lowering ability. In this case, the soluble fibre plays a major role – lowering the low-density lipoproteins (LDL), the so called “bad” cholesterol. How does it work? By binding to bile acids. Bile acids are produced for to digest and absorb fats in the small intestine. Soluble fibre traps bile acids and prevent them from reabsorption in the small intestine. These unabsorbed bile acids will be excreted as body’s waste. Subsequently, liver will use cholesterol to produce new bile acids, thus reducing blood cholesterol. 

 

Lowering your blood cholesterol, particularly the “bad” cholesterol and maintaining a healthy level is crucial for your heart health. High cholesterol will cause a build-up of fat in your blood vessel making it difficult for oxygen-rich blood to flow through your arteries. Heart attack may occur when there is a total blockage. 

 

2.     Stabilising blood glucose 

Foods that cause sudden increases in blood sugar are harmful to heart because high blood sugar can damage blood vessels and the nerves that control your heart. 

 

You need fibre to keeps your blood sugars from spiking. Foods higher in soluble fibre can help control your blood sugar levels at the same time increase your sensitivity to insulin by slowing down the absorption of sugar from food.  

 

3.     Managing healthy weight

It is long been known that an overweight or obese person has higher risk of developing serious diseases and health conditions such as high blood pressure, type-2 diabetes and high blood cholesterol – these are a combination of risk factors that increases one risk of developing heart disease. 

 

Managing a healthy weight and preventing from being overweight and obese become crucial for keeping your heart healthy. 

 

If you have grains for your breakfast, are they whole grains? Perhaps, you may consider to replace refined grains with fibre-rich whole grains. Whole grains are considered fibre-rich food which can help you feel full and satisfied – and this can help you from overeating. In fact, a diet of high-fibre foods tends to take longer to eat and to be less calories. This is because high-fibre foods come only from plants-based foods such as fruits, vegetables, legumes and whole grains. They are high in fibre and nutrients and yet low in calorie.

 

The benefits of dietary fibre come in package! Dietary fibre reduces your blood cholesterol level which has a direct implication on your heart health. It also helps in regulating your blood glucose and managing your weight by which reducing your risk of developing heart disease. 

 

Increase the dietary fibre intake as well as diversify the sources because you need both soluble and insoluble fibre to keep your heart healthy. 

 

The table below illustrates the fibre content of common plant-based foods. By including more plant-based foods in your meals do you more good than harm particularly to your heart health. 

Source: Jau-Fei Chen. 2015. Nutrition.Immunity.Longevity. E.Excel International Group.

 

Sources:

1. Diabetes and your heart. 2021. https://www.cdc.gov/diabetes/library/features/diabetes-and-heart.html Accessed on 16 July 2021.
2. Dietary fiber: Essential for a healthy diet. https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/fiber/art-20043983  Accessed on 22 June 2021.
3. Heart Disease Facts. 2020. https://www.cdc.gov/heartdisease/facts.htm Assessed on 15 July 2021.
4. Heart Disease in Canada. 2017. https://www.canada.ca/en/public-health/services/publications/diseases-conditions/heart-disease-canada.html Assessed on 15 July 2021.
5. Heart Disease Malaysia’s Number One Killer. 2019. https://codeblue.galencentre.org/2019/10/31/heart-disease-malaysias-number-one-killer/ Assessed on 15 July 2021 

Disclaimer: Healthy Heart 231 information aims to help readers understand heart health, and encourage them adopting a whole food plant-based diet. It does not replace care provided by medical practitioners and other qualified health professionals. 

NUTRIENTS AND HEART HEALTH

Healthy Heart-231 sees an unhealthy diet for heart is one high in fat, sugar and sodium, and low in dietary fibre and plant-based protein. Here, our focus is at these five nutrients which are clearly linked to heart health and disease.  

1.     Fat

Your body needs some fats from food to build cell membranes, absorb vitamins and minerals, and for blood clotting, muscle movement, and etc. But, you also need to know what fat is “good” for you and what is “bad” to limit and avoid because fats have different effects on the cholesterol levels in your body. Here, we are talking about the following major dietary fats in the foods you eat: 

•     Trans fats

•     Saturated fats

•     Monounsaturated fats

•     Polyunsaturated fats

 

The trans fats and saturated fats are commonly known the “bad” fats because they raise the bad cholesterol (LDL) levels in your blood. LDL cholesterol can increase your risk of heart disease and stroke. Trans fats can also cause inflammation contributing to heart disease, stroke and diabetes^[1]. As part of a healthy diet, monounsaturated fats and polyunsaturated fats are recommended to replace trans fats and saturated fats. Monounsaturated fats and polyunsaturated fats can lower LDL cholesterol levels when eaten in moderation.

 

Trans fats are found in fried foods like doughnuts, and baked goods such as cakes, pie, biscuits, frozen pizza, cookies, crackers, and muffins^[2]. Meanwhile, foods with saturated fats are such as fatty beef, lamb, pork, poultry with skin, beef fat (tallow), lard and cream, butter and cheese^[3]. Obviously, trans fats and saturated fats can be found in many foods that we eat every day! Limit them by reducing their portion and how often you eat them.

 

2.     Sugar

Be it added sugars or free sugars, you should not be eating and drinking too much because they contribute additional calories and zero nutrients for you. With the additional calories, it leads to weight gain and even obesity, thereby deteriorating your heart health. Besides weight gain, a dietary high in sugars can lead to an increased risk for type 2 diabetes, heart disease and other chronic diseases. 

 

Where do you get those added sugars? Soda, pop, cola, tonic, fruit punch, lemonade, sweetened powdered drinks, sports and energy drinks; dairy desserts, candy, grain-based desserts** ready-to-eat cereals, etc. Basically, added sugars and free sugars are easily found in our food and beverages which we consume every day. Cutting back on your sugar drinks and foods as part of your heart-healthy dietary plan. 

 

** The Dietary Guidelines for Americans has identified grain-based desserts as sources of added sugars and saturated fats^[4].

 

3.     Sodium

Like the fat your body needs sodium to function, but it is needed in a small amount. However, you can easily consume more than you need because most of the sodium are found in packaged, processed, store-bought, and restaurant foods^[5][6]. The key health concerns with the overconsumption of sodium is high blood pressure, and high blood pressure is a major risk factor for heart disease and stroke^[7]. High blood pressure burdens your heart and damages your arteries and organs over time. 

 

High blood pressure and high blood cholesterol are the leading causes of heart disease and stroke. 

Consuming too much foods high in fat can increase blood cholesterol levels. Consuming too much foods high in sodium can lead to high blood pressure. To avoid from developing high blood pressure and high blood cholesterol, the foods we that eat every day play an important role. 

 

Look carefully types of foods that contain trans fats and saturated fats (‘bad fats’) and those high in sodium, the packaged and processed foods give you these two unhealthy nutrients including added sugars. Adopt a whole food plant-based diet and reduce the packaged and processed foods gradually, alternatively you can choose minimally processed over the ultra-processed foods. It helps increase fibre in your diet at the same time lower the intake of trans fats, saturated fats and added sugar – a change in your dietary to prevent high blood cholesterol, high blood pressure and high blood glucose. 

 

4.     Dietary Fibre

Dietary fibre is a crucial component of heart healthy diet. Its benefits range from helping in weight control to stabilising blood glucose to lowering blood cholesterol. Dietary fibre is found only in plant foods. Therefore, it is crucial to include fresh fruits and vegetables, whole grains, and legumes in our daily meals. However, many of us consume less than 20 g of dietary fibre per day^[8]. 

 

Meta analyses show when compared to people eating less dietary fibre, people eating high dietary fibre have a lower risk of coronary heart disease, type 2 diabetes and colorectal cancer and stroke incidence and mortality^[9]. The research, on the other hand, also shows that a low dietary fibre diets can contribute to various non-communicable diseases. 

 

** We have few articles on Dietary Fibre and its heart health benefits published in this blog! You can find them at the ‘Dietary Fibre’ section.

 

5.     Protein

We need protein and we consume protein every day from the foods eaten. What is in your mind when you are asked the types of food which provide you protein? Eggs, meat, cheese, milk? Do you know that legumes are good source plant-based protein? Besides, plant-based foods also provide fibre and less saturated fat compared to high-fat meats – help minimise your risk of heart disease^[10]. 

 

Legumes, plant-based sources of protein, are:

·     All types of beans

·     Chickpeas

·     Lentils 

·     Split peas

·     Soybeans 

 

Plant-based protein foods can benefit everyone including vegans and vegetarians. 

Sources:

1.     The truth about fats: The good, the bad, and the in-between. https://www.health.harvard.edu/staying-healthy/the-truth-about-fats-bad-and-good Accessed on 5 July 2021. 

2.     Trans fats. https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/fats/trans-fat Accessed on 24 July 2021. 

1.     Saturated fats.  https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/fats/saturated-fats Accessed on 23 July 2021. 

2.     Grain-based desserts in the Child and Adult Care Food Program. 2017. https://www.fns.usda.gov/cacfp/grain-based-desserts-child-and-adult-care-food-program Accessed 24 July 2021.

3.     Shaking the salt habit to lower high blood pressure. 2016. American Heart Association. https://www.heart.org/en/health-topics/high-blood-pressure/changes-you-can-make-to-manage-high-blood-pressure/shaking-the-salt-habit-to-lower-high-blood-pressure Accessed on 26 July 2021. 

4.     Poor nutrition. 2021. Centers for Disease Control and Prevention (CDC). https://www.cdc.gov/chronicdisease/resources/publications/factsheets/nutrition.htm Accessed on 26 July 2021. 

5.     Sodium. 2020. Centers for Disease Control and Prevention (CDC).  https://www.cdc.gov/heartdisease/sodium.htm

6.     Stephen AM, Champ MM, Cloran SJ, et al. Dietary fibre in Europe: current state of knowledge on definitions, sources, recommendations, intakes and relationships to health. Nutr. Res. Rev 2017; 30: 149-90.

7.     Reynolds A, Mann, J. Cummings, J, et al. Carbohydrate quality and human health: a series of systematic reviews and meta-analyses. Lancet 2019; 393: 434-45.

8.     Protein and heart health. Heart Foundation Australia.  https://www.heartfoundation.org.au/heart-health-education/protein-and-heart-health Accessed on 31 July 2021. 

Disclaimer: Healthy Heart 231 information aims to help readers understand heart health, and encourage them adopting a whole food plant-based diet. It does not replace care provided by medical practitioners and other qualified health professionals.