Thanks to more coordinated, faster emergency response and improved treatment, heart attacks aren't as deadly as they used to be. But survivors still face a substantial risk of further cardiovascular events.
How to restore after a heart attack and prevent another one? What to do besides obvious things such as taking medications, reducing stress, calories, avoiding urban air pollution and getting rid of bad lifestyle habits like smoking?
Dietary fiber helps to lower cholesterol levels (as it inhibits cholesterol synthesis, increases the production of short-chain fatty acid and the rate of bile excretion), blood pressure, glucose absorption, improving insulin sensitivity, and increasing levels of antioxidants. A high-fiber diet, in general, was associated with a 31% reduction in dying from any cause and a 35% reduction in death from heart disease among over 4 thousand heart attack survivors from the Health Professionals Study and the Nurses’ Health Study.
More recent Harvard study went a step further analyzing the types of fiber consumed by thousands of men and women who survived a first myocardial infarction (MI). All participants of the study increased their average dietary fiber intake after MI, and the greater the increase, the lower was the risk of
subsequent all cause and cardiovascular mortality. among cereal fiber, fruit fiber, and vegetable fiber,
only intake of cereal fiber was strongly inversely associated with lower all cause and cardiovascular mortality: pooled hazard ratio 0.73 (0.58 to 0.91) for all cause mortality, 0.72 (0.52 to 0.99) for cardiovascular mortality. In the general population, a 20-40% risk reduction in coronary heart disease has consistently been observed among those who consume fiber-rich whole grains regularly
An earlier study of over 31,000 California Seventh-day Adventists found a 44% reduced risk of nonfatal coronary heart disease and an 11% reduced risk of fatal coronary heart disease for those who ate whole wheat bread compared with those who ate white bread.
One minor change in diet could, indeed, save a life.
Low carbohydrate plant diets might be beneficial in reducing blood pressure and reducing cholesterol.
Yet, Dr Shanshan Li and her Harvard colleagues did not find a health benefit for heart attack survivors from a low carbohydrate diet even if it was low in fat and came from plant sources.
Greater adherence to a low carbohydrate diet high in animal sources of fat and protein was associated with higher all-cause and cardiovascular mortality post-MI.
According to the Institute of Medicine. healthy individuals should get at least 10% of their daily calories, but not more than 35%, from protein. Heart attack survivors in the Harvard and the Nurses’ Health Study ate from 15% to 20% protein (65 to 40% carbohydrates) and the lowest intake of protein seemed to be the best. It also correlated with the lowest intake of fat. Associations between the animal-based low carbohydrate diets and mortality were diminished after additionally adjusting for saturated fat.
A few older studies suggested that low carbohydrate plant-based diet may slightly decrease coronary heart disease in women and heart-healthy individuals, but there might be different dietary benefits in those survived from a heart attack.
Nuts - eaten several times a week in small amounts - shown a consistent 30% to 50% lower risk of myocardial infarction, sudden cardiac death, or cardiovascular disease, as seen from several of the largest cohort studies, including the Adventist Study, the Iowa Women’s Health Study, the Nurses’ Health Study, and the Physicians’ Health Study.
The Stanford Coronary Risk Intervention Project followed 300 people with coronary artery disease for four years and found the best predictor of new coronary blockages was dietary fat intake. As fat intake rose, the number of coronary blockages rose. Those patients with the lowest intake of dietary fat (about 10% to 15%) had the greatest amount of improvement and plaque shrinkage.
Research from Cleveland clinic proposes a new link between animal protein and coronary heart disease (CHD) that doesn’t involve cholesterol, but is mediated through "bad" for heart bacteria converting trimethylamine to Trimethylamine N-oxide (TMAO) in the liver. The researchers followed roughly 4,000 adults for three years. At the end of the study period, those with the highest levels of TMAO had a 2.5-fold increased risk of heart attack, stroke and death.
Firmicutes Ruminococci are some of those bad bacteria, while Bacteroidales S24-7, an abundant family from Bacteroidetes, are inversely associated with TMA and TMAO levels.
Breakfast
- Oatmeal with dried cranberries
- 4oz. of natural vegetable or fruit juice
Morning Snack
- Non-fat granola bar
- Banana
- One cup of tea; green tea, without milk or sugar, is ideal
- Stir-fried veggies with low-sodium teriyaki sauce and brown rice
- Green salad with edamame, chickpeas, beans and fat-free raspberry dressing, and one whole wheat roll
Dinner
- Tacos: black beans, brown rice, fat-free sour cream, fat-free cheese and salsa; corn tortillas
Night Snack
- Hummus with assorted dipping vegetables
Li S, Flint A, Pai JK, Forman JP, Hu FB, Willett WC, Rexrode KM, Mukamal KJ, & Rimm EB (2014). Low carbohydrate diet from plant or animal sources and mortality among myocardial infarction survivors. Journal of the American Heart Association, 3 (5) PMID: 25246449
Li S, Flint A, Pai JK, Forman JP, Hu FB, Willett WC, Rexrode KM, Mukamal KJ, & Rimm EB (2014). Dietary fiber intake and mortality among survivors of myocardial infarction: prospective cohort study. BMJ (Clinical research ed.), 348 PMID: 24782515
Flight I, Clifton P. Cereal grains and legumes in the prevention of coronary heart disease and stroke: a review of the literature. Eur J Clin Nutr2006;60:1145-59.
Rimm EB, Ascherio A, Giovannucci E, Spiegelman D, Stampfer MJ, Willett WC. Vegetable, fruit, and cereal fiber intake and risk of coronary heart disease among men. JAMA1996;275:447-51.
Smith SC et al. AHA/ACC Guidelines for Secondary Prevention for Patients With Coronary and Other Atherosclerotic Vascular Disease: Circulation. Vol. 113:2363-2372.
Halton TL, Willett WC, Liu S, Manson JE, Albert CM, Rexrode K, Hu FB. Lowcarbohydrate-
diet score and the risk of coronary heart disease in women.
N Engl J Med. 2006;355:1991–2002.
Fung TT, van Dam RM, Hankinson SE, Stampfer M, Willett WC, Hu FB. Lowcarbohydrate
diets and all-cause and cause-specific mortality: two cohort
studies. Ann Intern Med. 2010;153:289–298.
Gustenhoff P et al. Effect of fish oil on heart rate variability in survivors of myocardial infarction: a double blind randomised controlled trial. Br Med J 1996;312:677-8.