Choosing the Right Fats and Carbohydrates to Prevent Heart Disease

By Frederick Wood, M.D.
PersonalMD.Com Medical Contributor

The diet currently recommended to prevent heart disease may not be the most effective one to be on, according to recent research. New studies indicate that fats in general may not be the fiend they were once labeled, certain fats may actually reduce heart disease risk, and a new enemy is refined carbohydrates found in "fat-free" foods.

Trans-fatty acids, found in margarines and processed foods containing partially hydrogenated oils, may contribute to heart disease. Why are these trans-fatty acids harmful?

During hydrogenation, where oils are converted to solid fats, the natural, more folded configuration of the fat molecule, called "cis," is replaced with a mixture of cis and "trans," a less folded, but nonetheless unnatural, molecule.

Industrial hydrogenation is unable to maintain nature's own molecular shape, and so produces the unnatural mixture of cis and trans fats. The problem is that our body's enzymes can't digest the trans forms of fats. These trans fats raise the bad "LDL" (low-density lipoprotein) cholesterol, and lower the good "HDL" (high-density lipoprotein) cholesterol. Trans fats also raise triglycerides and another harmful lipid called lipoprotein (a).

Three major recent studies of over 167,000 subjects revealed that just increasing one's intake of trans fats by a mere two percent increased the risk of heart disease by 32 percent! Think about that the next time you reach for those fries or chips.(1)

The bottom line? Avoid all fried fast foods such as french fries and doughnuts, as well as baked goods, which are made with hydrogenated shortening. Read your labels! Avoid all processed foods which contain the word "partially hydrogenated," and margarines, unless they are "trans-fat" or "trans-fatty acid"-free brands.

Are there any good fats?

Surprisingly, yes! Fish oils, which are rich in the omega-3 fatty acids, reduce triglycerides and the incidence of sudden cardiac death in several trials. These fats seem to help in the function of small arteries, such as the coronary arteries, and may prevent the abnormal heart rhythms which lead to sudden death.

In the Chicago Western Electric study of workers over a 30-year period, those who ate 8 1/2 ounces of fish weekly had a 40 percent lower risk of a heart attack.(2) In another trial conducted in Honolulu, eating 2 or more servings of fish weekly was associated with a 65 percent reduction in coronary narrowings.(3) Also, eating fish cut the cardiac risks of smoking in half, though the authors point out that tobacco cessation remains important.(4)

People living in countries bordering the Mediterranean Sea eat a diet rich in olive oil and enjoy low heart attack rates compared with their more western counterparts. Olive, canola and sunflower oils are "monounsaturated" appear to be heart protective.

In a study of 605 patients recovering from a heart attack, cardiac and total death were decreased by more than 70% in those on a high-monounsaturated fat Mediterranean diet compared to the "prudent" western diet.(5)

Another study followed over 4,000 patients for 4 years after their heart attack and found a 65% reduction in cardiac deaths on the high-olive oil diet.(6) So when you use oil, stick with moderate amounts of olive, canola and sunflower oils.

	Heart Disease? An abnormal organic condition of the heart or of the heart and circulation.

While fats have been in the limelight for reducing cardiac risk, new research also implicates refined carbohydrates in promoting heart disease. Processing grains into flour removes the germ and bran from the starch, removing nutritional components of the grain as well its fiber content.

The high-temperature and pressure process of milling alters and destroys nutrients directly. In one of the largest womens-only study, 121,700 nurses were followed for 10 years. Those who ate the most whole-grain foods had a 25-50 percent less heart disease than those who ate the most refined carbohydrates.(7)

Reducing refined carbohydrates in your diet will also promote healthy weight loss. Researchers in Denmark found that simply switching obese subjects to a complex-carbohydrate, high-protein diet without limiting their calories resulted in a 20 pound weight loss over 6 months. 35 percent of them lost more than 22 pounds. Just imagine how much more you could lose by limiting calories and exercising moderately!

So the bottom-line for carbohydrates is to eat the whole-grain cereals, popcorn, oatmeal, wheat germ, brown rice and bran. The foods to avoid include breads, muffins, cakes, biscuits, cookies, pasta, refined-grain cereal, pancakes, waffles and pizza.

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