Ten steps to preventing heart disease naturally

Today I will summarize the approach to preventing heart disease I’ve been writing about for the past couple of years. If you’re new to the blog and haven’t seen those articles, there’s an index of them here.

After today’s post I’m going to move on to some new topics. There are so many mainstream health myths out there it’s hard to cover them all! In the next few months we’re going to shift our attention to the digestive system. We’ll talk about the real cause of acid reflux (GERD), the high rates of gluten intolerance in the US and its consequences when undiagnosed and untreated, the hidden problem underlying Irritable Bowel Syndrome (IBS), and more.

As you know if you’ve been following this blog, heart disease is primarily caused by inflammation and oxidative damage. This is now well-accepted amongst medical researchers, though many physicians and medical professionals are still unfortunately focused on cholesterol.

It follows, then, that to prevent heart disease our primary goal should be to reduce inflammation and oxidative damage. How do we do that? Follow these nine steps:

1. Don’t eat industrial vegetable oils.

Industrial vegetable oils like corn, soy, cottonseed, sunflower, and safflower are high in omega-6 polyunsaturated fatty acids (n-6 PUFA). Countless studies show that n-6 PUFA promote both oxidative damage and inflammation, and significantly raise the risk of heart disease. Industrial vegetable oils are found in nearly all processed and packaged foods, and in most foods cooked in restaurants. My rule here is simple: if it comes in a package, don’t eat it. And make eating out a special occasion, not a daily ritual.

For more on the danger of vegetable oils, see How to Increase Your Risk of Heart Disease.

2. Eat traditional, saturated fats.

For more than five decades we’ve been brainwashed to believe that saturated fat causes heart disease. It’s such a deeply ingrained belief that few people even question it. It’s just part of our culture now.

But several recent studies have confirmed what many researchers have known all along: that eating saturated fat doesn’t cause heart disease. Saturated fats are protected against oxidative damage – one of the primary causes of heart disease. What’s more, saturated fats have numerous health benefits.

For more on this, see New Study Puts Final Nail in the “Saturated Fat Causes Heart Disease” Coffin, and The Most Important Thing You Probably Don’t Know About Cholesterol, and Have Some Butter with your Veggies!

3. Eat less sugar (including simple carbs).

Most people know that eating sugar wreaks havoc on their health. But what many don’t understand is that all carbohydrates eventually break down into sugar in the body. Simple carbohydrates such as rice, potatoes, pasta and bread can cause spikes in blood sugar and insulin, both of which contribute to oxidative damage and inflammation – and consequently increase the risk of heart disease.

For decades the American Heart Association and American Diabetes Association have been promoting a low-fat, high-carb diet. Research has shown that this diet actually increases the risk of both heart disease and diabetes! If you want to steer clear of these conditions, a high-fat, low-carb diet is your best choice.

The average American gets 57% of his/her calories from highly refined cereal grains and polyunsaturated (PUFA) oils. The #3 source of calories, behind grains and PUFA, is sugar and high-fructose corn syrup. Refined grains, polyunsaturated oils and sugar are all major contributors to both inflammation and oxidative damage. Clearly the low-fat, high-carb diet has been a failure.

For more on this, see The Most Important Thing You Probably Don’t Know About Cholesterol and, Low-Carb Diet Best for Weight Loss.

4. Eat nutrient dense foods (especially organ meats and egg yolks!)

The key to proper nutrition is eating nutrient-dense foods. Most people think about vegetables when they think of vitamins and minerals. However, a serving of beef liver has between 10-100 times the amount of key vitamins and minerals than those found in carrots or apples.

Egg yolks are another of nature’s superfoods. One egg provides 13 essential nutrients, all in the yolk (contrary to popular belief, the yolk is far higher in nutrients than the white). And despite conventional wisdom, it’s entirely safe to eat three eggs a day. In fact, studies show that egg consumption actually increases large, buoyant LDL cholesterol – which is the type that doesn’t cause heart disease!

Grass-fed, organic animal products and raw dairy (butter, milk) are also high in health promoting nutrients, and should be eaten liberally.

For more on this, see Three Eggs a Day Keeps the Doctor Away, Cholesterol Doesn’t Cause Heart Disease and Liver: Nature’s Most Potent Superfood.

5. Eat fermented foods.

Almost all healthy, traditional cultures that have been studied regularly consume fermented foods like yogurt, kefir, sauerkraut, kim chi and kombucha. These foods have numerous health benefits, but in the context of heart disease one of the most important reasons to include them in the diet is that they are one of the few dietary sources of vitamin K2.

Unfortunately, many people are not aware of the health benefits of vitamin K2. The K vitamins have been underrated and misunderstood up until very recently in both the scientific community and the general public. While K1 is preferentially used by the liver to activate blood clotting proteins, K2 is preferentially used by other tissues to deposit calcium in appropriate locations, such as in the bones and teeth, and prevent it from depositing in locations where it does not belong, such as the soft tissues.

A 1993 study showed that those in the highest third of vitamin K2 intake were 52 percent less likely to develop severe calcification of the arteries, 41 percent less likely to develop heart disease, and 57 percent less likely to die from it.

For more on this, see Vitamin K2: The Missing Nutrient.

6. Take your high-vitamin cod liver oil.

Cod liver oil is one of the only supplements I recommend to people. It’s a great source of long chain omega-3 fatty acids (EPA and DHA), which protect against inflammation. But even more importantly, cod liver oil is one of the few dietary sources of vitamin D. Low vitamin D levels associate with nearly every common non-communicable disorder, including obesity, diabetes, cardiovascular disease, autoimmune disease, osteoporosis and cancer.

But not all cod liver oils (CLOs) are created equal. Most commercially available CLOs are processed with heat and chemicals. Because heat and chemicals destroy the naturally occurring vitamins, synthetic vitamins are then added back in. Synthetic vitamins don’t have the same benefits as naturally occurring vitamins, and in fact they can be toxic at high doses (hence the hysteria of vitamin A toxicity from taking too much cod liver oil).

The only brand I know of that is cold-processed and contains the naturally occurring vitamins A & D in high amounts is Green Pastures Fermented Cod Liver Oil. Even better, because it’s fermented you’ll also get vitamin K2, which we know from step #5 protects against heart disease.

For more on this, see Separating Fact from Fiction on Cod Liver Oil, and Vitamin D: The New Super-Nutrient?.

7. Be active & go outside.

Physical inactivity is likely a major causative factor in the explosive rise of coronary heart disease in the 20th century. During the vast majority of evolutionary history, humans have had to exert themselves to obtain food and water. Even at the turn of the 20th century in the U.S., a majority of people had jobs that required physical activity (farmers, laborers, etc.) Now the majority of the workforce has sedentary occupations with little to no physical activity at all.

Currently more than 60% of American adults are not regularly active, and 25% of the adult population is completely sedentary. People that are physically inactive have between 1.5x and 2.4x the risk of developing heart disease.

On the other hand, regular exercise reduces both inflammation and oxidative damage. Even relatively low levels of activity are protective – as long as they are consistent. A public review at Harvard University showed that 30-minutes of moderate physical activity on most days of the week decreases deaths from heart disease by 20-30%.

It’s also important to spend time outdoors and get some sun. In addition to the obvious psychological and even spiritual benefits, sunlight exposure will boost your vitamin D levels. Just remember that sunscreen blocks your body from making vitamin D from sunlight.

For more on this, see Throw Away the Sunscreen!

8. Maintain a healthy weight (not too fat or thin)

Countless studies show that obesity causes both inflammation and oxidative damage, and significantly raises the risk of heart disease. For those who are obese, losing weight is perhaps the most important first step to take to reduce their risk profile.

However, most people aren’t aware that being too skinny can also increase the risk of heart disease.

It is also important to keep in mind that where you store body fat is probably more important than how much body fat you have. For example, body fat stored in the legs has consistently been shown to protect against metabolic risk in longitudinal studies. In contrast, abdominal fat, and in particular visceral fat, is independently associated with increased risk of morbidity and mortality.

For more on this, see this excellent offsite article: Get Fat, Live Longer.

9. Don’t smoke and minimize exposure to other toxins

Smoking promotes both oxidative damage and inflammation. Smoking as few as one cigarette a day can increase the risk of heart disease by 40 percent, while smoking 40 cigarettes a day increases the risk by 900 percent.

Over 70,000 synthetic chemicals are used commercially and approximately 1,000 new chemicals are introduced into our environment each year. These include insecticides, herbicides, gasoline, dry cleaning chemicals, personal care products, and more.

Environmental toxins cause both inflammation and oxidative damage, which as you certainly know by now, cause heart disease. Avoid exposure to these toxins as much as possible. Using environmentally friendly cleaning and personal care products in your home is a great start.

10. Manage stress & enjoy life

In the famous INTERHEART study, stress tripled the risk of heart disease. This was true across all countries and cultured that were studies. The primary mechanism by which stress causes heart disease is by dysregulating the hypothalamic-pituitary-adrenal (HPA) axis. The HPA axis is directly intertwined with the autonomic nervous system, and it governs the “fight-or-flight” response we experience in reaction to a stressor.

Continued activation of this “fight-or-flight” response leads to hyper-arousal of the sympathetic nervous system, which in turn leads to chronically elevated levels of cortisol. And elevated levels of cortisol can cause both inflammation and oxidative damage.

Stress management, then, should be a vital part of any heart disease prevention program. In fact, some researchers today believe that stress may be the single most significant factor in the cause and prevention of heart disease. There are several proven methods of stress reduction, including mindfulness-based stress reduction (MBSR), acupuncture and biofeedback. It doesn’t matter which method you choose. It just matters that you do it, and do it regularly.

If you follow these ten steps, you will dramatically reduce your risk of not only heart disease, but also diabetes, metabolic syndrome and almost every non-communicable modern disease. You’ll also have more energy, sleep better and improve your quality of life. So what do you have to lose? Sure beats taking dangerous statin drugs.

To read more about heart disease and cholesterol, check out the special report page.

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Heart Disease

Comments Join the Conversation

  1. Ian says

    I’m a student,  so I’m on a very small budget.  Do I have any alternatives to expensive grass-fed beef and cod liver oil?  What about ground flax seeds?  Are rolled oats just as bad for you as the more refined grains?  I need to be getting at least 3000 calories a day, so cost is a big matter to me.  Do you have any suggestions?

    • admin says

      Flax seeds don’t have the same benefit as fish and cod liver oil. The cod liver oil is primarily a fat-soluble vitamin (A, D & K2) supplement. Fish oil – at least high quality fish oil – is high in the pre-formed, long-chain omega-3 fatty acids DHA and EPA. Theoretically our body can convert the shorter chain alpha linolenic acid (ALA) found in flax and other vegetable omega-3 sources into the DHA and EPA. However, studies show that healthy women convert less than 10% and men even less than that, and those with chronic inflammation and illness have even poorer conversion rates.

      If you can’t afford grass-fed beef, I would at least try to buy beef without hormones or antibiotics. Another option is to buy the cheaper cuts of grass-fed beef and learn to cook them, i.e. roasts.

      Keep in mind that fats are much higher in calories than carbs. If you want to boost your caloric intake, eat more saturated fats. Coconut oil is an especially good choice.

      That said, oats are just fine for most people as long as they are soaked overnight to break down the nutrient inhibitors. Also, always remember to eat oats with a significant amount of fat (butter, cream, coconut oil) to prevent blood sugar spikes.

  2. pjnoir says

    I have been eating only ‘clean’ foods which cost more than the everyday supermarket crap for over a year. I crunched the numbers a while back and discovered that I am not spending that much more on food because 1- I eat less ( a great thing) and when I eat ‘clean’ I do not need to buy fish oil anymore or many supplements anymore- a huge savings. Fish oil’s biggest benefit is to bring back into balance the needed Om3 with the over consumed Om6s. Save a few bucks by drinking alcohol less, driving the car less. Their are many ways. If you are body building and need the 3000 cals- stop buying the mass market whey in a can and make your own.

  3. Carl Pinto says

    Hello. I love your web site.
    What do you think about Nutella? If I read the label, it’s high in fat. So is it generally bad for you, or does it have some “good” ingredients, as well?

    Thanks.

    • kara says

      Nutella is made with skim milk, which has had all the nutrient containing fat skimmed off, and generally has oxidated powdered milk added in for taste or appearance. There is a much better product, called rawtella, out there. It’s made with raw hazelnuts,, raw cacao nibs and coconut sugar. Because of the sugar, its still a product you would use in moderation, but its REAL food ingredients, and delicious!

  4. Lesley Snyder says

    have ben reading alot about L-arginine and it helping with hypertension. Have been eating paleo since christmas have lost a lot of weight but my BP is not coming down, also have hypothyroidoism (have been taking synthroid 18 years) Am I down the right track with the L-arginine or do you have other thoughts? Thanks

  5. Florent Berthet says

    Great article.

    Would you say that rice is still bad when taken post-workout along with fat, fibers and vinegar, since they all lower its glycemic index (as showed here: http://perfecthealthdiet.com/?p=4937)?

    Also, polyphenols are known to decrease heart disease occurrence, but it has been shown that dairy (especially casein) binds with polyphenols and may lower their beneficial impact. What is your opinion on that? If it’s true, how long should we wait between eating dairy and polyphenols-rich foods?

    Finally, on a non-related note, what’s your take on coffee?

    Thanks a lot.

    • Chris Kresser says

      I think white rice is well-tolerated by most people, since it’s mostly starch.

      I don’t think there’s sufficient evidence to worry about eating dairy at the same as polyphenol-rich foods.

      Coffee is individual. Some tolerate it well, some don’t. A lot of research suggests it’s beneficial for those that do tolerate it.

      • says

        When I was going research on green tea I remember one study that talked about the effect of milk on polyphenol absorption from green tea. Apparently there’s some controversy about this. Some researchers say it can bind to some polyphenols or otherwise prevent them from being absorbed. Some said there’s no effect. It’s probably not a major concern – if it’s any concern at all.

    • Kim says

      You can remove a lot of the sugar (starch) from rice by rinsing it in warm water until the water is no longer milky (place in a bowl and swish the rice around by hand,drain,repeat). Spanish cultures and Asians use this process to make the rice less sticky for things such as fried rice,sushi and Mexicans do it and save the rice water to make Horchata.I have diabetes and celiac disease so I have to watch my carbs and cant have wheat,rye,barley or casein products.Really makes a big difference to “wash” the rice as far as my blood sugars are concerned.

  6. Mark says

    I have a family history of heart disease. My dad had five bypass surgery when he was 45. I’m 39 today and in March had an extended blood workup done. It showed that my cholesterol levels were decent but my LDL-p were elevated. From a family history perspective, my dr wanted to put me on Lipitor. I said give me six months to clean up my eating and start more exercise. I followed a diet very similar to what you have laid out above. I went on a Men’s multi-vitamin (Garden of Life), taking two Fish Oils/day, and Vitamin D supplements. I increased my exercise as well. I’m not overweight and never have been. I don’t drink or smoke. Went back last week for my test and my blood work came back and the numbers went through the roof. My Triglycerides went from 137 to 250, Apo B went from 100 to 121, and the LDL-P went from 1200 to 2200. These numbers were horrible and depressing. The dr is pretty much pushing me now to go on statins.

    What did I miss here? Very frustrated!

    • Ian Watson says

      Do not go on STATINS, they almost killed my Father. Take high doses of serrapeptase for at least a year.

    • says

      I’m really disappointed that there is no response from Chris here.

      If there is something that Mark did wrong then that needs to be pointed out and corrected. Or else we all could just assume that there are major flaws in the recommendations made on this website by Chris.

      Mark, are you still following this post? Have things changed for you?

    • says

      My cholesterol was high 4 yrs ago when I was sedentary due to tib/fib break.I got my numbers to normal and theyve stayed that way by doing a few simple things: I used avacado as opposed to mayo and ate raw fruit,raw veg,pan seared meats (fish,turkey,chicken seasoned only with spices no oil at all) and oatmeal daily (not an oatmeal person but didnt want to die of a heart attack either).I used steel cut oats,butter,brown sugar and milk added after boiling in minimal water.Its the only carbohydrate I ate (the oatmeal).I didnt eat sugar or deep fry anything only grilled,baked & seared meats.

      • says

        I only followed the above “diet” 3 months by the way. Healthy food can taste great but seasoning is the key. I have a FB website for recipes and yes I do eat fried stuff now (not often though) but my numbers werent as bad as yours either but I do have heart disease and cancer in my families genes and am prone to high cholesterol,kidney disease and heart disease due to type I diabetes (brittle) which Ive had for over 40 yrs.

  7. says

    I just got my test results and wanted to get your opinion. My background : I’m a 44yr old female, 5’2″, 110 pounds, athletic. I switched to a paleo diet 2 yrs ago.

    Total Chol 299
    HLD-C 85
    Trigs 50
    LDL-P 1,981
    LDL-C 204
    HDL-P 41.6
    Small LDL-P 173
    LDL Size 21.4
    My Insulin resistance score was 6

    My doctor tells me that I have Familiar Hypocholesterolimia and need to be medicated.

    Should I be concerned? Should I stop eating so much saturated fat (coconut oil, coconut milk, and grass fed beef)
    Could it be related to why I don’t make hormones? I’ve gone to an endocrinologist since my guess is maybe if I have a pituitary issue, that could be the root cause of my high LDL? Is that possible?
    I had been on birth control pills for 13 years and never got a cycle, not even after I got pregnant twice using injectible hormones 10 years ago and still don’t cycle.

  8. Barbara says

    Wow, reading the above comments makes me realize there are so many of us in the same boat. We get one story from our doctors and then read all the contrary evidence online and we don’t know what to do or where to turn. Dr. Kresser, I appreciate your site, but obviously you have a practice and a life to attend and don’t have unlimited time to spend answering all of us. My husband had a major heart attack in January and is now on all kinds of prescriptions, including two statins. And figuring out what to eat is akin to rocket science these days! He is now on disability, but has no health insurance until medicare kicks in in 2014, so we are limited to the county health clinic or on our own at the moment. With an ejection fraction of 15, I’m very nervous about going it alone- just me and my search engine. And yet, keeping him on statins just feels like courting doom,too. Is there a Facebook page where you all go to discuss these things?

    • Cara Zaller says

      I believe the body is responding appropriately by raising cholesterol levels due to an inbalance of hormones. Cholesterol makes hormones (including cortisol, progesterone, DHEA, etc) so, if the body sees that hormones are not in balance, as most are depleted due to trying to make more cortisol thanks to everyone’s on-the-go, high-stress life-styles, etc, so the body signals the liver to make more cholesterol to help make more hormones. So, if we look at the underlying problem, deficiencies in one or more hormones in addition to lots of stress, lack of sleep, food choices or whatever stress the body is under, then cholesterol will remain high. If we figure out what hormones need to be supplemented, maybe just temporarily to balance the system, then cholesterol levels can come back to normal.

    • Ian Watson says

      Get him of Statins immediately.

      Tell him to take Nattokinase immediately.

      Tell him to take Serrapeptase also in high doses.

      Also to recover from the congestive heart failure,
      1000 mg of ubiqunol a day (Co-Enzyme Q10)
      1500 mg L-Carnitine a day.
      1000 mg Magnesium Chloride a day.
      6000 mg D-Ribose a day

      When he starts feeling better he can slowly reduce the amounts except magnesium.

    • Ian Watson says

      His ejection fracture is low because of damage to the heart muscle, he must work fast, HE MUST STOP STATINS it will kill his heart. Give him a safe blood thinner like Nattokinase and a powerful safe anti-inflammatory like serrapeptase. Give him massive amounts of Co-Enzyme-Q10, L-Carnitine, Magnesium chloride and D-ribose. act quickly. Throw in the B-Vitamins complex and taurine. His condition will only get worse if you do not act early. Your husband needs massive nutritional support and he needs it NOW !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

    • Ian Watson says

      Your husband needs help now, you must act quickly there is not much time when you ejection fraction is down to 15.
      Give him massive nutritional support NOW !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

  9. Tricia says

    Just found this site…WOW! This week I experienced a TIA which landed me in the hospital overnight for observation & tests. I had taken 2 aspirins about 15 minutes in and according to the tests – echo, carotid ultrasound, CT scan, everything is ok and no residual damage. However, my Dr prescribed a statin to lower cholesterol (mine is 220 but LDL is a little high), and a 325 aspirin daily since I refused the coumadin. I reluctantly agreed to 30 days with the Simvastatin 10 mg and now I’m reading here that is a BIG no-no (confirms my thoughts) We’ve started major dietary changes aiming at good nutrition and a considerable weight loss. I realize it will take a little time. My health is good – never had any problems and the only time I spent in the hospital was when my children were born – the last one 28 years ago.
    How do I handle this one?

  10. Amy says

    Dr. Kresser,

    Just got my full panel cholesterol test in. My LDL-P is at 1785, should I be concerned about this? I am 107 pounds, 4″11 tall and 37 years old. I am generally active. Average exercise is 3 days a week steady for 30 minutes. I need some wise council from a nutritionist point of view.

  11. Theresa says

    My family has heart heart disease. I had a TIA in 2007 which was brought on by high blood pressure. Thankfully, there was no damage. I decided to do EDTA Chleation through my veins instead of taking medication prescribed. In 2/6/08 my CT Coronary Artery Calcium Study was only 66.1 ; in 1/9/09 my CT CACScore was up to 96.3; in 3/9/10, it had increased to 177.71 so I stopped the cleation treatments and went to a heart doctor. He wanted to do an angiogram, but I refused because I did not want any stents. I started taking HCTZ for Blood Pressure and Niaspan and Red Yeast for cholesterol . I took all heart tests yearly thereafter (all good) and did exercise. I am 71 years of age and I exercise 2X’s a week for 2-Hours for cardiovascular health. I feel great with no heart pain. The doctor told me it had been a while and he would like for me to take another Coronary Artery Calcium Scoring Test in 2/14 which came back at 523.4 and am now in 86% having less calcium than me at my age. My doctor wanted to do an angiogram again. I told him I would take the test but refused to allow him to put in and stents. He got mad and said never mind. I was concerned, so I decided to take an oral cleation EDTA plus serraprptase. I had a diet of no carb, no sugar and no dairy products. I took about 40 bottles which consisted of 6 servings per bottle by taking 1oz 2XD on empty stomach. I lost a lot fo weight and it was very hard, but when I started getting major leg cramps after taking additional magnesium, I decided to stop. I told my heart doctor and asked him for an MRI. He said he has no medical reason for this and I would have to pay for it myself. He suggested that I take another calcium score to see if the chleation worked. So on 7/14/14 I took another test and my coronary artery calcium score had risen to 540.32 and I am now higher than other women my age and in the 87% percentile. My doctor called me back after he received these results and said he needs to see me and I have to start RX Medications for cholesterol. I do not want to take the medication. I am still feeling great with no pain in my heart which is still normal size. Could it be the calcium pills going into my artery? My chlosteral test always come back normal. When I called Herbal Doctor who suggested the chleation with serrapeptase, he said this is normal, and he’s suprised that my calcium score did not go higher. He said that the chleation therapy removes old calcium and renews new calcium and makes my bones stronger. He said the only way that I can find out if it worked is to get an MRI. Maybe my hormones are off? I am confused because my chlosterol is normal and I do not have high triglycerides. They are actually quite low. I also took Natto-Kinase for a while, but have been afraid to take with aspirin. I have never been able to find out what the right dose of Natto-Kinase would be to help my situation. Any suggestions.

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