Reversing heart disease with lifestyle changes

Heart disease is something we all need to take seriously.

According to the Heart Foundation, one Australian dies of heart disease every 30 minutes – that’s 52 deaths every day.

Nine out of 10 Australian adults have at least one risk factor for heart disease and one in four have three or more risk factors.  Many of these risk factors are lifestyle-related including high blood pressure, high cholesterol, overweight and obesity, physical inactivity, poor diet, alcohol and smoking.

The good news is that these are things we can change, and doing so can have big pay-offs.

When things go wrong…

The major cause of heart disease is a build-up of fatty material inside the artery walls, which is known as atherosclerosis. The fatty deposits gradually clog up the arteries, reducing blood flow to the heart.  A similar process can occur in the blood vessels to the brain, and is the major cause of stroke.

For your heart to continue beating, it needs a constant supply of oxygen from the lungs, which flows into the coronary arteries that feed the heart muscle. When there is narrowing or blockage of these arteries, blood flow and oxygen to the heart is reduced, causing angina or chest pain. If the flow stops completely, a heart attack results. If not treated quickly, this can result in permanent damage to the heart muscle.

The good news is that there are many things we can do to reduce the risk of developing atherosclerosis and even to reverse this narrowing of the arteries if it has already occurred.

Target your risk factors

While there are a number of risk factors we can’t change such as genetics, age and gender, the Heart Foundation lists a number of ‘modifiable’ risk factors we can take steps to address:

  • Smoking – both active smoking and being exposed to second-hand smoke.
  • High blood cholesterol
  • High blood pressure
  • Diabetes
  • Physical inactivity
  • Being overweight
  • Depression, social isolation and a lack of social support

Undoing the damage

While medications to control cholesterol and blood pressure, and surgery (including cardiac stents and bypass surgery) are the mainstays of treatment and life savers for many, research by US cardiologist Dr Dean Ornish has shown that a program of diet, exercise and stress management can reverse the damage.

In 1983, Ornish and colleagues published the results of the first randomised controlled trial showing improved heart function after 30 days of a lifestyle program targeting dietary changes and stress management.  Participants also had a 91% reduction in frequency of angina episodes compared to a control group.

Following this, in the 1990s, they conducted the Lifestyle Heart Trial, which looked at impact of comprehensive lifestyle changes (a low fat vegetarian diet, moderate exercise, smoking cessation and stress management training) over a longer time period in participants with existing heart disease.  The group taking part in the lifestyle program experienced a 4.5% relative improvement in the narrowing of their coronary arteries after one year and 7.9% relative improvement after five years.  In contrast, the control group, who were given usual care (they were asked to follow the lifestyle recommendations of their  doctor and take medication), had a 5.4% relative worsening at one year and 27.7% relative worsening after five years..

The lifestyle change group experienced more regression of their atherosclerosis without the use of cholesterol-lowering medications than the control participants who were taking medication.  Even more important was the fact that more than twice as many cardiac events (such as heart attacks and the need for cardiac surgery) occurred in the control versus the lifestyle intervention group.

The ‘Undo It’ program

Undo It with Ornish’ is the new name given to Dr. Ornish’s Program for Reversing Heart Disease. It’s described as the first program scientifically proven to reverse heart disease by optimising four important areas of your life, and is now covered by Medicare in the US. The comprehensive program involves 18 sessions of 4 hours each, and unlike most quick-fix diet programs, 88% of participants remain committed to the program after a year.

While the Ornish program isn’t available here in Australia, we have a similar program, called ‘Complete Health Improvement Program’ (CHIP). This program focuses on the same four key lifestyle areas as the Ornish program: revising dietary choices; increasing daily exercise; improving support from friends and family; and decreasing stress.

Results of the CHIP program have found that it reduces the need for medication in people with diabetes, reduces stroke risk, lowers blood pressure and cholesterol, reduces weight and improves depression — all factors which are known to reduce heart disease risk.

The CHIP programs are conducted by trained and licensed CHIP facilitators. According to facilitator Dr Darren Morton, who helped to develop the program, “CHIP is not simply a diet and exercise plan, it’s about moving towards an optimal lifestyle — one that promotes health and discourages disease”.

How to reverse heart disease

The Ornish program and CHIP focus on four key lifestyle areas:

  1. What you eat. Eat a plant-based diet of vegetables, fruits, wholegrains, legumes, nuts and seeds. If you are not quite ready to go vego, then just cutting down on animal foods and incorporating some plant-based meals is a good start.
  2. How much you move. Do regular, moderate intensity exercise. The ‘Undo It’ program recommends a minimum of 30 minutes per day or one hour every second day of aerobic exercise per week. More intense exercise will give additional benefits, as will strength training two–three times a week.
  3. How you manage stress. Better stress management is key. The programs encourage you to learn relaxation and stress management techniques.
  4. How much love and support you have. Love and support help to make you healthier and happier. Having people around you who care about you is a key component of good health.

The bottom line

Keeping your heart healthy is about more than just cutting out a few foods and taking medication. Making lasting changes in these four areas will benefit your heart and — literally — give you a new lease of life.

This blog post is an edited version of the article The Diet that Mends Broken Hearts, written by Dr Kate Marsh and originally published by Healthy Food Guide in March 2016.  Read the full article here.


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