Even though it is uncontroversial that a direct and effective way to improve heart health is through lifestyle changes, such as exercise and eating a well-balanced diet, patients and doctors alike share a deeply ingrained prejudice that favors pills and potions over mundane, everyday things like, well, taking a walk and eating your greens.
Patients will not be offered straightforward and practical dietary advice. For example, that:
- Garlic has acquired the status of ‘traditional’ remedy for hypertension and high cholesterol, after research in the mid-20th century found that it lowered ‘bad cholesterol’, as well as having rather wonderful antibacterial, antiviral and antifungal properties.
• Legumes like beans, peas and lentils can help lower cholesterol. A review of 26 randomized controlled studies found that eating a 1/2 cup (100 grams) of legumes per day lowered “bad” cholesterol by an average of 6.6 mg/dl,
* Eating a daily avocado is thought to provide monounsaturated fatty acids and fiber, two heart-healthy and cholesterol-lowering nutrients.
And then there’s nuts. Many nuts are high in monounsaturated fats and phytosterols. — plant compounds which are structurally similar to cholesterol and help lower cholesterol by blocking its absorption in your intestine. Walnuts, in particular, are also rich in the plant variety of omega-3 fatty acids, a type of polyunsaturated fat (“unsaturated” refers to the fact that the molecules contain less than their maximum amount of hydrogen) associated with heart health, while almonds are rich in L-arginine, an amino acid that helps your body make nitric oxide which, in turn, helps regulate blood pressure. What’s more, nuts provide calcium, magnesium and potassium, which it is thought help to reduce blood pressure and lower your risk of heart disease. One study found that a daily serving of nuts led to a 28% lower risk of both fatal and nonfatal heart disease .
Unfortunately neither doctors nor patients want to talk about nuts. Such health advice is seen as mere household ‘diet tips’ and inferior to the rather more scholarly and sophisticated stuff of pharmaceuticals, At the same time, the raft of problems with drugs is skipped over because neither doctors nor patients like talking about the nasty side effects of treatments. And no wonder! Statins on their own, for instance, run through
· sore throat
· a runny or blocked nose (non-allergic rhinitis)
· feeling sick
· problems with the digestive system, such as constipation, diarrhoea, indigestion or flatulence
· muscle and joint pain
· increased blood sugar level (hyperglycaemia)
· an increased risk of diabetes
That’s the official UK National Health Service list. However, there’s many more that could be added. How statins can cause memory loss for example. This is because drugs that lower blood levels of cholesterol may well impair memory and other mental processes by depleting brain levels of cholesterol at the same time. In the brain, these lipids are vital to the formation of connections between nerve cells — the links underlying memory and learning. When patients are encouraged to lower their cholesterol levels, they are not told that the brain, in fact, contains a quarter of the body’s cholesterol.
A study published in the journal Pharmacotherapy in 2009 found that three out of four people using cholesterol-lowing drugs experienced adverse cognitive effects “probably or definitely related to” the drug. The researchers also found that 90 percent of the patients who stopped statin therapy reported improvements in cognition, sometimes within days. (In February 2012, the Food and Drug Administration ordered drug companies to add a new warning label about possible memory problems to the prescribing information for statins.)
The fact is, neither patients nor doctors have a good handle on the risks drugs may involve. On the other hand, foods for heart health are not exactly complicated or obscure. Alas, both patients and doctors are co-conspirators in a deeply-embedded tradition of preferring pills to such practical remedies. The trouble with that is, as the case of statins well illustrates, there may be a very high price being paid in terms of public health.