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Heart-Healthy Diet: FAQs

Get the answers to your questions about heart health.

Find out answers to your heart-health questions, such as Does coffee increase cardiovascular risk—or not? I keep getting conflicting reports; Can excess iron cause heart disease; and what are healthy and unhealthy fats?

Does coffee increase cardiovascular risk—or not? I keep getting conflicting reports.

After years of hearing that coffee might be hazardous to our hearts, we learned that drinking java might not be so bad for us after all. Growing research, in fact, was (and is) starting to suggest that coffee might offer health benefits, such as improved memory and reduced risk for diabetes. But a recent study (in Epidemiology, September 2006), which suggested that an occasional cup of coffee could trigger a first heart attack in sedentary people, or those at high risk for cardiovascular disease, reignited the great coffee debate. Does drinking coffee harm—or help—health?

There’s just no hard evidence either way, says Alice Lichtenstein, D.Sc., director of the Cardiovascular Nutrition Laboratory at the USDA Human Nutrition Research Center on Aging at Tufts University and an EatingWell advisor. “We’re not telling people that they shouldn’t drink coffee, but it’s premature to recommend that they start drinking coffee to decrease their risk of anything.” Much of the research on coffee’s health impact is observational in nature, says Lichtenstein. Observational research—which generally refers to surveys that ask people about their lifestyle habits—can suggest relationships between behaviors (such as drinking coffee) and disease risk; it can’t, however, prove that a behavior is the cause of the observed effect, says Lichtenstein.

In the face of uncertain science, what’s a java lover to do? Enjoy your morning cup (or two) of coffee—watching the cream and sugar, of course. Focus on bigger-picture heart-healthy behaviors, such as eating a healthy diet—rich in vegetables, fruits, whole grains and lean proteins—and getting plenty of exercise. Doing so can help you maintain a healthy weight and keep your cholesterol level and blood pressure within healthy ranges—all factors that go a long way in reducing your risk for cardiovascular disease.

I've heard that excess iron can cause heart disease. Is that true?

In the 1980s, studies emerged that linked elevated iron stores to increased risk of heart disease. However, follow-up studies provided mixed support for this connection, finding no association with total iron intake but some link with heme iron intake from animal sources. For now, it is recommended that those who are not at risk of iron deficiency avoid excess iron intake (via iron supplements and highly fortified foods).

I'm always hearing about "healthy" and "unhealthy" fats; what do these terms really mean?

Generally, when people speak of “healthy” fats, they’re referring to the monounsaturated and polyunsaturated kinds that help protect the heart by lowering “bad” LDL cholesterol, raising “good” HDL cholesterol, reducing inflammation of blood vessels—or a combination of all three of these effects. Monounsaturated fats (naturally found in nuts, avocados and olives) and polyunsaturated fats (omega-3s in fish and flax and the omega-6s in vegetable oils) fall into this “healthy” group.

Saturated fats and trans fats are often referred to as “bad” or “unhealthy” fats because they contribute to increased heart risk by increasing LDL cholesterol. Saturated fats are found naturally in foods of animal origin (think: butter, meats, whole-fat dairy) and are solid at room temperature. Tropical oils, including coconut and palm oil, also are rich in saturated fats. Trans fats, on the other hand, are manmade: produced when food processors “partially hydrogenate” (i.e., add extra hydrogen molecules) to unsaturated plant oils to make them more stable. This increases the shelf life of foods, which translates into a greater bottom line for manufacturers. Because trans fats have been shown to harm the heart, and nutrition experts advise avoiding foods that contain them, food companies have been required to list the trans-fat content on the nutrition labels since January 2006. But it’s important to note that if a product contains less than 0.5 gram of trans fat, the listed amount can be rounded down to 0. It’s best to avoid all processed foods that list “partially hydrogenated” on the ingredients label.

Bottom line: Not all fats are “bad.” In fact, studies show that replacing “bad” fats (saturated and trans) with “healthy” unsaturated ones from foods including fish, nuts and olives is a more effective way to help your heart than dramatically limiting overall fat intake.

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