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Heart Disease in Women

Women and Heart Disease

In recent years, the impact of heart disease on women has gained increasing attention. Though it is often thought to affect men disproportionately, heart disease kills more women than men. Heart disease is responsible for 1 in 3 deaths of American women each year, killing more women than all cancers combined.1

The standard American diet (SAD) full of white flour, sugars, oils and animal products promotes heart disease; as a result, it has become nearly ubiquitous to take medications for elevated cholesterol and blood pressure, and common for heart attacks and strokes to occur. Health authorities often advise women to know the symptoms that may be characteristic of a heart attack, and they make lenient, ineffective dietary recommendations about reducing fat intake. This does not work. Instead, women can take control of their cardiovascular health; they can become so healthy that a heart attack is almost impossible. A growing body of scientific literature shows that heart disease is easily and almost completely preventable (and reversible) by following an eating style rich in plant produce and dramatically lower in processed foods and animal products.2-5 My 25 years in clinical practice is a testament to these principles. I have treated advanced heart disease for nearly a quarter century, and all my early adapters are still thriving into their eighties and nineties without experiencing heart disease again or requiring medications anymore for hypertension or high cholesterol.

When you learn how to take care your heart with superior nutrition, you automatically take steps that will help to prevent diabetes, cancer, osteoporosis and other diseases, and maintain youthful energy, positive emotional outlook and enthusiasm for life. It protects your brain, not just your heart.

The most important strategy for taking care of your heart is to eat your G-BOMBS daily: greens, beans, onions, mushrooms, berries and seeds. Natural plant foods have numerous cardioprotective effects. For example, greens activate the Nrf2 system, which turns on natural detoxification mechanisms and protects blood vessels against inflammatory processes that lead to atherosclerotic plaque buildup.6 Higher consumption of fiber-rich vegetables, fruits and beans helps to keep blood pressure in the favorable range.7 Beans, nuts and seeds have unique cholesterol-lowering capabilities.8-10 Berries and the flavonoids they contain have a blood pressure-lowering effect, plus berries and pomegranate have potent antioxidant and anti-inflammatory effects that protect against the development of heart disease.11-15 Getting frequent exercise and maintaining a healthy weight are of course also important, as is minimizing added saltalcohol and caffeine.

Radical fat exclusion or complete veganism is not the foundational principle here. The foundational principle is micronutrient adequacy and nutritional excellence. An extremely low-fat diet is not the optimal method to address this issue, since including nuts and seeds in the diet contributes to cardiovascular health in several different ways including cholesterol-lowering, arterial function, blood glucose lowering, and weight maintenance.8,16-19 Furthermore, the combination of delicious dressings and dips made from nuts and seeds with overall healthful diet and lifestyle habits, not only leads to more favorable outcomes, but also was demonstrated to add almost a decade of lifespan in the most thorough study investigating this issue.20


1. Go Red for Women: Heart Disease Statistics at a Glance. 2012. http://www.goredforwomen.org/about-heart-disease/facts_about_heart_disease_in_women-sub-category/statistics-at-a-glance/. Accessed 
2. Ornish D, Brown SE, Scherwitz LW, et al: Can lifestyle changes reverse coronary heart disease? The Lifestyle Heart Trial. Lancet 1990;336:129-133. 
3. Ornish D, Scherwitz LW, Billings JH, et al: Intensive lifestyle changes for reversal of coronary heart disease.JAMA 1998;280:2001-2007. 
4. Esselstyn CB, Jr.: Updating a 12-year experience with arrest and reversal therapy for coronary heart disease (an overdue requiem for palliative cardiology). Am J Cardiol 1999;84:339-341, A338. 
5. Esselstyn CB, Jr., Ellis SG, Medendorp SV, et al: A strategy to arrest and reverse coronary artery disease: a 5-year longitudinal study of a single physician's practice. J Fam Pract 1995;41:560-568. 
6. Zakkar M, Van der Heiden K, Luong le A, et al: Activation of Nrf2 in endothelial cells protects arteries from exhibiting a proinflammatory state. Arterioscler Thromb Vasc Biol 2009;29:1851-1857. 
7. Streppel MT, Arends LR, van 't Veer P, et al: Dietary fiber and blood pressure: a meta-analysis of randomized placebo-controlled trials. Arch Intern Med 2005;165:150-156. 
8. Sabate J, Oda K, Ros E: Nut consumption and blood lipid levels: a pooled analysis of 25 intervention trials.Arch Intern Med 2010;170:821-827. 
9. Kelly JH, Jr., Sabate J: Nuts and coronary heart disease: an epidemiological perspective. Br J Nutr 2006;96 Suppl 2:S61-67. 
10. Bazzano LA, Thompson AM, Tees MT, et al: Non-soy legume consumption lowers cholesterol levels: a meta-analysis of randomized controlled trials. Nutrition, metabolism, and cardiovascular diseases : NMCD 2011;21:94-103. 
11. Aviram M, Dornfeld L, Rosenblat M, et al: Pomegranate juice consumption reduces oxidative stress, atherogenic modifications to LDL, and platelet aggregation: studies in humans and in atherosclerotic apolipoprotein E-deficient mice. Am J Clin Nutr 2000;71:1062-1076. 
12. Aviram M, Rosenblat M, Gaitini D, et al: Pomegranate juice consumption for 3 years by patients with carotid artery stenosis reduces common carotid intima-media thickness, blood pressure and LDL oxidation. Clin Nutr2004;23:423-433. 
13. Cassidy A, Mukamal KJ, Liu L, et al: High anthocyanin intake is associated with a reduced risk of myocardial infarction in young and middle-aged women. Circulation 2013;127:188-196. 
14. Cassidy A, O'Reilly EJ, Kay C, et al: Habitual intake of flavonoid subclasses and incident hypertension in adults. Am J Clin Nutr 2011;93:338-347. 
15. Ros E, Tapsell LC, Sabate J: Nuts and berries for heart health. Curr Atheroscler Rep 2010;12:397-406. 
16. Kris-Etherton PM, Hu FB, Ros E, et al: The role of tree nuts and peanuts in the prevention of coronary heart disease: multiple potential mechanisms. J Nutr 2008;138:1746S-1751S. 
17. Rajaram S, Sabate J: Nuts, body weight and insulin resistance. Br J Nutr 2006;96 Suppl 2:S79-86. 
18. Jenkins DJ, Kendall CW, Josse AR, et al: Almonds decrease postprandial glycemia, insulinemia, and oxidative damage in healthy individuals. J Nutr 2006;136:2987-2992. 
19. Ma Y, Njike VY, Millet J, et al: Effects of walnut consumption on endothelial function in type 2 diabetic subjects: a randomized controlled crossover trial. Diabetes Care 2010;33:227-232. 
20. Fraser GE, Shavlik DJ: Ten years of life: Is it a matter of choice? Arch Intern Med 2001;161:1645-1652. 
21. Lagiou P, Sandin S, Lof M, et al: Low carbohydrate-high protein diet and incidence of cardiovascular diseases in Swedish women: prospective cohort study. BMJ 2012;344:e4026. 
22. Lagiou P, Sandin S, Weiderpass E, et al: Low carbohydrate-high protein diet and mortality in a cohort of Swedish women. J Intern Med 2007;261:366-374. 
23. Kaaks R: Nutrition, insulin, IGF-1 metabolism and cancer risk: a summary of epidemiological evidence.Novartis Found Symp 2004;262:247-260; discussion 260-268. 
24. van Bunderen CC, van Nieuwpoort IC, van Schoor NM, et al: The Association of Serum Insulin-Like Growth Factor-I with Mortality, Cardiovascular Disease, and Cancer in the Elderly: A Population-Based Study. J Clin Endocrinol Metab 2010.

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