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Nutrition + Diet



March 13, 2023

Heart disease is only something old, overweight men should be worrying about, right? Wrong. In fact heart disease is the leading cause of death in women in the U.S., being responsible for about 1 in 5 women’s deaths. Whilst cardiovascular disease is higher in post menopausal women (due to the protective effect of estrogen), rates of heart disease are increasing in younger women, due to a number of lifestyle factors and underlying determinants. 

Whilst a family history of heart disease is one of the leading risk factors, it’s important to understand genetics vs. epigenetics. Think of it this way, your genes load the gun, but your lifestyle triggers it.

I have a host of chronic diseases (including cardiovascular disease) in my family, but my blood markers are all in the optimum ranges because of my diet and lifestyle (#humblebrag). Whilst there are few studies on the risk of cardiovascular disease and heart attacks in younger women (hello, male medical bias), the literature that we do have shows a significant increase in the number of women aged 35 to 54 admitted to hospital with acute myocardial infarction (the medical name for a heart attack). And this is where diet comes in to play. Let me explain. And also, let me tell you what I am seeing in my practice.

The dangers of a high carbohydrate / low protein diet

With diet playing such a huge role in how chronic disease develops in the body, I’m taking a closer look at how diets that are low in animal protein could be contributing to an increased risk of cardiovascular disease. 

In 2018 there were over 20 million vegans in the US, with women making up almost three quarters of this number. Whilst vegan diets can be a healthy option for many, they can be higher in carbohydrates and lower in protein than that of a meat eater. And even if someone is not fully vegan we are seeing a huge trend towards eating less meat and protein in general, with this being replaced by higher amounts of carbohydrates in the diet.

There are a number of myths around protein consumption being harmful. This is quite simply not the case.

There is no FDA recommended upper limit for protein consumption, and only those suffering from diagnosed kidney disease should be limiting their protein intake. 

In my private practice I am seeing so many food diaries that are woefully low in protein, low in fibre, low in micronutrients (vitamins and minerals), and extremely high in carbohydrates. And my clients are not the typical unhealthy American you may be imagining – they workout regularly, take supplements, meditate and drink celery juice, but because they are avoiding meat and fish their diets are made up of grains, vegan based ‘protein’ products that contain more carbs and sugar than proteins, and vegan snack foods that are loaded with more grains, combined with coconut sugar and rice syrup (these still have an extremely negative impact on our insulin levels). 

In 2021 we can see a strong correlation to how diets high in sugar and carbohydrates increase levels of insulin resistance (the precursor to Type 2 diabetes), which is a key risk factor in the development of cardiovascular disease.  In my practice I am seeing these blood sugar markers increase in otherwise healthy, active young women who are trending towards a higher carb, lower protein diet. 

How to look at HDL and LDL

For years we have looked at Total Cholesterol or Cholesterol Ratio as risk markers for cardiovascular disease and thought that it was simply a case of HDL being a ‘good’ cholesterol, and LDL being ‘bad,’ but we are learning that it is not as simple as that. LDL can be divided into 2 types, large and small, and it is these small dense particles that increase risk of cardiovascular disease and heart attacks. And what causes an increase in Small Dense LDL? You’ve guessed it, high sugar and high carb diets. 

And if you have chosen to follow a plant based diet to avoid saturated fat, you may want to think again. Reducing saturated fat (typically found in animal protein) has been shown to lower just levels of large LDL, the levels of which are not indicative of risk of heart disease, and may even be protective in the prevention of heart disease. 

Additionally, not eating animal products may leave you deficient in certain essential fats, vitamins and minerals. Omega 3 fats, such as those found in oily fish such as salmon, tuna and mackerel are anti-inflammatory, and Omega 6 fats such as those found in canola oil and sunflower oil are pro-inflammatory. An imbalance in intake of these fats can lead to a rise in inflammation in the body, with higher levels of inflammation correlated with increased risk of cardiovascular disease.

Deficiencies in certain vitamins and minerals, such as potassium and magnesium, Vitamin D and Vitamin K also correlate with a higher risk of coronary heart disease. Can you get these from plant based foods, sure, but they are easier for the body to assimilate when consumed via meat, fish and seafood (especially in the case of Vitamin D). 

So am I telling you to ditch the plant based diet completely? Not at all. But if you are following it for health reasons you may want to take a deeper look at the studies, and explore both sides of the arguments for and against meat and fish consumption (not just the ‘shockumentaries’ on Netflix). And if you are a vegan for religious, moral or ethical reasons then heed the advice I give to all of my clients; eat foods in their most natural state, include protein at every meal and read the ingredients label of everything you eat to avoid refined carbohydrates and added sugars (including the ‘healthy ones). Consider supplementing with magnesium, Vitamin D and an algae oil. Your heart will thank you for it. 

Want more? Head to my website and instagram. Also, read some of of my latest on Charlotte’s Book, including The Top 4 Reasons Why You Are So TAFT (Tired All The F**King Time).

Photo credit: Ocean’s 8 is one of Robin Shobin’s all time favorite movies. Her girl crushes featured in this photo have very different diets. Cate Blanchett is a vegetarian. Sandra Bullock does eat meat but sticks to free range meat and small portions.

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