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Statistics may show a decline, but heart disease is still the number one killer in America. Paradoxically, heart disease can be prevented through diet, exercise and stress/sleep management. Is it harder than popping in a pill? Maybe, however no drug can truly fix the root of the problem.

A lot have been written about avoiding saturated fat, trans fat, cholesterol and sodium. Increasing the intake of fiber through vegetables and fruits, and omega-3 fatty acids have been advised.

Nevertheless, many people are still confused on what works and what does not to keep the vascular system to function at its best.

When it comes to preventing or decreasing hypertension and high-cholesterol levels, diet-wise this is what some of the most solid research points out:

a) Sodium red flag – Reducing sodium may prevent hypertension by 20 percent with or without weight changes. When over 77 percent of the sodium intake comes from processed food, it’s probably not the salt shaker that keeps Americans over the maximum daily amount suggested for healthy adults – 2,300 mg sodium the maximum vs. over 3,400 mg average per day.

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From cereals, TV dinners, breads, can soups to dressings you’ll find some with over 800 mg of sodium per serving – one packet of onion soup, dry mix has 3,132 mg of sodium.  Common sense: read the labels, buy low-sodium versions, hold the table salt and use more spices for flavor enhancement.

b) Potassium green light: The sodium counterbalance mineral, potassium, on the other hand, is way too low compared to the Tolerable Upper Intake level (UL) – around 3,200 mg/day for men and 2.400 mg/day for women vs. the suggested 4,700 mg/day.

Studies show that the more sodium intake in your diet, the greater the benefits of potassium to reduce blood pressure. Experts advise to increase the intake of raisins (1 cup has 1,086 mg of potassium), potato with the skin (1081 mg of potassium) as well as beans, spinach, yogurt, oranges, avocados and tomatoes.

The power of tomatoes is on the rise to improve total cholesterol and a better ration total cholesterol-HDL, good cholesterol. In a study published in The Journal of Nutrition, women who consumed over 10 servings of tomatoes based products a week (juice, sauce, raw, and other forms) compared to those who consumed less that 1.5 servings a week, showed the greater improvements.

c) Bulk up the vegetable protein: If the quest is to reduce blood pressure, plant protein has been associated with lowering blood pressure, particularly when soy,  which provides all essential amino acids, replaces carbohydrate intake.

Even though plant protein usually comes with the added plus of fiber, fiber has not been consistently proven to affect blood pressure. However, the evidence is different when decreasing cholesterol.

According to a study published in The Journal of Nutrition, legume consumption including lentils, peas, chickpeas and other kinds of beans was inversely associated with lipid peroxidation and other inflammatory biomarkers.

d) Vitamin C, not just for the flu: Epidemiological studies suggest that increased vitamin C intake is associated with lower blood pressure. C goes beyond the heart muscle to affect overall muscle-to-fat ratio.  One study shows that higher vitamin C consumption was related with leaner body mass.  Likewise, the powerful C has been shown to decrease the stress hormone cortisol, which affects the heart health.

Add strawberries, broccoli, kale, bell peppers, spinach, watermelon, cantaloupe among other sources of natural vitamin C to your daily meals.

e) Flavonoids a proven cardio-protector: Flavonoids are plant-based phytochemicals , primarily found in fruit, vegetables, nuts, cocoa, tea and wine.

As reported by an article published in Advances in Nutrition and International Review Journal indicates that major dietary sources of flavonols may lower cardiovascular risks factors such as high blood pressure and LDL cholesterol, bad cholesterol.

In particular, a study where over 38,000 men and 60,000 women were examined to evaluate the relationship between flavonoid intake and cardiovascular disease, the higher the food intake of these phytochemicals the lower the risk of cardiovascular death, “Flavonoids intake and Cardiovascular disease mortality in a prospective cohort of US adults,” reports the American Society for Nutrition.

There are many type of flavonoids, so if it’s tough for you to get your five a day, at least make sure that you include the ones that give you more heart protection such as blueberries, strawberries, kale, broccoli, spinach, walnuts, cherry tomatoes, celery, garlic, onions, tea, red wine, chocolate, oranges and pears.

Low Fat Dairy makes the mark: In a study, low fat dairy food sources such as milk, yogurt and cheese showed an antihypertensive effect. It seems that calcium may positively affect the blood pressure response to salt.

The jury is still out

Surprisingly, the evidence on these nutrients to affect the blood pressure response for good or bad has proven to be inconsistent.

a) Fats: Saturated fats and Omega 6 fatty acids have been heavily blamed in the incidence of blood pressure response. The blood pressure relation has not been confirmed, but diets high in these fats have been linked to high cholesterol.

b) Mono-saturated fats: Studies have shown the benefits of this type of fat to increase good cholesterol (HDL); however, its connection with blood pressure response is not supported.

c) Carbohydrates: Certainly a rush of sugar does not do any good for a diet, but the link with blood pressure response has not been fully established.  Nevertheless, some studies show an increase in the blood pressure after eating sugary carbohydrates while whole grain has demonstrated the opposite effect.

Triglycerides, the most common body fat, are affected in a diet high in sugar and alcohol. This is particularly important since usually, people who have high triglycerides may have low HDL or good cholesterol, increasing the overall risk of having high cholesterol and diabetes.

d) Coffee: Studies show that people who suffer from heart disease may experience an elevated blood pressure response to caffeine intake. Nevertheless, a recent study found that the increment may last just three hours – regardless, always consult with your physician.  Conversely, caffeine does not affect blood pressure on healthy people.