The role of diet and lifestyle
Philip Rouchotas, MSc, ND
Supplements, the Mediterranean diet, and aerobic exercise can all play an important part in heart attack recovery.
Heart disease is the second highest-ranking cause of death in Canada. A large percentage of Canadians survive a heart attack but must subsequently manage the resulting heart damage. Typically, in conventional medicine, this population is treated with medications including beta blockers, ACE inhibitors, diuretics, statins (cholesterol medications), and blood thinners.
Some patients are fortunate to be enrolled in cardiac rehab programs, but many do not receive adequate education on the essential role of diet and lifestyle for heart health. In addition, key nutrients support healthy heart function.
The Mediterranean diet
A landmark study in this field was the Lyon Diet Heart Study. This was the first large randomized trial that evaluated the effect of the Mediterranean dietary pattern on the risk of having a second heart attack. Participants who had recently suffered a heart attack were randomized to a Mediterranean diet or a “prudent Western diet” and followed for four years.
Rates of cardiac death or non-fatal heart attack were significantly reduced, with 14 events in the Mediterranian diet group versus 44 in the prudent Western diet group. This represents a reduction of almost 70 percent. Since then, several additional studies have corroborated this result. The Mediterranean diet consists of high fruit and vegetable intake, legumes, fish, and limited consumption of lean meats, very limited consumption of red meat, and regular intake of nuts, extra-virgin olive oil, and red wine.
Secondly, the adoption of a moderate aerobic exercise program has been shown unequivocally to improve cardiopulmonary function and reduce risk of a second heart attack. A recent meta-analysis evaluating the effectiveness of lifestyle-based rehab programs found a 30 percent reduction in risk of death from any cause and almost 50 percent reduced risk of cardiac death. Several other analyses have found similar results, including reduced risk of being readmitted to hospital.
Finally, key supplements such as fish oil, L-carnitine, and coenzyme Q10 have good evidence showing their ability to improve heart function, including promoting normal heart rhythm, affecting structural remodelling after a heart attack, promoting energy production in heart cells, and strengthening heart muscle pumping function.
L-carnitine is an important cofactor required for the mitochondria to break down fats into energy in the form of adenosine triphosphate (ATP), in a process using oxygen. Clinically, it has been shown to reduce mortality related to heart attack. Coenzyme Q10 also assists in the production of ATP and has been shown to improve symptoms and reduce the severity of cardiovascular events, based on the New York Heart Association’s (NYHA) grading scale for heart failure.
Patients are advised to consult a naturopathic doctor to ensure appropriate supplement use if they’re taking prescription medications.