Affecting more than 13 million people a year, coronary heart disease is the leading cause of death in America. Beginning in early adulthood, arteries of the heart that provide needed oxygen to the heart muscle can start to accumulate plaque and blockages. Plaque develops as fat begins to adhere to the blood vessel wall. As this damages the lining of the arteries, inflammatory cells, proteins and lipids also stick to the area to form atherosclerotic plaques. This then results in a blockage of the artery, or as the plaque becomes unstable, a release of material into the blood stream that can occlude arteries downstream. The result is an increasing potential for angina (heart chest pain) or a heart attack. The main health focus then is to avoid high cholesterol, reduce fat intake, maintain normal blood pressure, and attend to dietary and exercise habits that reduce risk.

 Despite some conflicting evidence describing nutrition, a diet rich in vegetables, fruits and whole grains promotes a healthy heart. Diets should avoid as many saturated fat and trans-fat foods as possible; replacing these with mono-saturated fats when necessary. Proteins should come from many sources rather than just from meat and dairy products, and cholesterol intake should be low. Fiber and whole grains have multiple benefits, but in heart disease decrease fat absorption and lower cholesterol levels. Skipping meals often will lead to rebound over-eating, so several smaller meals or snacks may often be a better health option.

Regarding vitamin and mineral sources that promote good cardiac function, anti-oxidants provide protection in a few ways. These substances mainly reduce the amount of plaque build-up through their effects on metabolism. They absorb particles called oxygen free radicals which are by-products of normal metabolism. These can damage blood vessel walls and accelerate plaque development. Air pollution and tobacco smoke are other sources from which we are exposed to free radicals. Micronutrients that exhibit anti-oxidant properties include Vitamins A, C and E as well as selenium. Coenzyme Q, which is another vitamin like substance, also has anti-oxidant effects, as does several plant and herbal micronutrients. These include catechins (found in various teas and wine), lycopenes (found in red fruits and vegetables), flavonoids (found in green tea, apples, red wine and onions), and various chemicals found in citrus fruits.

Several micronutrients can also help lower cholesterol and help keep blood pressure lower, both of which reduce coronary heart disease risk. In addition to the aforementioned anti-oxidant effects, lower cholesterol levels can be a benefit of isoflavones which are found in various soy products. Fish oils and omega 3 fats in the diet also reduce heart risk.  Raw garlic or garlic powder/tablets contain allicin which lowers LDL cholesterol and also has been shown to help control high blood pressure. Calcium also has dual effects by reducing absorption of fats and cholesterol from the stomach, and at the same time stabilizing blood pressure.

Magnesium deserves some special comments. Low levels of magnesium seem to correlate with a more rapid aging process, and increase the chances of a poor outcome after a heart attack. It may have some anti-oxidant properties as well, but also blocks the release of thromboxane which promotes blood clotting and narrows blood vessels. These properties are some of the reasons it appears to protect against heart disease.

Also regarding blood clot formation, the B vitamins and also folic acid are vitamins that reduce the chances of developing clogged heart arteries. These micronutrients facilitate the metabolism of homocysteine which is in many sources of food protein. If poorly metabolized it leads to a greater tendency to form blood clots. Fortunately, when eating plants/vegetables rich with this protein, there is usually adequate amounts of B vitamins and folic acid to accommodate this, but when an abundance of protein is obtained from animal sources, this may not be the case. Therefore a balanced source of protein from a variety of foods is helpful as is adequate amounts of B vitamins in the diet.

In addition to monitoring your weight, getting regular exercise, and controlling medical risk factors, diet and nutrition are a large part of preventing coronary artery disease. Smaller meals, balanced food groups, reduction in cholesterol and saturated fats, and increased fiber intake are all helpful at reducing risk.  Paying close attention to specific vitamins, minerals and other micronutrients can also greatly improve your healthy chances.