As the world moves to an endemic stage, recent studies have pointed out the rising risks of new heart problems due to the pandemic. With growing uncertainty around heart health data, what can the general public practice to minimise further risks to their vascular wellness? Against this backdrop, healthcare practitioners must play a more active role in ensuring the public is aware of the importance of nutrition and diet management.
As the world turns a page on the pandemic, much is still unknown on the full implications of the Covid-19 virus and its health impacts in the long term. For example, “long Covid1” is an emerging phenomenon that has brought about anxieties over the pandemic’s largely undiscovered long-term effects. Recent studies show that this virus could increase the risks2 of cardiovascular diseases (CVDs), particularly among people with pre-existing cardiovascular conditions or lifestyles that are not conducive to good vascular health.
In Asia, this is a concerning development given that CVDs were already the leading cause of 10.8 million deaths3 in 2019, or approximately 354 per cent of the total deaths in the region.
Amidst this landscape, how can consumers maintain or boost their vascular wellness? The shift in focus towards preventive care such as choosing a healthy lifestyle with balanced nutrition that promotes heart health, regular check-ups and maintaining a good relationship with a healthcare professional (HCP) are some of the primary measures that can help.
According to the Herbalife Nutrition Myth Survey5, consumers also want and rely on credible and accurate information from HCPs and nutrition companies when it comes to differentiating between nutrition myths and facts. Hence, HCPs can play an influential role in raising awareness on nutrition and lifestyle options for health risk prevention.
Here are some aspects for consumers and HCPs to look into when it comes to maintaining a healthy heart:
When it comes to nutrition for heart health, the ideal calorie consumption should comprise 40 per cent carbohydrates, 30 per cent protein, and 30 per cent healthy fats, coupled with 25 grams of fibre and adequate hydration – around eight glasses of water per day.
While a dietary pattern of fresh fruits, vegetables, lean protein and whole grains provide a good daily dose of vitamins and minerals, other natural molecules such as omega-3 fatty acids, nitric oxides, and flavanols have beneficial effects on vascular health.
Although still largely unfamiliar among the general public, the importance of the molecule nitric oxide is critical in supporting good heart health. Nitric oxide is a molecule that helps all the cells in our body to communicate with each other. Despite being a simple molecule, nitric oxide is an important biological regulator and therefore a fundamental component in many fields of physiology and medicine.
A component of our arteries and other organs, the natural molecule restores arterial elasticity and promotes vasodilation, which means the widening of blood vessels resulting from relaxation of the muscular walls of the vessels. With an intake of 3 grams or more of arginine, which can be found in protein-rich foods such as nuts, fish, meats, dairy, and multigrain, we can increase the amino acid, which gets directly converted into nitric oxide.
Flavanols, which are naturally occurring compounds found in plants, can support cardiovascular health by lowering blood pressure, and improve nitric oxide production and arterial function.
Flavanols are found in foods like berries, cocoa (dark chocolate), kale, and tea to name a few sources of high concentration.
To profit from flavanols found in cocoa, it is recommended6 that cocoa flavanols be consumed daily from sources such as cocoa powder (2.5 g), dark chocolate (10 g), and/or cocoa extract (200 mg). For health-conscious individuals, selecting chocolate products with less sugar and fat would allow them to reap maximum benefits from cocoa flavanols.
Similarly, studies have shown that drinking green or black tea may have beneficial effects on blood pressure7 in people with pre-and hypertensive ranges. Furthermore, tea consumption can benefit people with type 2 diabetes8, which contributes to a higher risk of heart disease and stroke.
Identifying people with existing or potential vascular risks should be followed by sharing with them tips on the importance of exercise and suggesting the right kind of exercises and duration. For instance, the American Heart Association9 recommends 150 minutes or more of moderate-intensity aerobic workouts or 75 minutes of intense aerobic exercises per week. Depending on the person, one can also choose a combination of both. The World Health Organization10 (WHO) also recommends aerobic exercise as the ideal form of physical exercise.
The aerobic exercises focus on repetitive and patterned movement of muscle groups such as legs, shoulders, and arms. The most popular aerobic activities11 include swimming, jogging, walking and dancing etc. HCPs can educate patients on the benefits of exercise such as lowering blood pressure, strengthening of muscles leading to superior oxygenation, weight management, lowering of stress and increase in presence of HDL cholesterol. Complementing these exercises with adequate nutrition and food intake is also crucial to enable one to keep up with one’s heart health endeavours, by providing the necessary dietary support needed to fuel an active lifestyle.
Omega-3 is helpful in maintaining healthy vascular performance due to its ability to reduce inflammation throughout the body. Inflammation is often responsible for the occurrence of heart diseases and strokes as it tends to restrict blood flow through the vascular system.
Foods like fatty fish (salmon, mackerel, and tuna), flaxseeds, walnuts, pumpkin seeds, and soybeans are high in omega-3 fatty acids. Not only is fish a great substitute for foods like beef, which is high in saturated fat, the omega-3s also help to support a healthy cardiovascular system by helping to lower triglyceride levels.
The consumption of plant-based omega-3 fatty acids supplements is useful for vegetarians, as these are primarily found in fish.
With the added threat of Covid-19 related cardiovascular risks, the importance of an active lifestyle becomes even more important. By advocating a lifestyle that is active and focused on the right nutrition, HCPs can bring about a transformation in the way people approach their vascular health. Medical facts and health resources need to be conveyed to the general public in an easy to-understand manner. Caregivers can also identify people who are at a higher risk by looking at their parameters such as lifestyle, food habits, existence of heart problems, diabetes and the individual as well as family health history.
Multi-sector collaborations can also go hand in hand with ongoing efforts to raise public education. For example, Herbalife Nutrition has formed collaborations with various government bodies and nutrition organisations in the region. In Indonesia, the company’s partnership with GERMAS, a government organisation under the Ministry of Health, has aided the dissemination of information from GERMAS’ many public health campaigns to local consumers, with the help of Herbalife Nutrition’s extensive distributor networks.
The identification of Covid-19 as a contributor to vascular diseases has raised a new area of concern. However, this risk can be managed and prevented by more meaningful collaborations between HCPs, nutrition companies and other stakeholders. Most often, it starts with enabling wider access to accurate and proper information about the causes of vascular diseases, and encouraging more prevention measures through balanced nutrition and an active lifestyle.
References:
1 https://www.bbc.com/news/health-57833394
2 https://www.nature.com/articles/s41591-022-01689-3
3 https://www.jacc.org/doi/10.1016/j.jacasi.2021.04.007?_ga=2.51021292.412519287.1648615111-697237784.1648615111#bib2
4 http://ghdx.healthdata.org/gbd-results-tool
5 https://www.herbalife.com.sg/apacnews/press-release/nutrition-myth-hcp/
6 https://efsa.onlinelibrary.wiley.com/doi/epdf/10.2903/j.efsa.2010.1792
7 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6567086/
8 https://www.medicalnewstoday.com/articles/tea-anddiabetes#summary
9 https://www.heart.org/en/health-topics/high-blood-pressure/changes-you-can-make-to-manage-high-blood-pressure/managing-blood-pressure-with-a-heart-healthy-diet
10 https://www.who.int/dietphysicalactivity/global-PArecs-2010.pdf
11 https://www.who.int/dietphysicalactivity/global-PArecs-2010.pdf
