When it comes to cardiovascular disease risk, what someone drinks can be as important as what he or she eats. But too often, clinicians overlook the beverage factor when making nutritional recommendations, says Steven Masley, MD, director of the Masley Optimal Health Center in St. Petersburg, FL, and author of the new book, "The 30-Day Heart Tune-Up (Hachette)."
The ordinary non-alcoholic beverages that people drink—often in huge quantities—throughout the day, are a more important influence on heart health than we realize. Many calories, processed sugars, unhealthy fats, allergens, and potentially toxic colorings, sweeteners and preservatives are hidden in the beverage "silo."
A patient may be eating healthfully, in the sense that they've ramped up their vegetable, lean protein and healthy fat intake. But they may still be compromising their heart health through excessive soft drinks, fruit juices, processed coffee treats and other not-so-healthy beverages.
The medical community has done a good job getting people to think about what they eat, says Dr. Masley, who is also a trained chef. But beverages have been something of a blind spot.
In his new patient-friendly book, he distills several decades' worth of practical heart-health wisdom gained from his experience with thousands of patients, as well as his diligent review of the cardiovascular literature. In the following excerpt, he shares his thinking about drinking.
Keep in mind, telling people what they can't have is a hard sell. Helping them "add" foods and beverages they enjoy and that are good for them is more appealing, easier to follow, and will be much more successful in making healthier choices, Dr. Masley says.
Beneficial Beverages for Your Heart
It's time for a little common sense when it comes to food, beverages, and your heart. And I certainly don't want to add to the confusion.
So let's set aside the government's recommendations and fad diets and think clearly about which foods and drinks will help you take better care of your heart—the choices that will actually lower your harmful cholesterol and raise your beneficial cholesterol, reduce arterial plaque and inflammation, prevent clots from forming, and open your arteries, thereby diminishing your risk for a cardiovascular event.
When we think of food intake, we often don't think about beverages, yet beverages make up more than 20 percent of the calories we consume, and have the potential to influence our health in powerful ways. Let's clarify which beverages are clearly beneficial for your heart, and then identify which drinks to avoid as well.
Our bodies are 80% water. We all need fluid to survive—6 to 8 cups a day would be ideal. Focus on getting pure, chemical-free water. Ideally water would come from a reverse osmosis tap or from a glass bottle. Limit use of plastic containers because they add phthalates to the water they contain. Phthalates are endocrine disruptors; both men and women should avoid them.
Green Tea: "All Good"
If you like to start your day with caffeine, enjoy green tea. Yes, you can still have 1 to 2 cups of coffee daily (without sugar and cream, although an almond milk, skim-milk, or soy latte would be fine), but tea is better for you. Yes, you read about coffee being rich in many healthy compounds and that it is associated with lower rates of cognitive decline. But also remember that in excess, it will stiffen arteries, and raise blood pressure and cholesterol levels.
In contrast, green tea is all good. Drinking 3 to 4 cups of green tea daily is associated with a marked drop in heart attack and stroke rates. Green tea is so powerful that its benefits are similar to those of cholesterol-lowering drugs. It has a pleasant, although slightly bitter flavor that you can learn to enjoy. Make a weak cup at first to appreciate the subtle flavor. If it still seems bitter, dilute it even more. Over time, you may learn to enjoy stronger green tea.
A Smooth Start
My favorite start to a day is a protein and fiber enriched smoothie. A smoothie made with 1-2 scoops of whey, pea or soy protein powder; a combination of organic berries, peaches, or other frozen fruits; ground flaxseed or chia seeds; liquid (almond milk, coconut milk, soy milk, or nonfat yogurt) provides many benefits, and can satisfy your hunger while helping you quickly achieve a few of your heart-healthy goals in one fell swoop.
Red or White?
Although red wine may seem like an indulgence, one 5-ounce glass daily helps keep your cardiovascular system young. It reduces plaque build-up, blood sugar rise after a meal, risk of clotting, overall oxidation, and it decreases death rates, too.
The key for health is stopping at one glass, and definitely not drinking more than two. Beyond that, who are we kidding?
Red wine is preferred, as it is the richest source of antioxidants and resveratrol (a plant compound thought to have many health benefits). If you avoid red wine, I'd suggest white wine over beer, and beer over hard liquor. Of all the alcoholic choices, hard liquor is the most irritating to your liver and the poorest choice. Yet, at one serving daily, any of these can be a good choice.
If you don't drink alcohol, you may have a good reason not to, so you need not start now. The heart-healthy pigments in red wine are also found in any smoothie prepared with a mixture of colorful berries, pomegranate, or beets. You can also take a supplement of resveratrol, which typically contains 50 to 100 times what is found in one glass of red wine.
Heart-Healthy Hot Chocolate
Have some hot cocoa every day as well. A cup of unsweetened cocoa decreases clotting and the oxidation of LDL into plaque. Cocoa also helps dilate your arteries—improving their function, lowering your blood pressure, and lowering the risk of clotting.
Cocoa is rich in magnesium, fiber, and is packed with anti-aging and stress-relieving compounds. I find a cup of unsweetened hot cocoa (made with skim milk, almond milk, or soy milk) to be a great dessert and surprisingly satisfying.
Caution: Although unsweetened cocoa lowers blood pressure, the improvement disappears if you add sugar. Soy milk tends to be sweeter than other kinds of milk, so if you find cocoa without sugar to be too bitter, it can be a good choice. If you are soy intolerant, a natural sweetener like stevia may work for you.
"Diet" Sodas are Deceptive
We all hear that drinking a lot of fluid is important—that we need to stay hydrated. That's true but we need to drink the right kinds of liquids.
Don't tack on extra calories by drinking empty calories like soda or fruit juices. A 12-ounce can of regular cola typically has 140 calories. If you drink only one a day for a whole year, unbelievable as it may seem, you've added an extra 51,100 calories—or 14 pounds of body fat weight. That is nearly 3 to 4 footballs of extra fat mass added to your frame in one year.
If you normally drink soda daily, switch to iced tea, seltzer, or water, and you should lose 14 pounds of fat over the next year.
Diet sodas can be deceptive—just like "sugar-free" fruit yogurt. The sweeteners stimulate hunger, so you're not taking in any calories for the moment, but you'll end up eating more later. Coffee and alcohol need to be taken in moderation and as they're diuretics—they won't hydrate you.
Watch out for juice. After the fiber has been removed, the blood sugar response to drinking fruit juice is nearly identical to that of drinking soda. Although some juices have many nutrients, their glycemic load has an adverse effect on blood sugar control. So enjoy eating the whole fruit, blend it in a smoothie, or skip it.
For more information on "The 30-Day Heart Tune-Up" and tips for nourishing the heart with adequate fiber, healthy fats, lean protein, and fabulous flavors, visit www.HeartTuneUp.com.
Audio & video of Dr. Masley's presentation on Evidence-Based Weight Loss at the 2013 Heal Thy Practice conference are available at www.holisticeducationexchange.net