In the third of a series of articles on men's health, Nutritionist, Belinda Rennie focuses on natural approaches to preventing heart disease, the leading global killer of men (and women after menopause!).

In 1990 when Dr Dean Ornish demonstrated that lifestyle changes could halt and even reverse heart disease and atherosclerosis without drugs the medical profession sat up and listened. Now it is thought that eighty per cent of coronary heart disease (CHD) can be prevented by changes in lifestyle. Even though diagnostic tests to assess a person's risk of CHD have become more sophisticated (see last months article) and treatment of heart disease is saving lives, the fundamentals of prevention remain the same.

Quitting smoking, an active lifestyle, a diet rich in good quality fats and antioxidants, maintaining a healthy body weight, finding joy in your relationships and a healthy balance between work and play strengthen the heart. For a long time organizations like the Heart Foundation refused to acknowledge that stress had a role to play in the development of CHD. Experts now agree that stress can be extremely damaging to your heart. It raises blood pressure and heart rate, constricts the coronary arteries and increases blood clotting. Your body has to produce the extra hormones adrenaline and cortisol and these hormones have to be broken down and excreted by the body. In the process these end products can act as free radicals damaging cells and tissues.

Free radicals are one of the greatest enemies of the heart. They are highly reactive particles that can cause damage to the lining of blood vessels, increase inflammation oxidise cholesterol and generally create havoc to cells and tissues. Rancid butter is the best example of how the oxidation process takes place. In our bloodstream, oxidised LDL (bad) cholesterol is thought to be one of the major initiators of atherosclerosis because it is unstable and much more likely to damage arteries. Free radicals can be produced in the body and they can also come from an external source like the chemicals in cigarette smoke. Smoking one cigarette can consume the daily intake of the antioxidant, Vitamin C to neutralize the damaging effects of chemicals.

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The best way to keep our arteries and heart young is to consume large amounts of antioxidants from fresh fruits and vegetables, wholegrains, nuts seeds, pulses, fish and sea vegetables like nori, wakame, dulse. These foods are rich in the antioxidants Vitamin A, C, E and betacarotene that helps to reduce blood stickiness and therefore improve blood flow and reduce blood pressure. Vitamin C is considered by some nutritionally oriented GP's a safer blood thinner than aspirin. Fresh organic produce has been shown in studies to be consistently higher in vitamin C and other antioxidants by up to fifty per cent.

Antioxidants are buddies with bioflavonoids, another clinically important group of nutrients. These include skins of fruits and vegetables sprouts like bean sprouts and buckwheat that strengthen capillaries and reduce inflammation. Other antioxidants that can have a dramatic effect include grape seeds and skins, berries and pine bark extract. A glass of great red grape beverage especially from pinot noir grapes has been shown in studies to have the strongest antioxidant capacity, so if you drink, enjoy a glass or two every few days.

Not only are fish and sea vegetables high in the heart healthy minerals selenium, calcium and magnesium they are rich in essential fatty acids (EFA). Omega 3 and omega 6 essential fatty acids help to reduce bad cholesterol and protect cell membranes. Soy protein in the form of soy milk or tofu, polysunsaturated and monounsaturated fats found in nuts and seeds like walnuts, macadamias, pumpkin and flaxseeds can also lower cholesterol as can the B group vitamin niacin. Eating at least three fish meals per week and incorporating nuts and seeds in salads and stir frys keeps your levels of EFA's high.

Removing cholesterol out of the system via the bowel is another important way of keeping levels in check. High soluble fibre foods such as oats, pulses, bran in barley and rice, psyllium husks and most fruits and vegetables bind up bile acids so include porridge oats on your breakfast menu with lots of pulses like lentils and chickpeas in salads and soups. There are a whole host of herbal remedies that are heart protective including hawthorn berries, garlic, ginger and turmeric.

Preventing CHD is not rocket science it is going back to the basics of a wholefood, preferably organic diet full of colourful fruits and vegetables, fish, soy nuts, seeds and wholegrains. But it does require a big shift in attitude and thinking by men to take responsibility for their own health. Dean Ornish's program to reverse CHD is based on a yoga philosophy thousands of years old, offering an intensive lifestyle change of meditation, low fat vegetarian diets, exercise and social support. Conversely those in the study being treated medically by current best practice had worsening of their heart disease by up to twenty per cent. You have to ask why more doctors don't prescribe the program, when for many men the first symptom of heart disease is death from a heart attack.

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