Fauquier Health celebrates Heart Month 2022 with a brief journey through the heart

The number one killer of mankind is heart attack and stroke—not cancer, not viruses. Plaque clog-up in our arteries leading to heart attacks is the most common form of heart disease. Sadly, this leading killer of mankind is largely a choice—a man-made disease—one driven by our behavior and our style of life. In the words of our esteemed colleague, Dr. Caldwell Esselstyn, plaque build-up in the arteries is a “toothless paper tiger that need not exist.”

Dr. Neel K. Shaw, Cardiologist, and Lucy Mumo, Fauquier Health Director of Dietary Services, are excited to showcase some new plant-based options to the menu for patients recovering from cardiac related events.

February is Heart Month, and with the words on this page, I am going to take you through a brief journey of heart disease. You will understand how best to take care of your heart, prevent the most common form of heart disease, and learn when to seek help from one of the many wonderful providers in our Fauquier County community.

The various forms of heart disease fall into one of three main categories:

1. Anomalies that you’re born with, or what we call congenital disease.
2. Degenerative, age-related conditions that occur as a function of time, radiation, and gravity chipping away at our tissues, impacting the roots of our DNA called telomeres.
3. Man-made heart disease, the most common form, which includes heart attacks/coronary artery disease.

Any of the above categories of heart disease can impact the function of the heart’s muscle, electrical system, and valves. These impacts can lead to a range of symptoms, and if you have any of these, please report them to your primary care provider without delay. Symptoms can include:

• Shortness of breath on exertion
• Chest discomfort (particularly with physical activity, relieved quickly on rest)
• Palpitations
• Unusual fatigue with activity
• Lightheadedness or fainting spells

Plant-basted dieting has never looked so good. Very similar to the real “meaty” taste many crave, plant-based dieting is a healthier alternative with long term effects.

Folks often will have one or more of these symptoms for quite some time and attribute them to simply being ‘out of shape’ or ‘just simple old age.’ Of course, a symptom, such as breathlessness, can be due to excess body fat and muscular de-conditioning. Regardless, it is important to see your provider. Your primary care provider will render an assessment and will decide whether you would benefit from referrals to a Cardiologist (heart specialist) and/or Pulmonologist (lung specialist).

So, how do we best care for our hearts? Keep in mind these key points:

1. We cannot do anything to prevent anomalies with which we are born (i.e. congenital heart disease) and cannot do much to prevent degenerative age-related conditions. However, if we recognize symptoms from these conditions, as detailed above, we can often begin treating them with medications and/or surgeries.
2. The most common form of heart disease, plaque clog-up in the arteries, can also be treated with medications and/or surgery. However, we usually don’t learn someone has heart disease until after they suffer their first heart attack.

Heart attack/coronary artery disease is due to the unholy tango of cholesterol and inflammation in our blood vessels exacting damage, over our lifetimes, to the walls of those blood vessels.

Even desserts can be made to be healthier – and still taste just as delicious.

Where does excess cholesterol and the predominant source of inflammation in our blood vessels come from?

• The food that we eat (animal-based foods, processed foods).
• The style of life that we lead (tobacco smoke, pollution, mental stress, physical inactivity, etc.).

When we look around the planet, we see large populations where individuals do not get heart disease and the other associated chronic diseases (diabetes, hypertension, certain common cancers) in anywhere near the frequency as do most Americans and other Western-style populations.

The tie that binds these populations (i.e., the original Okinawans, many Mediterranean Islanders, several rural Eastern African communities, and nearly a third of the Seventh Day Adventists right here in the US) are these key habits:

1. Eating a largely whole-foods plant-based diet (with the elimination of most animal protein including chicken, turkey, beef, pork, eggs, dairy):
   1. Understand that animal foods bring cholesterol as well as inflammation into your body through a variety of biochemical mechanisms. When it comes to your heart health, lean or white meat are not truly considered as heart healthy.
   2. For those who think moderation is key, I have some advice for you. When something is not considered as healthy or is deemed as potentially harmful, we should try our best not to “use” it at all. The World Health Organization (WHO) has already declared that processed meat (i.e., ham, sausage, and pepperoni), is a Group 1 carcinogen, meaning cancer-causing, just as asbestos, plutonium, and combustible tobacco are. Consider that next time you are craving that slice of pepperoni pizza or order pizza for dinner because it is an easier meal option.
2. Enjoying a lifestyle free of tobacco, drugs, and toxins.
3. Insert plenty of movement into your everyday routine – such as yoga/meditation – and a culture rich with love and connectedness in the community.

There are plenty of randomized-controlled scientific trial data that supports the reality that transforming your diet to a whole-foods plant-based diet and leading a healthy lifestyle can prevent, arrest, and reverse plaque build-up that is already inside your arteries. The most striking of these studies was presented by Dr. Dean Ornish’s landmark Lifestyle Heart Trial, published in the prestigious medical journal called the Lancet.

Based in part on this work, Dr. Ornish gained approval from Centers for Medicare and Medicaid Services (CMS) for his ‘Ornish Reversal Program,’ an Intensive Cardiac Rehabilitation program which helps individuals target these key reversible risk factors of chronic disease.

This is why we say with confidence that the leading killer of mankind—a heart attack—is largely preventable. It can be prevented by the choices you make and if it is already present, can be arrested and reversed.

If you have any concerning symptoms as outlined in the article, or simply just want to learn more about how to best to care for the engine of your body, please start the conversation with your primary care provider or a Cardiologist.

Neel K. Shah, M.D., FACC, RPVI