Natural Foods Merchandiser

Food First Line of Defense Against Disease

Unless faced themselves with a family history of heart problems, most consumers have little more than a passing knowledge of cardiovascular disease and heart health. They see products promoted as being heart healthy, and they read research reported in daily newspapers about how singular nutrients may affect their risk of heart disease. But what do they really know? The challenge is understanding the basic facts and applying them to a heart-healthy lifestyle.

The Heart Of The Matter
The heart works like a pump, delivering nutrients and oxygen to the body's tissues and removing wastes from them via the blood. If the heart is injured in any way, the ability of the body to function normally is impaired; imagine a misfiring cylinder and the impact that has on your car.

There are multiple injuries that can adversely affect the heart. Some impact the structure of the heart, such as walls, valves or the way it pumps. Others may affect the blood vessels, and perhaps more critically, some can result in a stroke. While some of these problems may be inherited, more often than not they result from lifestyle choices.

Heart disease risk factors are well known. Poor diet and physical inactivity together can result in obesity. Obesity in turn is linked to hypertension and diabetes—both independent risk factors for heart disease. Tobacco use may impact physical activity, leading to weight gain, or it may result in hypertension via arterial stenosis—narrowing of the arteries though plaque buildup. Because of these intertwined relationships, national health organizations counsel those at risk to focus on weight management, increasing physical activity, smoking cessation and prudent nutritional choices.

Nutrition is an evolving science, but what we know about the role of diet and nutrients in heart health is that some dietary components contribute to heart disease and others protect against it. Saturated fats, trans fatty acids, cholesterol, and diets low in antioxidants, fiber and possibly folate, vitamin B6 and B12 have been identified as contributing to heart disease. Heart-healthy foods include monounsaturated fats, soluble fiber, fruits, vegetables and soy protein.

The cholesterol story goes like this: Depending on their structures, fats are metabolized and affect the body differently. Saturated and trans fatty acids are linked to elevated low-density lipoprotein or "bad cholesterol" levels. Elevated LDL levels are associated with plaque accumulation in blood vessel walls. One theory suggests that plaque formation is caused by oxidized LDL, which subsequently damages blood vessel walls. Plaque buildup occurs at these damaged sites and may gradually cause vascular stenosis and reduced blood flow. Obstructing blood flow impacts the heart's ability to pump efficiently and can result in permanent stress and damage to the heart, blood vessels, kidneys and ultimately the brain through stroke. In general, diets rich in saturated and trans fatty acids are associated with higher "bad" LDL levels, while diets higher in monounsaturated fats are associated with higher "good" HDL levels.

Beyond minding cholesterol levels, consumers should also be aware of the protection provided by antioxidants, soy and fiber. Research suggests that antioxidants protect the heart by binding the free radicals that cause LDL oxidation. In numerous scientific studies, researchers have indicated that soy protein and its isoflavones can reduce LDL cholesterol levels, but the precise mechanism remains unclear.

Soluble fiber appears to assist with serum cholesterol levels by binding bile acids in the gut. When insufficient bile acids are absorbed from the gut, the body converts serum LDL-cholesterol to bile acids in the liver. Bile acids are essential for the absorption and digestion of lipids. It is worth noting that while cholesterol is regarded as the "enemy" in CVD, it is a vital component of many systems and structures of the body. But since the body can produce cholesterol itself, dietary intake is not essential. Researchers are also suggesting that low levels of vitamins B6 and folate are associated with elevated homocysteine levels, which is an emerging risk factor for heart disease.

Heart Health In Retail
Heart disease is, for the most part, preventable, and retailers can use this in marketing. But there are limitations. Heart disease can be treated with many combinations of therapies, including supplements and traditional drugs. Since drug-supplement interactions are possible, any well-meaning advice you dispense could have negative ramifications. Unless you have licensed health professionals on staff to provide health or product information, you are best advised not to. It's best to guide your customers to reputable informational resources and professionals, so they can make their own informed decisions.

Do not be deterred, however, from providing your customers with a diverse array of information and healthy products. Be prepared with resources that can provide health and fitness advice, dietary advice and smoking cessation support.

Beyond being a resource for heart-health information, you can contribute to disease prevention by merchandising products that encourage cardiovascular wellness. Heart-healthy nutrition is quite simple: lots of fruit, vegetables, whole grains and minimal foods from animal origin, which, if chosen, should be low in fat. A simple tip to encourage heart-healthy shopping is to recommend color-rich selections, and choices that emphasize fresh produce or bulk-bin ingredients. The more prepackaged products consumers add, the less heart-friendly their baskets.

Finally, you don't need to reinvent the wheel. There are many resources available from national health organizations that you can distribute to your customers. Seek professional health care resources in the community to help you design heart-healthy programs, shelf labeling, store tours and in-store advice.

Amanda Archibald is a marketing strategist and nutrition consultant. She can be reached at [email protected]

Natural Foods Merchandiser volume XXIII/number 11/p. 20, 24

Statistics Sound Alarm

According to the American Heart Association's 2002 statistics, cardiovascular diseases still are the No. 1 killers in the United States. Of the 2.4 million Americans who die each year, more than 40 percent die from cardiovascular disease. The Centers for Disease Control reports that, "more than 61 million Americans have some form of CVD." Associated health expenditures and lost productivity are estimated to cost $329.2 billion.

Cardiovascular disease involves the circulatory system and includes high blood pressure, coronary heart disease, stroke, congestive heart failure and a number of other conditions that impact or are a result of heart disease. It affects both sexes and all ethnic groups, with higher incidences occurring among blacks. Furthermore, with increased rates of both obesity and diabetes, the incidence of CVD is increasing in younger people. It is no longer just an "old people's" disease.

Risk factors for heart disease include smoking, lack of physical activity, poor dietary choices, being overweight, having an abnormal cholesterol profile, high blood pressure, diabetes, family history and age.

More recently, scientists have identified a number of other emerging risk factors that may play a role in heart disease: homocysteine, high-sensitivity C-reactive protein and fibrinogen. Homocysteine is an amino acid in blood acquired mostly from eating meat. Elevated levels have been linked to increased risk of cardiovascular disease and stroke. Fibrinogen is a protein that helps in blood clot formation, and studies have shown that fibrinogen levels increase in association with smoking, obesity, physical inactivity, elevated cholesterol, age and diabetes. A 1997 study published in the New England Journal of Medicine positively correlated elevated C-reactive protein levels with increased risk for both heart attacks and stroke among 1,086 "healthy" men. More recent research correlated elevated blood CRP with predictability of future heart attacks among patients with unstable angina.

Natural Foods Merchandiser volume XXIII/number 11/p. 24

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