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February 11, 2000
Prevention and Primary Care - Elizabeth Smoots, M.D.

Dietary Discoveries for a Healthier Heart
Part II: soy, seafood, phytochemicals, fiber, and garlic

February is Heart Health Month, the perfect time to pay attention to your ticker. The statistics on heart disease are sobering: It is the number one killer of men and women in the United States, and each year an estimated 750,000 Americans die of cardiac conditions. But we're far from helpless. Researchers are confirming more and more links between the foods we eat and the health of our heart.

In Part I, we discussed how a deficiency in antioxidant vitamins or folate may increase your risk of cardiovascular disease. Now we will explore several other dietary measures that show promise for improving your heart's health.

Soybeans. Research indicates that the regular consumption of soy products can help reduce your cholesterol. While maintaining your good (HDL) cholesterol, soy decreases both total and bad (LDL) cholesterol by about 10 percent. It also aids in the prevention of blood clots and arterial plaque -- both of which may set the stage for a subsequent heart attack. Based on this evidence, in October 1999 the U.S. Food and Drug Administration (FDA) gave approval for certain soy products to make the claim that they reduce the risk of heart disease. Tofu, tempeh, soy milk, texturized soy protein, and whole soybeans are among these products.

Seafood. Studies suggest that consuming one or two servings of seafood a week may help prevent the occurrence of blood clots, irregular heart rhythms, and sudden cardiac death. Although evidence is strongest in people with coronary heart disease, one large study yielded impressive results in healthy individuals as well. The U.S. Physicians' Health Study, which followed more than 20,000 male physicians, found that those who ate fish at least once a week were less likely to die of a sudden heart attack than those who ate fish less than once a month, regardless of a history of heart disease. The active ingredients appear to be the omega-3 fatty acids contained in seafood. The long-term safety of fish oil supplements, however, still remains in question.

Phytochemicals. Fruits and vegetables are rich sources of phytochemicals, plant substances that protect against heart disease. When consumed in adequate amounts -- five or more servings a day -- many phytochemicals exhibit antioxidant properties, much as vitamins do. In addition, phytochemicals appear to play an important role in preventing the buildup of fatty deposits inside your blood vessels. The table below lists food sources for certain phytochemicals:


Food sources


Soybeans, tofu, other soy products


Tomatoes, grapefruit, red peppers


Cabbage, cauliflower, broccoli, bok choy

Allyl sulfides

Onions, garlic, shallots, leeks, chives


Carrots, apricots, peaches, cantaloupe, yams, dark-green leafy vegetables


Cherries, citrus fruit peel, dill, caraway


Most fruits and vegetables, wine, tea

Fiber. People who eat a lot of fiber -- 25 to 35 grams per day -- may reduce their risk of heart attack by 36 percent, according to a report published in the Journal of the American Medical Association (JAMA) . One explanation is soluble fiber's cholesterol-lowering effect, which is strongest in people who already have high cholesterol. Several studies have shown that a daily serving of oat bran or oatmeal can reduce total cholesterol levels by about 3 percent. Other good sources of soluble fiber include barley, fruits, vegetables, and legumes.

Garlic. One freshly chopped clove of garlic a day seems to help reduce blood pressure and a tendency toward blood clots, according to early research. Studies also indicate that garlic consumption may lower bad (LDL) cholesterol up to 9 percent, and may slightly boost good (HDL) cholesterol.

Consult with your health care provider before taking food supplements or making major dietary changes. Then discover more foods for a healthier heart.

Further reading

For more information on heart-healthy foods, refer to the following Rx.magazine feature articles:

Dietary Discoveries for a Healthier Heart, Part I

Soy Power: The Benefit of the Bean

Want Heart Health? Go Fish

Elizabeth Smoots, M.D., F.A.A.F.P., is a board-certified family physician in Seattle, Washington. A fellow of the American Academy of Family Physicians, Dr. Smoots specializes in prevention and primary care medicine.