Expert Q&A

Wine, chocolate & garlic: Are some foods better at lowering heart disease risk?

It seems every week I read about about a new study that claims chocolate, fish, wine, garlic or some other food is "good for your heart." Are these studies true? Are there any foods that are particularly good at lowering my heart disease risk?

The media is full of information on how one food or another has been scientifically shown to lower cholesterol and reduce the risk of heart disease. What is not said is that when a scientific study is done, it looks at a very specific question in a very controlled situation. Too often, non-medical people read that something like chocolate can help reduce heart disease so they head to the store for more Hershey’s bars without considering the bigger picture.

At risk of heart disease - eat a healthy diet

Doctors and nutrition experts always say we should eat a health diet to lower our heart disease risk. That usually means minimizing fats, particularly saturated fats and trans fats, and balancing our carbohydrates and proteins while increasing fiber. Most people realize that we should include fruits and vegetables in our diets. We hear that fish is good also. But what about chocolate, red wine and garlic?

Many vegetable products contain a class of chemicals called flavonoids which reduce the inflammation in our systems—inflammation is responsible for cholesterol blockages developing in our arteries. Cocoa beans, deeply colored fruits and vegetables, and tea tend to have lots of flavonoids. Dark chocolate with more than 60% cacao carries cocoa bean flavonoids, and red wine has flavonoids from grapes.

Garlic and cholesterol levels

Garlic influences cholesterol levels if you eat a lot of it, but it’s unclear if eating garlic extract will do the same. Monounsaturated fats like olive and nut oils help change cholesterol to less harmful types. Omega- 3 fatty acids are found in many fish, nuts and seeds. They reduce the risk of an acute heart attack and in high enough quantities can lower triglycerides and reduce the risk of hardening of the arteries or atherosclerosis.

It's a combination of a healthy diet and exercise that works best

The caveat in all this is that one can not reduce heart disease risk just by eating more heart health foods and ignoring general nutrition and health principles. An overweight, sedentary smoker who eats a few fish meals with lots of garlic, broccoli and apples and drinks red wine is still worse off than a normal weight non-smoker who exercises regularly but eats a poor diet. However, someone who already eats properly, exercises and does not smoke can reduce their risk even further by including foods rich in flavonoids and omega-3 fatty acids.

John Messmer, MD
Contributing Expert

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