Nutrition and Vascular Disease

Peripheral arterial disease (PAD) is a common form of vascular disease (disease of the blood vessels). PAD is the result of a buildup of fatty material (plaque) in the vessel walls, resulting in narrowing or blockage of the artery(ies). This process is called atherosclerosis. Following a healthy diet may prevent or treat the complications of vascular disease, as well as high blood pressure, elevated cholesterol, diabetes, and obesity. Listed below are some of the risk factors for vascular disease that you can control by eating a healthy diet:

High Blood Pressure
High blood pressure or hypertension is a persistent increase in the pressure in your arteries. Eventually, this increased pressure can cause your arteries to become scarred, thickened, hardened, and less elastic, restricting blood flow.

High Lipid Levels
This is the amount of cholesterol and triglycerides in your blood. Having high total cholesterol is a major risk factor for vascular disease, and can lead to a build- up of fatty deposits called plaque in the arteries. This can lead to atherosclerosis.

Diabetes
Having diabetes puts you at increased risk for vascular disease. It causes your blood sugar to get too high. Over time, high blood sugars damage the lining of the arteries. This may also cause a build-up of plaque and lead to kidney disease, blindness, and nerve damage.

Excess weight can lead to high blood pressure, diabetes, and high cholesterol.

Eating a healthy diet can help you achieve a healthy weight while reducing harmful fats in your blood stream. It lowers high blood pressure, and, if you are diabetic helps you control your blood sugars. It is important that you learn about foods and what they contain by making a concerted effort to read labels containing facts about nutrition. They are on almost all foods.

You can reduce your risks for developing vascular disease and atherosclerosis of blood vessels by making changes in:

• How active you are
• What and how much you eat

Regular Exercise. Build up to 150 minutes of moderate activity each week (30 minutes of exercise, five days/week) Choose Whole-Grain Products. Foods made with whole grains have more fiber and other nutrients than foods made with refined grains such as white rice and white flour. You should aim for three ounces per day.

Good choices include:

• Bread (1 slice) and crackers made with whole wheat or other whole grains
• Brown rice (1/2 cup cooked)
• Whole-wheat pasta (1/2 cup cooked)
• Whole-grain cereals, such as oat meal (1/2 cup cooked)
• Lentils, dried peas. and beans (good sources of fiber)

Vary Your Vegetables. Eat at least two cups (at least five servings) of vegetables every day. These are a rich source of nutrients with virtually no fat. You should have 1/2 cup of cooked vegetables or one cup if raw.

Focus on fruits. Eat at least two cups of fruit each day. Choose:

• Fresh (1 medium piece)
• Frozen
• Canned (1/2 cup unsweetened)
• Dried fruit

Choice of Dairy Products. Select fat-free or low-fat dairy products. This is a good way to reduce fat and cholesterol in your diet.

Go Lean with Protein. When choosing foods with protein, select those that are low in fat and cholesterol. About three ounces of meat, fish, or poultry is one serving, which is about the size of a deck of cards.

Foods high in omega-3 fatty acids include:

• Bass, bluefish, herring, mackerel, salmon, sardines, shark, trout, and tuna
• Plant foods with protein include:
  • Beans
  • Peas
  • Nuts and seeds

Enjoy Sweets and High-Fat Foods in Small Amounts. Go easy on sweets and high-fat foods such as cookies, candies, salad dressings, and snack chips. These foods can be high in calories but do not contain many healthy nutrients.

Know Your Limitations for Salt. Sodium is a mineral that attracts and holds water and is found in many foods. In the right amount, it helps maintain the correct balance of fluids in the body. Most people consume more salt than is necessary. Manufacturers may add sodium to process foods or it can come from the salt shaker. About 75% of the salt which the average American eats comes from sodium added during the processing of foods. A high-salt diet is a major risk factor for high blood pressure.

Understanding Fats. Cholesterol is a fat-like substance found in your body and in food from animal sources (such as meat). Too much cholesterol in your blood can raise your risk for developing vascular disease. Eating foods with cholesterol can raise blood cholesterol in some people. Limit the cholesterol you eat to 300 milligrams (mg) or less daily. The type of fat you eat can be just as important as the amount of fat you eat:

• Choose unsaturated fats more often than saturated fats (also called monounsaturated and polyunsaturated fats).
• Nuts, seeds, fish, and some vegetables contain unsaturated fats.
• Limit or avoid saturated fat. You should obtain less than 10% of your daily calories from saturated fats.
• Butter, whole milk, and fatty meats contain saturated fats.
• Use margarine substitutes containing stanols and sterols.
• Choose monounsaturated oils such as canola, olive, or peanut oil.
• Avoid Trans fats, which can raise your blood choles terol. They also increase your risk for developing vascular disease. Eat as little Trans fats as possible.
• Some margarines, fried foods, and baked goods contain Trans fats.
• Foods with partially hydrogenated oil, hydrogenated oil, or shortening have Trans fats and should be avoided.

Sugars. Some healthy foods naturally contain sugars. Foods such as dairy products, grains, fruits, and vegetables all have natural sugars. When sugars are added to food, you get lots of calories but few healthy nutrients. Added sugars can be found by looking for words on labels such as "sucrose," "sugar," or "syrup."

When it comes to controlling your weight and your intake of fat and cholesterol, knowledge is the key. Knowing about the foods you eat makes it easier to control your intake of calories, fat, and cholesterol. Reading the labels on all packaged foods and looking for nutritious foods (sometimes labeled in menus) in restaurants can help you make healthy choices and lifestyle changes that can reduce your risk of vascular disease.

About the Author: Cindy Felty, MSN, RN, CNP, FCCWS, is the director of vascular ulcer/wound healing clinic at the Gonda Vascular Center. She is also an assistant professor of medicine at the Mayo Clinic College of Medicine in Rochester, MN.