The Beat Goes On: Heart Health and Nutrition

author : Nancy Clark
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Even athletes are not immune from heart disease. The following bits of information might inspire you eat wisely to keep your heart beating for a long and healthful lifetime.

The Athlete’s Kitchen
Copyright: Nancy Clark MS RD CSSD, May 2008


Although exercise is one of the best ways to improve heart health, even athletes are not immune from heart disease. You have undoubtedly heard reports of marathon runners who die of heart attacks and football players who have strokes. Women, like men, need to pay attention to heart disease; it is the #1 killer of women, higher than all cancers combined.

To address the topic of heart disease among active people, the Sports and Cardiovascular Nutrition practice group of the American Dietetic Association ( featured heart health as the theme of their annual convention (April 2008, Boston). The following bits of information from that conference might inspire you eat wisely to keep your heart beating for a long and healthful lifetime.

First of all, when it comes to heart disease, you should know your cholesterol numbers. Get your blood tested for total, LDL, and HDL cholesterol. Having a low LDL is the primary goal for reducing heart disease. If your LDL is >160 mg/dL, the sooner you lower it to <130, the better off you’ll be.

Foods that actively lower LDL include oats, barley, soy, beans, almonds/nuts, and plant sterols/stanols (added to margarines such as Benecol). Although each single food might have only a small cholesterol-lowering effect—for example, consuming three glasses of soy milk a day might lower LDL by only 5%—combining several of these foods becomes very powerful. For example, in subjects with high blood cholesterol, a diet rich in oats, nuts, soy, and phytosterol-enriched margarine reduced LDL by almost 30% in four weeks. That's as powerful as cholesterol-lowering drugs!

With minimal effort, you can consume LDL-lowering foods on a daily basis and achieve long term benefits. Plus, by filling up on oats, nuts, and beans, you are not chowing on bacon, cookies, and steak—and you gain the added benefit of displacing those sources of artery-clogging saturated fats.

Oatmeal is easy to add into a sports diet. If cooking oats is not your style, simply eat them raw—mixed in with cold cereal. For example, Wheaties + raw oats + slivered almonds + (soy) milk + fruit creates an easy heart-healthy breakfast. Microwaving a packet of instant oatmeal with a spoonful of peanut butter creates a tasty, effective pre-exercise and/or afternoon snack.

Inflammatory reducers

Inflammation, caused by cholesterol-filled plaques in blood vessels, plays a role in heart disease. Foods that reduce inflammation include salmon and other oily fish, walnuts, fiber-rich whole grains, fruits, vegetables, and even dark chocolate. Among fruits and veggies, the big six are apricots, bananas, oranges, tomatoes, broccoli, and spinach. Eat them often!

Mediterranean diet

The Mediterranean diet, rich in olive oil, fruits, vegetables, fish, and seafood is also protective and offers a 7% reduction in mortality from heart disease. Consider using more olive oil for salad dressings, sautéing vegetables, and as a dip for bread (instead of butter)—but watch the calories!


Eating eight ounces of fish per week, especially cold water fish (salmon, mackerel, sardines, herring) rich in omega-3 fats, can reduce the risk of death from heart disease by 36% (and from other diseases by 17%). Eating fish delays death within the hour after a heart attack, providing time to get the victim to the hospital for treatment. Plan one lunch with tuna (with lowfat mayo) and one dinner with salmon each week.

Omega-3 importance

Humans cannot make omega-3s; that’s why we need to eat them. A healthy person can get the recommended intake from fish. Just eight ounces of salmon (the richest source) provides a week’s worth of omega-3’s. (Cardiac patients need more, necessitating fish oil pills.) Salmon is also a rich source of vitamin D. Three ounces canned pink salmon provides the daily requirement for vitamin D. Vitamin D protects against high blood pressure, diabetes, cancer, and many other health issues. (For a recipe with canned salmon, try Simple Salmon Patties. See below)

Heart-Mind connection

What's good for the heart is good for the mind (and the rest of the body, for that matter, because all bodily systems are interconnected). Eating fish twice a week is associated with a 13% slower decline in mental performance.

PCB'S In fish

Some athletes believe farmed fish have higher levels of PCBs and other toxins. According to Dr. Charles Santerre of Purdue the risk is tiny compared to the strong heart-health benefits. PCBs are stored in the fat. To reduce intake of PCBs, don’t eat the fish skin or the fat drippings.

Heart disease and age

The risk of heart disease increases with age, particularly as women enter menopause. Menopause increases fat deposition in the trunk/waist area, more so than on the legs and arms. This abdominal fat is linked with heart disease.

Why does midlife fat settle around the waist? One theory relates to cortisol, a hormone that increases with stress. Post-menopausal women seem to have a robust cortisol response to stress. Thank goodness exercise can be a good stress reducer; keep active!

Body fat

Lugging around excess body fat adds a major stress to the heart, but being too thin can also raise heart-health issues. Athletes who severely undereat (such as those with anorexia) commonly develop irregular heart rhythms and have a dangerously low heart rate. Thinner is not always healthier.

Diminishing returns

The more you exercise, the more protection you have from heart disease—to a certain extent. The benefits plateau at about 2,000 calories per week; that's the equivalent of running about 4 miles a day (400 calories) for five days a week, with two rest days per week. No need to get compulsive.

The bottom line
Just as eating the wrong foods can be powerfully bad for your heart, eating the right foods can be powerfully good. Eat wisely to invest in an enjoyable future. If you need help creating a heart healthy sports diet, consult with your local sports dietitian; use the referral network at


Looking for inexpensive ways to add more fish to your diet? Here’s one of many family-friendly recipes from the new fourth edition of Nancy Clark’s Sports Nutrition Guidebook (April, 2008).

Simple Salmon Patties
These salmon patties are made with canned salmon, an inexpensive source of health-protective omega-3 fat. Enjoy them with brown rice and a green vegetable for a complete meal.

1 14-ounce (400 g) can pink salmon, drained and flaked (remove the skin, but keep the bones for added calcium)
1 cup (70 g) crushed whole-wheat saltine crackers or bread crumbs
1 egg or substitute, slightly beaten
1 cup (150 g) diced pepper, green or red
1/2 diced onion, preferably a sweet onion such as Vidalia
1/4 cup (60 ml) milk, preferably low fat
Lemon pepper or black pepper, as desired
1 to 2 tablespoons olive or canola oil, for cooking

Optional: 1 teaspoon Worcestershire sauce or soy sauce; dash of hot pepper sauce; 1/2 teaspoon dried dill or 2 teaspoons fresh dill

1. In a large bowl, stir together salmon, cracker or bread crumbs, egg, bell pepper, and onion. Mix in milk (and Worcestershire sauce and hot pepper sauce, as desired). Add pepper, and mix well with your hands. Lightly press the mixture into eight patties.

2. Heat oil in large sauté pan on medium heat. Once oil is hot, place the patties in the pan and cook on both sides until lightly browned, about 3 to 5 minutes.

Yield: 4 servings (8 patties)

Nutrition Information
1,200 total calories; 300 calories per serving (2 patties)
24 g carbohydrate; 27 g protein; 11 g fat (2 g omega-3)


Reprinted with permission from Nancy Clark’s Sports Nutrition Guidebook, 4th Edition (2008; Human Kinetics). Available via



Nancy Clark MS, RD counsels casual exercisers and competitive athletes at Healthworks, the premier fitness center in Chestnut Hill, MA (617-383-6100). Her NEW 2008 Nancy Clark's Sports Nutrition Guidebook 4th Edition, and her Food Guide for Marathoners and Cyclist’s Food Guide are available via


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date: June 16, 2008

Nancy Clark

Nancy Clark, MS, RD, an internationally known sports nutritionist and nutrition author, is a registered dietitian (RD) who specializes in nutrition for exercise, health and the nutritional management of eating disorders.

avatarNancy Clark

Nancy Clark, MS, RD, an internationally known sports nutritionist and nutrition author, is a registered dietitian (RD) who specializes in nutrition for exercise, health and the nutritional management of eating disorders.

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