Background:
Many people have heart attacks. It's the most common cause of death. Many (not most but many) young people have heart attacks too, i.e., people in their 40s and 50s (and sometimes much younger). Two of my cousins (physically active omivores) had heart attacks in their 30s and 40s (one of the RIP). My father (RIP) had heart attacks in his 50s and early 60s.Nutrition can be a powerful tool to lower the risk of having heart attack (and the risk of having another heart attack, for those who've already had one).
Many long-term vegans (e.g., vegans who became vegan in the 1990s, like myself) have never thought about "nutrition" much. And many 1990s-vegans still have (correct me if I'm wrong) ideas about nutrition that are stuck in the "Diet for a new America"-era.
Many well-known and widely respected (not so justifiably, I'm afraid) vegan medical doctors, still today, remain quiet about key nutrients that vegans should know about. Some even actively keep promoting outdated (or made up) nutrition information.
Consequently, many vegans might - incorrectly, I'm afraid - assume that a vegan diet per se (!) is protective against atherosclerosis and having a heart attack.
Vegans can have heart attacks too ... and young too. The founder of the American Vegan Society, H. J. Dinshah, died of a heart attack aged 66 years. And this isn't very young at all for heart attacks.
The classic vegetarian view of the "healthy food vs. unhealthy food" hierarchy may be something like this: animal products (extremely bad) -- sugary snacks, refined flour, French fries, junk food, etc. (intermediarily bad) -- fruit, vegetables, whole grains, legumes, nuts, seeds (really healthy). This idea isn't so bad, only the first two groups should probably be switched around. In addition, key nutrients for vegans are important (see below).
Vegans can have heart attacks too ... and young too. The founder of the American Vegan Society, H. J. Dinshah, died of a heart attack aged 66 years. And this isn't very young at all for heart attacks.
Time for a reality check ...
Dietary factors that influence heart attacks in vegans:
First: the basic dietary pattern
Everyone knows: sugary snacks, Coca Cola, Red Bull, etc. are poison. If you do not know, ... you know now.The classic vegetarian view of the "healthy food vs. unhealthy food" hierarchy may be something like this: animal products (extremely bad) -- sugary snacks, refined flour, French fries, junk food, etc. (intermediarily bad) -- fruit, vegetables, whole grains, legumes, nuts, seeds (really healthy). This idea isn't so bad, only the first two groups should probably be switched around. In addition, key nutrients for vegans are important (see below).
Researchers at Harvard University (USA) proposed a new dietary score around 2016. In 2017, they published this graphic (Satija et al. 2017), which nicely shows what I mean:
Or if you'd like it more simple:
What the graphics show is that unhealthy plant-based foods are even worse than meat and other animal products (processed red meat seems to be the worst among animal products).
Take home message: Have a healthy diet, based on "whole foods", i.e., fruit, vegetables, whole grains, legumes, nuts, and seeds, and mushrooms, spices, etc.
Second: key nutrients for vegans
For many years - decades - vegan nutritition scientists have tried to educate vegans, pushing the "key nutrients for vegans" message. However, this message is about as popular among vegans - especially "old school" vegans - as the "go vegan!" message is popular among most omnivores. Not popular.The key nutrients for vegans are vitamin B12, calcium, vitamin D, iodine, omega-3 fatty acids, iron, zinc, selenium, vitamin A, and protein. Of these, the ones below are probably the most relevant for cardiovascular disease prevention in vegans. If you do not take a supplement with these nutrients, your probably at least moderately deficient in these:
- Vitamin B12-- unless you supplement, you will be deficienct with a probability of ~99%.
- Vitamin D -- if you live far away from the equator - let's say >45 degrees latitude north or south - and you do not supplement, your likely deficient.
- Iodine -- your're likely deficient.
- Omega-3 fatty acids -- unless you eat good sources regularly ((e.g. linseed/flaxseed oil, ground linseeds, or walnuts), you're likely deficient.
- Selenium -- if you live in Europe (soils are typically low in selenium), you are likely deficient, unless you supplement (or eat Brazil nuts).
Deficiencies in all of these can likely contribute to atherosclerosis - a process that occurs in practically everyone throughout life. In this way, deficiencies can increase your risk of a heart attack.
What about genetics?
Diet is one factor that can influence disease. There are other lifestyle factors. And then there are genetics. Some people (a minority) have a very strong genetic predisposition to have extremely high blood cholesterol levels. If you're in your 40s (or any age really) and have never had your cholesterol levels tested (total cholesterol is the most basic test), then it would be a good idea to do so. If your cholesterol levels are extremely high (e.g., 300 mg/dl = ~7.7 mmol/L), you must take medication (statins etc.). No diet, no supplement, nothing will lower these levels except medication. The earlier you lower them, the better.
Many more people (but not the majority) have a genetic risk which makes them have high cholesterol levels much more quickly than others. Two important factors are age and overweight. Both factors increase cholesterol levels and disease risk. But some people are overweight by 1 kg and their cholesterol levels shoot up notably. Some people are overweight by 10 kg and their cholesterol levels are still totally fine.
Which risk markers are the most important for heart attacks?
- Cholesterol levels, blood sugar levels, and blood pressure.
- Very high fasting triglyceride levels are also bad.