We can see the bottleneck traffic jams immediately in congested cities with road repairs and holiday traffic. We don’t see so quickly the bottlenecks in our blood flow caused by deteriorating vascular health or the damage to the blood vessels themselves. Several factors create “traffic jams” inside the blood vessels: sludged blood, clots, clumped red blood cells, and endothelial dysfunction. In this blog, we examine some of the lifestyle factors that improve endothelial function and promote vascular health.
Endothelial dysfunction is characterized by higher vasoconstriction, reduced vasodilation, pro-clotting, and inflammatory activity. To express it more succinctly, endothelial dysfunction promotes high blood pressure and inflammation inside the arteries and encourages undesirable clotting!1
Understanding Vascular Health
Vascular health is more than just good cholesterol, HDL, LDL, and triglycerides levels. Vascular endothelial cells compose the innermost lining of arteries. These cells make molecules and substances that open blood vessels up and improve blood flow. Vascular endothelial cells also make compounds that cause blood vessels to constrict and dilate. These endothelial cells respond to different physical and chemical stimuli.
The Problem with Meat
Inflammation fuels all stages of the development of atherosclerosis. Meat contains certain long-chain saturated fats that elevate LDL cholesterol and produce inappropriate inflammatory responses.2 Additionally, the consumption of long-chain saturated fats from meat reduces blood flow through the blood vessels.
Eat a well-balanced, predominately plant-based diet of whole plant foods. A meta-analysis of randomized control studies found that substituting red meat with high-quality plant protein sources, but not with fish or low-quality carbohydrates, leads to more favorable blood lipids (cholesterol, triglycerides) and lipoprotein changes.3 A review study found that a healthful plant-based diet reduces the risk of death from cardiovascular disease by 40 percent, the risk of coronary heart disease by 40 percent, and fully or partially opens blocked arteries in 91 percent of patients.4
However, going vegetarian and substituting refined grains and sugar for saturated-fat-laden meat will not reduce one’s risk of cardiovascular problems.5 Sugar consumption increases the risk of coronary heart disease whereas whole grains reduce it.6
More Vegetarian Advantages
Regarding blood pressure, vegan and vegetarian diets reduce both systolic and diastolic blood pressure. Individuals in one study who excluded meats entirely had significantly lower blood viscosity than those eating meat occasionally (less than once a week).7 This means better blood flow and blood pressure. Diets rich in whole plant foods reduce inflammation. However, if refined carbohydrates take the place of meat in the diet, there is no cardiovascular benefit to a vegetarian diet.8
Lower blood pressure reduces the risk of atherosclerotic changes. Compared to high saturated fat diets and low carbohydrate diets, a vegetarian diet improved brachial artery flow-mediated vasodilation.9
Watch the Fat Intake!
A cafeteria diet (CAF) containing a variety of highly palatable, high-salt, high-fat, and low-fiber, energy dense foods promotes endothelial dysfunction and increases the risk for hypertension.10
When we eat high-fat meals, the fat molecules temporarily disrupt nitric oxide production, preventing the arteries from increasing blood flow in response to physical activity. High fat diets impair nitric oxide (NO) bioavailability and impair NO stability and synthesis.11 Aged cheese, ice cream, pudding, and custards have oxidized cholesterol that pushes inflammation inside the arteries.
On the other hand, diets rich in unsaturated fatty acids seem to show beneficial effects on endothelial function.12 Nuts contain the amino acid, arginine, a precursor to nitric oxide. Nuts, seeds, and avocadoes are the best fats for heart and immune health.
Limit the Sugar and Refined Carbs
Consuming sugar-laden foods causes a temporary and sudden dysfunction in the endothelial walls of the arteries.13 The endothelial layer makes molecules and compounds that open up blood vessels and improve blood flow.
Sugar, especially when combined with saturated fat from meat, compromises the ability of blood vessels to dilate. A single junk food meal – composed mainly of saturated fat – is detrimental to the health of the arteries. Eating one meal of junk food decreases the ability of blood vessels to dilate by 24%.14
Caveats for Vegetarians
Vegans and vegetarians who do not get sufficient B12 and omega-3 fats have an increased risk for cardiovascular disease.15
Vegans and vegetarians are at risk for B-12 deficiency.16
Unfortunately, B-12 deficiency promotes inflammation in the arteries and impairs the ability of arteries to dilate.17
Good, vegetarian sources for omega 3-fats include chia seed, flaxseed, organic non-GMO soy, walnuts, and leafy greens.
Healthful Foods for the Arteries
Legumes and Nuts
Arginine is an amino acid from nuts and legumes that is a precursor to nitric oxide, a molecule that, in moderation, helps the arteries to dilate and reduces platelet clumping. Walnut consumption encourages the elasticity and flexibility of the arteries, regardless of people’s cholesterol levels.18
Soluble fiber promotes cholesterol excretion and exerts anti-inflammatory activity. Sources of soluble fiber include legumes, berries, apples, figs, pears, broccoli, sweet potatoes, carrots, nuts, flaxseed, oats, and barley. Use organically grown whole grains if possible. Why? Pesticides may increase the risk for heart disease and stroke even in apparently healthy men.19
Colorful Plant Foods
Colorful plant foods are loaded with antioxidants. Why are they important to vascular health? Excess production of free radicals produce endothelial dysfunction. Both potassium-rich foods, found in fruits and vegetables, and magnesium from leafy greens and whole grains help the arteries to relax. Polyphenols in grapes and berries encourage the production of nitric oxide.20
In sedentary humans, arterial stiffness in the central (cardiothoracic) circulation increases with advancing age, even in healthy men and women. Frequent, regular moderate exercise helps to keep the arteries elastic.21 The imbalance between pro-oxidants and antioxidants is linked to cardiovascular and metabolic diseases. Persistent moderate and vigorous exercise exerts anti-oxidant effects.22 Regular physical activity has been shown to promote the activities of antioxidant enzymes and stimulate glutathione levels in body fluids.23 24
Carbon monoxide from smoking makes tiny holes in the intima of arteries and reduces nitric oxide production. Additionally, smoking increases the risk for undesirable clot formation. Cigarette smoking turns the entire body into a breeding ground for infection which may allow artery-clogging plaques to take hold. Even in young adults (18 to 30 years old), one cigarette increases the stiffness of the arteries by 25 percent.25
A 30-minute exposure to the level of secondhand smoke that one might typically inhale in an average group setting was enough to result in blood vessel injury in young and otherwise healthy lifelong nonsmokers. Not only that, but exposure to secondhand smoke impedes the function of the body’s natural repair mechanisms. These mechanisms are activated in the face of blood vessel injury. In this research many of these effects persisted 24 hours later.26
Obesity can increase the loss of elasticity in arteries, especially the aorta. Weight loss enhances the elasticity of arteries.27 Lifelong wise caloric restrictions has been shown to prolong lifespan, reduce atherosclerosis, and improve endothelial function.28 29
Granted there is conflicted information on coffee and endothelial dysfunction. One study showed that in healthy volunteers, the equivalent of two cups of caffeinated coffee reduced the body’s ability to boost blood flow to the heart muscle in response to exercise.30 When one engages in physical exercise, myocardial blood flow has to increase to match the increased need for oxygen.
Hydrate with Water!
Minor dehydration may promote cardiac disease and arterial hardening in young, healthy men. In fact, by impairing the ability of blood vessels to dilate, mild dehydration significantly reduces vascular function nearly as much as smoking a cigarette.31
A lack of vitamin D, even in healthy people, is linked with stiffer arteries and an inability of blood vessels to relax even after controlling for factors such as age, weight, and cholesterol. In one study, people with vitamin D deficiency had vascular dysfunction comparable to those with diabetes or hypertension.32">www.sciencedaily.com/releases/2011/04/110403205232.htm))
Long-term interrupted sleep or brief arousals from a sleep period leads to actual changes in the structure of blood vessels.33 It damages the elastic fibers in arteries, encourages vascular endothelial dysfunction, and increases inflammation in the arteries.34
- Define your two weakest links in cardiovascular health.
- Create two specific goal-focused strategies to correct them.
- Commit to your goals for a definite time frame.
- Each day review how your daily activities subverted your attention from achieving your goals and what intervening steps help you achieve your goals.
Defagó, María Daniela et al. “Influence of food patterns on endothelial biomarkers: a systematic review.” Journal of clinical hypertension (Greenwich, Conn.) vol. 16,12 (2014): 907-13. doi:10.1111/jch.12431
de Oliveira, P.A. “Unsaturated fatty acids improve atherosclerosis markers in obese and overweight non-diabetic elderly patients,” Obesity Surgery, vol. 27, no. 10, pp. 2663–2671, 2017.
- Davigon J. & Gans P. Role of Endothelial Dysfunction in Atherosclerosis. Circulation. 2004;109: III-27–III-32
- University of Vermont College of Medicine. (2015, September 24). Inflammatory response may fan the flame of dietary fats’ role in obesity-related diseases: Study supports merits of Mediterranean diet. ScienceDaily. Retrieved April 14, 2021 from https://www.sciencedaily.com/releases/2015/09/150924142927.htm
- Guasch-Ferré M. Et al. Meta-Analysis of Randomized Controlled Trials of Red Meat Consumption in Comparison With Various Comparison Diets on Cardiovascular Risk Factors. Circulation. 2019 Apr 9;139(15):1828-1845. https://pubmed.ncbi.nlm.nih.gov/30958719/
- Kahleova H, Levin S, Barnard ND. Vegetarian Dietary Patterns and Cardiovascular Disease. Prog Cardiovasc Dis. 2018 May-Jun;61(1):54-61. https://pubmed.ncbi.nlm.nih.gov/29800598/
- Temple, Norman J. “Fat, Sugar, Whole Grains and Heart Disease: 50 Years of Confusion.” Nutrients vol. 10,1 39. 4 Jan. 2018. https://www.mdpi.com/2072-6643/10/1/39
- Ibid., Temple
- Barnard ND, Goldman DM, Loomis JF, Kahleova H, Levin SM, Neabore S, Batts TC. Plant-Based Diets for Cardiovascular Safety and Performance in Endurance Sports. Nutrients. 2019 Jan 10;11(1):130. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6356661/
- Kim H. Plant‐Based Diets Are Associated With a Lower Risk of Incident Cardiovascular Disease, Cardiovascular Disease Mortality, and All‐Cause Mortality in a General Population of Middle‐Aged Adults.JAHA. vol.8 issue 16. https://www.ahajournals.org/doi/10.1161/JAHA.119.012865
- Kahleova H, Levin S, Barnard ND. Vegetarian Dietary Patterns and Cardiovascular Disease. Prog Cardiovasc Dis. 2018 May-Jun;61(1):54-61.
- Naderali, E.K., et al, “Diet-induced endothelial dysfunction in the rat is independent of the degree of increase in total body weight,” Clinical Science (London, England), vol. 100, no. 6, pp. 635–641, 2001. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7533760/
- Razny U, Kiec-Wilk B, Wator L, et al. Increased nitric oxide availability attenuates high fat diet metabolic alterations and gene expression associated with insulin resistance. Cardiovasc Diabetol. 2011; 10:68. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3212914/
- de Oliveira, P.A. “Unsaturated fatty acids improve atherosclerosis markers in obese and overweight non-diabetic elderly patients,” Obesity Surgery, vol. 27, no. 10, pp. 2663–2671, 2017.
- Tel Aviv University. “How High Carbohydrate Foods Can Raise Risk For Heart Problems.” ScienceDaily. ScienceDaily, 27 June 2009. www.sciencedaily.com/releases/2009/06/090625133215.htm
- Cantin J., et al., Does the Adherence to a Mediterranean Diet Influence Baseline and Postprandial Endothelial Function? Canadian Journal of Cardiology, 2012; 28 (5): S245 DOI: 10.1016/j.cjca.2012.07.367
- Duo Li. Chemistry behind Vegetarianism. Journal of Agricultural and Food Chemistry, 2011; 110104095843036
- Pawlak R, Parrott SJ, Raj S, Cullum-Dugan D, Lucus D. How prevalent is vitamin B(12) deficiency among vegetarians? Nutr Rev. 2013 Feb;71(2):110-7
- Woo KS. Vegan diet, subnormal vitamin B-12 status and cardiovascular health. Nutrients. 2014 Aug 19;6(8):3259-73.
- American College of Cardiology. “Eating Walnuts With High-fat Meals Helps To Protect Arteries Against Short-term Damage.” ScienceDaily. ScienceDaily, 11 October 2006. https://www.sciencedaily.com/releases/2006/10/061010022750.htm
- Zara K. Berg, Beatriz Rodriguez, James Davis, Alan R. Katz, Robert V. Cooney, Kamal Masaki. Association Between Occupational Exposure to Pesticides and Cardiovascular Disease Incidence: The Kuakini Honolulu Heart Program. Journal of the American Heart Association, 2019; 8 (19) DOI: 10.1161/JAHA.119.012569
- Auger C, et al. Potential of Food and Natural Products to Promote Endothelial and Vascular Health. J Cardiovasc Pharmacol. 2016 Jul;68(1):11-8.
- Hemifura Tanaka. Antiaging Effects of Aerobic Exercise on Systemic Arteries. Hypertension. 2019; 74:237–243
- de Sousa CV, Sales MM, Rosa TS, Lewis JE, de Andrade RV, Simões HG. The Antioxidant Effect of Exercise: A Systematic Review and Meta-Analysis. Sports Med. 2017 Feb;47(2):277-293.
- Chakraphan, D, “Attenuation of endothelial dysfunction by exercise training in STZ-induced diabetic rats,” Clinical Hemorheology and Microcirculation, vol. 32, no. 3, pp. 217–226, 2005.
- Hollander J. “Superoxide dismutase gene expression is activated by a single bout of exercise in rat skeletal muscle,” Pflügers Archiv, vol. 442, no. 3, pp. 426–434, 2001.
- Heart and Stroke Foundation of Canada. “Smoking Gun: Just One Cigarette Has Harmful Effect On Arteries Of Young Healthy Adults.” ScienceDaily. ScienceDaily, 27 October 2009. www.sciencedaily.com/releases/2009/10/091027085300.htm
- University of California – San Francisco. “Secondhand Smoke Exposure Can Cause Cell Damage In 30 Minutes.” ScienceDaily. ScienceDaily, 5 May 2008. www.sciencedaily.com/releases/2008/05/080505094136.htm
- Safar M. Obesity, Arterial Stiffness, and Cardiovascular Risk. J Am Soc Nephrol 17: S109 –S111, 2006
- Fontana, L. Et al., “Long-term calorie restriction is highly effective in reducing the risk for atherosclerosis in humans,” Proceedings of the National Academy of Sciences of the United States of America, vol. 101, no. 17, pp. 6659–6663, 2004.
- Man, Andy W C et al. “Impact of Lifestyles (Diet and Exercise) on Vascular Health: Oxidative Stress and Endothelial Function.” Oxidative medicine and cellular longevity vol. 2020 1496462. 26 Sep. 2020, doi:10.1155/2020/149646
- American College of Cardiology. “Caffeine Limits Blood Flow To Heart Muscle During Exercise.” ScienceDaily. ScienceDaily, 14 January 2006. www.sciencedaily.com/releases/2006/01/060114232653.htm
- Arnaoutis G. The effect of hypohydration on endothelial function in young healthy adults. European Journal of Nutrition, 2016; DOI: 10.1007/s00394-016-1170-8.
- Emory University. “Vitamin D levels linked with health of blood vessels.” ScienceDaily, 3 April 2011. ↩
- Calvin AD. Experimental sleep restriction causes endothelial dysfunction in healthy humans. J Am Heart Assoc. 2014 Nov 25;3(6):e001143.
- Carreras A. Chronic sleep fragmentation induces endothelial dysfunction and structural vascular changes in mice. Sleep. 2014 Nov 1; 37(11):1817-24.