Your heart-healthy diet at midlife

        The times they are a-changin’—and so are your odds of getting cardiovascular disease. Thirty-nine percent of women between the ages of 40 and 59 are affected. The odds advance to three out of four between ages 60 and 79. After 65, you’re more likely to die of cardiovascular disease than your male peers. Why?
       During your childbearing years, estrogen helps keep your LDL, or “bad,” cholesterol level low and your HDL, or “good,” cholesterol level high. This combination keeps your arteries clear and allows for free blood flow.
       But your estrogen level diminishes as you age and so does your protection against cardiovascular disease. Gradually, your LDL level rises and your HDL level may go down slightly. This sets the stage for atherosclerosis, high blood pressure, angina, heart attack and stroke. In contrast, men’s cholesterol levels don’t change as drastically.

Food fight
       So, what’s a woman to do? Step up your activity level. If you smoke—quit. And follow a heart-healthy diet to fight the impact hormonal changes have on your body. Your heart-healthy diet should be low in fats and sodium and include the following:
       • Fiber. As soluble plant fiber passes through your body, it lowers blood cholesterol and blood sugar levels, reducing your risk of heart attack. Eat plenty of oat bran, oatmeal, beans, peas, rice bran, barley, citrus fruits, strawberries and apples to get enough fiber.
        • Soy. This “miracle legume” is packed with protein and healthy nutrients. Try adding one to two ounces (25 to 50 grams) of soybeans, tempeh, miso, soy milk, soy flour, tofu or textured soy protein to your diet each day. Soy works in several different ways. It contains a plant estrogen (isoflavone) that fights cholesterol already in your body, much like human estrogen. Soy reduces your total cholesterol, LDL cholesterol and triglycerides (blood fat) and raises your HDL cholesterol to protect you against heart disease. Also, the linolenic acid and isoflavones in soy inhibit the formation of blood clots, a key cause of heart attacks.
       • Fish oils. Cold-water fish, such as salmon, mackerel and herring, contain high amounts of omega-3 fatty acids, which lower your blood triglyceride level, reduce blood clots and lower blood pressure. Eat at least two meals of fish every week.
       • Folic acid, vitamin B6 and vitamin B12. These nutrients reduce the amount of homocysteine in your body. Homocysteine increases your risk of heart attack, stroke and loss of circulation in your hands and feet. Eat cereals, pastas, vegetables, fruits, legumes, poultry and fish to take in these nutrients.
       • Garlic. The sulfur compounds in garlic make platelets slippery, preventing blood clots and even reducing the plaque that lines the walls of your arteries. Unfortunately, stomach acids break down these sulfur compounds, neutralizing their effect. The jury is still out on the effectiveness of garlic tablets, and two studies have been unable to show them to be of any benefit. Enjoy food prepared with garlic, knowing that whatever sulfur compounds do make it into your blood will benefit you.
       • Antioxidants. Vitamin C, vitamin E and beta-carotene are antioxidants—substances that can prevent cholesterol from damaging the lining of your arteries. The best way to get antioxidants is by eating lots of fruits and vegetables. Vitamin supplements are not recommended because some offer no protection and some even interfere with the action of cholesterol-lowering drugs.

Small changes add up
Make the following changes one or two at a time.