🔒A nutritious recipe for better health

Last summer at Rick Agbay’s annual checkup, his doctor broke tough news: Agbay’s cholesterol, blood pressure, and blood sugar levels were elevated, and he needed to go on medication.

The Worcester resident received a follow-up call from a nurse case manager at his Medicare plan, who asked if he wanted to make diet changes to improve his health. Agbay enthusiastically agreed: “I knew I needed to do something,” he said.

Agbay had phone consultations with Blue Cross Blue Shield of Mass. dietitian Nancy Dowling, who taught him about the foods to help manage his conditions. By November, Agbay had lost 10 pounds, his bloodwork revealed his cholesterol, blood pressure and blood sugar levels had gone down, and his doctor took him off his medication.

One of Agbay’s first calls after getting the good news was to Dowling: “I don’t think I could have done this if she didn’t motivate me,” he said.

A cardiologist’s insights

Dr. Amanda Vest, medical director of the Cardiac Transplantation Program at Tufts Medical Center, says some heart transplants may be prevented with lifestyle changes, such as diet, physical activity, stopping smoking and moderate weight loss.

“High cholesterol and high blood pressure encourage inflammation inside the coronary arteries that take blood to the heart muscle,” said Vest, co-director of the nutrition course at Tufts University School of Medicine in Boston. “These conditions cause cholesterol to deposit in the artery, creating what is known as a plaque, narrowing the coronary artery and increasing the risk for cardiovascular diseases.”

More than 102 million adult Americans have high cholesterol, and roughly one-third of those have cholesterol levels so high they are at risk for heart disease – the leading cause of death in the U.S., according to the Centers for Disease Control. A roughly equal number have high blood pressure, another risk factor for heart attack and stroke. Blue Cross Blue Shield data shows about 330,000 members have heart disease, with men over 65 showing the most prevalence.

“If I could have met patients at high risk for coronary artery disease decades ago and helped set them on the right path... we might have prevented the need for a transplant,” she said.

How the Mediterranean and DASH diets work

Large clinical studies have differed in their findings on the effects of specific diets. Many clinicians recommend the anti-inflammatory Mediterranean and DASH (dietary approaches to stop hypertension) diets to help roll back artery-hardening processes, improve heart and blood vessel health, and reduce weight, cholesterol and blood pressure. Both diets emphasize fruits, vegetables, fish, lean poultry, legumes, nuts, healthy fats and whole grains.

Both diets include the following:

• Lots of fruits and vegetables

• Legumes (such as beans and lentils), and seeds and tree nuts like walnuts, almonds and pistachios

• Healthy fats from foods like olive oil, avocados and fish

• Whole grain foods

• A moderate amount of low-fat or non-fat dairy products such as eggs, yogurt and cheese

• Cutting out excess sugar

• Cutting down on salt

• A healthy dose of exercise

While most people will benefit from these diets, Vest advises patients to speak with their doctor or a nutritionist about what’s best for them.

“Even making small changes in food choices, physical activity and stopping smoking can lead to significant improvements in well-being,” she said.

Taking action

Agbay has taken Dowling’s advice to heart. He is eating more fish, including tuna fish sandwiches on whole grain bread. Despite being “pretty lazy when it comes to cooking,” he’s added one of Dowling’s quick and easy stovetop recipes to his repertoire. The dish calls for ground turkey or chicken, bell peppers, onions, Italian seasoning and canned tomato sauce with no added salt.

While Agbay says he “still has the temptation to eat certain things” like pistachio ice cream, he’s smarter at choosing what he indulges in now.

On top of feeling healthier, Agbay believes he can maintain his healthy behaviors for the long term: “As I get older, I’m facing more health challenges, but I feel I’ve developed better habits that can help me. My success gives me confidence moving forward.”

Rachel Coppola is a writer for Coverage, a news service of Blue Cross Blue Shield of Massachusetts.