Knowing how to prevent cardiovascular disease can literally be a life saver.
How can you avoid cardiovascular disease? What can you do yourself to prevent these common diseases as much as possible?
As a whole, it is always better to prevent cardiovascular disease than trying to cure it. Lower cholesterol levels, reducing obesity, keeping physically active, no smoking, preventing the onset of diabetes, and limited alcohol consumption are all essential to prevent cardiovascular issues.
Preventing cardiovascular disease is better than curing it, so read on to learn how you can protect yourself.
Table of Contents
- 1 How to prevent cardiovascular disease: Introduction
- 2 Preventing or eliminating obesity
- 3 Exercise and sports to fight cardiovascular disease
- 3.1 Is exercise beneficial for cholesterol levels?
- 3.2 The impact of sport is often underestimated
- 3.3 Sports have an anti-inflammatory effect
- 3.4 Sport is not an isolated factor
- 3.5 Which sports and activities should be preferred?
- 4 Quitting smoking
- 4.1 Effect of smoking on cholesterol levels
- 4.2 Effect of smoking on blood vessels
- 4.3 Effect of smoking on heart rate and blood pressure
- 4.4 Quitting smoking quickly delivers health benefits
- 4.5 Common wood smoke also poses a threat
- 5 Preventing diabetes
- 5.1 How do you develop type 2 diabetes?
- 5.2 Consequences of diabetes
- 5.3 Diabetes patients are at very high risk of cardiovascular disease
- 5.4 How can I avoid diabetes?
- 5.5 Even temporary adjustments help prevent diabetes
- 6 Does alcohol protect the heart and blood vessels?
- 7 Adjusting your lifestyle: Is that even useful?
- 8 How to prevent cardiovascular disease: Conclusion
How to prevent cardiovascular disease: Introduction
Prevention will continue to be one of the primary weapons to keep the heart and vessels from being damaged.
And fortunately, we can influence many factors through our lifestyle and eating habits.
For example, we must never lose sight of the real, underlying goal when addressing cholesterol and that is to preventively address and lower your risk of cardiovascular disease.
After all, cholesterol is only 1 factor in your overall risk picture thus, a holistic approach with attention to all risk factors is imperative!
Also, being overweight, smoking, diabetes, high blood pressure, and other risk factors of cardiovascular disease will remain important.
So lowering your cholesterol is not the primary goal but only a means to reduce your risk of cardiovascular disease.
In addition to reducing cholesterol levels, several other interesting avenues can contribute to this.
The body's high or low cholesterol production is primarily the result of our genes, determined from birth.
This does not mean that you can do nothing at all to prevent your cholesterol levels from causing problems.
On the contrary, several other risk factors also impact cholesterol levels in your body, such as:
- Physical activity
- High blood pressure
Preventing or eliminating obesity
What you eat and how active you are primarily determine how much you weigh. In addition, apart from your weight and excess pounds, your daily diet also affects your cholesterol levels.
About 30 to 40 percent of the adult population is overweight, while about 20 percent is obese. Let that sink in. How to prevent cardiovascular disease, therefore, is about weight too.
Obesity upsets the balance between good and bad cholesterol
Obesity has a negative impact on the balance between HDL cholesterol (good cholesterol) and LDL cholesterol (bad cholesterol).
Those who weigh too much and struggle with excess pounds will see their good HDL cholesterol drop. In contrast, the bad LDL cholesterol begins to rise.
This causes the ratio of HDL to LDL cholesterol (good versus bad cholesterol) to go in the wrong direction.
And also, the fat content in the blood, the triglycerides, begins to rise.
BMI and belly fat are the cause of cholesterol imbalance
It is not just an excessive BMI that causes this negative effect on cholesterol balance. In fact, an excessively large abdominal circumference is, if possible, even more harmful.
Abdominal fat, also called visceral fat, is actually a very active form of fat. This fat is not just a dormant layer of bacon lying passively around the body.
It is an organ in its own right that is also much more active than previously assumed.
This belly fat, for example, secretes a host of hormones that end up in the blood.
These so-called adipokines (hormonal products) cause latent, chronic inflammatory reactions.
And these, in turn, act on plaques in the blood vessel wall, which can become unstable and may rupture.
Belly fat is also directly linked to the development of high blood pressure and diabetes, among other things. Belly fat and diabetes mutually influence and interact.
Diabetes is a huge risk factor for all kinds of cardiovascular problems anyway, so it's an important factor in how to prevent cardiovascular disease
Does your weight automatically say something about your cholesterol levels?
We must move away from this clichéd thinking because it is not correct.
An obese person does not necessarily have elevated bad LDL cholesterol. And not every slim or normally built person is automatically exempt from cholesterol concerns because cholesterol truly is a silent killer.
The reality is more complex than we think.
Being heavier and being fit: One does not rule out the other
Body weight alone certainly doesn't tell you everything about your risk of cardiovascular disease.
It is essential to list the various components of obesity to correctly assess the risk:
- Does being overweight cause a disturbed metabolism?
- Are you less fit because of excess weight?
- Is the excess weight accompanied by belly fat?
- Or are the extra pounds more likely to be around the hips or legs?
In practice, obesity is too often automatically linked to a lack of physical fitness. But that's not always true.
There is such a thing as being fit, and there is such a thing as being overweight. Someone who is overweight is usually not too fit. But that is not always the case!
Even heavier people can do quite a lot of exercise and stay exceptionally fit.
And as a result, they lower their risk of cardiovascular disease despite their increased weight.
On the other hand, someone with normal or low body weight but who leads an utterly sedentary life may have very poor fitness.
The BMI values of such a person are pretty good to excellent. However, such a person still has a higher risk of cardiovascular disease.
Several scientific studies show that a person who is obese but still in good shape is at the same risk for cardiovascular disease as a slim person who does little exercise and leads a sedentary life.
Staying active and exercising a lot, even when overweight and obese, thus plays a part in how to prevent cardiovascular disease.
And being slim and fit at the same time is even better, of course.
Exercise and sports to fight cardiovascular disease
Is exercise beneficial for cholesterol levels?
Yes, exercise is good for keeping your cholesterol levels good and better, although it must be seen from a broader perspective as regards how to prevent cardiovascular disease .
The cholesterol values under the influence of extra sport or another physical activity alone will not immediately start to change spectacularly.
More exercise usually slightly lowers unfavorable LDL cholesterol.
In addition, regular workouts or sports efforts also help raise good HDL cholesterol levels.
And as this HDL cholesterol increases, triglycerides (fats) will decrease simultaneously.
But don't just look at cholesterol values.
After all, physical activity simultaneously produces many other beneficial effects on the heart and vessels, such as increased fitness, more energy, more muscle building, increased metabolism, more calorie burning, etc.
The benefits this brings to your heart and vessels are far greater than what can be read from cholesterol blood results and is essential for how to prevent cardiovascular disease
The impact of sport is often underestimated
Sport, especially in its early stages, is not always accompanied by weight loss.
And because you are going to burn body fat and build muscle simultaneously, you may even get the impression that your BMI barely drops and that your rolls of fat don't disappear at all.
In reality, the fat content in your body, and fortunately especially belly fat, often does drop thanks to regular exercise and sports.
And less (belly) fat protects you from developing diabetes and cardiovascular disease.
But unfortunately, the effects of more exercise do not always translate into a lowered BMI or lowered cholesterol levels. So the impact of sport and exercise is often underestimated.
However, the beneficial effects of exercise and sufficient physical activity go far beyond what you might expect, so in other words, sport affects more than just your cholesterol levels and blood pressure.
Sports have an anti-inflammatory effect
For example, chronic inflammation in the blood vessel wall is one of the crucial factors in developing arteriosclerosis and the risk of cardiovascular disease.
And exercise has a significant anti-inflammatory effect.
Paradoxically, you sustain minor damage and inflammation while exercising and moving.
Think micro muscle tears, limited damage to your joints, etc. This minor damage then activates your built-in healing and repair mechanisms.
So, in other words, by exercising, you are training your body and your body's healing and repair mechanisms.
And it is precisely the optimal functioning of these mechanisms that ensures that your body can fight chronic inflammatory processes!
Sport is not an isolated factor
We should certainly not look at sport and exercise as an isolated factor that helps prevent cardiovascular disease.
Those who do a lot of exercise tend to be more health-conscious as well, and at the same time, will have other beneficial habits such as:
- No smoking
- Limited alcohol consumption
- Eating less fatty snacks
- Eating lots of fruits and vegetables
- Eating less meat, etc.
In fact, all these factors should not be considered in isolation.
Sport and other lifestyle factors influence each other. They together bring about the beneficial effect of how to prevent cardiovascular disease.
Which sports and activities should be preferred?
When you build in more physical activity to reduce your risk of cardiovascular disease focus on promoting fitness.
And you don't get something like that by walking up and down the stairs for a few minutes.
It requires more sustained efforts such as 45 to 60 minutes of cycling workout, swimming, brisk walking, jogging, swimming, etc.
It doesn't have to be daily, but try to do something at least 3-4 times a week.
A good walk, for example, does wonders! And don't forget that a sedentary lifestyle is really the enemy in how to prevent cardiovascular disease.
Minor interventions to maintain combustion levels
Are your physical activities aimed at losing weight?
Then every little bit can help, such as:
- trading in the elevator for the stairs,
- eating a carrot or apple instead of a cookie,
- parking your car as far away from the supermarket entrance as possible,
- eating a seafood dish instead of greasy burgers and fries,
- handling your phone calls while walking,
- going to the store on foot instead of by car, etc.
In short, little things that are easy to build into your daily life but that won't get you instant fitness but will get you some extra calorie burn and less risk of diabetes.
On the other hand, building your fitness requires you to really start exercising. Exercise is crucial in how to prevent cardiovascular disease.
Dynamic endurance sports to really get fitter
Favor dynamic endurance sports in terms of cardiovascular disease prevention.
These are sports efforts in which you move your body smoothly, such as swimming, tennis, squash, running, cycling, dancing, etc.
These activities (such as trampoline activities) are preferred over pure strength exercises or static exercises such as weight lifting because they stimulate muscle mass but hardly improve fitness.
A good ratio is 75% endurance sports for fitness and 25% strength sports for muscle building.
Are you looking for a feasible and good guideline?
- Try to do 30 to 60 minutes of exercise 3 to 4 times a week that makes you slightly sweaty and slightly short of breath but allows you to carry on a conversation.
- This is the right frequency and level of exercise for most of us who want to exercise consciously to reduce our risk of cardiovascular disease.
That active and passive smoking harms health is no longer disputed by anyone, and not only when asking how to prevent cardiovascular disease
The laundry list of negative health effects that smoking has to its credit is gigantic and endless.
In addition to tumors and lung disease, tobacco use is equally disastrous for the cardiovascular system.
Smoking has 3 significant effects:
- Smoking is an enormously powerful stimulus that fuels all inflammatory phenomena. Those inflammatory phenomena, in turn, are responsible for the transition from a harmless plaque to a plaque whose capsule is gnawed, tears, and leads to a clot.
- Smoking directly damages the vessel wall and, unfortunately, promotes arteriosclerosis.
- Smoking also negatively affects your cholesterol levels.
Effect of smoking on cholesterol levels
Smoking lowers the good HDL cholesterol.
As a result, the balance of HDL to LDL tilts more in favor of the harmful LDL.
Smoking also gives rise to a hazardous form of cholesterol: oxidized LDL cholesterol.
Oxidized LDL cholesterol versus plain bad LDL cholesterol
That substance is much more dangerous than the regular LDL because this oxidized variant is exactly the trigger that initiates and promotes the process of arteriosclerosis.
Normal LDL cholesterol is a body's own molecule.
In places where the blood vessel wall is more stressed, this LDL cholesterol can manage to penetrate the blood vessel wall and settle into the wall itself.
But under the influence of factors such as smoking, LDL cholesterol can then begin to oxidize.
And that oxidation process causes the LDL cholesterol to change its structure. So you can compare it to metal that rusts or butter that starts to go bad.
And this oxidized LDL cholesterol, an altered molecule, is very difficult to remove from the body (a lot harder than regular LDL cholesterol).
Arterial calcification due to oxidized LDL cholesterol
Our body responds to that oxidized LDL cholesterol by sending an army of white blood cells to it.
These are the blood cells responsible for fighting inflammation and clearing away waste products.
But those white blood cells are unfortunately not equipped to break down this oxidized LDL cholesterol.
They succeed in absorbing these oxidized particles, but they cannot dispose of them efficiently from the human body and as a result, those white blood cells die after absorbing that oxidized LDL cholesterol.
And those dying white blood cells release a lot of breakdown material and inflammatory factors into the blood.
This is one of the crucial factors in the mechanism of arteriosclerosis, as those breakdown materials accumulate in the plaques, and the so-called foam cells of the plaques contain a lot of this oxidized LDL cholesterol.
This explains the role of cholesterol in how to prevent cardiovascular disease.
Effect of smoking on blood vessels
The biggest negative effect of smoking is in the processes taking place in our blood vessel walls (without us noticing).
Every time you inhale a cigarette or breathe in cigarette smoke, you introduce foreign substances into your airways and thus into your bloodstream.
This provokes a chronic inflammatory process as the body attempts to defend itself against the foreign and unhealthy junk that is being introduced.
But those inflammatory responses have an impact on the firmness of the plaques.
Those plaques become more unstable because of the inflammation. The capsule around the plaques that protects them from tearing is eaten away by these inflammatory cells and becomes thinner.
This increases the likelihood that the plaques will begin to rupture over time and can cause dangerous clot formation.
In other words, smoking is at the root of chronic inflammatory processes that our bodies simply cannot win.
Cigarette smoking creates a war of attrition that debilitates the body, similar to what goes on in allergic reactions or autoimmune disorders.
Effect of smoking on heart rate and blood pressure
Finally, smoking also increases blood pressure, heart rate, and the tendency for blood to clot.
These harmful effects of cigarette smoke are evident even after smoking a single cigarette. The effects on heart rate and blood pressure are short-lived. But the most dangerous, the increased tendency to clot, persists for several hours.
So even if you were to light up only 1 or 2 cigarettes a day, you expose yourself to an increased risk of blood clot formation for several hours on a daily basis.
Smoking, along with diabetes, is one of the most significant risk factors for developing cardiovascular disease.
Quitting smoking quickly delivers health benefits
Did you know that quitting smoking brings health benefits in the short term?
For example, within a few months, the real risk of cardiovascular problems drops.
The damage you've done before from smoking (such as calcifications) won't disappear.
But by quitting smoking, you reduce the chances of those lesions tearing and giving rise to clot formation.
And that's how to prevent cardiovascular disease by not smoking.
Not smoking reduces the inflammatory responses that cause the plaques to rupture, resulting in clot formation.
Those who stop their smoking habits already halve their risk of cardiovascular disease in the short term.
Common wood smoke also poses a threat
The nicotine harms the blood vessels, but the soot particles we effectively inhale are also very destructive.
After all, the same phenomena as with smoking also manifest themselves in non-smokers, who often spend time near an open fire.
In several African and Asian countries, for example, where in many places cooking is still done primitively on wood or dried dung, people have to deal with exactly the same body reactions.
Especially women, who often spend several hours a day next to the fire while cooking, inhale the same type of soot particles and develop chronic inflammatory reactions.
Thus, the phenomenon is not limited to cigarettes but affects everyone who inhales too much smoke or particulate matter, and therefore also applies to a lesser extent to air pollution.
The development of type 2 diabetes, which used to be called adult-onset diabetes, is closely related to a person's lifestyle.
Both obesity and a sedentary lifestyle contribute to the development of type 2 diabetes.
This form differs from the much less frequent type 1 diabetes, which is an autoimmune disorder completely unrelated to eating habits or exercise.
How do you develop type 2 diabetes?
Type 2 diabetes is essentially a body that has become insensitive to insulin. But what exactly do we mean by this insensitivity to insulin?
When we eat, all kinds of automatic processes take place in the body to absorb and digest the food.
One such response is the production of insulin by the pancreas (also known as the pancreas).
Insulin is the hormone that causes the sugar (blood glucose) that has entered our bloodstream after a meal to be absorbed by the body's cells.
This glucose is essential because it provides the body and brain with the necessary energy, among other things.
Continually saturated body cells are the cause
Unfortunately, in people who are overweight and/or have a sedentary lifestyle, that well-oiled insulin process in the body comes under severe strain.
After all, all body cells are saturated with them and already contain a gigantic load of glucose or fat due to that excess weight.
At that point, when the insulin hormone comes knocking asking for additional sugars to be taken up, the cells will simply stop responding due to that saturation.
Because of their excessive supply of sugars and/or fats, they become insensitive to the demand of the insulin hormones over time. In this case, insulin resistance occurs.
Insulin resistance: Effects
A body that has become insensitive to insulin reacts in 2 ways to this crisis situation (which, by the way, is happening silently):
Insufficient insulin production by the pancreas
The pancreas will further increase insulin production, resulting in this organ completely exhausting itself after a while. However, that high rate of insulin production cannot be sustained.
Eventually, insulin production will fail and fall back to very low levels.
The exhausted pancreas can no longer produce enough insulin, after which one has to start giving insulin (via injections).
Rising and excessively high blood sugar levels
In parallel, a second process also occurs (in addition to insufficient insulin production).
Because the cells are insensitive to insulin, the sugar in the blood cannot be absorbed by the body's cells and remains present in the bloodstream.
And this gives rise to excessive blood sugar.
Consequences of diabetes
That excess blood sugar will then precipitate in the small and large blood vessels (resulting in arteriosclerosis), and it can also affect the nerves.
Related: Read our other article for the consequences of atherosclerosis in particular: Artery Blockage Consequences and How to Prevent Atherosclerosis
This can lead to typical diabetic conditions such as kidney problems, eye abnormalities (diabetic retinopathy), and nerve abnormalities.
In themselves, these are not life-threatening conditions, but they do seriously detract from the quality of life of diabetic patients.
Diabetes is currently the leading cause of kidney failure and the need for dialysis in the Western world. These problems can culminate in:
- Numbness of some limbs
- Chronic pain complaints
- In some cases, even amputations are involved, usually resulting from a combination of blood vessel narrowing and numbness (diabetic neuropathy).
Diabetes patients are at very high risk of cardiovascular disease
Diabetes seldom comes alone because this disease almost always goes hand in hand with other risk factors such as low (good) HDL cholesterol, obesity, more inflammatory factors in the blood, disturbed metabolism, etc.
Put another way, in diabetes, the entire metabolism goes haywire.
Whether you are just above or below the limits for a diabetes diagnosis does not make that much difference to your cardiovascular risk.
After all, even if you're just below that limit, you already belong to the very high-risk group.
Most people with diabetes die from cardiovascular disease.
Having a little diabetes, as is sometimes said, does not exist. That's as absurd as being just a little pregnant.
There are, however, different degrees of development of diabetes, which mildly or severely exceed the limits for a diabetes diagnosis.
But as soon as a person rises above the threshold of diabetes values, there is an increased burden on the cardiovascular system.
Everyone with type 2 diabetes is placed in the very high-risk category to provide maximum protection for these patients against cardiovascular disease.
How can I avoid diabetes?
There is also good news! Diabetes (type 2) is not inevitable.
This chronic condition can even be reversed in the early stages through appropriate lifestyle interventions.
First, it comes down to maintaining your cells' sensitivity to insulin.
This, of course, requires a reduction in your body weight combined with the necessary physical activity.
When the body's cells are not continuously saturated, they remain able to take up blood sugar from the blood and then process it.
Regular physical activity as a basis for prevention
The fastest prevention results can be achieved by incorporating regular exercise.
Physical activity is a crucial diabetes preventive tool that is achievable for everyone and pays immediate dividends.
Try to do an activity at least daily (or at least 3 to 4 times a week) for half an hour or more, which increases your heart rate, requires you to breathe deeply, and makes you slightly clammy or sweaty.
Are you a beginner without much fitness? Then start slowly, for example, with 10 or 15 minutes, and over time build up to 30, 40, 50, and 60 minutes per session.
At that point, your body consumes exactly the sugar that is present in the body's cells (mainly in the muscle and liver cells).
Sport releases capacity in the body's cells
Those cells quickly regain their sensitivity to insulin as a result.
Thus, exercise and sports release the capacity to remove sugar from the bloodstream and thus allow the body's cells to respond sensitively to insulin again.
Thus, especially in the early stages, when the pancreas is not yet too affected, diabetes is still very reversible.
This has also been demonstrated in patients who have undergone specific obesity procedures.
Because of their usually spectacular weight loss and lifestyle changes, most people with diabetes managed to get rid of their chronic disease after the procedure.
Even temporary adjustments help prevent diabetes
Two massive population studies (the Diabetes Prevention Study and the Diabetes Prevention Project) have comprehensively demonstrated that lifestyle modifications can halt the development of diabetes.
Those studies took place in people who were just short of the stage of diabetes, known as pre-diabetics.
In those studies, some of the participants underwent significant lifestyle changes.
They followed a healthier diet and jacked up their physical activities.
The goals included a 7 percent weight loss, limiting fat intake, increasing fiber intake, and incorporating daily physical activity of at least 30 minutes per day.
Ultimately, it was found that their chances of developing diabetes dropped by a whopping 58 percent as a result.
The effect of the modified lifestyle on blood sugar levels was found to be twice as effective as administering medication, which was also tested in those studies.
Reality check: 7% weight loss is not impossible, even for someone who is overweight or obese.
If you spread that out over one year, it equates to slimming a few pounds per month (depending on your starting weight).
This is perfectly achievable through small but sustained lifestyle changes.
Another important finding from these studies was that even temporary lifestyle modifications are beneficial.
For example, people who manage to control their metabolism through a lifestyle for a while, but for one reason or another don't stick with it, will get results from that as well.
Because of our so-called metabolic memory, this effect lasts longer.
Indeed, these studies showed that even those who could not permanently maintain their healthy lifestyle were still better protected than those who had never revised their habits.
Moral of the story: Even if you only manage to turn your lifestyle around for a limited time, these efforts are still worthwhile to reduce your risks.
The message here is (even if you have a brief relapse) that you should try to get back on track as soon as possible!
Tip: Have a read through our other post and learn how to make these heart-friendly lifestyle changes last: How to Stick to a Lasting Healthy-Heart Diet? Tips to Make Lifestyle Changes That Last
Does alcohol protect the heart and blood vessels?
Most scientists and doctors currently accept the consensus that 1 to 2 glasses a day for women and 2 to 3 glasses of alcohol for men would have a neutral to a slightly protective effect in terms of cardiovascular disease.
That slight protective effect applies only to those not in the high-risk groups (no diabetes, no tendency to obesity, and no cardiovascular disease).
Those who do belong to those high-risk groups will slightly increase rather than decrease their risk through the consumption of alcohol.
Alcohol and cardiovascular disease: Eternal source of discussion
Alcohol creates enormous controversy in the scientific community.
The link between alcohol and cardiovascular disease has been the subject of fierce debate among scientists for years.
The biggest cause of this ongoing controversy is that it is complicated to scientifically solidify the exact effect of alcohol.
Alcohol, for example, is very difficult to fit into randomized, double-blind studies, like studies on medication. Double-blind means that neither the participants nor the researchers know which group is the target group (consuming the alcohol) and which is the control group (consuming a placebo.)
Several scientific studies state that drinking 1-2 glasses of red wine a day has a preventive effect on the development of cardiovascular disease.
In France, for example, according to some studies, this appears to be the case. Such a finding naturally raises questions...
Is that a positive effect on health due only to the red wine itself?
Or is it due to the combination with a healthy Mediterranean lifestyle where more fish, vegetables, fruits, and healthy fats are on the menu?
Especially in the south, this also means more outdoor physical activity, more sunshine, more vitamin D, etc.
In other words, it is impossible to scientifically disconnect all these other healthy factors in a double-blind population study with a focus on the effects of alcohol.
Try having a group test alcohol without allowing the participants to know whether they are drinking actual alcohol or a placebo.
Such an objective examination is not feasible in practice. Perhaps red wine is part of a complete package of lifestyle factors, but red wine by itself is not the main ingredient.
It is essential to see this issue in context. For example, it is a fact that most people just drink a glass of red wine with their meal.
But, of course, this is not comparable to consuming alcohol in larger quantities (as some young people do while going out).
Can I drink limited alcohol with elevated cholesterol?
You can still drink alcohol with elevated cholesterol, but in limited amounts and with moderation.
Those belonging to a high-risk group, such as people with obesity, diabetes, or cardiovascular disease, should really stick to the limit of 2 glasses a day (upper limit for men) and 1 glass for women.
Because from the moment you go above, you are more likely to see negative effects of alcohol on your health.
Alcoholic drinks contain empty calories because alcohol is a form of sugar. Alcohol, therefore, also affects blood sugar levels, so especially in diabetics or pre-diabetics, regular consumption of alcohol is not recommended.
For those battling the scale and excess pounds, alcohol guarantees the supply of extra, empty calories.
We speak of empty calories because alcoholic beverages do not supply additional energy or useful nutrients such as vitamins.
Too much alcohol, more than 2 to 3 glasses a day, also stimulates blood triglyceride levels. And this has an unfavorable effect on cholesterol metabolism.
To give you an idea of the number of calories you take in with alcohol, take the example of a glass of wine. An average glass of wine is equivalent to about 0.88 ounces of sugar (equal to 4 large or 6 small sugar cubes) or 100 kilocalories.
Excessive drinking also increases the risks of cardiovascular problems and diabetes. Heavy drinkers whose liver is affected may, for example, have to deal with extremely high cholesterol levels (known as alcoholic liver steatosis).
After all, alcohol addicts' battered livers can no longer maintain cholesterol production at normal levels.
What alcoholic beverages?
Does the slightly protective effect of consuming alcohol play out in certain groups only with 1 or 2 glasses of red wine?
No, the type of alcohol you drink probably doesn't matter much.
This slightly protective effect of alcohol is related to a complete lifestyle of which alcohol is only a tiny part.
Put another way, drinking alcohol in moderation is allowed, but it is definitely not necessary to fight against cardiovascular disease.
Adjusting your lifestyle: Is that even useful?
In reality, this seemingly straightforward question is a tough one to answer.
Double-blind clinical trials are not applicable for lifestyle modifications
For example, suppose one wants to assess the effect of an intervention (a drug or a surgical procedure). In that case, we do so using a randomized, double-blind clinical trial.
Randomized means giving haphazardly (nowadays usually chosen by a computer) half of the volunteers the active ingredient and the other half of the volunteers a fake pill or placebo that looks identical.
Double-blind refers to the fact that neither the volunteers nor the physician assessing the effect during the study is aware of who is receiving the active ingredient and who is receiving a placebo.
Only at the end of the study, after all side effects and workings have been identified, is revealed who received the active treatment and who received the placebo treatment.
With these kinds of studies, almost every drug has had to prove its efficacy.
Of course, with lifestyle modifications, this is almost impossible to do.
Not only do volunteers know whether they are effectively eating healthier, exercising more and participating in sports, drinking less alcohol, etc.
But equally important is the fact that such studies seek to study mostly minor effects.
To study the effect of these minor effects on, for example, the development of cardiovascular disease, you would have to maintain these lifestyle modifications for decades.
We must also consider that for this type of lifestyle modification in studies, usually only 50% to 33% of people effectively manage to maintain it for several years.
Thus, in the course of such studies, there is always a significant dropout of participants.
In other words, one would have to set up studies with several tens of thousands of volunteers who would have to be followed up for more than a decade.
Only then would one have indisputable scientific evidence that one would also effectively have less risk of cardiovascular disease with these lifestyle modifications.
But in reality, this is unaffordable and unfeasible.
Observational studies as an alternative
Science does have data from multiple observational studies. These are large-scale studies where people's lifestyle habits have been surveyed and followed.
The significant difference with the intervention studies described above is that they are about people who are already living a healthy lifestyle by themselves.
So, they are not about people in whom lifestyle changes are being attempted.
Importantly, we are talking about a group of people who have probably already lived a relatively healthy lifestyle for a lifetime.
These studies find that people who report having a healthy lifestyle have up to 80 percent less cardiovascular disease!
Thus, the potential positive effects of a healthy lifestyle are definitely not to be underestimated!
So there is currently a gap of knowledge between what is seen in these observational studies (up to 80 percent reduction in the risk of cardiovascular disease) and the effects that can be seen in the short term with a healthy lifestyle.
A healthy lifestyle is associated with a moderate decrease in cholesterol levels, blood pressure, and body weight.
But there are no studies yet that study these moderate effects over, say, 25 years and show that there is less cardiovascular disease as a result.
Study of human heredity as a solution
This gap of knowledge, meanwhile, is being closed from an unexpected angle with the help of genetics (also known as the study of human heredity).
There is a random distribution of our hereditary material or genes in our population.
In other words, nature has given us a specific genetic profile that is largely determined by chance (because, of course, you don't choose your parents yourself).
So in that way, we also got our genes randomized, giving us a slightly higher or slightly lower cholesterol level or blood pressure.
Interestingly, the orders of magnitude of heritable differences in cholesterol, blood pressure, or weight are pretty small, about the same order of magnitude as those for lifestyle modifications.
Nature as a guide to experimentation
By looking at genetic material in this way in studies, it was possible to see that people who had somewhat lower cholesterol levels due to the random composition of a genetic profile also effectively had less cardiovascular disease as a result.
And the same goes for lower blood pressure and less obesity, by the way.
These decreases in risk were much greater than expected and seem to confirm those data from observational studies (up to 80 percent fewer cardiovascular events).
And these genetic effects are, of course, lifelong.
In other words, nature has actually already performed large-scale experiments.
Through this heredity study, one can see how small decreases in blood pressure, weight, or cholesterol over a lifetime translate into markedly less cardiovascular disease.
How to prevent cardiovascular disease: Conclusion
We can prevent cardiovascular disease by eating heart-healthy foods and by lowering cholesterol levels and weight, increasing physical exercise, not smoking, preventing diabetes, and consuming only a limited amount of alcohol.
Lifestyle modifications are associated with improved well-being and moderate improvements in your risk profile.
Even though these improvements may seem limited, if you can keep this up for quite some time, the accumulation of these little benefits over the years makes it particularly likely that your risk of cardiovascular disease will drop dramatically.