Millennials, Nutrition and Heart Disease with Michelle Routhenstein, MS, RD
Written by Melissa Schenkman, MPH, MSJ
How Nutrition Plays a Role in Preventing Cardiovascular Disease
What are the ingredients for success when it comes to your heart health?
The two you most commonly hear about are diet and exercise. But when it comes to finding your path to success—getting the right nutrition, knowing which foods can make a difference, how much of them to eat, and how to make realistic change— it can be a real challenge, especially when you are a millennial. Given our limited time every day, without having a plan and easy access to the right foods, it’s hard to make it happen.
That’s where Michelle Routhenstein, MS, RD, comes in. She is the Owner and President of Entirely Nourished, a virtual nutrition counseling and consulting private practice.
As a fellow millennial and preventive cardiology nutritionist, she helps individuals take a proactive role in their heart health by implementing a truly heart-healthy diet that optimizes heart disease risk factors, improves blood flow and blood vessel health and reduces any strain on the heart so it can do its job more effectively.
Her work is focused on reducing your risk of heart attacks and strokes, and increasing your quality of life through science-based nutrition and lifestyle management. In doing so, she approaches clients by looking at the whole person, which includes their lifestyle—a major factor in why many of us struggle with being proactive about our heart health. In taking this personalized approach, she merges the science with her client’s lifestyle, customizing a plan for long-term nutrition and lifestyle change that can work for them.
I talked with Routhenstein about how we, as busy on-the-go millennials, should frame our thinking about nutrition in relation to our heart health, which foods and nutrients should be at the top of our list, realistic ways to incorporate making these choices into our jam-packed days and much more.
YMyHealth: How do you think millennials should think about diet and nutrition overall in relation to their heart?
Michelle Routhenstein: Early intervention is key! Heart disease is the number 1 killer globally yet research shows that 80% of it can be prevented through science-based nutrition and lifestyle medicine. If we take an earlier proactive approach we can reduce this devastating statistic and age more peacefully and gracefully.
Heart disease is a silent disease, and it takes years and decades to present. It can happen to anybody and we are seeing more people having heart attacks and cardiovascular complications earlier in life.
It is important that you understand your risk, and you take a proactive approach now to reduce your risk of heart disease and its complications later.
In our 20s, 30s and early 40s, sometimes it can be hard to imagine how what we eat today can impact our heart health years down the road. Why does what we eat today make a difference long term?
Michelle Routhenstein: Heart disease is a progressive disease, meaning it takes years and decades for it to present as clogged arteries or progress to heart failure. We need to protect our hearts and understand what that means early to prevent the #1 cause of death.
Heart disease does not discriminate based on body size, age, gender, family history, etc. It can affect each and every one of us and unless we take a proactive approach by optimizing our nutrition, lifestyle and laboratory values, we are all at risk.
When you avoid paying attention to your heart health and optimizing your risk profile (looking at blood pressure, cholesterol, blood sugar levels, waist circumference, etc), you put yourself at risk for a cardiovascular event. Unmanaged high blood pressure for instance can silently lead to heart failure, stroke, aortic aneurysm, vascular dementia, kidney failure, and sexual dysfunction. It can also lead to forming plaque in the arteries, which can cause a heart attack.
The good news is that we can control these values and therefore reduce the risk for these cardiovascular complications through science-based nutrition, but we need to take an early proactive approach and implement daily actionable steps to achieve them.
Michelle Routhenstein, MS, RD, is a preventive cardiology nutritionist, registered dietitian nutritionist, certified diabetes educator and cardiology dietitian.
She has more than a decade of experience successfully improving her client's laboratory parameters, mitigating risk factors and maximizing heart function to avoid and treat heart disease and its related chronic illnesses.
As we make food choices each day, which foods are at the top of your list (that we should also have on our radar) for positively impacting our heart health/cardiac function?
Michelle Routhenstein: We often focus on what we shouldn't be eating for optimal health, but what we actually eat helps to achieve optimal heart health values and keeps the arteries healthy. A nutrient-sufficient heart-healthy diet can help reduce the workload of the heart, help to vasodilate the arteries (widening them) to allow for better blood flow, and it protects the arterial lining to avoid plaque formation in the arteries.
Some nutrients to pay attention to include:
Calcium
Necessary for the proper electrical activity of the heart, muscle contraction and pumping function of the heart, along with blood pressure regulation. Low dietary calcium has been associated with higher systolic blood pressure, which is a risk factor for stiffness in the arteries, heart failure, and stroke.
Foods rich in calcium include yogurt, kefir and collard greens.
Potassium
An important mineral for optimal blood vessel health. Potassium reduces tension in the arteries and maintains heartbeat regularity.
Foods rich in Potassium include beets, Swiss chard, and avocado.
Magnesium
Magnesium is involved in over 300 enzymatic reactions (chemical reactions in the body aided and regulated by substances called enzymes), such as those responsible for regulating blood pressure, glycemic control and lipid peroxidation (the gradual breakdown of lipids by free radicals).
Foods rich in magnesium include cashews, almonds and black beans.
It is important to note that the dietary intake of these foods is safer than their supplemental forms, especially with potassium and calcium. You should be cautious about taking potassium and calcium supplements when it comes to your heart health.
For your fellow millennials who have very busy schedules (myself included), what are three ways that you would recommend we go about incorporating a heart-healthy diet into our lives?
Michelle Routhenstein: Take a step back and see which lifestyle category you can improve on. Then take action by selecting one or two small things you will prioritize for the upcoming 1-2 weeks.
For instance, if you choose to focus on nutrition, you may then need to focus on a specific meal at first like breakfast - is it well balanced with complex carbohydrates, lean protein and heart-healthy fat, does it have enough potassium, does it have enough magnesium or calcium, etc? Once it is honed into and worked on where it is now an established habit, then you can add 1-2 more small actionable steps to reach your goals.
This small-step approach allows you to see good progress with your heart health goals and leads to establishing habits long term. If you are struggling with achieving optimal values on your own, consult with a Registered Dietitian who specializes in heart disease management and prevention to help support and guide you.
Routhenstein at work counseling one of her clients. She believes in the importance of explaining the science behind all her recommendations, in order for her clients to be active participants in their care. It is this approach, she says, that will truly optimize each person's heart health and increase their longevity. Learn more about Routhenstein and her services at www.entirelynourished.com
For millennials living with gastrointestinal problems, for whom eating lots of vegetables and fruits can be difficult, how would you recommend we strike a balance between eating heart-healthy while not aggravating the gastrointestinal system?
Michelle Routhenstein: Gut health and heart health are very connected.
In order to optimize heart health, we need to ensure we are optimizing gut health as well. In order to ensure this, I would look to heal the gut and address the root cause. Avoiding all fibrous foods, or not achieving the adequate quantity can impede optimal motility which is essential for keeping your arteries clean.
If you were told to go on an elimination diet such as the FODMAP diet, that is a temporary diet, and you need to work on reintroducing foods with a specialist. There may be certain fibrous foods that you tolerate well and others that you don't. It may be a quantity you tolerate that can be slowly incorporated into your diet.
Working with a specialized Registered Dietitian can help guide you on this path to heal your gut, avoid gastrointestinal (GI) distress and ensure you are achieving the therapeutic cardiovascular nutrients you need for optimal heart health and gut health.
What are your three key takeaway messages for millennials when it comes to diet and heart health?
#1 Do not wait until an event happens for you to take action on implementing a heart-healthy diet.
Michelle Routhenstein: I often see so many clients after they had a heart attack and they had no idea they were at risk. Had they been more proactive in their health: monitored their laboratory reports, gone for a thorough risk assessment, and implemented a truly heart-healthy diet and lifestyle, they may have prevented their heart attack from occurring.
I have also seen many individuals who are on a statin who think they are immune to a heart attack - they never paid attention to their diet because they thought they didn't need to. Make sure if you are taking heart disease medications, that you are also paying attention to your diet because if you don't, your arteries can still become clogged and it can cause a cardiovascular event.
#2 Be proactive.
Michelle Routhenstein: When we talk about a proactive approach, I am referring to knowing your numbers, assessing trends, and ensuring we are optimizing them through science-based nutrition and lifestyle medicine in order to avoid high cholesterol or high blood pressure causing silent damage and cardiovascular complications.
#3 Focus on what you are adding to your diet versus only what you are avoiding.
Michelle Routhenstein: Both matter but many tend to hyper focus on certain things like calories, it can lead to nutrient deficiencies. A heart healthy diet is a diet that is nutrient sufficient and well balanced in macro and micronutrients for the individual to thrive and for their heart and body to work optimally.
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