What is Vitamin L and why is it important to heart health?
You say in The Whole Heart Solution that more than 75% of heart disease diagnoses could be prevented. That’s an outstanding figure. How do we know this is true?
JK: Predominantly from studies that were designed this way: Let’s take 20,000 people that on entry have no detectable heart disease—no chest pain, no bypass, no stents, etc. Then let’s take detailed histories of their lifestyle—do they smoke, what do they eat, do they sleep well, etc. Let’s follow them for 15−20 years, and at the end of that time period, reassess: Who’s had a stroke, a heart attack, a bypass, a stent. And let’s look at the lifestyle that predicts freedom from having a heart event.
Many of these studies have been done and reported on in the last 10 years. They’re from all over the world: from England, Sweden, the U.S. They encompass well over 100,000 people, and they all have remarkably similar findings, which are: With a simple pattern of habits that are not expensive and not exotic, you can achieve more than 75%, an even up to 85% heart-attack free, stroke-free life.
The results are pretty conclusive, and personally I think we’re likely to get even better results, higher than 85%, if we add in medical evaluations, which these studies didn’t require.
I’m very excited that lifestyle, or what I like to call Vitamin L, is the key factor in heart disease prevention.
What’s the protocol for "Vitamin L"— the healthy lifestyle habits that give up to 85% heart disease protection?
JK: Five essential lifestyle habits consistently appeared across all the studies:
Don’t smoke. We don’t know and still debate what about smoking is so dangerous, but all the studies reinforce the now 40-year-old notion that smoking is an extremely bad habit.
Be active. We’re talking moderately active. These studies didn’t ask how many pounds you can clean jerk or how many spinning classes you took last week. They asked, "Do you walk 30−40 minutes a day on average?"
Control weight. The weight parameters aren’t extreme either. The general guideline is to maintain a relatively healthy weight. The most consistent finding is a prediction of freedom from heart attack for men who keep their waists under 40 inches and women who keep theirs under 35. These also predict freedom from diabetes, and, to a lesser extent, freedom from stroke and cancer.
Consume alcohol in moderation. This finding is very controversial, but the data is the data: Almost every study showed that some consistent use of alcohol was favorable in predicting up to 85% freedom from heart attack. And it’s interesting, because different countries have different alcohol cultures, but the results indicate that one ounce of hard liquor, five ounces of wine, and eight ounces of beer are relatively equivalent in protection. Some studies showed positive results with a few drinks a month; others supported as much as daily ingestion of one drink.
Seven hours of sleep on average. This relatively novel finding, assessed in just a few of the studies, is that if you average fewer than seven hours of sleep a night, you’re at significant increased risk of heart attack. The Morgen Study of 1,000 people, for example, found that the people who did all the lifestyle habits we’re talking about but typically slept under seven hours had about a 65% chance of being heart attack-free, compared to up to 85% for those who got seven hours. Good sleep offers a substantial amount of heart attack freedom.
Five or more servings of vegetables and fruits a day. I saved this habit for last because it’s the one people hit the least--only 1−3% of Americans do it—but it’s the most important. Every single one of these studies said that five plus servings of vegetables and fruits a day is that "special sauce" in achieving the up to 85% number. And there’s no reason we can’t do it. It’s simple and very doable. It’s not expensive, no one specified you have to eat organic produce, although we could talk about whether or when going organic might be helpful in some instances.
That’s the program. And we should be teaching it as the "holy grail" of heart disease prevention in this country, where heart disease is the #1 killer of both men and women over 30.