Introduction
In the quest to combat serious chronic diseases, such as heart disease and type 2 diabetes, maintaining excellent cardiometabolic health is of utmost importance. Shockingly, studies have shown that less than 7% of American adults have optimal levels of key determinants of cardiometabolic health. Although this may seem disheartening, there is still hope. By addressing the underlying causes, restoring and maintaining excellent cardiometabolic health is within reach. And what better way to start than with our diet? In this article, we will explore the principles, benefits, and how the Cardiometabolic Food Plan developed by the Institute for Functional Medicine (IFM) can help reverse risk factors for chronic diseases.
What is Cardiometabolic Health?
Cardiometabolic health encompasses the overall fitness of the cardiovascular system and the body’s metabolic functions. Waist circumference, blood pressure, and levels of cholesterol, triglycerides, and glucose are factors that determine an individual’s cardiometabolic health. It’s important to note that having two or more risk factors significantly increases the likelihood of heart attacks, strokes, and type 2 diabetes. On the other hand, maintaining optimal levels of these factors plays a protective role against such chronic diseases.
Risk Factors And Prevalence Of Cardiometabolic Conditions
Cardiometabolic diseases share common characteristics, including inflammation, insulin resistance, and obesity. While factors like age and genetics are beyond our control, many risk factors for cardiometabolic diseases are related to diet and lifestyle. Consuming an inflammatory diet, having limited physical activity, inadequate sleep, unmanaged stress, and engaging in alcohol consumption or smoking are all factors that we can control. Unfortunately, despite numerous public health initiatives, the cardiometabolic health of Americans remains poor, with cardiovascular disease claiming the most lives. Statistics indicate that around one-third of American adults have metabolic syndrome, while millions are affected by diabetes or prediabetes. These diseases not only impact individuals on a personal level but also burden the already overwhelmed healthcare system.
Impact Of Diet On Cardiometabolic Health
Over the past few decades, traditional diets rich in whole foods have been replaced by convenient meal options. This shift has resulted in the standard American diet, which is characterized by processed foods containing significant amounts of sugar, salt, and inflammatory fats. Not surprisingly, this type of eating pattern is a major contributor to the rise of chronic diseases such as obesity, diabetes, cardiovascular disease, and cancer. Excess calorie and fat intake leads to poor mitochondrial function and increased fat storage. As fat accumulates in organs such as the liver, muscle, pancreas, and heart, it impairs insulin secretion and contributes to insulin resistance, significantly raising the risk of cardiometabolic dysfunction, type 2 diabetes, and cardiovascular disease.
On the other hand, consuming nourishing foods can have the opposite effect. Plant-centric diets that include whole grains, fruits, vegetables, nuts, beans, and seeds are associated with lower rates of cardiovascular disease and type 2 diabetes. The beneficial impact of these dietary choices can be attributed to bioactive compounds called phytonutrients, which positively influence metabolic pathways and modulate inflammation. Additionally, high-quality animal foods, including lean red meat, fish, and poultry, provide nutrients like omega-3 fatty acids that help protect against cardiometabolic diseases.
The Cardiometabolic Food Plan: Who Is It For?
The Cardiometabolic Food Plan is a well-rounded approach to eating that promotes excellent cardiometabolic health for individuals of all ages. However, the IFM developed this plan specifically as a therapeutic option for those seeking to reverse cardiometabolic dysfunction. Therefore, it is suitable for individuals who:
- Have been diagnosed with or display risk factors for cardiovascular disease, such as high blood pressure, high cholesterol, and obesity.
- Have been diagnosed with type 2 diabetes mellitus, metabolic syndrome, or exhibit risk factors like high blood sugar and increased abdominal fat.
Principles of the Cardiometabolic Food Plan
The Cardiometabolic Food Plan centers around consuming whole, unprocessed foods to target the root causes of cardiometabolic diseases, such as inflammation, insulin resistance, and obesity. Based on a modified Mediterranean diet, the plan emphasizes specific therapeutic foods. Let’s take a closer look at its core principles:
Modified Mediterranean
The Mediterranean diet, known for its abundance of plant-based foods, fish, and healthy fats, has been extensively studied and found to significantly reduce the risk of cardiometabolic diseases. By improving insulin, glucose, cholesterol, and triglyceride levels, as well as reducing waist circumference, this meal plan offers immense benefits.
Low Glycemic, Low Simple Sugar, High Fiber
A primary goal of the Cardiometabolic Food Plan is to maintain stable blood sugar and insulin levels throughout the day. This not only decreases the risk of cardiometabolic dysfunction but also helps control hunger and mood. By focusing on low to medium glycemic foods, restricting simple sugars, and prioritizing fiber, the plan prevents major fluctuations in blood sugar and insulin levels, enhances gut health, and promotes balanced cholesterol levels.
Targeted Calories and Routine Meal Times
While personalizing calorie recommendations may not always be necessary, the Cardiometabolic Food Plan offers practitioners the option to provide patients with specific serving recommendations in each food category. This approach can aid weight loss, ensure nutrient balance, and establish a meal plan structure. Incorporating routine meal times helps establish healthy eating habits, ensures adequate nutrient intake for energy, and supports blood sugar management and satiety.
Condition-Specific Phytonutrients
Certain phytonutrients found in various plant compounds play a vital role in promoting cardiometabolic health. These compounds regulate blood sugar, improve cholesterol balance, and normalize blood pressure. For example, phytonutrients like cinnamaldehyde in cinnamon, soybean isoflavones, and beta-glucan from oats and barley aid in blood sugar regulation. Tomatoes, green tea, dark chocolate, onions, garlic, and pomegranate, with their respective polyphenols and compounds, contribute to lower blood pressure. The Cardiometabolic Food Plan emphasizes the incorporation of these phytonutrients and provides specific recommendations to harness their benefits.
Balanced Quality Fats
Individuals with cardiometabolic dysfunction often believe that all dietary fats should be avoided. However, high-quality, healthy fats like unsaturated fats (mono- and polyunsaturated) have been proven to improve lipid levels, lower blood pressure, support brain function, and reduce inflammation.
Components of the Cardiometabolic Food Plan
The Cardiometabolic Food Plan encourages a wide variety of whole, unprocessed foods while highlighting specific therapeutic foods and phytonutrients that enhance cardiometabolic function. Here are the recommended food categories and their benefits:
Healthy Carbohydrates: Fruits and Vegetables
Vegetables can be classified as starchy or non-starchy. The Cardiometabolic Food Plan encourages generous consumption of non-starchy vegetables, as they offer protection against cardiometabolic diseases. Aim for 8-12 servings daily, selecting a diverse range of colors. Therapeutic options include leafy greens like kale and spinach, rich in nitrates that help control blood pressure; onions, which may reduce blood clotting and contain the antioxidant quercetin; and tomatoes, which contain heart-protective carotenoids. Starchy vegetables should be limited to one serving per day, with beets being the recommended therapeutic option due to their heart-healthy compounds.
Fruits also contribute to blood pressure and blood glucose regulation. However, their natural sugars can impact blood sugar levels. To minimize this effect, consume fruit with a meal, limit intake to two servings per day, and avoid dried fruit and fruit juices (except for pomegranate juice). Blueberries, renowned for their antioxidant properties and ability to lower blood pressure, and pomegranate juice, which reduces blood lipids, blood pressure, and arterial plaque, are particularly therapeutic options.
Lean Proteins
The Cardiometabolic Food Plan suggests including a mix of plant and animal proteins in every meal to regulate blood sugar and hunger levels. Protein, an essential macronutrient, consists of various amino acids that support numerous bodily functions. IFM recommends protein comprising approximately one-third of daily calories for most individuals unless otherwise contraindicated. Opt for lean, free-range, grass-fed, organic animal proteins, as well as non-GMO, organic plant proteins, and low-mercury, wild-caught fish. Soy-containing proteins like miso, tofu, tempeh, and soy protein offer additional benefits, such as lower blood pressure and improved cardiovascular health. Fatty fish rich in omega-3 fatty acids, such as salmon and trout, can lower blood pressure and reduce the risk of cardiovascular-related deaths.
Heart-Healthy Fats
Fats not only provide energy but are also vital for cell structure, brain function, and the absorption of fat-soluble vitamins. Unsaturated fats (mono- and polyunsaturated) have been proven to improve lipid levels, lower blood pressure, and reduce inflammation. The Cardiometabolic Food Plan recommends fats and oils making up about one-third of daily calorie intake, while minimizing saturated fats and avoiding trans fats. Opt for minimally processed, cold-pressed, organic, non-GMO options such as avocado, butter, coconut milk, ghee, and cooking oils like coconut, grapeseed, extra virgin olive oil, rice bran, and sesame. Additional therapeutic options include avocado, rich in heart-healthy fiber, monounsaturated fats, and potassium; olives and extra-virgin olive oil, which lower blood pressure and prevent LDL cholesterol oxidation; and dark chocolate, containing favorable effects on blood pressure and protection against free radicals.
Nuts and seeds are excellent sources of healthy fats and protein, as well as micronutrients like magnesium, which helps with blood sugar and insulin control. On the Cardiometabolic Food Plan, include 1-2 servings daily of unsweetened, unsalted, and organic varieties, such as almonds, Brazil nuts, chia seeds, flaxseeds, hazelnuts, hemp seeds, macadamia nuts, peanuts, pecans, pine nuts, pistachios, pumpkin seeds, sesame seeds, soy nuts, sunflower seeds, and walnuts, or their respective butters. Mixed nuts and soy nuts, containing plant sterols, healthy fats, polyphenols, and fiber, help reduce inflammation and cardiovascular disease risk. Flaxseeds, with their healthy fats and phytonutrients, are known to decrease the risk of cardiovascular disease and metabolic syndrome.
Fiber-Rich Foods: Legumes and Whole Grains
Legumes provide not only protein but also complex carbohydrates that contribute to gut health and lower inflammation levels. Additionally, they offer essential micronutrients like B vitamins, potassium, and magnesium, which are often lacking in the typical American diet. The Cardiometabolic Food Plan recommends one serving per day of legumes, including organic and non-GMO beans, soybeans, lentils, and green peas. Therapeutic options include black soybeans and edamame, which contain phytoestrogens that reduce blood pressure and cardiovascular disease risk.
Whole grains are also rich in micronutrients, fiber, and phytonutrients that assist in balancing cholesterol and blood sugar levels. The Cardiometabolic Food Plan suggests limiting whole grain intake to two servings per day, with serving sizes varying based on the type of grain. Gluten-free options like amaranth, buckwheat, millet, oats, quinoa, rice, sorghum, and teff are suitable for individuals with celiac disease or gluten sensitivity. Oats and barley, both therapeutic options, contain beta-glucans, a type of fiber that aids in managing cholesterol and blood sugar levels.
Therapeutic Foods on the Cardiometabolic Food Plan
The therapeutic foods mentioned above contain specific phytonutrients that help reduce risk factors for cardiometabolic diseases, such as high blood pressure, LDL cholesterol oxidation, and blood sugar imbalances. The Cardiometabolic Food Plan provides tailored recommendations for individuals with existing cardiometabolic risk factors.
Specialized Lab Tests for Personalized Food Planning
Functional medicine labs can provide valuable insights into the underlying causes of cardiometabolic dysfunction, such as inflammation and insulin resistance. Here are a few lab options to consider:
Food Sensitivity Testing
Food sensitivity testing measures the body’s immune response to different foods, helping identify potential drivers of inflammation. The Array-10 Multiple Food Immune Reactivity Screen by Cyrex Laboratories analyzes blood samples for specific antibodies. This information allows practitioners to personalize the Cardiometabolic Food Plan based on an individual’s food sensitivities.
Celiac Disease and Gluten Sensitivity
For individuals with celiac disease or gluten sensitivity, the Celiac & Gluten Sensitivity Panel from Vibrant America measures antibodies and genetic markers to aid in diagnosis. Consuming gluten can increase inflammation in these individuals, and tailoring the Cardiometabolic Food Plan to exclude gluten may be necessary.
Diabetes Panel
Hyperglycemia is a root cause of inflammation, making assessing metabolic dysfunction and insulin resistance crucial. The Diabetes Panel from Vibrant America measures biomarkers such as fasting insulin, fasting glucose, and hemoglobin A1c to determine early signs of metabolic dysfunction. Such markers help practitioners customize the carbohydrate content of the Cardiometabolic Food Plan.
Comprehensive Cardiac Risk Assessment
BostonHeart Diagnostics offers various labs, including a basic lipid panel, high-sensitivity CRP, and specialized tests like the HDL Map Test and the Cholesterol Balance Test. These tests provide a comprehensive analysis of cardiac risk, cholesterol synthesis, and HDL particle size. By understanding their patients’ cardiovascular risk, practitioners can tailor the Cardiometabolic Food Plan accordingly.
Omega-3 Index
A balanced ratio of omega-6 to omega-3 fatty acids indicates lower inflammation and a reduced risk of heart disease. The Omega-3 Index Complete from Ayumetrix measures the percentage of EPA and DHA in the blood, offering insights into an individual’s omega-3 profile. If the omega-3 index is suboptimal, practitioners can personalize the healthy fat recommendations in the Cardiometabolic Food Plan to improve it.
Micronutrient Testing
The SpectraCell Micronutrient Test analyzes 31 vitamins, minerals, and other nutrients, highlighting both nutritional deficiencies and functional micronutrient deficiencies. Poor nutrient status increases the risk of high blood pressure, obesity, high blood sugar, inflammation, and insulin resistance. By identifying specific deficiencies, practitioners can emphasize the necessary nutrients in a patient’s meal plan.
Summary
Cardiometabolic dysfunction lies at the core of the most prevalent chronic diseases in the United States today. By addressing poor nutrition, significant strides can be made towards restoring optimal cardiometabolic health. The Cardiometabolic Food Plan, developed by the Institute for Functional Medicine, targets the root causes of cardiometabolic diseases, including inflammation, insulin resistance, and obesity. Rooted in a modified Mediterranean approach, this plan is low in simple sugars, rich in fiber and phytonutrients, and emphasizes a balanced intake of healthy fats. Furthermore, the Cardiometabolic Food Plan offers tailored therapeutic modifiers for individuals with cardiometabolic disorders like high blood pressure, metabolic syndrome, and dyslipidemia.
