Don’t Go Breaking My Heart: The Importance of Lifestyle Interventions in Preventing Cardiovascular Disease

Celebrating Heart Month and World Heart Day in South Africa

The heart may be a mysterious organ, but not when it comes to keeping it in fine fiddle. ProVeg and PAN South Africa explore the importance of dietary changes in maintaining good cardiovascular health.  

Heart Awareness Month is earmarked for September in South Africa, culminating in World Heart Day on the 29th. This period is dedicated to raising awareness about heart disease and its risk factors among our population and the importance of living a healthy lifestyle to prevent the onset of disease. In this month, the importance of prevention and treatment for those who have cardiac-related medical conditions is also highlighted. 

According to the Heart and Stroke Foundation South Africa, Cardiovascular disease [CVD] is the leading cause of disabilities and death worldwide, accounting for 17 million deaths a year at a rate of 31% of total global deaths. Cardiovascular disease is the leading cause of death nationally after HIV/AIDS. In fact, more South Africans die of cardiovascular disease than of all cancers combined. Premature deaths caused by cardiovascular disease in people of working age are expected to increase by 41% around 2030, and up to 80% of these premature deaths in young people are preventable through a healthy lifestyle. 

From 2024-2026 the campaign will operate under the theme of ‘Use Heart for Action’ – supporting individuals to care for their heart and empowering them to urge leaders in government to take cardiovascular health seriously in their policies and social programmes by providing a broad platform for action. 

One South African study concluded that although the estimated CVD risk was highest in those with hyperglycemia, it was also evident in normal-weight, and younger individuals. Results from this pilot study have important public health implications as CVD is often underestimated in the young. A significant number of participants were unaware of their diabetic status, pointing to the need to identify this group as a potentially high-risk CVD group. 

A new prospective cohort study of adults in India has found that those following a predominantly plant-based diet had lower risk of cardiovascular events than those eating an animal-based or mixed diet. Researchers followed nearly 10,000 participants and found that the plant-based group also had lower blood pressure, LDL cholesterol, and body weight.

It’s clear that CVD is the most common cause of death worldwide. In the United States, Cardiovascular disease and cancer are the top two causes of death, with one person dying every 36 seconds from CVD. Vegan and vegetarian diets were again found to improve cardiovascular risk factors such as total and LDL cholesterol, weight, and blood sugar control according to a new umbrella review published in PLOS One. Plant-based diets have also been shown to reverse established heart disease and type 2 diabetes diagnoses.

Much has changed in the world of health in the last few decades – not merely technologically but also with a nuanced shift to focus on lifestyle diseases and their common causes. From a time when doctors would recommend smoking certain brands of cigarettes and when nutrition wasn’t in the spotlight as a healthcare priority – to today when preventative care and dietary changes are becoming a primary treatment methodology. Yet despite this, the rate of cardiovascular disease in South Africa continues to rise and is a leading cause of death in the country. The South Africa fast food market size was valued at $2.7 billion in 2018 and is expected to reach $4.9 billion by 2026, at an expected compound annual growth rate (CAGR) of 9.0%, between 2023 and 2027 due to urbanisation and the effects of load-shedding. The increase in sales of processed meat products are closely correlated with the increase in high cholesterol epidemiology, obesity and CVD prevalence. 

Atherosclerosis is a degenerative process in which the arterial walls harden and the arteries themselves become narrower. The most common symptom of atherosclerosis is coronary heart disease, which causes circulatory problems in the coronary heart vessels. These typically manifest as angina pectoris, heart failure and palpitations, heart attacks, and sudden cardiac death. Circulatory disorders can also affect the limbs and the brain, resulting in a stroke or occlusive peripheral arterial disease (a blockage or narrowing of an artery in the limbs). People who follow a vegan/vegetarian diet are less likely to have risk factors for atherosclerosis and are less likely to develop CVD than people who follow a conventional meat-heavy or omnivorous diet.

People living a vegan/vegetarian lifestyle usually have significantly lower blood concentrations of total and LDL cholesterol than those following a conventional diet.  These favourable blood-fat values can be attributed, above all, to a lower intake of saturated fatty acids and cholesterol, whose primary sources are animal-based foods. Another reason for the low cholesterol levels observed in people on a vegan/vegetarian diet is the higher supply of simple and polyunsaturated fatty acids, as well as fibre, which can only be found in plant-based foods.

According to the World Health Organization, about 6.7 million deaths worldwide can be attributed to insufficient consumption of fruits and vegetables. Due to their food choices, people on a vegan/vegetarian diet have a lower risk of atherosclerosis and CVD. Switching to a plant-based diet can lower your risk of atherosclerosis and cardiovascular disease – by up to 40% in the case of coronary heart disease.  An increased consumption of vegetables, fruits, whole grains, legumes and nuts has a particularly positive effect. Daily consumption of fruits and vegetables can not only reduce the risk of coronary heart disease and stroke, but also has a positive effect on health in general. 

Dr. Nanine Wyma, Executive Director of the Physicians Association for Nutrition (PAN) South Africa, highlighted the urgent need for better nutrition education in the fight against cardiovascular disease (CVD), one of the leading causes of death in the country. “Despite CVD being a major cause of death, physicians do not receive enough nutrition education in medical school, and plant-based nutrition is rarely integrated into public healthcare systems. There’s awareness of the role of nutrition in managing CVD, but not enough action. We often use nutrition to treat patients, yet we fail to inform them about a plant-based dietary approach as an option for managing their heart health.”

In light of growing concerns about both public health and environmental sustainability, the EAT-Lancet Commission proposed the Planetary Health Diet in 2019. This diet aims to optimise chronic disease prevention while also benefiting the planet. A recent study examined the connection between adherence to this diet and the risk of cardiovascular disease (CVD) in three large cohorts in the USA. The findings revealed that individuals who closely followed the Planetary Health Diet had a lower risk of developing CVD, supporting the diet as a promising approach to improving human and environmental health.

A recent study, “The Association between Plant-Based Diets and Dietary Patterns with Cardiometabolic Risk in a Sample of Commercial Taxi Drivers in South Africa,” further supports Dr. Wyma’s points. It found that taxi drivers who adhered to healthier plant-based diets had a reduced risk of high triglycerides, which raises the likelihood of heart disease. Triglycerides can contribute to artery hardening, leading to serious cardiovascular events like heart attacks and strokes. Dr. Wyma noted, “These findings highlight the urgent need for more research into plant-based dietary patterns for South Africans, especially in populations with limited access to healthy food and those leading sedentary lifestyles. Understanding these connections can pave the way for better public health strategies in South Africa.”

ENDS

Media Contact

ProVeg South Africa – Wikus Engelbrecht – Communications Manager: [email protected]; +27 64 172 0120

About ProVeg South Africa:

ProVeg South Africa is the local branch of ProVeg International. ProVeg is an international food awareness organisation working to transform the global food system by replacing conventional animal-based products with plant-based and cultured alternatives.

ProVeg works with international decision-making bodies, governments, food producers, investors, the media, and the general public to help the world transition to a society and economy that are less dependent on animal agriculture and more sustainable for humans, animals, and the planet.

About PAN South Africa: 

The Physicians Association for Nutrition (PAN) South Africa is a national office of the non-profit organisation PAN International. We work with health science students, healthcare professionals, and policymakers to raise awareness of the power of whole-food, plant-based nutrition for health promotion and disease prevention.  

Media Contact

PAN South Africa – Nosipho Luthuli – Communications Manager: [email protected]; +27 72 579 5222