Heart of the Matter

As he indulged in a jumbo sugar-covered fried pastry, the pro athlete unabashedly remarked, “I’m skinny; I can eat this.” Well, the truth is that even lean athletes—including rowers—die suddenly of heart attacks and strokes. Heart disease is the number-one killer, ahead of cancer, and accounts for one in three deaths. No one can out-row a bad diet.

While we’ve all heard “Let food be thy medicine,” the latest dietary advice from the American Heart Association (AHA) focuses less on individual foods and nutrients (such as eggs, meat, fat, sodium) and more on lifestyle and lifelong dietary patterns. Given that cardiovascular disease begins in the womb, adopting heart-healthy eating patterns early and maintaining them throughout your life is important. We can be thankful that the same food plan that invests in heart health invests in sports performance—as well as reduced risk of Type II diabetes and mental decline.

Below are the latest AHA dietary guidelines. Because these guidelines are aimed at the general public, rowers might want to make some tweaks to attain optimal sports performance.

1. Adjust energy intake and expenditure to achieve and maintain a healthy body weight.

Most rowers do a good job with weight control. Just remember: Large portions of even “heart healthy” foods can contribute to weight gain.

2. Eat plenty of fruits and vegetables; choose a wide variety.

Fruits and veggies—in particular, those with deep colors, such as peaches, berries, spinach, and carrots—offer natural vitamins as well as phytochemicals that improve heart health. Many fruits and veggies are rich in potassium, which has been associated with lower blood pressure. Some fruits and veggies (such as arugula, romaine lettuce, beets, rhubarb) are nitrate-rich and improve blood flow and athletic performance. 

If you have trouble including plenty of fresh fruits and veggies in your daily meals, make food prep easier by using frozen fruits and veggies. They can offer more nutrients than the wilted produce that has been sitting in your refrigerator for several days. Frozen produce is ready to use, reduces food waste, and costs less than fresh. Stock up!  

3. Choose foods made mostly with whole grains rather than refined grains.

The fiber in whole grains helps feed gut microbes that enhance your immune system and overall health. While most of your bread, cereals, and pasta should be whole grain, eating refined grains at one meal a day will not undermine your health. That is, if you eat oatmeal for breakfast, whole-wheat bread at lunch, and popcorn for a snack, enjoying white pasta for dinner fits within the guideline that more than half your grains should be whole. 

4. Choose healthy sources of protein.

Your protein should come mostly from plants (legumes and nuts); fish and seafood; and low-fat or fat-free dairy products. If you desire meat or poultry, choose lean cuts and avoid processed forms. Plant protein is excellent for heart health: lentils, hummus, edamame, tofu, beans, and nuts. The more nuts and nut butter, the lower the risk of CVD and stroke.

The relative benefits of low-fat and fat-free versus full-fat dairy are controversial and continue to be debated. As of now, the AHA reports, yogurt and kefir are positive additions to your diet. If you choose to consume plant-based beverages, note that almond milk (and other nut milk) is actually almond juice—low in protein and lacking other nutrients. The more nutrient-dense options are soy milk and pea milk.

Processed meats (ham, hot dogs, bacon, sausage, pepperoni, salami) have a stronger link to CVD than lean red meats. The potential adverse effects of red meat on heart health have been attributed to a combination of factors, including saturated fat, heme iron, gut microbiota, and TMAO (a metabolite of red meat). 

In the past, the AHA has limited eggs because of their high cholesterol. The question arises: Are eggs a contributor to CVD? Or are the bacon and sausage that accompany eggs the culprits? The intake of dietary cholesterol and saturated fat tends to increase in tandem with other foods—for example, eating eggs with bacon and sausage. Dietary cholesterol itself is currently less of a nutrient of concern.

5. Use liquid plant oils rather than tropical oils (coconut, palm, and palm kernel), animal fats (butter and lard), and partially hydrogenated fats.

Robust scientific evidence shows that replacing saturated fats that are hard at room temperature (butter, coconut oil, lard) with polyunsaturated and monounsaturated fats that are soft or liquid at room temperature (olive oil, canola oil, peanut oil) will protect you from heart disease by lowering LDL or “bad” cholesterol. This reduces the risk of developing heart disease. By comparison, coconut oil is high in saturated fat and raises LDL cholesterol, with little evidence of health benefit.

6. Choose minimally processed foods instead of ultra-processed foods.

Ultra-processed foods (ramen noodles, cheese curls, commercially baked cookies) are easy to over-consume. Choose unprocessed or minimally foods, such as homemade granola bars and trail mix made with nuts and dried fruit.

7. Minimize intake of beverages and foods with added sugars.

Sugar comes in many forms: glucose, dextrose, sucrose, corn syrup, concentrated fruit juice, honey, and maple syrup. The same rowers who scrutinize food labels for added sugar often consume lots of sport drinks, gels, and chomps. Simple-to-digest sugar is actually what your body needs during long rows when the goal is survival and not good nutrition. 

Sugar becomes a problem when rowers skip wholesome meals, get too hungry, begin to crave sugary foods, and then eat the whole plate of cookies. Preventing hunger is the key to preventing cravings for sugary foods. Eating a hearty protein-rich breakfast can set the stage for reduced sugar cravings toward the end of the day, making it easier to reduce your sugar intake.

8. Choose and prepare foods with little or no salt.

In general, reduced salt intake is linked to reduced blood pressure. That said, most rowers have low blood pressure. Rowers also lose salt (more correctly, sodium) in sweat. Rowers who sweat heavily can appropriately replace sodium losses by eating salty foods. 

The leading sources of dietary sodium are processed restaurant and packaged foods. If your sports diet is mostly unprocessed foods, it can be low in sodium. If you find yourself craving salt, eat it.

9. If you do not drink alcohol, don’t start; if you choose to drink alcohol, limit intake.

The link between alcohol and heart disease is complex, depending on how and how much you drink. Athletes are known to drink more alcohol than non-athletes. Alcohol has negative effects not only on heart health but also athletic performance and is linked to injuries, violence, digestive diseases, poor pregnancy outcomes, and cancer. How about simply enjoying the natural high associated with a good workout?

10. Adhere to this guidance regardless of where food is prepared or consumed.

Because so many rowers buy takeout food, healthy eating patterns need to apply to meals prepared both inside and outside the home. Occasional treats are fine; just be sure they aren’t the norm.

By following the above guidelines, you’ll be taking steps toward a lifetime of better health, which generally means better quality of life and happiness. Be wise, choose your foods wisely, and enjoy miles of smiles.

Nancy Clark, M.S., R.D., C.S.S.D., counsels fitness exercisers and competitive athletes in the Boston area (Newton: 617-795-1875). Her best-selling Sports Nutrition Guidebook is a popular resource, as is her online workshop. Visit NancyClarkRD.com for more information.