Peripheral artery disease (PAD) involves the partial occlusion (blockage) of the peripheral arteries that feed your extremities with oxygen-rich blood. With reduced blood flow, muscles, nerves, and other bodily structures fed by this arterial branch do not receive the life-giving nutrients they need to function correctly. The result is a progression through four stages of PAD that can ultimately lead to significant disability and even limb amputation if not diagnosed and treated early on.
To understand why diet is so crucial for PAD, we have to look at what causes atherosclerosis or the occlusion of arteries in the first place. Excess fat traveling in the blood system can attach itself to the walls of the arteries. As these fats build, they can start to harden. At this point, even with improved diet and exercise, the hardened plaque cannot be removed without a procedural intervention. If coronary arteries are blocked, this could lead to a heart attack. Peripheral artery occlusion leads to PAD amongst other issues.
While improving your diet is not the solution for reversing existing PAD, it certainly can prevent the progression of the disease. With that said, here are some dietary tricks to slow it down.
First, we should address the elephant in the room. While fat circulating in the bloodstream is a problem, this does not mean you should avoid all fats in your diet. Monounsaturated and polyunsaturated fats are both essential. Think avocado (and its oil), various nuts, seeds, and more. On the other hand, saturated and trans fats, the latter of which has fortunately fallen out of favor in the United States, have decidedly negative consequences if consumed in high quantities. These saturated fats are contained in high-fat dairy, red meats, and highly processed foods. Even various vegetable oils, coconut oils, and more are not ideal for the PAD diet.
Patients should also focus on what they drink. Hydration is essential for the cardiovascular system in general. Blood is more than 90% water, and chronic dehydration, which affects many Americans, can make the heart work harder to pump. Further, high-sugar drinks like fruit juices, sodas, and alcoholic beverages, often with mixers, can also promote metabolic problems like type 2 diabetes, constrict blood vessels, and contribute to PAD and other cardiovascular conditions.
Last but certainly not least, fiber is an integral part of the diet. Dietary fiber combines with fat and flushes it out of your body, thus avoiding introduction into the bloodstream. Almost anyone will benefit from increased fiber intake, as most Americans do not get enough. Fiber can be derived naturally from whole grains, vegetables, and fruits, including beans, legumes, and nuts. A fiber supplement may also be appropriate if recommended by your doctor. Just note that if you suddenly increase your fiber intake, you may experience GI issues like bloating and flatulence. You can either start slowly or rest assured that these GI symptoms will subside in time as your body adjusts.
What Does a “Diet” Look Like?
When we think of a diet, we often approach it with trepidation. But that does not have to be the case. A balanced diet should not be a quick way to lose weight but a long-term tactic for improving your health by slowly and methodically dropping pounds. Fad diets and extreme dieting can be counterproductive as you often lose water and muscle weight. Instead, aim for moderate caloric restriction and weight loss of 1 to 2 pounds per week. There are hundreds of diets out there, most of which are ineffective or unsustainable. The Mediterranean diet is a great option that is delicious and has been proven consistent with weight loss. This is less of a diet and more of a lifestyle change, promoting healthy lean proteins like fish and highly nutritious fats like olive oil.
But How Do I Get Started?
This is an excellent question and one that our medical system often does not approach comprehensively. Typically, when we reach the point of wanting to diet, we are desperate and frustrated. We want to find the quickest solution to the problem of excess weight, which often takes us down an extreme path. This can be exacerbated by a PAD diagnosis, which can certainly be concerning, if not scary. However, we must take a long-term approach to change our lives and diets. So, you can start with a stepwise approach to this new lifestyle:
Start by eliminating the most egregious foods. You might eat a bag of potato chips daily or grab fast food for lunch. Eliminating either or both habits will drop calories and reduce your sodium intake dramatically. Try this first step for a week or ten days before moving on to your subsequent elimination, which may be soda, fruit juice, or any other high-sugar drinks you may be consuming. Once again, wait seven to 10 days before eliminating the subsequent offender, maybe alcohol or red meat. This is not to say that you can’t enjoy these occasionally – eliminating them from your regular diet is the goal.
No diet program can be entirely successful without exercise for PAD. For many of us, this is simply nonexistent in our lives. Starting slow is a great option and one that allows you to keep consistency over the long term. Exercise does not have to be running on the treadmill for hours, doing a 5K, or benching 300 pounds, though any of these things can be a long-term goal. Today, we can start with a simple walk. Most phones and exercise apps can track your steps. Start with something that challenges you but does not cause pain. It may be 2000, 5000, or even 10,000 steps. You can increase your step count over time and as your body allows.
It’s also essential to start building muscle; you can do this with strength training exercises. Speak to your doctor about the lowest impact and best practices to help overcome PAD.
The Good and Bad in Every Fruit Food Group
There is so much conflicting information on the Internet. Hundreds, if not thousands, of people claim to be experts in nutrition and exercise, but all that noise contributes to confusion and frustration. This is especially true in the food realm, and recognizing how each food group has both bad and good options is essential. In other words, eliminating an entire food group from your diet is neither healthy nor sustainable:
Carbohydrates: carbs are vilified to the point where several diets eliminate them almost entirely. However, carbs are a primary energy source for us to perform activities and keep our brains sharp. Good carbs are whole grains, vegetables, and fruits. These complex carbs level off sugar spikes and can even help lower bad cholesterol. Yes, fruits have sugar, but these natural sugars are essential for the proper functioning of the cells in our body. On the other hand, simple carbs like added sugar, white bread, white rice, and more have very little nutritional value and have been stripped of the fiber you would get from their complex carb cousins.
Fats: As we alluded to before, polyunsaturated and monounsaturated fats are healthy and shouldn’t be avoided. These include fatty fish like salmon, nuts, seeds, and avocados, including avocado oil. These fats do not cause problematic plaque accumulation in the bloodstream. On the other hand, Saturated fats – the bad kind – are typically found in vegetable oils, snack foods, pre-prepared dinners, and other highly processed meals. While you cannot avoid saturated fats, minimizing them can reduce the risk of clogged arteries.
Aside from fats, cholesterol has also been given a bad rap. While high cholesterol (as in the reading you get from a blood test) is problematic, some foods containing cholesterol are not as bad as you think and have been mistakenly hated for their cholesterol content. For example, egg yolks are highly nutritious, and while they contain lots of cholesterol, they offer a good boost of nutrition when eaten in moderation. Similarly, shellfish like shrimp are high in cholesterol. However, they are an excellent source of lean protein that should not be avoided.
Protein: proteins are the building blocks of muscle and consequently are extremely important, especially as we age and begin to lose our youthful musculature. There is a big difference between lean proteins and those that contribute to PAD. Your cardiologist has probably suggested reducing your red meat intake as it is full of saturated fat. While it can be an occasional enjoyable indulgence, it should not be a regular staple in your diet. Skinless chicken and turkey, fish, and shellfish are all great ways to get protein without much saturated fat.
A note on vegetarianism and veganism. It may be tempting to pursue a vegetarian or vegan diet. This should only be followed under the supervision of a qualified physician or nutritionist, as there is the potential for malnutrition (only a few plants, like quinoa and soy, are complete proteins). However, a vegetarian or vegan diet can significantly improve specific cardiovascular disease markers, including high blood pressure and cholesterol. You may also consider a pesco-vegetarian diet which adds fish to the mix for a low-fat high-impact protein boost.
Ultimately, the increased incidence of PAD follows a societal shift towards a decidedly less healthy diet. While diet is a primary culprit, we can’t forget about lifestyle factors that make a big difference in our arterial health, including quitting smoking and upping exercise. Taken together and slowly but surely moving towards an improved lifestyle, we can minimize the risk of progression of PAD and even make procedural interventions performed by Dr. Farrugia more effective over the long term. Schedule a consultation with us to learn more about PAD treatment and what you can do to improve your health.