Walnuts are an ancient plant food that has sustained humans since the dawn of civilization. They are key to heart health because they are a top source of ALA (alpha-linolenic acid). ALA is the omega-3 fatty acid derived from plants which our bodies need in addition to the other omega-3 that comes from salmon and other fish. Studies show that people who eat an ALA-rich diet are less likely to suffer a fatal heart attack.

Walnuts (along with flaxseeds) are one of the eight key food groups - - along with olive oil, leafy greens, figs, and other fruits, lentils and other legumes, salmon and other seafood, oatmeal and other whole grains, and red wine - - that are part of my plan to reverse heart disease, or build good heart health to hopefully avoid heart troubles. Dark chocolate is a bonus food in this plan.

Walnuts stand apart from all other types of nuts for two reasons:

	they provide the highest amount of the "vegetarian" omega-3 fatty acid, ALA, and
	they are packed with the most plaque-fighting antioxidants relative to all other nuts

While the thin brown skin that surrounds the walnut meat - - the pellicle - - may taste a bit bitter, this is naturally rich in antioxidant polyphenols, which combat plaque buildup, so try to eat that portion when you eat your walnuts. Walnuts are also naturally rich in vitamin E, the potent healthy antioxidant, concentrated mostly in the nut kernel.

Consuming just a handful of walnuts daily can help:

	Make your dysfunctional endothelium (the damaged inner arterial layer that instigates and promotes heart disease progression) more functional by reducing inflammation and promoting more relaxed and dilated blood vessels.
	Lower your cholesterol (both walnuts and flaxseeds will work together to make a dent in your "bad" LDL cholesterol level).
	Make your blood less likely to clot.
	Lower your blood level of inflammation. Eating walnuts is probably the easiest and tastiest way to incorporate ALA into your day because they can be enjoyed multiple ways: as a handy and portable snack or as an embellishment to any meal.
	Lower your blood level of inflammation. Eating walnuts is probably the easiest and tastiest way to incorporate ALA into your day because they can be enjoyed multiple ways: as a handy and portable snack or as an embellishment to any meal.

Here are a few of the ideas I offer in Prevent a Second Heart Attack:

	Keep a bag of shelled walnuts on your kitchen counter and grab some nuts as a quick and healthy snack.
	Go Greek: enjoy a fat-free Greek yogurt topped with a little honey, some crushed walnuts and savor a nutritious choice that makes a sensational and satisfying sweet dessert.
	Sprinkle walnuts on your green salads. (Dr. Janet's Spinach Salad with Apples, Toasted Walnuts, and Dried Cranberries and Dr. Janet's Arugla Salad with Figs and Walnuts can be found on page 284 and 285)
	Try candied walnuts - - bake walnuts sprinkled with a little brown sugar for a sweet treat.
	Toss walnuts and dried fruit together in a small plastic bag and you have a super-antioxidant-rich and convenient snack for when you are out and about or even as a late-afternoon pick-me-up.
	Use walnuts in cooking to add taste and nutrition to your favorite dishes.

So, go nuts (walnuts, that is) every day, and get heart healthy.

© 2011 Janet Bond Brill, Ph. D. R.D., LDN, author of Prevent a Second Heart Attack: 8 Foods, 8 Weeks to Reverse Heart Disease

Author Bio
Janet Bond Brill, Ph.D., R.D., LDN, author of Prevent a Second Heart Attack: 8 Foods, 8 Weeks to Reverse Heart Disease, is a diet, nutrition, and fitness expert who has appeared on national television. She is the author of Cholesterol Down: 10 Simple Steps to Lower Your Cholesterol In 4 Weeks Without Prescription Drugs, and specializes in cardiovascular disease prevention. Dr. Brill lives in Pennsylvania with her husband and three children.

For more information please visit preventasecondheartattack.com and follow the author on Facebook and Twitter

Q & A with Janet Bond Brill, Ph.D. R.D., LDN
Author of Prevent a Second Heart Attack: 8 Foods, 8 Weeks to Reverse Heart Disease

Q: Why did you write the book Prevent a Second Heart Attack?

A: I saw a need among heart attack survivors that was not being filled. Currently, more than 13 million Americans have either survived a heart attack or been diagnosed with heart disease. As a registered dietitian specializing in cardiovascular disease prevention, I have found that heart attack survivors simply are not following a lifestyle plan that would help them to prevent a second attack. What many of these "survivors" need to know is that a healthy lifestyle and carefully following doctor's orders can prevent another heart attack. The problem is that many of these individuals find the "cardiac diet" too restrictive or complicated, and some receive no lifestyle counseling. What's more, if the heart attack survivor decides to go it alone and purchase a self-help book, he or she may reach for one of the best-selling heart disease reversal books that promote a punishing, "extreme" fringe diet. Most of these books feature Spartan, vegan-style eating plans that are simply too difficult to follow and frankly are just not livable. Why should heart attack survivors be punished further with the burden of tasteless, low-fat plans when there is a better way? My book gives these people good news - - that they can prevent new plaque buildup and even reverse or stabilize dangerous, vulnerable plaque in their coronary arteries with a delightfully palatable lifestyle strategy where they can still enjoy the good things in life.

Q: But what exactly are the best lifestyle changes - - alongside drugs - - for preventing a second heart attack and even reversing heart disease?

A: That is the very question this book answers. A tremendous amount of scientific research has investigated the application of various diet and exercise plans in preventing further coronary events. I have found that the bulk of the scientific evidence overwhelmingly supports the notion that post–heart attack patients should be advised to eat a Mediterranean-style diet, be physically active at least thirty minutes a day, and not smoke. In fact, the famed Lyon Heart Study that tested a Cretan Mediterranean diet in cardiac patients reported a phenomenal reduction of recurrence rate of 70 percent compared to the control diet (a typical low-fat Western-style diet). Thus, the bulk of the scientific research is crystal clear: a Mediterranean style of eating combined with physical activity is the optimal lifestyle plan for preventing a second heart attack and is far superior to the low-fat vegetarian diet regimens typically prescribed to heart patients in the fat-phobic '90s (and that continue to line bookstore shelves today). I propose that a Mediterranean-style diet, as outlined in Prevent a Second Heart Attack and backed by powerful evidence, can be even more effective than the eating plans currently recommended by many cardiologists - - simply because it tastes good and makes life more enjoyable. Following vegan-style plans can also reverse heart disease but only if adhered to - - an extremely difficult chore for most Americans.

Q: Did you have a personal reason for writing this book?

A: All the men I love have either died of heart disease or are currently living with the disease. My father had his first heart attack at age forty-five and died from his second attack several years later. He was never given any lifestyle advice that could have helped him prevent or reverse his disease. My father-in-law, Harry, had his first heart attack at forty-eight years old and had his second bypass operation two years ago at age seventy-eight. He has tried many of the low-fat vegetarian diets over the years but has found them too difficult to adhere to on a consistent basis. My husband, Sam, had his first heart attack two years ago at age fifty-one. So I wrote this book with the hope that Sam, Harry, and the 13 million other American heart attack survivors will follow the advice set forth in these pages: a livable lifestyle that will show them the way to a long, happy, and healthy life by teaching them how to prevent that second lethal attack and even reverse the actual disease process.

Q: Hindsight is 20/20, but is there anything you would have suggested your husband, Sam, do to prevent his first heart attack?

A: Looking back, I would say I underestimated the power of three risk factors to promote a heart attack: severe emotional duress, family history, and a low HDL ("good") cholesterol. Fearful that he would follow in his father's and grandfather's footsteps (his grandfather died of a heart attack at age thirty-five), Sam underwent an invasive medical test (an angiogram) at age forty-five to reassure him that he was free of his family scourge. The results came back negative for any trace of cardiovascular disease. His blood values were excellent except for a low HDL value of 32 (under 40 mg/dL is considered a risk factor). He didn't smoke, had normal blood pressure, and was not overweight. He continued under the care of his cardiologist - - and had passed his exercise stress tests with flying colors. Then came the economic tsunami that hit the Florida real estate market (my husband is a general contractor) . . . combined with the stress of his father's second bypass operation . . . and he had a heart attack on July 31, 2009 - - and thankfully survived with minor heart muscle damage. So obviously, looking back, he should have been taking much more aggressive preventive measures given his family history - - such as medications, HDL-boosting lifestyle measures, and practicing more stress management techniques.

Q: Is heart disease really reversible?

A: Yes. Studies published in leading medical journals have shown that following a lifestyle similar to the one outlined in my book - - and combined with physician-prescribed medications - - can stabilize and even reverse vulnerable plaque.

Q: Can I eat red meat?

A: The Prevent a Second Heart Attack plan consists of removing the plaque- building foods (red meat, cream, butter, eggs, and cheese) that cause blood vessel damage and replacing them with delicious anti-inflammatory foods that facilitate the body's natural healing processes to reverse existing heart disease and restore quality of life. To combat the confusion issue, the Prevent a Second Heart Attack Plan o ffers powerful lifesaving advice, translating the complex clinical findings into a simple, easy-to-follow set of guidelines, "The Eight Dietary Commandments": (1) no more butter and cream, to be replaced by extra virgin olive oil; (2) no day without greens and other vegetables; (3) no day without figs or other fruit; (4 & 5) no meat (beef, lamb, pork), and replaced by fish and legumes; (6) no day without walnuts and flaxseeds; (7) no day without whole grains and cereals; (8) and moderate alcohol consumption, mainly in the form of red wine, recommended at dinner. (Plus a bonus food - - deep, dark, sinfully rich chocolate!)

Q: What is the best exercise for my heart?

A: The scientific consensus is that walking is the best exercise prescription for fighting off heart disease. How much, how often, and how fast (plus a discussion of the latest scientific research on exercise for heart disease) is detailed in the chapter on exercise. The best medicine for healing the arteries and reversing heart disease is moderate exercise, and the best exercise for you is the one you will do on a daily basis!

Q: What makes your plan so different and easier to follow than some of the other heart disease reversal plans on the market?

A: Many of the best-selling plans advise avoiding fish; any and all kinds of oil; avocado; nuts; seeds, and chocolate--delightfully tasty foods--all advocated in my plan.

Q: Can I really begin to heal my arteries in just 8 weeks?

A: Clinical research has shown a significant reduction in the rate of secondary events in post-heart attack subjects switching to a Mediterranean-style diet--in as little as 6 weeks.

Q: What about protein--where do I get my protein from?

A: The Prevent a Second heart Attack plan urges you to become a "vegaquarium." By getting your protein from the earth and the sea, you will also be fueling your body with numerous additional nutrients that fortify your daily heart disease defense system--artery healing components not found in a Western-style diet high in animal protein.

Q: Can I drink coffee and tea?

A: The Prevent a Second heart Attack plan is a plant-based diet. Both coffee and tea are made from plants--and plants contain plaque-fighting phytonutrients. So yes, you can have coffee and tea.

Q: What about supplements?

A: Not all supplements are created equally when it comes to treating and reversing plaque buildup. Three stand out among the crowd and should be in every heart attack survivor's medicine chest: Niacin; Vitamin D3; Fish oil.

© 2011 Janet Bond Brill, Ph. D. R.D., LDN