Maggie McKay (Host): Welcome to Wellness in Reach: A Mount Carmel podcast. I'm your host, Maggie McKay. Joining us today is cardiologist and Co-Director of the Women's Heart Program at Mount Carmel, Dr. Amrita Karve, to discuss dietary shifts and whole foods-based eating versus ultraprocessed foods. Thank you so much for being here.

Amrita Karve, MD: It's a pleasure to be here. Thank you.

Host: Absolutely. I can't wait to hear more about this. In what ways can dietary choices impact cardiovascular function and just overall heart health?

Amrita Karve, MD: I think it starts on a very broad level, just as you were describing, "How does it impact our body as a whole And the heart as a whole?" I think in general, And the studies do show that healthy, plant-based, not exclusively plant-based, but leaning on fresh vegetables and fruits along with whole grains, unprocessed meats and generally foods that are low in processing along with low carbs do have an extremely positive impact on heart health.

Host: What are the cardiovascular implications of choosing a whole food diet compared to one high in ultraprocessed foods? Because I think it was just this week or last week, there was a lot in the news about, for instance, processed meats and how bad they are for us.

Amrita Karve, MD: Yes. I think in general there seems to be a shift towards whole foods and less processed foods, although that has been in the works for several years. But that has been very much emphasized by the most recent dietary guidelines. The emphasis is on foods that are not very processed at all. And in fact, thinking about foods in a way where you can think about the levels of processing, like is it just heated? Is it frozen? Is it canned? Are there other added sugars and other processed chemicals, oils, fats that are added to it? How long is the shelf life?

And so, there are several different layers of how food can be processed. And I think distilling it down to those first initial phases is what those new dietary guidelines are trying to get at. Because even though the food may start off as a healthy food, every time it is touched by something artificial, it loses a little bit of its nutrition. And those points where it loses its nutritional value lead to increases in the risk for diabetes, obesity, heart disease on the cellular level, but also, just in general in terms of what they do to the blood glucose level and other hormones that are released by the heart in that moment.

Host: How quickly can heart health improvements become evident after adopting a whole food diet?

Amrita Karve, MD: I think, very quickly, if you look at just like within 24 hours of eating a healthier diet that's lower in sugars and salt and fat, you would probably notice an improvement just within a day. And that can be reflected in the glucose level, in terms of some of the hormones that the heart releases when it is assaulted by like a high salt load or the quality of sleep for people who have sleep apnea or sleep disordered breathing, the level of salt can then impact them that very night. So, I think the results are immediate and probably lowering salt and sugar intake in the very short term would probably result in improved mood and energy level even later on in the day; the next day, reduced fatigue.

But in terms of reducing the amount of plaque buildup in the arteries that would probably take on the order of a few weeks to at least reduce the circulating cholesterol content and then, on the order of months to really slow down the progression of how fast cholesterol is being laid down. And then, in the very long-term, you can actually reverse plaque buildup through a healthy plant-based diet. But that takes years for it to show up in something like a heart catheterization, but it is possible. So, every day counts towards that.

Host: That's amazing that you could feel the difference in a day. I believe it, completely. Is moderation of ultraprocessed foods safe for people striving to improve cardiovascular outcomes, or should these be minimized altogether?

Amrita Karve, MD: I think they should just be eliminated completely. Of course, that's not totally realistic because, you know, we have what we have in our pantries and some processed foods are just more cheaper and convenient. But I don't think there is a way. Perhaps like the best way to moderate it is to not get processed baked goods and prepared foods, but maybe like a moderate version of that would be to get something like canned tomatoes for soups and stews rather than buying fresh tomatoes. Because in the dead of winter, it is really hard to find fresh tomatoes. And if that's the only way to make other vegetables delicious, then that's better than nothing. So probably, I would say if one would call anything moderation, maybe it would be in canned vegetables or frozen vegetables, because that's probably like the least amount of processing before it comes from nature. And anything after that, whether it's like a frozen food or anything you can buy in a box or bag, is probably not healthy enough.

Host: What specific cardiovascular risks are associated with diets high in ultraprocessed foods?

Amrita Karve, MD: Specific risk factors would be diabetes and obesity, and probably heart failure because of the high salt content of some of those processed foods. The way in which they do it works on a cellular level in the gut too, along with the heart. And it's very complex. But one thing we do know is that because processed foods are much easier to break down than absorb, actually, you can think of them as having a much higher calorie content than is reported on the label, because your body doesn't even burn as many calories as it would to digest, for example, a piece of broccoli compared to something that is very easy to digest. So, I just tell my patients, if something says 50 calories on the processed food, you should just double it to a hundred because that's you're not even burning any calories and breaking down the food.

Host: How do you approach counseling patients about reducing ultraprocessed food intake and transitioning to a whole foods-based diet?

Amrita Karve, MD: I think most people want to enjoy healthy, delicious food. Sometimes it's just the ease of going to the center aisles of the grocery store and getting those things that makes it more enticing or just makes it an easy way out to, you know, when you don't have a lot of time or money to spend making vegetables or other whole foods into delicious meals. So, sometimes it's just about starting with small steps and figuring out which vegetables and meats they do enjoy and how difficult they are to prepare and to find recipes that are extremely easy because you want to make the healthy thing look as delicious as the unhealthy thing. And I think once people realize that and they get a flavor for that, then they want more of it.

Host: Thank you so much for sharing your expertise. This has been really eye-opening and informative, And we appreciate your time.

Amrita Karve, MD: It was a pleasure to be here. Thank you for having me.

Host: Absolutely. Again, that's Dr. Amrita Karve. For more information, please visit mountcarmelhealth.com/services/heartandvascular. And if you found this podcast helpful, please share it on your social channels and check out our entire podcast library for topics of interest to you. Thanks for listening to Wellness in Reach: A Mount Carmel podcast.