When former US president Bill Clinton mentioned in an interview that he’d adopted a near-vegan diet for the sake of his heart’s health, the media went wild. Once known for his love of hamburgers and junk food, Clinton—who had bypass surgery in 2004 and an angioplasty in 2010 to remove blockages from a clogged artery—was not a likely candidate for dietary asceticism. But he was persuaded to make the radical change by an extensive review of the scientific evidence. And if you’re concerned about heart health, it’s food for thought that you, too, may want to consider.

Clinton learned that in 1986, several hundred people with heart disease participating in a trial by heart-health guru Dr Dean Ornish began following a plant-based diet as part of a lifestyle program that included walking, social support and yoga practice—and 82 per cent of them experienced a reduction in arterial blockages after one year. And just like many of the participants in the Ornish program, Clinton experienced an unexpected but welcome side effect of his own diet: within months, he’d lost 11 kilograms, returning to his high-school weight.

Heart disease kills far more people than any other illness, more than all forms of cancer combined. Here are a few surprising things you should know about cardiac health—and simple things you can do to keep your heart healthy and strong for years to come.

Beat by Beat

Clearly, our culture is concerned with heart health. Statins (pharmaceuticals such as Lipitor and Pravachol designed to prevent a build-up of “bad” LDL cholesterol in the coronary arteries) have become the most-prescribed class of drugs in the world. For someone who already has heart disease, statins not only impressively lower LDL cholesterol and the risk of heart attack but, according to some studies, increase life expectancy of men as well. However, such longevity benefits may not materialise for people who don’t already have heart disease, and not a single study has found that statins increase the life expectancy of women.

The fact remains that after a quarter of a century and billions of dollars in research, a holistic approach to heart disease still works better than medicine for most people. When Dr Ornish, who is the founder of the non-profit Preventive Medicine Research Institute in Sausalito, California, invited his first heart disease patients to start his program in 1977, some had symptoms so severe that their regular doctors had recommended immediate bypass surgery. Yet without surgery and without the statins and other cholesterol-lowering medications that most members of the control group took, his patients improved and symptoms such as chest pain began to lessen almost immediately.

Not only did their heart disease improve, but so did their weight, blood pressure, blood sugar and markers of inflammation. The program was the first intervention of any kind documented to reverse heart disease—that is, to reduce the size of blockages in the coronary arteries—without drugs or surgery. “When people make these comprehensive lifestyle changes,” says Dr Ornish, “most of them are able to reduce or even discontinue medications under their doctor’s supervision.”

Even more exciting, recent research on Dr Ornish’s program is revealing that dozens of disease-preventing genes are getting down-regulated, or switched on, in program participants, while hundreds of bad genes—including some that are linked to heart disease, inflammation and even cancer—are getting up-regulated, or deactivated. Another recent study found beneficial effects on telomeres, special DNA sequences at the end of chromosomes that affect the rate of ageing (as your telomeres get longer, your life gets longer), suggesting that his program slows cellular ageing. “Even drugs haven’t been shown to do this,” says Dr Ornish.

Ancient yoga teachings on diet and lifestyle reflect a practical wisdom.

It’s easy to get caught up in the latest scientific findings—the promising new drug, the life-saving surgery, the breakthrough insights into the complex relationship between cholesterol and heart disease—but if you’re willing to dig a little deeper, you’ll discover that ancient yogic teachings on diet and lifestyle reflect a practical wisdom that modern medicine is gradually validating.

One of the strengths of a holistic approach to heart disease is that it doesn’t reject reductionist tools such as drugs or surgery when necessary. But if you take the holistic route, you are simply less likely to need them. Here’s what you need to know.

What to Eat

Diet is clearly a cornerstone of the holistic approach to heart health. Dr Ornish encourages a low-fat, vegetarian diet.

He originally learned the basics of this diet from his spiritual teacher, Swami Satchidananda, the founder of Integral Yoga. Years later, Dr Ornish began testing the diet’s benefits on heart disease patients, with great success. Today, Dr Ornish recommends the following:

  • a wide variety of vegetables, fruits, whole grains and legumes.
  • natural, unrefined soy foods (think miso and tempeh, not products with soy protein isolate or hydrolysed soy protein).
  • no more than one cup per day of non-fat dairy products (such as skim milk).
  • 3 to 4 grams per day of omega-3 fats (derived from algae or from fish oil that has been purified of toxins).

Why Yoga Helps

As Dr Ornish explains, “Chronic emotional stress makes plaque build up twice as fast in the coronary arteries that feed the heart. Stress also causes the coronary arteries to constrict, reducing blood flow to the heart. It makes the platelets stickier and more likely to form blood clots that may precipitate a heart attack.” Yoga is perhaps the most effective stress-reduction method ever invented.

If you want to keep your heart healthy, incorporate these tips into your yoga practice:

  • Do a yogic relaxation for at least a few minutes every day. Research suggests that it can increase your resiliency to stress—and, by extension, to heart disease.
  • Balance your emotions with a regular yoga practice. Studies suggest that yoga helps diffuse emotions such as anger, hostility and impatience that are linked to heart attacks.
  • Combat loneliness, another risk factor for heart disease, by becoming part of a community. A recent study suggests that people with spiritual practices who meet regularly in a group live longer and have fewer heart attacks.
  • Offer service (karma yoga) to those less fortunate than yourself—whether that means volunteering in a food pantry, or teaching a free yoga class in a retirement community. According to the yoga tradition, there is no better way to open your heart.

The New Heart-Smart Workout

Although conventional medicine often recommends heart-pounding aerobic workouts for cardiac health, there is evidence that less-intense exercise provides major benefits.

  • Don’t overexercise; recent studies suggest that extreme exercise, such as running 15 kilometres if that’s not your norm, may actually promote inflammation.
  • Get 20 to 30 minutes of slow to moderate walking daily, recommends Dr Ornish.
  • Practise gentle asanas, such as Ardha Matsyendrasana (Half Lord of the Fishes Pose); Bhujangasana (Cobra Pose) with the chest just barely lifted; brief, modified Salamba Sarvangasana (Supported Shoulderstand) with your feet on the wall; and Savasana (Corpse Pose). Also practise easy pranayama exercises such as three-part breathing and meditation. Even a few minutes per day, says Dr Ornish, can make a huge difference.

 Semi-Sweet Heart Fix

If you have high blood pressure, treat yourself to a few squares of dark chocolate. Last year, researchers analysed 15 studies investigating the effect of cocoa on blood pressure and concluded that dark chocolate (which is rich in flavonols, compounds that cause blood vessels to dilate) significantly reduced blood pressure for people with hypertension (but alas, not for regular people!). The researchers concluded that eating some dark chocolate can lower blood pressure approximately as much as 30 minutes of exercise, and that it may reduce the risk of heart attack by about 20 per cent over five years.