kris ulland

Your Nutrition Partner

Heart disease is the number one killer in the US.

Heart disease starts at the delicate inner lining of your blood vessels and veins. This is called the vascular endothelium. When these cells become injured or dysfunctional because of excessive LDL cholesterol, high blood pressure, or inflammation, the damage attracts immune cells, which accumulate excess fatty deposits like LDL cholesterol, cell waste, and circulating calcium.

Atherosclerosis is when you arteries narrow and harden due to accumulation of arterial plaque. This arterial plaque is bad for a number of reasons. It will restrict blood flow over time, or worse, it can actually rupture or break apart:

  • Intimal thickening: During intimal thickening, the inner layers of your vascular endothelium accumulate smooth muscle cells and extracellular matrix.
  • Fatty streaks: One of the early signs of heart disease, fatty streaks, can be reversed with timely lifestyle and diet changes and/or medication.
  • Fibro-calcific plaque: Plaque forms when cholesterol lodges in the wall of the artery. To fight back, the body sends white blood cells to trap the cholesterol, which then turn into foamy cells that ooze more fat and cause more inflammation. That triggers muscle cells in the artery wall to multiply and form a cap over the area. But the soft plaque beneath the cap is dangerous. Fibrous plaques restrict blood flow. they are composed of a thick (fibrous) cap that encapsulates accumulated cellular debris.
  • Vulnerable plaque: Ruptured plaque deposits are the most common cause of heart attacks, strokes, and sudden death.

Calcium connection: Atherosclerotic plaques can also accumulate circulating calcium, further adding to your risk of heart attack or stroke.

Heart attacks and strokes can both be caused when pieces of plaque breaks off, travels through your circulatory system, and clogs an artery. If that clog blocks blood flow to your brain, it’s a stroke. If it blocks blood flow to your heart, it is called a myocardial infarction, or heart attack. Both are acute and often fatal emergencies that require immediate medical intervention.

A study on this topic published in The Lancet attracted worldwide attention. It documented that mummified human bodies dating back 4,000 years suffered clogged arteries. MRI imaging documented clear signs of heart disease in 34% of mummified humans whose estimated mean age at death was 43 years. Those who died at an estimated mean age of 32 years were less likely to show signs of atherosclerosis.

The prevalence and severity of atherosclerosis worsens with aging.

There is more to preventing atherosclerosis than simply preventing the formation of plaque. Much of the danger posed by plaque occurs when it becomes unstable. The fibro-calcific plaques which are soft on the inside but covered with a hard, thick, fibrous cap on the plaque surface that faces the blood flow.

As long as these plaques remain thick, they are stable, meaning they are firm enough to not pose a major risk of rupturing. Over time, the cap begins to thin and weaken, making the plaque more vulnerable to rupturing.

An important step in lowering acute cardiovascular risk therefore is to help stabilize plaques.

Very intensive lifestyle changes have been shown to stabilize and shrink plaque.

  • Eat a Mediterranean diet. It can reduce heart disease risk by 30%. It is rich in olive oil, fruits, vegetables, and nuts; low in red or processed meats; and moderate in the amounts of cheese and wine you can consume.
  • Kick the habit. Smoking damages the lining of the arteries. Quitting can help raise HDL levels.
  • Exercise. Aerobic exercise can raise HDL, lower blood pressure, burn body fat, and lower blood sugar levels. Exercise combined with weight loss can also lower LDL levels. Aim for 150 minutes per week of moderate-intensity exercise.

Heart health is a combination of choices you make and genetics. You cannot change your genetics, but you can improve your chances with a  heart-healthy lifestyle. Monitor your heart health with regular check ups that test for C-reactive protein, a marker for inflammation. Also, along with diet and exercise, it is important to get enough sleep and take a supplement when needed.

Adding a supplement of CoQ10 will help the heart (and more!).

Aging and use of statin drugs lowers levels of CoQ10 in the body. Researchers have discovered new benefits for CoQ10 including reducing the brain damage inflicted by ischemic stroke.

  • CoQ10 is an important coenzyme in the processes that supply energy to cells.
  • Increasing CoQ10 intake has been linked to protection from cardiovascular disease, neurological conditions, age-related bone loss, metabolic disorders such as obesity, diabetes, and more.
  • While the intake of CoQ10 from a typical diet is small, it can easily be increased by supplementation and is well-tolerated even at high doses.

One recent study found that, even without a statin drug, CoQ10 alone (120 mg daily) decreased blood pressure, triglycerides, and LDL cholesterol. After 24 weeks, subjects with abnormal lipid profiles benefited from a 20% reduction of triglycerides, 7% reduction of LDL, and 6%-8% reduction in blood pressure.

In experimental animal models, CoQ10 has been found to improve markers of blood vessel health and protect the heart muscle. In a rat model of myocardial infarction (heart attack), control animals that did not receive CoQ10 displayed damage to over 65% of the heart surface. CoQ10-supplemented animals reduced this damage to only 26%.

Studies show that CoQ10 is protective in patients with a history of heart disease, specifically heart failure. In meta-analyses of available studies, researchers found that, compared to control patients without supplementation, CoQ10 decreased mortality, presumably by reducing the incidence of serious cardiac events.

Because statin medications are associated with diminished levels of CoQ10 in the body, many physicians now recommend that their patients increase their intake of CoQ10 during statin treatment. Also, it is believed that CoQ10 supplementation helps reduce the occurrence and severity of some of the most common side effects of statin drugs, in particular muscle pain.

*A word about cholesterol. It is often vilified, but we need this waxy, fatty substance to make vitamin D, hormones, bile that aids digestion, and the coverings of our cells. The liver produces 75% of the body’s cholesterol, but all cells have the ability to make it.

When cells need more cholesterol, the liver sends it via the bloodstream in packages made of cholesterol on the inside and protein on the outside. These cholesterol-laden particles are known as low-density lipoprotein, or LDL. Too much LDL in the blood can cause cholesterol to lodge in the artery walls and form plaques. That’s why LDL is known as “bad” cholesterol. It isn’t really bad, it is doing a very important job.


Watercress has small, round leaves and edible stems that have a peppery, slightly spicy flavor. It is part of the Brassicaceae family of vegetables, which also includes kale, Brussels sprouts and cabbage.

Once considered a weed, it was first cultivated in the UK in the early 1800s but is now grown in watery beds throughout the world.

Watercress is low in calories but it is nutrient dense. It is ranked number one on the US Centers for Disease Control’s Powerhouse Fruits and Vegetables list.

One cup of watercress contains the following:

  • Calories: 4
  • Carbs: 0.4 grams
  • Protein: 0.8 grams
  • Fat: 0 grams
  • Fiber: 0.2 grams
  • Vitamin A: 22% of the Reference Daily Intake (RDI)
  • Vitamin C: 24% of the RDI
  • Vitamin K: 106% of the RDI
  • Calcium: 4% of the RDI
  • Manganese: 4% of the RDI

One cup of watercress provides over 100% of the RDI for vitamin K, a fat-soluble vitamin necessary for blood clotting and healthy bones. Vitamin K is a component of osteocalcin, a protein that makes up healthy bone tissue and helps regulate bone turnover. In one study, people with the highest intake of vitamin K were 35% less likely to experience a hip fracture than people with the lowest intake.

It is rich in vitamin A, also known as retinol, which is important for keeping your retinas healthy and your vision good. Getting enough vitamin A is also crucial to keeping your organs healthy because it’s critical for cell division.

Watercress is also rich in vitamin C, which supports your immune system, helps you heal from injuries, and supports healthy collagen production. Watercress also contains small amounts of vitamin E, thiamine, riboflavin, vitamin B6, folate, pantothenic acid, magnesium, phosphorus, potassium, sodium and copper.

Watercress contains lutein and zeaxanthin, which are antioxidant compounds in the carotenoid family. Antioxidants protect against cell damage caused by free radicals, which are harmful molecules that lead to oxidative stress.  Lutein and zeaxanthin are essential for eye health and are linked to a lower risk of developing age-related macular degeneration and cataracts. The vitamin C in watercress is also associated with a lower risk of developing cataracts.

One study on the antioxidant compounds in 12 different cruciferous vegetables found over 40 unique flavonoids in watercress. Watercress outperformed all other vegetables in this study in terms of total amount of phenols and the ability to neutralize free radicals. Studies have linked the antioxidants in watercress to a lower risk of cancer, diabetes and heart disease.

Watercress contains the antioxidant alpha-lipoic acid. This compound can:

  • lower glucose levels
  • increase insulin sensitivity
  • prevent oxidative stress-induced changes in people with diabetes

Studies on alpha-lipoic acid have also shown that it can decrease nerve damage in people with diabetes. The Food and Drug Administration (FDA) has approved supplementary alpha-lipoic acid to treat diabetic neuropathy.

Watercress contains potent anticancer compounds called isothiocyanates that have been shown to ward off several types of cancer. These glucosinolates are activated when they are cut with a knife or chewed. These compounds protect against cancer by safeguarding healthy cells from damage, inactivating carcinogenic chemicals and blocking the growth and spread of tumors. Isothiocyanates found in watercress have been shown to prevent colon, lung, prostate and skin cancers. Research indicates that the isothiocyanates and sulforaphane found in watercress suppress the growth of breast cancer cells.

If you don’t have enough calcium, magnesium, and potassium in your diet, you might be prone to high blood pressure. These minerals are thought to bring blood pressure down by releasing sodium from the body and helping arteries dilate. These minerals in supplement form will not provide the same health benefits as consuming them as part of a healthy diet. Watercress contains all three of these healthy minerals.

According to a 2013 study published in the British Journal of Clinical Pharmacology, foods containing dietary nitrates such as watercress have multiple benefits for blood vessels.

  • Reducing blood pressure
  • Inhibiting the buildup of platelets
  • Preserving or improving endothelial dysfunction
  • Decreasing the stiffness and thickness of your blood vessels.

* For individuals managing a blood clotting disorder with blood-thinning medications such as warfarin, it is important not to change their intake of vitamin K suddenly. This is because vitamin K has an essential role in blood clotting and can interfere with some medications, including warfarin.

*  If a person does not refrigerate vegetable juice that contains nitrates, this may lead to a buildup of bacteria. These bacteria convert nitrate to nitrite and contaminate the juice. Too high levels of nitrite can be potentially harmful.

How to Buy

Select watercress with dark green and crisp leaves. If you want less spicy, look for upland cress.

How to Store

Most greens do not have a long shelf life. Watercress, which is 93% water, is no exception. Once harvested, this aquatic leaf is highly perishable and needs to be refrigerated.

To keep watercress fresh for up to 5 days, store it in the refrigerator in a deep bowl, upside-down with the stems submerged in cold water.

How to Cook

Before using watercress, wash it, then shake or spin dry.

Watercress can be used in a wide variety of dishes. To get the most benefits from its active antioxidant compounds, it’s best eaten raw or lightly steamed.

Here are some easy ways to add watercress to your diet:

  • Sprinkle it on your salad.
  • Stir it into your soup near the end of cooking.
  • Use it to replace lettuce in a sandwich.
  • Turn it into pesto by blending it with garlic and olive oil.
  • Use it to top any dish.


15-Minute Zucchini, Pea, and Watercress Minestrone

Katy from One Green Planet/ Photo credit: Katy

4 Servings


  • 1 tablespoon sunflower oil
  • 1 onion, roughly chopped
  • 3.5 ounces asparagus tips
  • 1 medium zucchini, chopped
  • 2 celery stalks, chopped
  • 1 1/4 cups hot vegetable stock
  • 14-ounce can chopped tomatoes
  • 2 teaspoons dried mixed herbs
  • 1 ounce dried spaghetti (gluten-free if necessary)
  • 2 handfuls of watercress
  • 3 tablespoons frozen peas
  • Handful of fresh flat-leaf parsley, roughly chopped
  • Pinch of sea salt and black pepper


  1. Heat the oil in a large pan over a medium heat, then add the onion and asparagus tips. Allow to cook for 2 minutes, then add the eggplant and celery to the pan along with the vegetable stock.
  2. Add the tomatoes and mixed herbs, and increase the heat to high. Break the spaghetti into small pieces and add to the pan. Cover with a lid and cook for 10 minutes, stirring occasionally.
  3. Stir in the watercress and peas, cooking for another minute. Scatter the parsley over the dish after you remove the pan from the heat. Season with sea salt and black pepper.

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Zhang P, Yang C, Guo H, et al. Treatment of coenzyme Q10 for 24 weeks improves lipid and glycemic profile in dyslipidemic individuals. J Clin Lipidol. 2018 Mar - Apr;12(2):417-27 e5.
Khan NA, Abid M, Ahmad A, et al. Cardioprotective Effect of Coenzyme Q10 on Apoptotic Myocardial Cell Death by Regulation of Bcl-2 Gene Expression. J Pharmacol Pharmacother. 2017 Jul-Sep;8(3):122-7.
Molinari C, Morsanuto V, Polli S, et al. Cooperative Effects of Q10, Vitamin D3, and L-Arginine on Cardiac and Endothelial Cells. J Vasc Res. 2018;55(1):47-60.
Fotino AD, Thompson-Paul AM, Bazzano LA. Effect of coenzyme Q(1)(0) supplementation on heart failure: a meta-analysis. Am J Clin Nutr. 2013 Feb;97(2):268-75.
Skarlovnik A, Janic M, Lunder M, et al. Coenzyme Q10 supplementation decreases statin-related mild-to-moderate muscle symptoms: a randomized clinical study. Med Sci Monit. 2014 Nov 6;20:2183-8.
Littlefield N, Beckstrand RL, Luthy KE. Statins' effect on plasma levels of Coenzyme Q10 and improvement in myopathy with supplementation. J Am Assoc Nurse Pract. 2014 Feb;26(2):85-90.


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