When you think about heart disease, you imagine an overweight, older male experiencing heart palpitations and chest pain. That’s definitely valid, but a cardiologist who is an athlete also wants people to know that heart disease is not one-size-fits-all, and it can show up in a wide variety of symptoms and affect people of all ages. Heart disease is currently the leading cause of death for men, women, and people of every racial and ethnic background in the United States, according to the Centers for Disease Control and Prevention, and it's never too early to start eating a heart-healthy diet rich in plant-based foods. No amount of exercise can outrun the damage we can do with our forks, and being active is only half the equation.

Even though heart disease is common, it is also preventable 80% of the time, according to the American Heart Association. So if heart disease is preventable, why are rates so high? This is attributed to the Standard American Diet, which consists largely of processed foods that are high in sugar and fat, and a sedentary lifestyle.

Dr. Heather Shenkman, MD, FAAC, a vegan cardiologist and athlete, is on a mission to help individuals regain their health by focusing on healthy lifestyle changes. In her practice, she takes a whole-person approach –– treating food as medicine by promoting plant-based food choices in addition to regular exercise habits. In an exclusive interview with The Beet, Dr. Shenkman walks us through the benefits of a plant-based diet for cardiovascular health, and her personal favorite vegan meals. She is an endurance athlete who eats an entirely vegan diet. Her advice to patients:  Add more plants and movement to your life, which will nourish your body and keep your heart healthy. Stay active but don't count on your gym workouts to be enough to fight a diet that is laden with fat, sugar and chemicals.

Photo Credit: Shiggy Ichinomiya

The Beet: What made you decide to go vegan?

Dr. Heather Shenkman: I became a vegetarian while in high school, because of my love for animals. I was a vegetarian throughout college and medical school, but I became a vegan during my cardiology fellowship. I had originally become a vegetarian because of animal cruelty. However, as I learned more about the plight of farm animals, I felt like it was the right thing to do to also cut out dairy and eggs. I became fully vegan during my cardiology fellowship. During my research at that time, I had read about the work that Drs. Esselstyn and Ornish had done to successfully reverse heart disease with a plant-based diet. So since then, about 16 years ago, I’ve been a vegan.

The Beet: What inspired you to become an avid athlete and engage in a variety of sports?

HS: I've always been active physically in one way or another. In 2005, the same year I adopted a vegan diet, I was recovering from a foot injury, and could not do the running that I used to do to stay fit. As a result, I took up swimming and road cycling. Once my foot healed and I started running again, I asked my spin instructor, who was an avid triathlete, to coach me for my first triathlon, the Finger Lakes sprint triathlon, in September 2005. I had so much fun training, meeting other triathletes, and racing, that I was hooked!

The Beet: What sparked your interest in cardiology? Did a plant-based diet have anything to do with it?

HS: My interest in cardiology initially stemmed from an interest in being able to make an impact in my patients' lives, and honestly didn't have anything to do with a plant-based diet. I didn't go plant-based/vegan until the second year of the cardiology fellowship. I used every chance I could to encourage my patients to make better diet and lifestyle choices. But, back then in 2005, there wasn't much understanding of plant-based diets, this was before Forks Over Knives and before most people had any understanding of the word "vegan". As time has gone on, it's become easier to encourage patients to adopt more plant-based styles of eating.

The Beet: As a cardiologist, do you place a great emphasis on food as medicine?

HS: I encourage my patients to eat more fruits and vegetables. That's always a good starting point. We talk about minimizing processed food, restaurant food, fried foods, soda, and sweets. We agree that years of animal products, fast food, junk food, lack of exercise, and smoking have all contributed to their current state of health. We also agree that in order to do better, some of those habits need to change. To help guide them in the right direction, I advise them to watch the Forks Over Knives documentary and frame a whole-food, plant-based diet as the healthiest choice. Since no other diet has been shown to reverse heart disease, I tell them that the closest they can come to this diet as possible is best for their heart.

The Beet: Tell us about your book, The Vegan Heart Doctor's Guide to Reversing Heart Disease, Losing Weight, and Reclaiming Your Life. What drove you to write this?

HS: I wanted my patients to know the basics of heart disease and that they can make an impact on their own health. I talk about how to incorporate better eating habits and incorporate more exercise, and how to find joy in it all. Now, I recognize that not every patient who walks into my office is going to walk out a vegan. In fact, most won’t. My goal as a cardiologist is to provide my patients with the best information on how to improve their heart health and reduce their risk of cardiovascular events.

The Beet: What advice do you give your patients often if they are considering going plant-based?

HS: I give them literature, in particular, the Physicians Committee's "Vegetarian Starter Kit." It reinforces a lot of why a plant-based diet is a healthy choice and provides meal ideas. I try to frame diet change as an adventure, not deprivation, a chance to try new foods, and something that will help them to feel better and improve their health.

The Beet: What is your favorite vegan meal?

HS: For breakfast, I love oatmeal or a homemade smoothie. Many mornings, I will make a smoothie bowl for myself and my 17-month-old daughter Ava; I add a banana, an orange, frozen strawberries, a couple of chunks of carrot, and maybe a tiny amount of broccoli, unsweetened soy milk, oats, dried coconut, flax and chia seeds to my Vitamix. I also love cooking up a shepherd's pie with lentils and veggies and mashed potatoes on top.

The Beet: Tell us about your advocacy, such as making sure kids have access to heart-healthy, plant-based meals in schools. Why is it crucial to start a healthy lifestyle at a young age?

HS: So many of my patients tell me that they are not used to eating vegetables. But also, much of my motivation to advocate for healthy meals in schools is that I now have a young daughter and want her to be healthy.  We know that our preferences for foods start early in life.  If we can introduce children to healthy foods when young, this will shape their taste buds for years to come.

The Beet: What has been your personal biggest triumph? What are you proudest of?

HS: I'm proudest of earning a medal at the Maccabiah Games in Israel in 2013.  I competed in the "Maccabi Man and Woman" Competition, which was a four-event competition occurring within a week, including a time-trial bike race, a half marathon, an Olympic distance triathlon, and a 5-kilometer swim.  It was challenging not only to compete in these events but to do so in such a short amount of time, in very hot weather.