Lifestyle changes can make a big difference
By Kathleen Zelman, MPH, RD/LD
WebMD Weight Loss Clinic - Feature
Reviewed By Louise Chang, MD
Stop smoking, exercise, lose weight, and eat healthfully -- that's the mantra heard across the country from cardiologists. That's because diet and lifestyle changes can help prevent heart disease, improve your cardiovascular function, and help you live a longer life.
In fact, according to a recent study in the BMJ, encouraging everyone to follow a heart-healthy diet and lifestyle could substantially cut the number of deaths from heart disease.
So what exactly should you be eating for optimal heart health? Here are some simple dietary changes that can make a difference, according to experts and research:
A Mediterranean-style diet may help lower the risk of heart disease. People who live in the Mediterranean region enjoy a bounty of fruits, vegetables, whole grains, beans, olive oil, seafood and lean meats. Eating fewer refined grains and plenty of seafood are thought to be among the secrets to their lower rates of heart disease.
Increasing the soluble fiber in your diet is another easy heart-healthy change. The fiber found in foods like oats, legumes, fruits, and vegetables can help lower cholesterol levels. So start your day with a bowl of oatmeal topped with fruit for a nutritious breakfast that will keep you feeling full all morning. And enjoy beans on your salad or in soups to pump up the fiber while helping to lower your cholesterol level.
Recent research suggests that whole grains can slow the rate of heart disease progression. Indeed, the U.S. Department of Agriculture's 2005 Dietary Guidelines recommend that at least half of your daily grain servings come from whole grains. Whenever you can, choose any of these whole grains instead of refined ones:
- Whole wheat
- Whole oats/oatmeal
- Whole grain corn
- Brown rice
- Whole rye
- Whole grain barley
- Wild rice
- Bulgur (cracked wheat)
A low-fat diet is not only lower in calories, but is also important for heart health. Choosing lower-fat sources of protein such as low-fat or nonfat dairy products, skinless poultry breast, pork tenderloin, and "round" cuts of beef will help reduce the fat in your eating plan. Avoiding foods that are fried or processed with fats (such as cookies, crackers, baked goods, and other snack foods) is another way to cut the fat in your diet.
Avoiding trans fats and saturated fats is especially important for managing your cholesterol levels. So whenever possible, opt for an unsaturated fat instead of one that is saturated or contains trans fats. Look for the helpful monounsaturated fats found in canola oil, olive oil, avocados, nuts, and seeds. Other unsaturated fats, such as corn, safflower and soybean oil, are also better choices than saturated or trans fats. But keep in mind that unsaturated fats are still fats, still high-calorie, and need to be limited in your diet.
Among the best of the many foods that tout heart-healthy properties are products fortified with plant sterols, which can help lower your "bad" LDL cholesterol levels. Plant sterols are found naturally in some foods - like vegetable oils, almonds, beans, corn, wheat, banana, apples, and tomatoes. A healthy diet should provide a certain amount of plant sterols. You can buy sterol-fortified margarines, orange juice, cereal bars, yogurt, chocolate bars, and more. However, more studies need to be done to evaluate its long-term effects.
Alcohol in moderation - that's one drink a day for women and two for men -- can help increase your HDL "good cholesterol." But beyond these recommended amounts, it can have harmful effects. Researchers agree that people who don't drink should not start. There are many other dietary and lifestyle changes that can give nondrinkers similar heart benefits.
For an easy dietary boost, try enjoying a vegetarian meal a few times a week, suggests researcher Wahida Karmally, RD.
"Plant-based diets offer an abundance of low-calorie, nutrient-dense vitamins, minerals, and disease-fighting antioxidants that offer tremendous benefits for your health and your heart," she says.
Maintain a Healthy Weight
Diet isn't the only lifestyle change that can help you get heart-healthy. Excess weight puts extra strain on all parts of your body, including your heart.
"Being overweight can increase your risk for heart disease, diabetes, as well as other diseases," says Karmally, RD. "The first line of defense, and one of the best things you can do for your heart, is to get your weight within normal limits."
Your body mass index (BMI) is a good barometer of whether you're overweight or obese, but your waist-to-hip ratio may be better for evaluating your heart-disease risk, according to a recent study published in the journal Lancet. If you carry excess weight in your midsection, the risks are greater than if the extra pounds settle on your hips.
The good news is that losing as little as 5%-10% of your body weight can reduce your risk of heart disease, by lowering your cholesterol levels and blood pressure and improving blood sugar and insulin sensitivity. You don't need to get to your goal weight to improve your health.
The Exercise Equation
Along with a healthy diet, a lifestyle that includes regular physical activity is key to heart health, says Winston Price, MD. Price advises his patients to strap on pedometers and try to incorporate extra steps into their daily routines.
"The combination of a heart-healthy diet -- a Mediterranean-style one that is rich in fiber, fruits, vegetables, and low- or nonfat diary -- and a commitment to exercise can have a huge impact on the development of heart disease," he says.
Regular physical activity not only burns calories and strengthens your cardiovascular system, but can also raise your HDL "good" cholesterol levels. You can get this heart benefit from brisk walking, jogging, cycling, swimming laps, or other aerobic exercise. Doing the equivalent of 3 miles, four times a week, will provide the greatest benefit.
Two recent studies in the journal Archives of Internal Medicine suggest that walking a half hour a day can add three years to your life and improve your heart health.
See Your Doctor
It's important to keep in mind that, even with a heart-healthy diet and other lifestyle improvements, some people will still need medication. Talk with your doctor and see if you could reduce or eliminate your medications by adopting a heart-healthy lifestyle.
SOURCES:BMJ, Aug. 17, 2005. Lancet, Nov. 5, 2005. Archives of Internal Medicine, Nov. 14, 2005. Wahida Karmally, DrPH, RD, associate research scientist, Columbia University. Winston Price, MD, FAAP, immediate past president, National Medical Association.
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