Heart Health Tips From a Top Cardiologist

Last Editorial Review: 1/31/2008

Cut through the heart health confusion. Get tips from a cardiologist about diet, lifestyle, and more.

By Gina Shaw
WebMD Feature

Reviewed By Brunilda Nazario, MD

Your grandmother, father, and cousin may have heart disease, but even with a strongly inherited predisposition to the condition you can cut your risks dramatically by pursuing a heart healthy lifestyle -- and it's easier than you think.

Over 800,000 Americans died from heart attacks and other cardiac illnesses lasts year, but most of those deaths -- four out of five -- were preventable. With a few key tips from a world-renowned heart expert you can be on your way to building a healthy heart that will last a lifetime.

Do You Eat What's Best for a Healthy Heart?

Chocolate is bad for your heart. No, it's good. Wine is unhealthy. No, it's healthy. Pack your plate with protein and cut back on bread to lose weight. No...

With all the mixed messages about "good" and "bad" foods in the media, it's not surprising that many people just give up trying to figure out what they should eat. If you're confused, you're not alone.

"Our research has shown that the No. 1 thing people are confused about when it comes to heart health is what the best diet is," says preventive cardiologist Lori Mosca, MD, founder of Columbia University Medical Center's Preventive Cardiology Program and author of Heart to Heart: A Personal Plan for Creating a Heart-Healthy Family. "Every week there's a conflicting research study or a new book that refutes last year's book."

Forget the competing headlines -- the best way to eat heart healthy is to follow national guidelines from organizations like the American Heart Association. "These are established by experts who monitor research, and are not focused on the latest fads and trends. It's actually much simpler than people realize," Mosca says.

5 Simple Steps to a Heart Healthy Diet

Ready to step up to a diet rich in the healthy nutrients your heart craves? The experts recommend staring here:

  • Eat a diet rich in vegetables, fruits, whole grains, and fiber.
  • Eat fish at least twice a week.
  • Limit how much saturated fat, trans fat, and cholesterol you eat. Only 30% of your daily calories should come from fat, with very little of that from saturated fats.
  • Select fat-free, 1% fat, and low-fat dairy products.
  • Cut back on foods containing partially hydrogenated vegetable oils to reduce trans fat in your diet.
  • Limit your salt intake.

One way to make sure that your diet is rich in fruits, vegetables, and fiber, and low in saturated fats, is to divide your plate at each meal: half vegetables, 1/4 high-quality protein (like legumes -- terrific sources of protein and great for a healthy heart!), and 1/4 for fish or a very lean meat.

And remember, you should get your nutrients from foods themselves, the antioxidants and other heart-healthy goodies found in foods like blueberries, beans, and artichokes don't pack the same punch when they're not in food form.

And avoid fad diets, advises Mosca. "Almost every one may result in short-term weight loss but leave you weighing even more a year later, and preventing weight gain is one of the best ways to prevent developing heart disease risk factors."

Is Your Exercise Routine Really Helping You Have a Healthy Heart?

It's easy to get discouraged about exercise: It's hard to fit into a busy lifestyle. The people at the gym look like they spend hours there. You haven't run a mile since college. But no excuses -- like eating right, getting the exercise your heart needs is easier than it looks.

If you're not overweight, all you need to maintain a heart healthy lifestyle is 30 minutes of moderate physical activity five or more times a week. And you don't have to do it all at once -- 15 minutes in the morning and 15 minutes in the evening are just fine.

"Getting that amount of exercise has substantial benefits for your heart," says Mosca. Just how much is hard to quantify, but research shows that being physically inactive is a major risk factor for developing coronary artery disease.

And exercise is the gift that keeps on giving. That's because regular, moderate exercise also helps:

If you need to lose weight, it's going to take a little more effort. "For weight management, we want low to moderate intensity activities for 60 minutes per day," says Mosca. "The only way to really lose weight is to decrease calories in and increase calories out, and what works best is a modest approach to both. If you just reduce your caloric intake, for example, your body slows its metabolism to compensate."

Exactly what kind of exercise you do is less important than simply doing it in the first place. One way to make sure you don't skip it: Structure family time around physical activity.

For example, Mosca, her husband, and son have found a track team they can all participate in, and they often hang out at their local swim club. Your local YMCA is often a great place to start in finding opportunities for your family to get heart-healthy exercise together.

Do You Know Your Other Heart Health Risk Factors?

A heart-healthy lifestyle is about more than just diet and exercise. The single most dangerous thing you can do to your heart is to smoke. Just by itself, cigarette smoking increases your risk of heart disease, but it also worsens other factors that contribute to heart disease:

  • It increases blood pressure
  • It increases the tendency of blood to clot
  • It decreases levels of HDL -- the good cholesterol

If you smoke a pack a day, you have more than twice the risk of a heart attack than someone who doesn't smoke.

"Every cigarette you cut back matters," says Mosca. "The goal is always complete cessation, but even eliminating one cigarette a day can make a difference. Start there, and then try to keep going until you've quit altogether."

A big plus: It doesn't take long for your body -- and your heart in particular -- to reap the health benefits of quitting. Twenty minutes after your last cigarette, your heart rate and blood pressure drop. Two weeks to three months later, your circulation and lung function improve. Just one year after quitting, your excess risk of coronary heart disease is just half that of a smoker's.

You may have other risk factors for heart disease that are not on your radar. Mosca calls anxiety, anger, depression, and social isolation "silent epidemics" that are very prevalent, commonly missed, and potentially dangerous for your heart.

"Depression, for example, is very common, and it's very strongly linked to heart disease," she says. "If you or someone you love is depressed or harboring a lot of anger, or seems isolated, encourage them to seek help.  There are many methods to help you deal with these risk factors."


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A Healthy Heart: What's Up Your Family Tree?

There are some risk factors for heart disease that you can't control, and family history is one of them. If a close relative, like a mother, father, sister, or brother had a heart attack or died of heart disease -- especially at a young age -- then the health of your heart may be at greater risk as well.

"Families can share a predisposition to heart disease both because they have shared genes and a shared lifestyle," says Mosca. You get half your genes from mom and half your genes from dad -- but you probably also get your eating and exercise habits from them, too.

"If you have a family history of heart disease, it's important that you have yourself checked out," says Mosca.

You may find, for example, that you have high cholesterol and it needs to be managed with medication. On the flip side, you may be greatly reassured to find out that Dad's heart attack probably had to do with smoking and being overweight, and you don't share those risk factors. Either way, you can do something about your risk: genetics is not destiny.

The most important thing to understand about a healthy heart is that many of the factors that put you at risk for disease lie within your power to control.

"Even if you're not at high risk now, your most important goal should be to prevent yourself from developing increased risk," says Mosca. "You can do that through a heart-healthy lifestyle."

SOURCES: Lori Mosca, MD, PhD, director, preventive cardiology program, Columbia University Medical Center, New York City. Walter Willett, MD, professor of epidemiology and nutrition, Harvard School of Public Health, Cambridge, Mass. American Heart Association, Dallas. National Heart, Lung, and Blood Institute, Bethesda, Md. American Cancer Society, Atlanta. WebMD Medical Reference: "Heart Disease: Smoking and Heart Disease."

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