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Heart-Healthy Habits
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Your risk of heart disease can be controlled, if you replace old habits with new ones
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By Catherine Winters
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REMEDY Winter 2007
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Look around: Whether you’re standing in line at the grocery store or attending a party with relatives and friends, chances are, someone nearby has or is at risk of developing cardiovascular disease (CVD). In the United States, almost 80 million people have CVD, and many more are at risk of developing it: An estimated 72 million people aged 20 and older have high blood pressure, and 105 million have high cholesterol.
While these numbers are scary, take heart: It’s never too late to dramatically reduce your risk of heart disease. In a four-year survey of nearly 16,000 people aged 45 to 64, researchers at the Medical University of South Carolina, in Charleston, found that those who overhaul their exercise, eating and smoking habits reduce their incidence of CVD by 35 percent and their risk of death by all causes by 40 percent. What did it take? Participants in the study adopted four healthy behaviors:
- Eating five or more fruits and vegetables per day
- Exercising at least two and a half hours per week
- Maintaining a healthy body weight
- Not smoking
The sooner you make changes like these, the better.
If left unchecked, heart disease makes its presence known by your 50s, or earlier. “But in truth, the whole process of heart disease starts silently, in the late teenage years,” says Jennifer Mieres, M.D., director of nuclear cardiology at the New York University School of Medicine in New York City and a spokesperson for the American Heart Association (AHA).
Risk factors include family history of heart disease, getting older, high cholesterol, high blood pressure, smoking or exposure to secondhand smoke, excess weight or obesity, being sedentary, type 2 diabetes, stress, and overconsumption of alcohol.
While you can’t do anything about your genes or age, you can—and should—take action to reduce other risk factors. Why? Consider the toll they take over time:
- High cholesterol promotes buildup of artery-clogging plaque, which restricts blood flow to your heart.
- High blood pressure forces the heart to pump harder, which can make arteries stiff, further restricting blood flow.
- The nicotine and carbon monoxide in cigarette smoke damages the insides of arteries and increases clotting. Smokers’ risk of developing CVD is two to four times greater than that of nonsmokers.
- Excess weight makes the heart work harder, may raise blood pressure and cholesterol, and boosts one’s risk of type 2.
- Being sedentary increases one’s risk of excess weight, as well as high cholesterol and high blood pressure.
- The high levels of blood glucose associated with type 2 can damage the lining of blood vessels.
- Chronic stress can boost blood pressure and lead to overeating or smoking.
- Excessive alcohol use may raise blood pressure and triglycerides. Heavy drinkers often smoke or overeat, too.
The biggest challenges for many people are getting started and then sticking to a heart-healthy routine. You are more apt to stick to a routine, if it is acceptable, accessible and effective, says psychologist Carlo C. DiClemente, Ph.D., director of the UMBC Habits Lab at the University of Maryland, Baltimore County.
What doesn’t work? Vowing to run for two hours each day when your schedule won’t allow it, or trying to eat so little that you end up feeling famished.
The first plan is not accessible; the second is ineffective in the long run. What does work? Walking 30 minutes per day at first, then gradually increasing your exercise time, or working with a nutritionist, so you learn how to cut calories without sacrificing nutrition or leaving your stomach to grumble.
As these behaviors become routine and you see results, you will be motivated to bump up your exercise regimen and cut even more calories. “The moment you change eating habits and start exercising, the moment you stop smoking, the moment you make sure your blood pressure and cholesterol levels are healthy—that’s the moment you affect your risk of cardiovascular disease,” says Richard Stein, M.D., the director of preventive cardiology at Beth Israel Medical Center in New York City and a spokesperson for the AHA. Here are the AHA’s seven steps to reclaiming your heart health:
1. Eat a diet high in fruits and vegetables and whole grains. Limit your consumption of saturated fat to less than 7 percent of your daily calories. Consume less than 1 percent of calories from trans fats. Limit dietary cholesterol to less than 300 milligrams (mg) per day.
2. Eat fish twice a week. The best choice is an oily fish, such as mackerel or salmon, which is high in heart-healthy omega-3 fatty acids.
3. Limit alcohol to no more than one drink per day for women, no more than two drinks per day for men. Despite the benefits of small amounts of alcohol that have been noted in the media, overindulgence can have serious negative consequences.
4. Watch your sodium (salt) intake—it can contribute to high blood pressure. Have no more than 2,300 mg a day (that’s a bit less than a teaspoon).
5. Get at least 30 minutes of physical activity, such as brisk walking, five or more days per week. If you need to shed pounds or maintain weight loss, strive for 60 to 90 minutes of daily exercise.
6. Control your weight with a combination of sensible eating and physical activity. Aim for a body mass index of 18.5 to 24.9 and a waist circumference of less than 35 inches if you’re a woman, less than 40 inches if you are a man.
7. Learn to manage stress. Carve out time to unwind. Do yoga. Meditate. Get a massage. Participate in a group activity or hobby. Find time for yourself. Whatever you do, be sure that you take time each day to breathe deeply and think peaceful thoughts.
Sign up for Choose to Move at choosetomove.org, and for 12 weeks the American Heart Association will email you exercise tips, nutritional advice and an assessment of your heart health. On the site, you’ll find advice, motivation and walking buddies. It works: A group of seven participants lost a total of 60 pounds and lowered their blood pressure. One woman cut her cholesterol level by 86 points!
 Even
the most committed exercisers may hibernate when the weather turns cold
and dark. But there are ways to keep your heart rate up when the
temperature plummets.
- Get creative at home. Work
out to an exercise DVD. Or try boxing: All you need is a pair of boxing
gloves and a punching bag. (To maximize your workouts, hire a trainer
for one session to make sure you have the moves down.)
- Hit the mall on icy days. Most open early for fitness walkers.
- Don’t snub the snow. Cross-country
ski or snowshoe in a nearby park or nature preserve. You may be able to
rent equipment from a sporting-goods store or ski shop, or buy it
secondhand.
- Do at-home strength training. With
a set of two- to five-pound dumbbells, you can work your biceps,
triceps and pectorals. Use ankle weights to work thighs. Do two sets of
12 to 14 repetitions two to three times per week. Also do ab crunches.
- Invest in a treadmill or stationary bicycle—but only if you’ll use it.
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 Habits
are hard to break. “They let us live our lives without thinking too
much,” says UMBC’s Habits Lab director DiClemente. A new behavior
typically takes three to six months to become a new habit. Changing
habits is a five-stage process:
- Pre-contemplation Many
people get stuck in this stage. They want to change, just not in the
near future. But this stage does get people to think about what they
should—or might—do.
- Contemplation
In this stage, people “focus on what they would like to change and
why,” explains DiClemente. “For example, you may ask yourself, ‘How
will a heart attack affect me?’ Your answer might be, ‘It will shorten
my life and be a burden on my family.’”
- Preparation Once
you’ve decided to lower your risk of heart disease, you should devise a
plan that spells out where you are going to concentrate your
energies—on exercising more and reducing fat, for example—and the
strategies that will help you make the change. Also, you should
prioritize the elements of your plan; decide what is most important and
what’s less important. Finally, set a specific time to begin.
- Action “You
need to stick to your plan long enough to create a new pattern in your
life,” DiClemente notes. During this stage, revise your plan as needed.
- Maintenance
During this stage, be vigilant about following your exercise routine.
If you go on vacation, for instance, figure out how to maintain your
exercise and eating regimens. “The task of maintenance involves coping
with unusual and sometimes pretty tough situations,” according to
DiClemente.
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