5 Steps to a Healthy Heart
A healthy lifestyle is good for your heart. You've heard that so often your eyes are glazing over.
But what if we told you there's a way to cut your chances of heart disease by a whopping 87 percent? Would that get your attention?
That is, in fact, the finding of a 16-year study that tracked nearly 43,000 male health professionals, ages 40 to 75. The results appeared in the journal Circulation. They show that a combination of eating a healthy diet, staying at a healthy weight, exercising regularly, not smoking, and drinking alcohol in moderation may sharply cut your risk of heart disease.
Why? The study's authors, from Harvard and the American Cancer Society (ACS), say those steps take aim at a number of heart disease risk factors, including blood pressure and cholesterol levels.
Lifestyle changes important
Here's another eye-popping statistic from the study: 62 percent of the heart attacks suffered by men who didn't follow any of the five healthy lifestyle measures might have been prevented if they had followed all five steps. In other words, healthy lifestyle changes could head off most U.S. heart attacks.
"At the beginning of the study all of these men were apparently healthy," says lead author Stephanie E. Chiuve, Sc.D., a research fellow in the Harvard School of Public Health's Department of Nutrition. "It shows the power of following a healthy lifestyle."
That's also true for women, based on a similar large, long-term study of nurses. "Even though the biology between men and women is different, that study found similar results," says Dr. Chiuve. "The magnitude of the benefit derived from these five lifestyle factors may be different, but the benefits for everyone are clear."
Can lifestyle changes do more than pills? The National Heart, Lung, and Blood Institute (NHLBI) studied more than 800 men and women who had hypertension (high blood pressure) or pre-hypertension. After 18 months, three out of five people who went to sessions on weight loss, physical activity, and limiting sodium and alcohol no longer had high blood pressure.
"Only 50 percent of people with high blood pressure who see a doctor and are prescribed blood pressure medications get their blood pressure under control," says NHLBI research nutritionist Eva Obarazanek, Ph.D., co-author of the study. "So, with 60 percent success, a healthy lifestyle is better than drugs in controlling blood pressure."
With that kind of evidence, why not follow these five steps?
Step 1: Eat healthy
In the Circulation study, a low-risk diet included about three servings of vegetables, 2-1/2 servings of fruit, half a serving of nuts and 9 grams of cereal fiber a day, with fairly low fat intake. The healthy diet was low in red meat, which is often high in saturated fat. For each serving of red meat the men ate, they ate 2-1/2 servings of chicken and fish.
Dr. Chiuve says many sensible diets would have met this low-risk test. For example, depending on your age and sex, the government's new food pyramid calls for you to consume 2 to 3 cups of vegetables and 1-1/2 to 2 cups of fruit each day. You should also shoot for 5 to 8 ounces of grains, with a focus on whole grains. A slice of bread, a cup of cereal or a half-cup of cooked pasta counts as an ounce. You can eat more if you're physically active.
The pyramid also says you should keep your total fat intake between 20 to 35 percent of calories. Make most of your fat the healthy polyunsaturated and monounsaturated kind, such as fish, nuts and vegetable oils. Eat as little trans fat (common in baked goods and fried foods) as you can. And try to keep saturated fats (like butter or red meat) to less than 10 percent of calories.
"The key is making small changes you feel comfortable with and can sustain over time," says Alice Lichtenstein, D.Sc., director of cardiovascular nutrition at the USDA Human Nutrition Research Center on Aging at Tufts University.
"Consider switching to low- and non-fat dairy products," she says. "Continue eating what you enjoy, but you might want to make changes in your portion sizes, or in the proportion of meat to vegetables at dinner."
She also suggests you cut back on nutrient-poor foods. That includes the "liquid calories" you can pile up fast from soft drinks, fruit juices, coffee blends and alcohol.
Don't go crazy trying to work out the amount of saturated fat and trans fats you can have. "The point is to choose foods that minimize your intake of these fats," says Dr. Lichtenstein. That means more fruits, vegetables and fish, leaner cuts of meat, lower-fat diary products, smaller serving sizes and fewer foods made with trans fats.
Step 2: Maintain a healthy weight
The Harvard and ACS researchers say a body mass index (BMI) of 25 or less is low risk. The BMI is a fair indicator of body fat, which is tied to your risk of disease and death.
If you're overweight (with a BMI above 25), losing just 10 percent of your weight will help lower your risk for diseases linked to obesity. So if you weigh 200 pounds, shedding 20 pounds may make you less prone to heart disease, stroke, type 2 diabetes and some cancers.
Step 3: Exercise
Get moving, at a moderate or vigorous rate, for a total of at least 30 minutes a day. The American Heart Association (AHA) stressed the role of exercise in 2006 when it updated its lifestyle recommendations, which used to rely more on diet.
"The two go together—they should be inseparable," says Dr. Lichtenstein, who chaired the AHA's 2006 committee. "You don't have to do it all at once, but 30 minutes a day most days should be a minimum goal. For most people, doing more is probably better." If you're trying to lose weight, for instance, the AHA suggests you aim for up to 60 minutes all or most days.
Moderate to vigorous workouts in the men's study included walking at a brisk pace (at least 3 miles an hour), jogging, running, bicycling, swimming, tennis, squash, racquetball, rowing, and calisthenics.
Step 4: Don't smoke
According to a National Institutes of Health panel of experts, the United States could double or triple smokers' success at quitting by promoting proven measures that can help smokers stop. These include nicotine replacement therapy, telephone quit lines and counseling. The panel found these strategies work even better when combined.
Want to quit? Call 1-800-QUIT-NOW (1-800-784-8669) or visit http://www.smokefree.gov. You also can get help from the American Lung Association, http://www.lungusa.org, or the American Cancer Society, 1-800-ACS-2345 (1-800-227-2345), http://www.cancer.org.
Step 5: Drink alcohol moderately
A standard drink contains 11 to 14 grams of alcohol. That drink can be 12 ounces of beer, 5 ounces of wine or 1.5 ounces of liquor. Researchers from Harvard and the ACS considered 5 to 30 grams of alcohol per day—roughly one-half to two standard drinks—to be low risk. The government's Dietary Guidelines for Americans say men can safely have two drinks each day, compared with one drink a day for women.
These five steps help whether or not you're taking medication to control high blood pressure or high cholesterol. The Circulation study concluded that 57 percent of the heart attacks suffered by men taking such drugs might have been avoided if they had followed a healthy lifestyle.
Your age doesn't matter, either. "Even though the youngest men were 40 years old when the study started, we found that men who adopted lower-risk lifestyles lowered their risk for heart disease," says Dr. Chiuve. "In other words, it's never too late to change."