Keeping your heart healthy is not rocket science, but it does require going back to basics that have fallen by the wayside in our industrialized world. The new focus is on prevention, although the American Heart Association (AHA) reports that over the past decade it has reduced death rates from heart attack and stroke by 25 percent, due mainly to improved techniques in treatment.
Dr. Carl "Chip" Lavie, medical director of cardiac rehabilitation and prevention and director of the exercise laboratory at Ochsner Medical Center, outlines a trio of preventative measures, with a strong emphasis on exercise and physical activity. He also emphasizes the need to maintain a healthy weight and prevent obesity, and lastly not to smoke tobacco.
"All individuals should be performing some exercise or physical activity for 30 minutes on most days, meaning six to seven days per week," he says. "AHA statistics show that 61 percent of all people are performing no physical activity."
Physical activity, even if it's just walking briskly, is tremendously beneficial to the human body, Lavie says. It lowers blood pressure, burns calories, increases good cholesterol, lowers bad cholesterol, normalizes glucose and insulin sensitivity to help eliminate the risk of diabetes, decreases inflammation and more.
"Exercise can help almost everything," Lavie says "It doesn't matter what people do, whether they walk, ride a bike, do an elliptical machine or dance, to get up to a good aerobic workout. The leading excuse people give is they don't have time. I have a good cartoon for that: The doctor says, 'Would you rather have to find 30 minutes a day for exercise, or 24 hours a day to be dead?' If you don't make exercise a high priority, it's hard for most people to get it done."
Increasing physical activity is key in realizing Lavie's second component to heart health: weight reduction and preventing obesity, which he says is epidemic in the United States and particularly in Louisiana and New Orleans, which has at least once been named the "fattest city" in the United States. Obesity, he says, raises triglycerides and blood pressure, increases blood sugar (leading to diabetes) and inflammation and has other detrimental effects.
"National statistics right now say over 70 percent of adults are either overweight or obese," he says. "Obesity is an independent risk factor for most of the heart diseases. If we could reverse obesity or at least prevent weight gain or get obese people to lose some weight ... that would be a tremendous preventative service for our society.
"It's very difficult to prevent obesity, especially in our society, where there is abundant food and good food, and you aren't exercising."
Nutrition is key both in preventing heart disease, maintaining cardiovascular health and avoiding obesity. It's not hard to eat right, says Chantal Lemoine, a registered dietician at East Jefferson General Hospital, you just have to think about what you are consuming and avoid processed foods.
"It's basically eating more natural; eating fruits and vegetables, making sure you're getting plenty of vitamins, minerals, fiber, lean meats, low-fat dairy products," she says. "It's pretty much the food people normally eat. Some people may just have to make more healthy choices, like getting a low-fat yogurt instead of a regular yogurt."
Lemoine counsels patients on how to change their diets to lose weight, recover from heart disease and other conditions."It really is a psychological thing," she says. "A lot of people when they want to start a diet they say, 'If it tastes good, spit it out.' They have a mindset that healthy food is like tasting cardboard, but healthy food can be really, really good. If you reduce the fats and sugar, instead of tasting the butter or sugar, you can taste the food. Herbs and spices are a good way of spicing up food, and a lot of them do have antioxidants."
One thing to pay attention to is the type of fats you consume. Lemoine says everyone should avoid saturated and trans fats that come from animal products and are found in highly refined products such as cakes and cookies, instead choosing liquid fats such as olive oil, canola oil and those you get from nuts, seeds and avocados. Next, adjust the way you prepare foods, opting for grilling, baking, broiling and steaming instead of frying. "You want to start off with a healthy food and have it remain healthy (through preparation)," she says.
One of her favorite, easy-to-prepare dishes is cutting up a mixture of vegetables (carrots, onions, garlic, squash, zucchini, broccoli) placing them on a baking pan that has been sprayed with olive oil to prevent sticking, sprinkling basic Italian seasoning over them and baking them for 45 minutes in a 400-degree oven.
An important tool in choosing what to put in your grocery cart is reading product labels and knowing what components you want to avoid.
"It's a great guide to tell you what's in your food," Lemoine says. "You should educate yourself about what you're putting in your body. It also gives you a guide on how much you should be eating (by looking at the serving size). Whenever you see a number other than zero next to the trans fat (nutritional information listing), you want to put it back on the shelf. It's going to raise your cholesterol more than saturated fat. It tends to lower your good cholesterol and raise your bad."
Product labels also provide a guide for how much fat is in a product (the list states how much fat is present as well as the percentage of the daily recommended amount it represents).
"One of the most important things about heart health is controlling your weight," Lemoine says. "Looking at the fat content is important. The AHA recommends you have 7 percent or less of your total calories come from saturated fat. For cholesterol, you should limit it to 300 milligrams per day.
"Salt plays a part in helping to raise your blood pressure. Typically, the recommendation is to limit your sodium to 2,300 milligrams or less per day. That's about a teaspoon of table salt. That can really add up, because there is typically salt in everything." It's not a nutrient we need much of and came into favor as a meat preservative and a cover for food that didn't taste great. Parents should help their children avoid salt at an early age. "Salt is a learned flavor," she says. "We aren't born liking salt."
Product labels also can help consumers identify artificial colorings, flavorings and other products in their foods. "Avoid the words 'refined,' 'salt' or 'sugar' in the first few ingredients listed," Lemoine says. "You also want to avoid hydrogenated oils and partially hydrogenated oils, because that's a clue to trans fats." Everything included in a product must be listed on the ingredients list of the food label, although not everything has to be listed in the nutrition facts part.
Lavie and Lemoine both emphasize the virtue of eating lots of fiber, and the doctor adds omega-3 fatty acids to the list of nutrients highly beneficial to heart health.
"Fiber is one of the main items that can help lower cholesterol and help improve heart health," Lemoine says. "Soluble fiber is the type you want. It absorbs water and makes you feel more full and lowers cholesterol." Good sources, they say, include oatmeal, whole-grain bread, apples and pears.
Lavie also touts the value of omega-3 fatty acids in preventing heart disease and promoting overall health.
"Something that I've been very high on is benefits of omega-3 fatty acids and fish oil (either through supplements or eating foods high in them)," he says. "It's relatively inexpensive and has tremendous benefits. Right now everyone is recommended to average 500 milligrams a day, and for heart patients 800 to 1,000 milligrams a day. There is evidence it is reducing cardiovascular disease."
Lavie also says not smoking is critical to heart health because the habit contributes to atherosclerosis (hardening of the arteries), causes inflammation, lowers good cholesterol and promotes heart attacks and strokes. Further, numerous chemicals added to cigarettes are toxins and damage the walls of the arteries. The good news is that conditions caused by smoking improve quickly once a person puts down tobacco products.
"You usually don't get heart attack and stroke if you don't have hardening of the arteries," he says. "When one stops smoking, you get almost immediate reduction in heart attack and stroke. Within weeks and months it goes down, and within a year you almost reach the level of a nonsmoker." (With lung cancer, he points out, it takes almost 20 years for the risk to drop to the level of a nonsmoker.)
As adults learn the value of not smoking, exercising regularly and eating well, it is hoped that our children will grow up with good habits and avoid or reverse this country's trends of obesity, diabetes, heart disease, etc.
"The obesity epidemic we see in adults is also certainly showing up in children. It's been evolving for a long time," Lavie says. "If you go back centuries, people were hunters and gatherers and they had to gather their food. The industrial age has been good for us ... but we no longer have to work for our food; it comes to us. We've gone from people having to be active to figuring out how to make ourselves active."