Heart health matters!

Heart disease may be a leading cause of death, but the good news, however, is that 80 percent of premature heart attacks and strokes are preventable. While one cannot modify some of the risk factors such as family history, sex or age, there are some key steps to prevent heart disease that one can always implement successfully.

A Healthy diet, regular physical activity and not using tobacco products are the key to prevent a heart attack. Eating a healthy diet can reduce the risk of heart disease. Two examples of heart-healthy food plans include the Dietary Approaches to Stop Hypertension (DASH) diet plan and the Mediterranean diet.

It is also necessary to periodically check and control risk factors for heart disease and strokes such as high blood pressure, high cholesterol and high blood sugar levels or Diabetes. Preventive steps mentioned hereon also detail on ways to lead a lifestyle with a lower risk of heart attacks.

Don’t smoke or use tobacco

Smoking or consuming tobacco of any kind is one of the most important risk factors for developing heart disease. Chemicals in tobacco can damage the heart and blood vessels, leading to narrowing of the arteries due to plaque build-up (atherosclerosis). Atherosclerosis can ultimately lead to a heart attack.

Carbon monoxide in cigarette smoke replaces the oxygen in one’s blood. This increases blood pressure and heart rate by forcing the heart to work harder to supply adequate oxygen.

Women who smoke and take birth control pills are at greater risk of having a heart attack or stroke than those who don’t smoke or take birth control pills, as both the factors can increase the risk of blood clots.

Please note that no amount of smoking is safe. The more one smokes, the greater is the risk. Smokeless tobacco, low-tar and low-nicotine cigarettes and secondhand smoke can also be risky. Even the so-called ‘social smoking’ – smoking only while at a bar or restaurant in a social setting – can be dangerous and increase the risk of heart disease. The redeeming news, though, is that one’s risk of heart disease begins to lower soon after quitting. The risk of coronary heart disease substantially reduces after one year of quitting smoking and drops almost to that of a non-smoker in about 15 years.

Exercise for about 30 minutes 

Regular exercise reduces the risk of heart disease. The payoff is even more handsome if one can combine physical activity with other lifestyle measures such as maintaining a healthy weight.

Physical activity can help control our weight and reduce our chances of developing other conditions that may put a strain on our heart, such as high blood pressure, high cholesterol and Diabetes.

Regular physical activity for at least 30 minutes every day helps to maintain cardiovascular fitness; at least 60 minutes on most days of the week helps to maintain a healthy weight.

For more health benefits, aim for 300 minutes of moderate aerobic activity or 150 minutes of vigorous aerobic activity every week. Additionally, one can do strength training exercises for two or more days a week. Same health benefits will accrue even if one divides workout time into three 10-minute sessions for most days of the week.

Activities such as gardening, housekeeping, walking up and down the stairs and walking the pet dog contribute positively. Avoid strenuous exercise instead one can realise bigger benefits by gradually increasing the intensity, duration and frequency of workouts.

Eat a heart-healthy diet

• Control the quantity

How much one eats is just as important as what one eats. Eating until one feels unduly stuffed can lead to excess caloric consumption. Use a small plate or bowl to help control your portions. Eat relatively larger portions of low-calorie, nutrient-rich foods such as fruits and vegetables and smaller portions of high-calorie, high-sodium foods such as refined, processed or fast foods. Such an approach can ensure a healthy heart and waistline.

One must keep track of the number of servings one eats. A serving size is a specific amount of food, defined by common measurements such as cups, ounces or pieces. For example, one serving of pasta is 1/2 cup or about the size of a hockey puck. A serving of meat, fish or chicken is about 2 to 3 ounces or about the size and thickness of a deck of cards.

• Eat more vegetables and fruits

Vegetables and fruits are good sources of vitamins and minerals. They are low in calories and are rich in dietary fibre. One must add more fruits and vegetables to one’s diet with a goal of around five servings a day. Eating fresh fruits and vegetables not only helps prevent heart disease but also it benefits in improving blood pressure, cholesterol levels and Diabetes.

• Select whole grains

Whole grains are a good source of fibre and other nutrients that play a role in regulating blood pressure and improving overall health. The preferred grains include whole wheat flour, whole grain bread, whole grain pasta and oatmeal. Examples of grain products that are better to be avoided include muffins, cakes, doughnuts, buttered popcorn and frozen waffles.

• Limit unhealthy fats

A high blood cholesterol level can lead to a build-up of plaques in our arteries, called atherosclerosis, which can increase one’s risk of heart attack and stroke. We can restrict the bad saturated fats (to less than 7 percent of total daily calories) and the worst trans fats (to less than 1 percent of total daily calories) in our diet by avoiding butter, margarine and shortening (The term shortening refers to any baking fat that’s solid at room temperature, like butter and margarine or a semi-solid fat made from hydrogenated vegetable oil) – which we tend to add to food when cooking and serving.

Major sources of saturated fat include red meat, full-fat dairy products, coconut and palm oils. Sources of trans-fat include deep-fried fast foods, bakery products, packaged snack foods, margarine, crackers, chips and cookies.

Other ways of reducing saturated fat in our diet include trimming fat off meat or choosing lean cuts of meat with less than 10 percent fat, replacing butter with low-fat yogurt, using sliced whole fruit on our toast instead of margarine and shunning cookies, crackers or chips whose label reads any ingredient as partially hydrogenated.

Sources of monounsaturated fats, such as olive oil or canola oil and polyunsaturated fats, found in certain fish, avocados, nuts and seeds make good choices for a heart-healthy diet. But moderation is essential as all types of fat are high in calories.

Ground flaxseed or chia seeds soaked in water are high in fibre and omega-3 fatty acids and may help lower the cholesterol levels. Powdered flax seeds can be added to yogurt, applesauce or hot cereal.

• Choose low-fat protein sources

Lean meat, poultry and fish, low-fat dairy products and eggs are some of the best sources of protein. However, I prefer lower fat options, such as skim milk rather than whole milk and grilled chicken breasts rather than fried chicken.

Fish is another good alternative to high-fat meats. And certain types of fish are rich in omega-3 fatty acids, which can lower blood fats called triglycerides.  The highest amounts of omega-3 fatty acids are found in cold-water fish such as salmon, mackerel and herring. Other sources of omega-3 fatty acids are flaxseed, walnuts, soybeans and canola oil.

Legumes such as beans, peas and lentils are also good sources of protein and contain less fat and no cholesterol, making them good substitutes for meat. Substituting plant protein for animal protein, for example, a soy or bean burger for a hamburger leads to lower fat and cholesterol intake. One may avoid full-fat milk, organ meats such as liver, hot dogs and sausages, bacon, fried or breaded meats.

• Reduce the sodium intake

Eating a lot of sodium can contribute to high blood pressure, a risk factor for cardiovascular disease. Reducing sodium is an important part of a heart-healthy diet. Ideally, healthy adults should consume not more than 2.3 g of sodium (about a teaspoon of salt) per day. Older people and especially those who have been diagnosed with high blood pressure, Diabetes or chronic kidney disease are best advised to not exceed the consumption of 1.5 g of sodium a day.

Reducing the amount of salt we add to food at the table or while cooking is a good first step, though much of the salt we consume comes from canned or processed foods, such as soups and frozen dinners. Eating fresh foods and making our own soups and stews can reduce our salt intake.

Be wary of foods that claim to be lower in sodium because they are seasoned with sea salt instead of regular table salt – sea salt has the same nutritional value as regular salt.

Many condiments are available in reduced-sodium versions and salt substitutes or herbs and spices can add flavour to our food with less sodium.

• Plan ahead: Create daily menus, Eat to be your best

When selecting foods for each meal and snack, we need to limit the portion size and consider vegetables, fruits and whole grains. We must choose lean protein sources and healthy fats and limit salty foods. Variety in one’s diet is a good way to get all the nutrients we need.

An occasional ice cream cone or a handful of potato chips won’t derail our heart-healthy diet. However, overindulgence has to be an exception, rather than the rule. What is important is to ensure that we eat healthy foods most of the time.

Following a heart-healthy diet also means keeping an eye on how much alcohol one drinks. Too much alcohol can become a health hazard.

Maintain a healthy weight

Being overweight, especially if one carries excess weight around the waist, increases one’s risk of heart disease. Excess weight can lead to conditions that increase our chances of heart disease – including high blood pressure, high cholesterol and Diabetes. Metabolic syndrome – a combination of fat around the abdomen, high blood pressure, high blood sugar levels and high triglycerides – also increases the risk of heart disease.

One way to see if our weight is healthy is to calculate our body mass index (BMI), which considers our height and weight in determining whether we have a healthy or unhealthy percentage of body fat. A BMI level of 25 kg/m2 and higher is generally associated with higher cholesterol, higher blood pressure and an increased risk of heart disease and stroke.

Waist circumference can also be a useful tool to measure how much abdominal fat one has:

• Men are generally considered overweight if their waist measurement is greater than 90 cm.
• Women are generally considered overweight if their waist measurement is greater than 80cm.

Even a small weight loss can be beneficial. Reducing our weight by just 3 to 5 percent can help decrease our triglycerides (a type of fat) and blood sugar, and reduce our risk of Diabetes. Losing even more weight can help lower our blood pressure and blood cholesterol level.

Get enough quality sleep

Sleep deprivation can do more than leave us just yawning throughout the day; it can harm our health. People who don’t get enough sleep have a higher risk of obesity, high blood pressure, heart attack, Diabetes and depression. Most adults require seven to nine hours of sleep each night. If we wake up without our alarm clock and feel refreshed, we are probably getting enough sleep. Set a sleep schedule and stick to it by going to bed and waking up at the same times each day. Let’s keep our bedroom dark and quiet, so it’s easier to sleep. Despite getting enough sleep, if one still feels tired throughout the day, it is necessary to be evaluated for obstructive sleep apnoea.

In obstructive sleep apnoea, our throat muscles relax and block our airway intermittently during sleep. This stops the breathing temporarily. Signs and symptoms of sleep apnoea include snoring loudly, gasping for air during sleep, waking up several times during the night, waking up with a headache, sore throat or dry mouth and memory or learning problems.

Treatment for obstructive sleep apnoea includes losing weight if one is overweight or using a continuous positive airway pressure (CPAP) device that keeps one’s airway open while one is asleep. CPAP treatment significantly mitigates the risk of heart disease from sleep apnoea and improves the quality of life.

Manage stress

Some people cope with stress in an unhealthy manner, like by overeating, drinking or smoking. Pursuing ways to manage stress – such as physical activity, relaxation techniques, yoga or meditation – can help improve one’s health.

Get regular health screenings

High blood pressure and high cholesterol can damage our heart and blood vessels. But without testing for them, nobody probably would know whether he or she has these conditions. Regular screening can tell us what our numbers are and whether we need to take action.

• Blood pressure – Regular blood pressure screenings usually start in childhood. One should have a blood pressure test performed annually to screen for high blood pressure as a risk factor for heart disease and stroke, starting at age 18. Optimal blood pressure is less than 120/80 mm Hg.
• Cholesterol levels – Adults should generally have their cholesterol level measured at least once every five years starting at age 18. Early testing may be recommended if one has other risk factors such as a family history of early-onset heart disease.
• Diabetes screening – Since Diabetes or a family history of Diabetes remains a risk factor for developing heart disease; it is advisable to get screened for Diabetes. Options include getting an oral glucose tolerance test (OGTT) and HbA1c test, under a physician’s guidance.

If one is found to have conditions such as high cholesterol, high blood pressure or Diabetes, the doctor may prescribe medications and recommend lifestyle changes. Make sure to adhere to the prescription and follow a healthy lifestyle.

The bottom line

The positive heart disease risk reduction yields of the above points include:

• A 36 per cent risk reduction attributed to not smoking.
• An 18 per cent risk reduction by eating a diet rich in fruits, vegetables, legumes, nuts, reduced-fat dairy products, whole grains and fish.
• A 12 per cent risk reduction for maintaining a waistline of 90 cm or less (for men) and 80 cm or less for women.
• An 11 per cent risk reduction for drinking fewer than two alcoholic drinks per day.
• A 25 per cent risk reduction for moderate, daily and weekly exercise routines.

In summary, one is never too young – or too old – to take care of one’s heart.

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