Dr Saheb Sahu, FAAP, MPH
Note – 90% of the information provided in this article is from National Institute of Health (NIH-USA) web site. They are the recommendations of experts. I have made some additions and subtractions to make it understandable for non-medical people.
Overview
Heart disease is a leading cause of death for both men and women, both in developed and developing countries. Heart attack (coronary artery disease-CAD) is the most common type of heart disease. Some heart diseases seen in children are from birth and are called congenital heart disease. You have no say on how you get it. It is just bad luck. Heart diseases seen in adults are acquired. Heart is a pump, which supplies blood and nutrition to all the organs of the body via a network of arteries and capillaries. When some part of heart muscle dies because of lack of blood supply to the heart, we have a heart attack. The heart has two coronary arteries-right and left. They supply blood to the heart. When one or both are blocked because of narrowing, heart attack happens. The arteries get blocked because of plaque buildup during one’s life time. The process is called atherosclerosis and it starts in our childhood.
Heart attack, diabetes and stroke are called life-style diseases meaning our day to day living contribute to their causes and we can do something about them.We can do a lot to protect our heart and stay healthy.
Heart –healthy living involves understanding your risks, making choices, and taking steps to reduce your chance of getting heart disease, including coronary artery disease, the most common type. Coronary and other types of heart disease cause heart attacks.
The first step toward heart health is understanding your risk of heart disease. Your risk depends on many factors, some of which are changeable and others that are not. Risk factors are conditions or habits that make a person more likely to develop a disease. These risk factors may be different for each person.
Preventing heart disease starts with knowing what your risks factors are and what you can do to lower them.
Risk factors for heart disease
Your risk of heart disease is higher if you:
- Have high blood pressure
- Have high blood cholesterol
- Are overweight or obese
- Have prediabetes or diabetes
- Smoke
- Do not get regular physical activity
- Have a family history of early heart disease (your father or brother was diagnosed before age 55, or your mother or sister was diagnosed before age 65)
- Have a history of preeclampsia (a sudden rise in blood pressure and too much protein in the urine during pregnancy)
- Have unhealthy eating behaviors
- Are older (age 55 or older for women or age 45 or older for men)
Each risk factor increases a person’s chance of developing heart disease. The more risks you have, the higher your overall risks.
Some risk factors cannot be changed. These include your age, sex, and a family history of early heart disease. But many others can be modified. For example, being more physically active and eating healthy are important steps for your heart health. You can make the changes gradually, one at a time. But making them is very important.
Women and heart disease
Women generally get heart disease about 10 years later than men do, but it’s still women’s #1 killer. After menopause, women are more likely to get heart disease, in part because estrogen hormone levels drop. Women who have gone through early menopause, either naturally or because they have had a hysterectomy, are twice as likely to develop heart disease as women of the same age who have not gone through menopause. Middle age is also a time when women tend to develop other risk factors for heart disease, such as high blood pressure.
Preeclampsia (high blood pressure during pregnancy) raises your risk of developing coronary heart disease later in life. It is a risk factor that you can’t control. However, if you’ve had the condition, you should take extra care to monitor your blood pressure and try to lower other heart disease risk factors.
Get Your Blood Pressure and Cholesterol Checked
Two of the major risk factors for heart disease are high blood pressure and high blood cholesterol. If either of these numbers is high, work with your doctor to get it to a healthy range.
Choose Heart-Healthy Foods
Heart-healthy eating involves choosing certain foods, such as fruits and vegetables, while limiting others, such as saturated and trans fats and added sugars.
Your doctor may recommend the heart-healthy Dietary Approaches to Stop Hypertension (DASH) eating plan because it has been proven to lower high blood pressure and “bad” LDL cholesterol in the blood.
Foods to eat
The following foods are the foundation of a heart-healthy eating plan.
- Vegetables such as leafy greens (spinach, collard greens, kale, cabbage), broccoli, and carrots
- Fruits such as apples, bananas, oranges, pears, grapes, and prunes
- Whole grains such as plain oatmeal, brown rice, and whole-grain bread or tortillas
- Fat-free or low-fat dairy foods such as milk, cheese, or yogurt
- Protein-rich foods:
- Fish high in omega-3 fatty acids (salmon, tuna, and trout)
- Lean meats such as 95% lean meat or skinless chicken or turkey
- Eggs
- Nuts, seeds, and soy products (tofu)
- Legumes such as kidney beans, lentils, chickpeas, black-eyed peas, and lima beans
- Oils and foods high in monounsaturated and polyunsaturated fats:
- Canola, corn, olive, safflower, sunflower, and soybean oils, peanut or sesame (not coconut or palm oil)
- Nuts such as peanuts, walnuts, almonds, and pine nuts
- Nut and seed butters
- Salmon and trout
- Seeds (sesame, sunflower, pumpkin, or flax)
- Avocados
- Tofu
Limit sodium (salts)
Adults and children over age 14 should eat less than 2,300 milligrams of sodium a day. Children younger than age 14 may need to eat even less sodium each day based on their sex and age. If you have high blood pressure, you may need to limit sodium even more. Talk to your doctor or healthcare provider about what amount of sodium is right for you or your child.
Limit saturated fats
Saturated or “bad” fats come from animal sources such as butter, cheese, and fatty meats and should make up less than 10% of your daily calories. Read food labels and choose foods that are lower in these fats and higher in unsaturated fat.
A heart-healthy eating plan limits sodium (salt), saturated and trans fats, added sugars, and alcohol. Understanding nutrition labels can help you choose healthier foods.
- Read food labels and choose products that have less sodium for the same serving size.
- Choose low-sodium, reduced-sodium, or no-salt-added products.
- Choose fresh, frozen, or no-salt-added foods instead of pre-seasoned, sauce-marinated, brined, or processed meats, poultry, and vegetables.
- Eat at home more often so you can cook food from scratch, which will allow you to control the amount of sodium in your meals.
- Flavor foods with herbs and spices instead of salt.
- When cooking, limit your use of premade sauces, mixes, and instant products such as rice, noodles, and ready-made pasta.
Limit trans fats
Limit trans fats as much as possible by:
- Limiting foods high in trans fats. Thisincludes foods made with partially hydrogenated oils such as some desserts, microwave popcorn, frozen pizza, stick margarines, and coffee creamers.
- Reading the nutrition labels and choosing foods that do not contain trans fats.
Dairy products and meats naturally contain very small amounts of trans fats. You do not need to avoid these foods because they have other important nutrients.
Limit added sugars
You should limit the amount of calories you get each day from added sugars. This will help you choose nutrient-rich foods and stay within your daily calorie limit.
Some foods, such as fruit, contain natural sugars. Added sugars do not occur naturally in foods but instead are used to sweeten foods and drinks. They include brown sugar, corn syrup, dextrose, fructose, glucose, high-fructose corn syrup, raw sugar, and sucrose.
Limit alcohol
Talk to your doctor about how much alcohol you drink. Your doctor may recommend that you reduce the amount of alcohol you drink or that you stop drinking alcohol. Alcohol can:
- Add calories to your daily diet and possibly cause you to gain weight.
- Raise your blood pressure and levels of triglyceride fats in your blood.
- Contribute to or worsen heart failure in some people, such as some people who have cardiomyopathy(weakness of heart muscle).
- Raise your risk of other diseases such as cancer.
If you do not drink, you should not start. You should not drink if you are pregnant, are under the age of 21, taking certain medicines, or if you have certain medical conditions, including heart failure.
Aim for a Healthy Weight
A healthy weight for adults is usually when the body mass index (BMI) is between 18.5 and 24.9. To figure out your BMI, use our online BMI calculator and compare your BMI with the following table. You can also download the BMI calculator app for iPhoneexternal link and Androidexternal link.
Body mass index (BMI) is used to determine whether you are at a healthy weight. Adults are underweight if their BMI is below 18.5 and are at a healthy weight if their BMI is 18.5 to 24.9. Adults are overweight if their BMI is 25 to 29.9 and have obesity if their BMI is 30 or above.Newer studies show that normal BMI for Asians is up to 23 instead of 24.5.
Always talk to your doctor or healthcare provider about what BMI is right for you. Talk to your child’s doctor to determine whether your growing child has a healthy weight, because his or her BMI should be compared to growth charts specific for your child’s age and sex. Following a heart-healthy eating plan and being physically active are some ways to help you achieve and maintain a healthy weight.
Measuring waist circumference
If most of your fat is around your waist rather than at your hips, you are at a higher risk for heart disease and type 2 diabetes. For Indian men the waist circumstance should be less than 78cm and for women less than 72cm.
To correctly measure your waist circumference, stand and place a tape measure around your middle, just above your hipbones. Measure your waist just after you breathe out.
Get Regular Physical Activity
Regular physical activity can:
- Help you lose excess weight
- Improve physical fitness
- Lower many heart disease risk factors such as “bad” LDL cholesterol levels, increase “good” HDL cholesterol levels, and manage high blood pressure
- Lower stress and improve your mental health
- Lower your risk for other conditions such as type 2 diabetes, high blood pressure, dementia, depression and some cancers
Talk with your doctor before you start a new exercise plan. Discuss how much and what types of physical activity are safe for you. Even modest amounts of physical activity are good for your health.
Aerobic exercise benefits your lungs the most. This is any exercise in which your heart beats faster and you use more oxygen than usual, such as brisk walking, running, biking, and swimming.
The more active you are, the more you will benefit. Participate in aerobic exercise for at least a few minutes at a time throughout the week. The U.S. Department of Health and Human Services’ Physical Activity Guidelines for Americansexternal link recommends that each week, adults get at least:
- 2 hours and 30 minutes of moderate-intensity aerobic activity (for example, 30 minutes 5 days a week), or
- 1 hour and 15 minutes of vigorous-intensity aerobic activity (for example, 25 minutes 3 days a week), or
- A combination of both moderate-intensity and vigorous-intensity activity.
Another way you can begin to increase your activity level is by reducing how long you sit at a given time. Breaking up how long you sit will benefit your overall health.
Quite smoking
If you smoke, quit. Smoking can increase your risk of heart disease, heart attack, lung cancer, pancreatic cancer, kidney cancer and esophageal cancer.
Get Enough Good-Quality Sleep
Sleep plays a vital role in good health and well-being throughout your life. During sleep, your body is working to support healthy brain function and maintain your physical health. Not getting enough sleep or good-quality sleep over time can raise your risk for chronic health problems. The amount of sleep you need each day will change over the course of your life. This table reflects recent American Academy of Sleep Medicine (AASM) recommendations that the American Academy of Pediatrics (AAP) has endorsed.
| Age | Recommended Hours of Sleep a Day |
| Babies 4-12 months | 12-16 (including naps) |
| Children 1-2 years | 11-14 (including naps) |
| Children 3-5 years | 10-13 (including naps) |
| Children 6-12 years | 9-12 |
| Teens 13-18 years | 8-10 |
| Adults 18 years or older | 7-9 |
Manage Stress
Research suggests that an emotionally upsetting event, particularly one involving anger, can serve as a trigger for a heart attack or angina in some people. Stress can contribute to high blood pressure and other heart disease risk factors. Some of the ways people cope with stress—drinking alcohol, using other substances, smoking, or overeating—are not healthy ways to manage stress.
Learning how to manage stress and cope with problems can improve your mental and physical health. Consider healthy stress-reducing activities such as:
- Practicing meditation
- Being physically active
- Trying relaxation techniques
- Talking with friends, family, and community or religious support systems.
Summary
Type-2 diabetes, high blood pressure, stroke and heart diseases are called life style diseases. That means the risks for them can be reduced by how well we live every day. Do we sit, eat, smoke or drink every day or we change our everyday living style for better health. We cannot change our genes, our age or our sex but we can do something about how we live every day. A healthy life style include- eating a diet of whole grains, lots fruits and vegetables, chicken and fish, low salt ,low sugar, exercising or being physically active, not being overweight, not smoking or drinking, reducing stress when possible and getting a good night sleep.
Source-National Institute of Health-nhlbi.nih.gov/health-topic/heart-healthy-living Feb 15, 2021