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Lifestyle changes for a healthy heart

Mira Tueny
Dietician and Smoking Cessation Therapist
MSc in Preventive Cardiology at Imperial College London (UK)
Yaduna - WHHC Dietician

Cardiovascular disease is the leading cause of death worldwide. The good thing about this disease is that we can prevent it and prolong our well-being. You may think that it is already too late or that it is too difficult to change our way of living. However, it is never too late and nothing is irreversible. Changing a bad habit has a positive effect on your health even if you have been following this habit for long. Undoubtedly, modifying your lifestyle is not the easiest thing you can do but it is definitely easier than you can imagine and easier than curing the disease. Actually, even small steps towards a healthier lifestyle have major benefits in the prevention of diseases. In fact, some aspects of your life may have put you at risk for heart disease. These are called risk factors and include the following:

• Smoking
• Unhealthy diet: excess alcohol and salt consumption in conjunction with limited intake of fruits and vegetables
• High blood pressure
• Overweight and Abdominal obesity
• Having unhealthy blood fat and cholesterol levels
• Diabetes
• Physical inactivity
• Age
• Family history: Having family members who had heart disease or a heart attack early in life: under 55 for your father or brother; under 65 for your mother or sister
• Psychosocial factors: stress, depression,…

There are some risk factors which cannot be modified (such as age or family history). However, other risk factors are related to your lifestyle (smoking, overweight, unhealthy diet, inactivity); by modifying these you can help prevent your chances of getting heart disease.

Fortunately, adopting a heart-healthy lifestyle can improve your health, even if you already have some risk factors, have suffered a heart attack or suffer from other forms of heart disease (high blood pressure, diabetes or high cholesterol). The effect of this lifestyle on our health encompasses:

• Reducing your blood pressure
• Reducing your bad cholesterol and triglyceride (blood fat) levels
• Reducing you blood sugar levels
• Easing the stress on your heart
• Lowering your risk of heart attack and stroke
• Having a healthy body weight
• Prolonging your life

In this respect, a heart-healthy lifestyle covers seven lifestyle areas where changes can improve your heart health and general health:

• Stopping smoking
• Healthy body weight
• Healthy diet
• Limited sodium (salt) intake
• Physical activity
• Moderate alcohol consumption
• Stress control

Smoking Cessation

Smoking represents the leading risk factor for cardiovascular disease: smokers almost double their risk of having heart attack and developing diabetes when compared with non-smokers. A 2010 report from the Surgeon General stated that cigarettes are an addictive, fatal mixture of more than 7,000 chemicals that harm your arteries, heart, lungs, reproductive system as well as your children’s health. Moreover if you suffer from diabetes, smoking makes controlling blood sugar levels more difficult. Therefore, quitting is one of the most important things you can do for your heart health. In fact, only a year after quitting, your risk of having a heart attack is halved and 2-5years later, your risk becomes the same as a non-smoker.

Breaking the cigarette habit may be the hardest. If you've tried to quit and failed before, things should be reconsidered; getting the right support from qualified medical professionals and support groups makes a major difference. Be aware that each person is different; you started smoking and continued to smoke for personal reasons that are unique to you. Hence, even if a technique worked for someone it may not work for you. Most of us actually need a combination of strategies (nicotine replacement therapies or drugs) and support to succeed. 

In light of this, the following advice will greatly improve your chance for success:

1. Understand and remind yourself why you want to quit
2. Know why you smoke
3. Plan your success and ask for help
4. Don't Give Up: learn from your mistakes

Healthy Diet

A healthy diet is one of the best ways to fight cardiovascular disease. Following a healthy diet will help in maintaining healthy blood sugar, blood lipid and, blood pressure levels as well as body weight; thereby reducing the risk of cardiovascular disease or slowing the progression of an existing disease. Your dietician will provide you the needed support to identify and adopt a diet which is consistent with your needs and habits to promote improved cardiovascular health.

A healthy diet means you need to choose nutrient-rich foods that have vitamins, minerals, fibres and other important nutrients whilst remaining low in calories. A heart-healthy balanced diet consist of the following:

• Fruits and Vegetables
• Fish (especially oily fish rich in omega 3), lean protein (chicken, turkey), beans, lentils
• Fat-free or low-fat dairy products
• Olive oil, Canola oil, nuts and avocado 

However, this diet is low in:
• Meat, cheese, processed meats, butter, margarines,…
• Processed foods: chips, biscuits, ready prepared meals
• Fried foods
• Salt
• Added sugars

Moreover, this diet provides a moderate alcohol intake which means no more than 2 drinks per day for men and 1 drink for women. It can lower a little your blood pressure and increase the HDL (good cholesterol). However, higher amounts can cause heart diseases, diabetes and other health problems (liver, pancreas, oesophagus,…). In addition, you need to check with your doctor the appropriate amount of alcohol for your heart health. For some people, the potential harms associated with drinking may outweigh the possible advantages of moderate alcohol use.

Achieving your ideal body weight - which depends on your age and height - is also a good way to reduce your risk of heart problems. If you are overweight or obese, refer to a dietician that will arrange a weight loss plan. Even a small weight loss of 5-10% of your current weight (4-8kg if you weigh 80kg) can have important benefits for your heart health, including:

• Lowering your blood pressure
• Reducing your risk of heart attack
• Reducing your LDL (bad cholesterol), triglycerides and raising your HDL (good cholesterol) blood levels
• Lowering your risk for other serious problems that can affect your heart such as diabetes or sleep apnea

Note that to achieve and maintain weight loss, it needs to be a slow and gradual process losing 0.5-1kg weekly. The best way to do it is to combine a healthy diet with fewer calories and regular exercise (see below).

Physical activity
Physical activity is fundamental in the prevention of cardiovascular disease and improving health. Physical activity improves your fitness level and your health. The goal to achieve is 150 minutes of moderate exercise weekly such as walking, jogging, cycling, dancing, and housecleaning. You may even split them up into a minimum of 10 minute periods if you need to. Just try to be as physically active as you can.

Before you start, check with your doctor whether or not there are activities that are not appropriate for you. Then choose activities that you enjoy most and that you can add in your daily life. Additionally, you might stay motivated if you involve friends or family in your activities.

Getting even as little as 30 minutes of moderate exercise on most days can have these benefits:

• Strengthens the heart: reduces heart diseases
• Burns calories and help you lose weight
• Improves mental health: reduces stress and depression
• Reduces your chances of stroke
• Lowers your blood pressure four to nine points
• Reduces your risk for diabetes, another heart disease risk factor
• Lowers your chances of developing other serious medical problems

Treat Related Conditions
After adopting all the lifestyle changes, some conditions will still need to be treated with medicines in order to reduce the cardiovascular risk. These include: diabetes, high blood cholesterol and high blood pressure. Even though you are taking medicines, adopt these healthy lifestyle changes, don’t rely on drugs as these changes have a positive effect on your overall health and not just one condition. Moreover, by adopting these lifestyle changes you may be able to reduce the number of medications you are taking. Building good lifestyle habits will also be beneficial to all your family and will help prevent them suffering from heart conditions in the future.