By Dr. Matthew Wolff, Meriter Cardiologist and Division Chief of Meriter’s Cardiovascular Program.
Of course, any time is a perfect time to begin a heart-healthy life! But, February is designated as American Heart Month, and as such, should act as a reminder for all Americans to review their own heart risk. It is also an ideal time to consider lifestyle changes that are necessary – for most of us – to reduce this risk. The need to do so is obvious: heart disease remains the number one killer of men and women in our country, responsible for one quarter of all deaths. Each year in the U.S., over 900,000 people suffer heart attacks, and over 600,000 people die of heart disease. As our nation begins to address the overwhelming costs of health care, it is important to recognize that heart disease costs over $100 billion annually in direct medical care costs and lost productivity.
Prevention of Heart Disease
The Centers of Disease Control estimates that at least 80% of all heart disease is preventable. Cigarette smoking is one of the major risk factors for heart attack and stroke, and the changes in culture, laws and smoking cessation programs. Meriter offers several highly effective smoking cessation programs, employing a variety of strategies-some involving medications, all employing proven non-drug techniques to help individuals quit. This nationwide effort has lead to significant reductions in cigarette smoking in the U.S. and, thus, a major decline in heart disease rates over the past two decades. Unfortunately, much of this advancement is now threatened by the explosion of obesity. The National Health and Nutrition Examination Survey from 2009 to 2010 discovered that over two-thirds of all Americans are overweight, and over one third meet the medical definition of obese. A quick glance at any public venue confirms that these statistics apply to Wisconsin, as well as the rest of the nation.
Obesity is a major cause of high blood pressure, adult-onset (or Type II) diabetes, and elevated blood cholesterol levels, the other main risk factors for heart attack and stroke. The American Heart Association emphasizes diets low in saturated (animal) fats and trans-saturated fat (partially hydrogenated fats, found in many prepared foods) as ways to improve blood cholesterol levels and reduce heart disease risk. In contrast, mono-unsaturated fats (in many plant oils, such as olive and canola) actually improve blood cholesterol levels and reduce heart attack risk.
The role of carbohydrates in heart risk has received much less attention, but increased consumption of simple carbohydrates is perhaps the greatest driver of obesity in our population and likely represents as great of a cause of heart disease as animal fats. Sugary drinks, like soda and juice, have received a lot of attention recently as major causes of childhood obesity. Snacks and desserts are commonly recognized as an enemy in the battle of the bulge. Simple and/or heavily processed carbohydrates such as breads, pastas and potatoes are central drivers of obesity in adults. Many popular diets stress the importance of reducing carbohydrate consumption in weight loss.
What is the best diet? I recommend the simplest approach: “eat what the earth produces, not what man makes…” Another adage I favor is “buy, cook, and eat what you can get on the perimeter of the grocery store—skipping over the bakery—and only go down the aisles for toilet paper…” This will lead to a diet heavy in fruits and vegetables, supplemented by modest amounts of meat—fish is better than chicken, chicken better than beef and pork. Low-fat or no-fat dairy is a great source of protein and calcium, and frozen vegetables are as nutritional as fresh (particularly in the winter). Avoid canned vegetables, as they are less nutritious than fresh or frozen and typically contain a great deal of salt. Most Americans consume too much sodium, which causes high blood pressure and increases the risk of heart attack and stroke. Put the salt shaker away, and avoid processed foods that contain high levels of salt (most canned soups and vegetables, snack foods and the always-evil French fries).
Many of us were raised on carbohydrate-rich Midwestern comfort foods, so this style of diet may represent a significant change for many Wisconsinites. However, with a little effort, the diet I’m suggesting can be absolutely delicious, as well as healthy and slimming.
Any diet strategy to lose weight or reduce heart risk will be more successful when combined with a regular exercise program. The American Heart Association recommends exercising at least 4 days a week for 40 minutes each day. The intensity of exercise should be reasonably vigorous—walking at a clip just beyond comfortable conversation. Unfortunately, “I run around a lot at work” or “I spend my day chasing the kids” is probably not going to achieve the same results. Many of my patients have arthritis or other problems that make walking difficult, but often, we can find a form of exercise that they can tolerate, like exercise bicycles or water aerobics.
February is a great month to begin a new, heart-healthy lifestyle.