Cardiovascular disease is preventable for most people, says functional-medicine physician Shilpa P. Saxena, MD. “A lot of people think, ‘Oh, it runs in my family so I am doomed to it,’” she says. “But terrible lifestyle choices can also run in families.”
The root causes of heart disease will vary from person to person. Recent studies have linked stress, environmental pollutants, and even the state of your microbiome to increased cardiovascular risk. But everyone can benefit from making positive adjustments to their nutrition, fitness, stress-management practices, and sleep habits.
The key, says Saxena, is modifying and leveraging lifestyle changes so that we don’t have to rely solely on medications and procedures.
These tips from our experts on the best lifestyle changes can help you take a proactive approach to preventing — or even reversing — heart disease.
1. Eat more whole foods.
Adopting a “food first” mentality is key to preventing heart disease, says cardiologist Mimi Guarneri, MD, FACC, president of the Academy of Integrative Health and Medicine. Make the switch to higher-quality whole foods and anti-inflammatory spices. And stay away from processed foods that can drive up blood sugar.
Guarneri recommends a Mediterranean-style diet but notes that there are other protein-rich, plant-centered ways of eating; she says the key is in knowing what to avoid. “We know trans fats are bad. We know simple carbs are bad. We know refined sugar is bad,” she says.
Yousef Elyaman, MD, IFMCP, recommends starting off simply: Eat half a handful of nuts every day, two servings a week of fish that are high in omega-3 fatty acids but low in mercury (like wild-caught salmon), and six servings of colorful vegetables and two servings of fruit a day.
2. Get off the low-fat bandwagon.
Low-fat diets generally replace fat with sugar and refined carbs to compensate for lack of taste, which can lead to problems with insulin regulation, notes Saxena. Embracing healthy fats helps stabilize blood sugar and appetite. Mark Hyman, MD, director of the Center for Functional Medicine at the Cleveland Clinic, adds that long-maligned saturated fats like coconut oil can actually lower inflammation.
Still, it’s critical to eat plenty of vegetables and avoid refined carbohydrates, because “saturated fats cause inflammation only in the context of two things: low levels of omega-3 fats and high levels of carbohydrates,” Hyman writes in his book Eat Fat, Get Thin. While Elyaman agrees that healthy fats can be beneficial, he adds that there are some people who have the APOE4 gene, known as the Alzheimer’s gene, who may do worse on a high-fat diet. “It’s not one-size-fits-all,” he says.
3. Time your meals.
Once you’ve improved the quality and quantity of your diet, says Saxena, aim for optimal timing: “Avoid late-night eating and consider intermittent fasting.” Many experts agree that eating your biggest meal at midday is best, as is adhering to an “eat light after dark” policy whenever possible.
4. Rightsize meals and portions.
Saxena says it’s important not to overeat. Focus on filling up on vegetables; use smaller plates so you’re not tempted by an abundance of food.
5. Go beyond cardio.
Cardio exercise has the best reputation when it comes to heart health, but most experts agree it’s not enough by itself. Saxena recommends strength training to build muscle. “By optimizing your muscle mass, you can increase longevity, fight illness, and prevent injuries — all of which are equally important for total body health, inside and out,” she says.
Elyaman agrees that there are benefits to both cardio and strength training, and adds that, from a cardiovascular point of view, “you get more bang for your buck with high-intensity interval training. It helps clear out old mitochondria and stimulate new mitochondria.” (For more on interval training, see “Steady-State Cardio Vs. High-Intensity Interval Training.”)
6. Quit smoking.
Smoking raises triglycerides in the blood, increases platelet “stickiness,” and leads to thickened and narrowed blood vessels — all risk factors for heart disease. If you smoke, quitting is one of the most direct ways to improve your heart health.
7. Manage your stress.
Saxena recommends techniques like mindfulness, meditation, prayer, and deep breathing to increase the “cool, calm, connected healing state of the body.” This is critical for heart health, she says, because the autonomic nervous system, which controls our stress response, “is strongly connected to optimal function of the cardiovascular and metabolic systems of your body.”
Our fight-or-flight stress hormones are important in helping us manage acute situations, Guarneri explains, but they backfire over the long term. “If you got hit by a car tomorrow and you were bleeding in the street, you would want those hormones because they would say, ‘We’re bleeding. Raise the heart rate, raise the blood pressure, raise the aldosterone to conserve salt and water.’” But, she adds, when these stress hormones are flowing constantly, “the platelets get stickier. The coronaries constrict. The blood pressure goes up. The heart rate goes up. The heart-rate variability goes down.” These factors all put heart health at risk. (For more on managing daily stress, see “The Cortisol Curve.”)
8. Nurture positive connections.
Relationships with family, friends, and others can go a long way toward improving — or undermining — overall health. A study presented in 2014 at the American College of Cardiology symposium identified that being in a happy marriage predicts lower risk of cardiovascular disease; another 2014 study in the Journal of Health and Social Behavior conversely found that being in an unhappy marriage leads to higher risks to heart health.
Read the original full article, “Rethinking Heart Health,” in the September 2016 issue of Experience Life magazine.