Proof! Reduce Your Risk of a Heart Attack by 87%

September 30, 2006Proof!  Reduce Your Risk of a Heart Attack by 87% Competency # 20 – “The Lifestyle(Cuisine) of the Long-Lived” Reference: Circulation:  July 11th, 2006 This is big!  We should be singing this from the rooftops.  Half of all Americans die from coronary artery disease.   Each and every one of us should be looking for the  methods and combinations of behaviors to prevent that risk.  Now we have the methods.  The proof is in.  Published this last month in the Journal Circulation are the results of 16 years of longitudinal research on 43,000 health professionals (Unfortunately, all men.  Bet it works for women too but the “proof” isn’t there yet).  This research out of Harvard should be our aggregated guidelines for each of us.  Here is the “skinny” on the combination that works. Strategy 1.  Literally.  The skinny.  A body mass index below 25.  Keeping your weight in control has a very powerful effect that can’t be denied.  (Calculate BMI by taking your weight in pounds, divided by your height in inches, divided again by your height in inches, multiply by 703 = BMI).  Readers of this column know from our reporting last fall that we now know that your waist to hip ratio is 2.8 times as accurate in predicting future heart desease.   That is not what was followed in this landmark study.  Your waist to hip ratio should be < .9 for men and less than .85 for women. Strategy 2.  Not smoking.  (Whew, a freebie for many of us).  That’s how important that one is for those who do.  Yes, it’s that dangerous. Strategy 3.  Exercise.  (Ouch.  As painful as the last one was easy).  “ A day without exercise is as bad as a day of smoking”.   The study said: 30 minutes each and every day.  Walk, stretch, lift, sweat, park far, take stairs.  30 minutes.  Plain and simple.  That’s what works.  Just do it. Strategy 4.  Alcohol.  1-2 drink a day.  Here the risks are clear.  We didn’t say it was a 24 oz glass of Scotch.  If alcoholism is in your family, the risks might weigh against this one.  And for women, there may be some added risk in other venues.  For men, 1-2 drinks a day, tops. Strategy 5.  Eat healthily.  Reduce trans fats and saturated fats.  That’s the summary message about eating from this study that started 16 years ago.  That’s pretty simple and we’ve known that saturated fats are wicked.  You have heard me rail against trans fats many times. There are pieces of evidence taken singly that suggest we can add details to this to make the admonition of healthy eating more precise and effective.  Here is my list of what I’m doing for me.  The Sinai Wellness Institute’s “Best Strategies for a Healthy Diet” a.  Adding olive oil to my diet in place of other oils (more salads). b.  We have clear proof that fish oil daily reduces sudden death. (Fish or pills)   Getting more omega threes back in and eating fewer omega sixes. c.  There are also additional benefits from increasing fiber.  30 grams a day is a great start.  40 grams and even bigger changes happen. d.  Reducing refined grains.  Eat whole grains.  Chunks.  You have to see them. e.  Adding potassium to your diet in the form of the DASH diet with its 8 servings a day of fruits and veggies is a known winner, and recent studies have even shown that adding potassium in the form of potassium based salt substitute is a winner.  And dump the sodium.  Every way you can. f.  Antioxidants are a whole new world opening up.  Stay tuned. g.  Sugar’s gotta go.  Find every way you can to cut down on it.  We'll cover more on this later.  Most of it is in sugared soda.  Start there. WWW:  What will work for me.  These five strategies are going to become part of my teaching and thinking to each and every patient I see going forward.  This is how we will make progress in our number one killer, heart disease.  No kidding.  87% reduction.  It’s how we will all practice prevention.  Hurray.  We’ve got the proof.

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