HYDRATE RIGHT
Your body is about 60 percent water, and that portion is even higher in your heart—73 percent. So it makes sense that you need to stay properly hydrated to help keep your heart in tip-top shape. Water will help the blood move through your vessels more easily, putting less stress on the heart. “You need about 64 ounces of water every day,” says Smith. He recommends drinking two big glasses in the morning, one at lunch and one with dinner. Look at your urine—if it’s clear (or straw-colored), you’re in the clear. If it’s dark, drink more.
GET MOVING
Exercise joins sleep, hydration and diet as the fourth pillar of heart health, says Smith. “People get overwhelmed by the thought of exercise,” he says. “But everyone has 30 minutes a day, you just have to make the effort. It’s about building the habit.”
Smith recommends cardiovascular exercise like walking, biking and swimming. Try to get your heart rate up to about 70 percent of your maximum predicted heart rate. To find that max number, subtract your age from 220.
“In order to get a good cardio workout and get collateral circulation—that’s building blood vessels in the heart—you need 30 minutes of sustained exercise at about 70 percent,” Smith says. “The Centers for Disease Control and Prevention says do it at least five days a week. I say seven days.” It’s ok to start slow and work your way up to that much, especially if you haven’t been exercising at all.
CUT DOWN ON THAT HABIT
Think of smoking as a sliding scale, with “bad” on one side and “worse” on the other. “Any smoke is bad, but the more you smoke, the higher your risk,” says Smith. Just one cigarette can raise your blood pressure and make your arteries stiffer. “Smoke three cigarettes and you’ve pretty much covered an entire day’s worth of inflammation,” adds Smith.
If you can’t quit right now, at least cut down. “If you go from three packs a day to one pack, I’ll applaud you,” he says. “It’s a really terrible habit and you’ve done yourself a good service. But cessation is key.”
STRESS LESS
You can never underestimate the effects of stress on well-being, says Smith. According to research from January 2017, people who are stressed have high activity in an area of the brain called the amygdala, which is linked to an increased risk of heart attack and stroke. Stress can even cause a heart attack-like condition known as stress cardiomyopathy. “Some people do acupuncture to reduce their stress,” says Smith. “Some do hypnosis. But exercise is at the top of the list in terms of stress reduction, and meditation is a close second.”
BE SMART ABOUT SALT
Americans eat, on average, 3,440 milligrams (mg) of sodium—salt—per day, far higher than the recommended 2,400 mg per day. Too much sodium can make already-high blood pressure even higher, says Smith. There’s at least one compelling reason to cut your salt even if you have healthy blood pressure: More than 70 percent of salt in the average American diet comes from high-calorie processed and restaurant foods, so preparing your own food instead can improve your overall health.
HOLD THE (ADDED) SUGAR
The more added sugar you eat, the greater your risk of dying from heart disease, according to a 2014 study of more than 31,000 people published in JAMA Internal Medicine. People who got more than 25 percent of their daily calorie total had more than double the risk of death from heart disease than people who ate 10 percent or less of their daily calories in added sugar.
The study’s authors didn’t know why this association between added sugar and heart disease exists. They pointed to other studies that suggest that people who eat lots of added sugar eat more calories in total and have less healthy diets.
Added sugar causes weight gain, among other problems. “If you eat too much sugar, the excess gets stored as fat in the midsection. That’s the bad fat,” says Smith. “It’s responsible for metabolic syndrome and raises blood sugar, blood pressure and cholesterol.”
FATTEN UP
No, not around your waistline. We’re talking about dietary fats. Smith says for a healthier heart, cut out saturated fat, which you find in meat and other animal products, and swap in unsaturated fats like olive oil, avocados, salmon and nuts. “Saturated fat is inflammatory and has a lot of cholesterol,” he says. On the other hand, monounsaturated fat can help lower your LDL cholesterol levels (that’s the bad kind). It also helps protect cells and is high in vitamin E.
GET MORE FIBER
If you’re like most Americans, you probably don’t get enough fiber. On average men eat 18 grams per day and women eat 15. But men under age 50 need at least 38g per day and women, 25g. Fiber needs drop a bit in middle age. Men over age 50 should eat 30g per day and women, 21g. A systematic review of 22 studies, published in December 2013 in BMJ, found eating more fiber was associated with a lower risk of cardiovascular disease, and coronary heart disease specifically.
“Fruits and vegetables have fiber. You don’t need to get fiber from whole grains, although those are an acceptable source,” says Smith. “If you’re going to get fiber from bread, be aware that most have added sugar. A better choice of grain is oatmeal, but not the kind that comes in a packet. Those also have too much sugar.” Other good sources of fiber include peas, beans, lentils, nuts, artichokes and raspberries.
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