Heading Off Heart Disease
By Linda Knittel

Considering heart disease is the leading cause of death in American men over 35 and of all Americans over 45, there is a good chance that you or someone you love will die of this condition. But you can change that. In fact, by eating well, staying active, using supplements, not smoking, and maintaining healthy blood pressure and cholesterol levels, you have the power to significantly cut your chances of developing heart disease. In other words, the key to taming this deadly condition is not some new surgical procedure or high-tech drug cocktail, but rather a healthy lifestyle and an ounce of prevention.

For the most part, heart disease is a product of atherosclerosis—a buildup of sticky plaque in the arteries due to excess cholesterol in the blood. While cholesterol serves some very important functions in the body, such as forming cell membranes and hormones, an overabundance of this compound can damage the lining of the arteries, allowing plaque to form there. Over time these buildups prevent adequate blood flow to the heart and brain, and when combined with other risk factors such as high blood pressure, diabetes, obesity and smoking, the result is often heart attack or stroke.

"Just because you have diabetes or high cholesterol does not mean you are going to die from heart disease," says Derrick DeSilva, M.D., a well-known internist, lecturer and radio talk-show host. "By controlling your risk factors and simply lowering your cholesterol, you can actually reverse the disease."

DeSilva is a big proponent of personal responsibility and points out that nearly every heart disease risk factor, with the exception of family history and age, can be controlled. "The single most important thing Americans can do to keep their hearts healthy is to get off their butts," he says. "Exercise can lower blood pressure, reduce cholesterol, help control diabetes and keep weight in check."

Although exercise is also at the top of his prevention list, Derek Johnson, a private nutritionist in Los Angeles, focuses on diet first. "Even if someone starts hitting the gym or stops smoking, they won't be able to keep their heart healthy if they keep eating salt- and fat-filled foods," he says. "Research has shown that plaque can start building as early as age 11, so learning how to eat well early on is crucial."

As you might imagine, Johnson encourages his clients to eat lots of fresh fruits, vegetables and grains as well as omega-3-rich fish, soy foods and an occasional glass of red wine. "I also try to keep people's salt intake below 2,000 mg per day and their fiber and water intakes high." In addition, both Johnson and DeSilva closely monitor their clients' cholesterol levels. "The critical number is the ratio of your total cholesterol to your good HDL cholesterol," says DeSilva. "It should be less than 4 for people without heart disease and no more that 3.5 for those with the condition."

Recently, a few other factors have moved in on cholesterol's high-ranking bad reputation. For example, elevated levels of homocysteine—an amino acid normally found in low concentrations in the blood—have been linked to higher incidences of heart attack, artery damage and blood clots. "Having an elevated homocysteine number—a value greater than 10—is five times more dangerous than having elevated cholesterol," says DeSilva. Likewise, a substance known as C-reactive protein (CRP) has been recognized as a marker of inflammation in blood vessels. High levels of CRP have also been correlated with a higher incidence of second heart attacks. Fortunately, a simple blood test can determine whether homocysteine and CRP levels are high. Furthermore, eating a low-fat diet, exercising, maintaining a healthy weight and not smoking all lower CRP, while a diet rich in fresh fruits, vegetables and fish, combined with supplements of folate and vitamins B6 and B12, can keep homocysteine in check.

Changing your diet and lifestyle is not an easy task, but it is one that can deliver exceptional results. "You can do a complete turnaround by taking the right steps," says Johnson. "People have come to believe that having heart attacks is a normal part of life," he says. "It has only become normal because our population is overweight and sedentary; that can and needs to change."

By using the "Heart Disease Prevention Guide," as a starting point, and working with your health care practitioner to create a program of your own, you have the power to defy the odds and hold onto your heart health.

Linda Knittel is a senior editor for Delicious Living.