The number-one killer in America (for both men and women), heart disease is the result of the narrowing of the arteries that supply the heart with blood, oxygen, and nutrients. This process, called coronary artery disease, can generally be traced to a condition called atherosclerosis, the build-up of cholesterol-rich fatty deposits, or plaques, on the inside of arterial walls. As these deposits accumulate over time, the coronary arteries narrow to the point that the flow of oxygenated blood to the heart is impeded. (Arterial spasms — triggered by smoking, extreme emotional stress, or exposure to very cold temperature —may also cause coronary arteries to narrow suddenly and dangerously.)

The Risk Factors — and How You Can Reduce Yours
Major risk factors for cardiovascular disease include cigarette smoking, high blood pressure, high cholesterol and/or triglycerides, diabetes mellitus, obesity, sedentary lifestyle, and poor nutrition. Prevention and treatment centers around these risk factors — and these approaches will help you lower risk for many other types of illness, as well as helping you feel great and have more energy overall.

1. Don’t smoke.
Cigarette smoking remains the leading preventable cause of cardiovascular disease in women, with more than 50 percent of heart attacks among middle-aged women attributable to tobacco. Risk of cardiovascular disease begins to decline within months of smoking cessation and reaches the level of persons who have never smoked within 3 to 5 years.

2. Lower your cholesterol.
High blood cholesterol is a condition that greatly increases your chances of developing coronary heart disease. Extra cholesterol in the blood settles on the inner walls of the arteries, narrowing them and allowing less blood to pass through them to the heart. Aim for total cholesterol below 200 mg/dL; LDL cholesterol below 130 mg/dL and HDL above 35 mg/dL.

3. Maintain a healthy weight.
Obesity and sedentary lifestyles are epidemics in the United States that contribute to increased risk of cardiovascular disease. The prevalence of obesity has increased among both men and women in the United States in the past decade; currently about one third of adult women (or 34 million) are classified as obese. Also, 60% of both men and women get no regular physical activity. Obesity, especially abdominal adiposity, is an important risk factor for cardiovascular disease in women.

4. Exercise regularly.
Recent evidence suggests that even moderate-intensity activity, including brisk walking, is associated with substantial reduction of cardiovascular disease risk. These findings support the 1995 federal exercise guidelines endorsing 30 minutes of moderately intense physical activity most days of the week, a program that should be feasible and safe for most of the population. Regular exercise and maintenance of healthy weight should also help reduce insulin resistance and the risk of non–insulin-dependent diabetes mellitus, which appears to be an even stronger risk factor for cardiovascular disease in women than in men. Diabetes is associated with a threefold to sevenfold elevation in cardiovascular disease risk among women, compared with a twofold to threefold elevation among men. Approximately half of all deaths in patients with non–insulin dependent diabetes mellitus are due to heart disease.

5. Eat less saturated fat, more produce & more fiber.
Diets low in saturated fat and high in fruits, vegetables, whole grains, and fiber are associated with a reduced risk of cardiovascular disease. Also, a recent study reported in the Annals of Internal Medicine journal confirmed that the consumption of fruits and vegetables, particularly green leafy vegetables and vitamin C-rich fruits and vegetables, seems to have a protective effect against coronary heart disease. You may even think about moving toward more flexitarian or vegetarian eating habits: A vegetarian diet reduces the risk of coronary artery disease, and may even reverse existing coronary artery disease when combined with other lifestyle changes. A Mediterranean diet that uses olive oil can reduce the risk of coronary artery disease.

6. Avoid trans fats.
Trans fatty acids have been linked to adverse lipid profiles and an increased risk of cardiovascular disease. This includes most margarines. The role of other fatty acids, including monounsaturated, polyunsaturated, and marine omega-3 fatty acids, remains controversial.

7. Consume alcohol only in moderation.
Moderate intake of alcohol is related to reduction of cardiovascular disease — but may raise blood pressure and increase risk of breast cancer. Early surgical menopause is linked to increased risk of cardiovascular disease, which appears to be negated by the use of estrogen therapy.

8. Arm yourself with risk-reducing supplements.
Antioxidant vitamin supplements, particularly vitamin E and homocysteine-lowering agents such as folate and B6, have promising roles in prevention of cardiovascular disease, but conclusive evidence may hinge on the results of several ongoing randomized clinical trials. When it is found in unusually high levels, homocysteine brings the same degree of risk as having high cholesterol does. The B vitamins, especially folic acid and B12, will drive elevated homocysteine levels down to normal, often without the need of any prescription medication.

9. Give yourself some new stress-management tools.
Poorly controlled stress may have an adverse effect on blood lipids. An attitude of hostility has been powerfully linked with a higher incidence of cardiac events, and cynical distrust has been associated with accelerated progression of carotid artery disease. Relaxation methods (meditation, breathing exercises), yoga, and stress management techniques are essential for preventing cardiovascular disease and coronary artery disease and for reducing the risk of recurrent cardiac problems. Meditation improves exercise tolerance and decreases electrical changes associated with poor circulation to the heart. Meditation has also been shown to lower cholesterol and reverse carotid artery thickening. Also consider acupuncture, which has been shown to help relax the myocardium and improve circulation.

10. Ask your health professional about herbs and nutritional supplements that may be useful in preventing and treating cardiovascular disease, including:

- Bilberry
- Turmeric (curcumin)
- Fenugreek
- Ginger
- Guggul
- Ginkgo
- Garlic (one garlic clove is roughly equal to 4 mg to 1 gram of garlic; a daily dose of 600 to 800mg may be recommended)
- Onion
- Vitamin B12
- Folic acid (500 to 5000 micrograms daily may be recommended)
- B6
- L-Carnitine
- Coenzyme Q10 (100 to 300 mg daily may be recommended)
- Vitamin E (400 to 800 International Units daily may be recommended)
- Magnesium (200 to 400 mg daily may be recommended)
- Niacin (A typical oral dose of 100 mg, three times daily; may gradually increase to avg. dose of 1 gram three times daily, with a maximum dose of 6 grams. Extended release tablets: Dosing may begin with one 375-milligram tablet at bedtime and be increased by no more than 500 mg per four-week period, to a maximum of 2,000 mg, given as two 1,000-milligram tablets before bed)
- Fish oils (6 grams daily may be recommended))
- Soy (Isoflavones may be recommended))

You hear a lot about living a healthy lifestyle, but what does that mean? In general, a healthy person doesn’t smoke, is at a healthy weight, eats healthy and exercises. Sounds simple, doesn’t it? The trick to healthy living is making small changes…taking more steps, adding fruit to your cereal, having an extra glass of water…these are just a few ways you can start living healthy without drastic changes.

Exercise
One of the biggest problems in America today is lack of activity. We know it’s good for us but avoid it like the plague either because we’re used to being sedentary or afraid that exercise has to be vigorous to be worth our time. The truth is, movement is movement and the more you do, the healthier you’ll be. Even moderate activities like chores, gardening and walking can make a difference. Just adding a little movement to your life can:

• Reduce the risk of heart disease, stroke and diabetes
• Improve joint stability
• Increase and improve range of movement
• Help maintain flexibility as you age
• Maintain bone mass
• Prevent osteoporosis and fractures
• Improve mood and reduce symptoms of anxiety and depression
• Enhance self esteem
• Improve memory in elderly people
• Reduce stress

So, even if you opt for small changes and a more modest weight loss, you can see the benefits are still pretty good. One study has found that just a 10% weight reduction helped obese patients reduce blood pressure, cholesterol and increase longevity.

Simple Ways to Move Your Body
You can start the process of weight loss now by adding a little more activity to your life. If you’re not ready for a structured program, start small. Every little bit counts and it all adds up to burning more calories.

• Turn off the TV. Once a week, turn off the TV and do something a little more physical with your family. Play games, take a walk…almost anything will be more active than sitting on the couch.
• Walk more. Look for small ways to walk more. When you get the mail, take a walk around the block, take the dog for an extra outing each day or walk on your treadmill for 5 minutes before getting ready for work.
• Do some chores. Shoveling snow, working in the garden, raking leaves, sweeping the floor…these kinds of activities may not be ‘vigorous’ exercise, but they can keep you moving while getting your house in order.
• Pace while you talk. When you’re on the phone, pace around or even do some cleaning while gabbing. This is a great way to stay moving while doing something you enjoy.
• Be aware. Make a list of all the physical activities you do on a typical day. If you find that the bulk of your time is spent sitting, make another list of all the ways you could move more–getting up each hour to stretch or walk, walk the stairs at work, etc.

Eating Well
Eating a healthy diet is another part of the healthy lifestyle. Not only can a clean diet help with weight management, it can also improve your health and quality of life as you get older. You can use the new Food Guide Pyramid to determine how many calories you need and what food groups you should focus on or, if you’re looking for smaller changes, you can use these tips for simple ways to change how you eat:

• Eat more fruit. Add it to your cereal, your salads or even your dinners
• Sneak in more veggies. Add them wherever you can–a tomato on your sandwich, peppers on your pizza, or extra veggies in your pasta sauce. Keep pre-cut or canned/frozen veggies ready for quick snacks.
• Switch your salad dressing. If you eat full-fat dressing, switch to something lighter and you’ll automatically eat less calories.
• Eat low-fat or fat-free dairy. Switching to skim milk or fat free yogurt is another simple way to eat less calories without having to change too much in your diet.
• Make some substitutes. Look through your cabinets or fridge and pick 3 foods you eat every day. Write down the nutritional content and, the next time you’re at the store, find lower-calorie substitutes for just those 3 items.

Creating a healthy lifestyle doesn’t have to mean drastic changes. In fact, drastic changes almost always lead to failure. Making small changes in how you live each day can lead to big rewards, so figure out what you can to be healthy today.