Get the dish on heart health

One of the keys to avoiding heart disease could be sitting right on your dinner plate. Providence cardiologist Alicia Ross, M.D., and dietitian Kimra Hawk, RD, LD, dish out more great advice on how to protect your heart.

Eat nutritious foods. Exercise regularly. Maintain a healthy weight. Don't smoke. Don't drink too much alcohol. Do these five things and you'll reduce your risk of heart disease by almost 70 percent. That's a huge dent you can make in your chances of dying from America's No. 1 killer.

Some of the factors that influence your level of risk – such as increasing age, or heart disease in the family – are beyond your control. But even risk-raising conditions like diabetes, high blood pressure and high cholesterol can be modified through these five lifestyle choices.

Eat nutritious foods

People who eat more vegetables, fruit and fiber tend to have less heart disease and are healthier overall. The American College of Cardiology recommends a diet that emphasizes fruits and vegetables, whole grains, high-fiber carbohydrates, monounsaturated fats like olive and canola oils, and seafood. Things that you should minimize include saturated fats, trans fats, red meat, cholesterol and sodium.

You could spend a lot of time measuring foods and counting calories, but there is a much easier way to balance your plate. The government's www.choosemyplate.gov shows you how. Imagine taking your lunch or dinner plate and dividing it into quarters. Right off the bat, the best thing you can do for your heart is to fill two of those sections – half of your plate – with vegetables and fruit. All that produce will really pump up the fiber in your diet, and if you choose fruits and vegetables in a variety of colors, it'll pump up the nutritional value, as well.

With half of your plate already filled with low-calorie, heart-healthy fuel, only half is left for higher-calorie foods. Lean protein should take no more than a quarter of your plate. Whole grains or other high-fiber carbohydrates can take up the other quarter. To keep things simple, the plate diagram doesn't show fats, but that doesn't mean they're not included. A heart-healthy diet needs to include some good-for-you fats such as olive oil, nuts, seeds, avocados and omega-3-rich salmon.

And about that plate – we're talking about a 9- or 10-inch dish, not the 12- or 14-inch platter that has become standard in today's kitchens. As cardiologist James Beckerman, M.D. says, dish up on a smaller plate and you won't even notice that you're eating less.

Exercise regularly

Thirty minutes of activity per day, five days a week, is all it takes to keep your heart in shape, according to the American Heart Association. You don't have to run or do calisthenics, as long as you get your heart pumping in the aerobic range. Brisk walking is about the best form of exercise there is. If it's too cold and wet for a walk outside, hop on a treadmill, elliptical trainer or stationary bike, or just turn up the music and dance. Whatever you do, go at a pace that makes you a little out of breath and a bit sweaty – that's how you can tell that you're in the aerobic zone.

If you're new to exercise or you have a medical condition, talk to your doctor before you begin a new exercise program. Start slowly and work your way up to those 30 minutes. Once there, your heart will benefit most if you can sustain that heart-thumping level for the full 30 minutes. If your schedule is just too packed to do it all in one shot, then breaking it up into smaller increments – say, a 15-minute walk first thing in the morning and another one at lunch – is good, too. The important thing is to make it a priority, write it on your schedule and do it.

Maintain a healthy weight

If you struggle with your weight, you're not alone. Two-thirds of American adults are overweight or obese, and their kids aren't far behind. As weight goes up, so does the risk for cardiovascular disease. Take the weight down a notch, and you take down your heart risks, too. Here are five ways to work on your weight:

  1. Master the plan. Follow the eating and exercise guidelines we've already talked about – these will go a long way toward starting that downward trend on the scale. In addition, they'll set the right example to lead your kids into longer, healthier lives.
  2. Double down on the exercise. Thirty minutes of daily exercise is sufficient for heart health, but for weight loss, you need to get in 60 minutes or more. It isn't that hard: get up 15 minutes early and go for an energizing wake-up walk; take a rejuvenating 15-minute walk at lunchtime; hop on the stationary bike for 30 minutes while you watch the evening news. Done.
  3. Practice mindful eating. Mindful eating means being more conscious of what you're eating, when you're eating and why. It's the opposite of detached eating, which is eating without really thinking about it – like eating in front of the TV or computer, or eating straight out of the bag. Detached eating often has no relationship to hunger, and leads us to eat way more than we realized. To be more mindful, just check in with yourself before you eat. Ask yourself: Why am I making this choice? Is this going to help me in my health goals? And if it's not, is there a different choice I can make?
  4. Write it down. Keeping a food journal forces you to be more mindful. You are more likely to stop and think about what you are eating if you know that you have to write it down. Research shows that people who keep food records lose twice as much weight as people who don't.
  5. Watch out for portion distortion. Today's bagels are two or three times bigger than the bagels of 10 years ago. That's just one example of the way portion sizes have exploded in recent years. To avoid portion distortion, read labels to find out how many calories you're actually getting in the package. And stick with that 9-inch plate.

Don't smoke

Depending on how much and how long you have smoked, cigarette smoking can double, triple or quadruple your risk of cardiovascular disease and heart attack. Keep trying to quit until you succeed. Work with your doctor to take advantage of all the resources that can help you quit for good.

Don't drink too much

If you drink alcohol, keep it moderate. That means one drink a day for women and one to two drinks for men. More than that, according to the American Heart Association, can raise your levels of triglycerides (a type of blood fat), increase your blood pressure (a known heart risk) and lead to heart failure. In addition, the calories in alcohol can make you gain weight – another risk to your heart. It's best to enjoy alcohol in moderation, or not at all.

Focusing on these five things – whether you tackle them one at a time or all at once – can go a long way toward protecting your heart.


Alicia Ross, M.D., cardiology, is the medical director of the Center for Advanced Heart Disease at Providence Portland Medical Center, part of Providence Heart and Vascular Institute. Kimra Hawk, RD, LD, is an outpatient dietitian with Providence Nutrition Services.