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How to Take Care of Your Heart: Steps for Good Heart Health

Written by Dr. Michael Ruscio, DC on October 1, 2021

Written by Dr. Michael Ruscio, DC on October 1, 2021 — Reviewed by Dr. Hannah Hamlin

How to Look After Your Heart So It Can Look After You

• Caring for Your Heart|
• What Causes Heart Disease|
• Heart Health and Other Areas of Health|
• Healthy Heart Diet|
• Exercises for Heart Health|
• Why Sleep Is Key|
• Check Your Heart Health|

As organs go, the human heart is one of the most important for maintaining life, pumping a steady supply of oxygen-rich blood to the brain and other vital organs.

Most of the time we just take our heart for granted. But when things happen — for example you get high blood pressure, your cholesterol levels are up or your cardiovascular fitness drops — it can be a worry.

When heart health is compromised, overall physical and mental health can also be affected and vice versa. But you can make positive changes happen relatively easily by finding the right kind of diet for you, optimizing your fitness protocol, prioritizing your sleep, and improving your gut health.

This article will lay out key information you need to keep your heart healthier. The details are important, but first, let’s also take a broad brushstroke view:

How to Take Care of Your Heart: A Snapshot 

Here is a roundup of the key diet and lifestyle changes that can make your heart stronger and healthier:

• Pick a heart healthy diet:
  • Eat fresh unprocessed whole foods and not too much saturated fat, salt or sugar.
  • A Mediterranean diet, the DASH diet, or a paleo-style helps most people.
• Work up to better physical fitness: 
  • If you don’t already do regular cardio, start small with short, regular running, swimming or brisk cycling sessions.
  • Build up to at least 2.5 hours a week of moderate aerobic exercise, and balance this with 2-3 weekly strength training sessions.  
• Take steps to sleep better:
  • Aim for at least seven hours sleep, keeping to the same bed and waking times.
  • Wind down with a book and/or bath before bed (and turn off screens).
  • Learn stress-relieving techniques, such as mediation.
• Harness the heart-gut connection: 
  • Use probiotics and potentially prebiotics to help maintain heart health via the gut microbiome and its effects on metabolic and cardiovascular function. 
• Check in on your heart health:
  • Don’t skip your regular physical — your cholesterol level and blood pressure numbers are important. 
  • Try an at-home test such as the Cooper treadmill or run test ­to see how your cardiovascular endurance improves over time.

While our main focus here is how to take care of your heart, it’s worth framing this within the context of what happens when things go wrong: i.e., what heart disease is, and what causes it.

What Causes Coronary Heart Disease?

Coronary heart disease (CHD) remains the leading cause of death in the U.S., according to American Heart Association data, accounting for approximately 13% of deaths in 2018 [1].

CHD usually occurs because there’s a build-up of waxy plaque inside the lining of coronary arteries. This build-up can partially or totally block blood flow in the blood vessels of the heart. Symptoms can include angina (episodes of chest pain/tightness) lightheadedness, or shortness of breath, but there may be no signs until someone has a heart attack [2].

Family history may play a role in your susceptibility to heart disease, but the three risk factors that will put you at higher risk of CHD are [3]:

• High blood pressure
• High blood cholesterol
• Smoking, including exposure to secondhand smoke

Other medical conditions and lifestyle choices that also increase the risk of heart disease include [3]:

• Eating unhealthily
• Having diabetes
• Being overweight ot obese
• Physical inactivity
• Drinking too much alcohol

How Heart Health Links to Other Areas of Health 

Your heart health and other aspects of your health are intimately interlinked. For example:

• Those with a fitter heart have a reduced rate of dying from any cause (not just heart disease [4].
• Prolonged anxiety and stress can increase heart rate and blood pressure, reduce blood flow to the heart, and increase levels of cortisol. Over time, this could lead to calcification of arteries, insulin resistance, and heart disease [5, 6].
• Better cardiorespiratory fitness (a measure of heart health) is linked with enhanced brain function (ability to multitask) in older people [7].
• In young people, having higher cardiovascular fitness is also a predictor of higher academic success [8] and better mental health [9, 10].

A Heart-Gut Connection?

The “gut hypothesis” of heart disease suggests that inflammation and imbalances in gut microbes (dysbiosis) may also be drivers behind heart disease.

This is still an emerging area of research, but there have been some interesting findings that support the possibility of a gut/health link. For example, three reviews examining this hypothesis found that [11, 12, 13, 14, 15]:

• Gut microbiome imbalances can increase heart disease risk. Compounds produced by gut bacteria can lead to increased or decreased susceptibility to heart disease depending on the good/bad bacteria balance.
• Patients with heart disease have been shown to have altered gut microbiomes. Changes in the composition and diversity of gut microbiome have been observed in patients with heart failure and diseased arteries.
• Leaky gut may contribute to inflammation in heart disease. Increased intestinal permeability (leaky gut) is likely the precursor for the low-grade inflammation found in heart disease patients.

Interestingly, people with gum disease, caused by a bacteria build-up on teeth, also have up to three times the risk of having a heart attack or stroke [16].

Eating for Heart Health

The jury is still out regarding one specific diet that is best for heart health, but below are some key principles that should be at the core of a heart healthy eating plan. (Not surprisingly, a diet that is healthy for your gut is also healthy for your heart.)

• Focused on minimally processed foods. This means eating veggies, fruits, whole grains and lean proteins as opposed to ultra-processed foods, which are associated with increased risk of cardiovascular disease) [17].
• Balanced in fat. Saturated fats (in particular, from fatty meat) can raise blood cholesterol if you have them in excess. Unsaturated fats from nuts, seeds, vegetable and olive oil, and omega-3 fatty acids from oily fish are the ones to eat more of [18].
• Reduced sodium. Excess sodium from salt-added foods draws water into the body like a sponge, increasing blood pressure [19].
• Low in sugar and refined carbs. High intakes of refined carbohydrates, and specifically added sugars (like sucrose or high fructose corn syrup) leads to unfavourable changes to your triglyceride and cholesterol levels that may increase the risk of CHD [20].
• Low in alcohol. While one drink a day doesn’t necessarily harm heart health, too much can raise blood pressure and contribute to weight gain [21].

Some specific heart-healthy diets you could consider include the Mediterranean diet, the DASH diet and the paleo diet. Here’s a quick overview to help you decide which might work best for you: 

How to Take Care of Your Heart With Exercise

Physical activity, particularly aerobic exercises such as running, swimming or fast cycling, is absolutely essential for good heart health.

The Physical Guidelines for Americans recommendations advise at least 2.5 hours (150 minutes) of moderate-intensity physical activity a week [27].

To work out what your heart rate should be during moderate intensity exercise, subtract your age from 180 — i.e for a 35-year-old, that is 145 beats per minute (bpm).

If you haven’t been active in a while, it’s a good idea to start low and go slow, building up over 8-12 weeks. Even a little movement (i.e standing up and moving around) is better than sitting down all day.

Fitness to Optimize Heart Health

Later on, when you want to amp up the benefits and optimize your heart healthy lifestyle, you can increase the time, or intensity, you spend doing aerobic activity.

Additional heart health benefits can be gained by:

• Increasing to 300 minutes (5 hours) or beyond a week of moderate-intensity physical activity
• OR doing half that amount (at least 2 hours and 30 minutes) per week of vigorous-intensity aerobic physical activity at a higher heart rate
• Adding in some HIIT sessions where you intersperse short, all-out efforts with longer periods or moderate exercise

For a 35-year-old, the rough guide for heart rate when doing vigorous intensity exercise goes up to 172 bpm. You can calculate what heart rate counts as doing vigorous exercise for you here.

Cardiovascular endurance, general fitness, and overall health is better if you also add some strength exercises, such as: 

• Weights
• Body pump or kettlebell classes
• Body weight exercises such as squats, lunges, planks, etc.

Aim for at least two strength sessions a week as per the Physical Activity Guidelines for Americans recommendations.  

Too much focus just on bodybuilding gains without aerobic exercise may not be good for the heart, but a balanced combination of the two is optimal [28, 29].

Boost Your Microbiome With Probiotics

As we touched on above, having a healthy gut likely means having a healthier heart. So improving the microbial balance in your gut with probiotics, and maybe prebiotics, could be another valuable way to keep your heart in good shape. 

A 2020 systematic review / meta-analysis of randomized controlled trials found good quality evidence that when adults at risk of heart disease took probiotics they accrued these benefits [30]:

• Reduced systolic and diastolic blood pressure
• Reduced total cholesterol 
• Reduced LDL (“bad”) cholesterol and increased HDL (“good”) cholesterol (improving cholesterol balance)
• Improved blood sugar 
• Reduced body mass index (BMI)

Another comprehensive review concluded that prebiotics have quite similar benefits, improving all these risk factors for metabolic and heart disease in people with type 2 diabetes [31]:

• Fasting glucose and hemoglobin A1c (the measure of your average level of blood sugar over the past 2 to 3 months)
• Insulin resistance
• Total cholesterol
• Triglycerides
• Systolic blood pressure
• Body weight and body mass index (BMI)

The Importance of Good Sleep

Most adults need a minimum of seven hours of sleep to help reduce the risk of blood pressure, obesity, and diabetes [21].

Both short sleep duration and poor sleep quality are associated with the risk of coronary heart disease [32].

Some ways to get better sleep include:

• Have a consistent sleep schedule. This means aiming to get to bed and wake up at the same time, even on weekends [33].
• Adopt some calming bedtime rituals. For example, reading, meditating or taking a warm bath in the half hour to an hour before sleep can help [33].
• No screens in the bedroom. Blue light from cell phones and tablets can make it seem to your brain that it is daytime and you should be awake [34, 35].
• Off-load stress. Being able to let go of stress will help with your ability to sleep. Mediation with an app such as Headspace helps many people [36].
• Use sleep supplements when needed. Melatonin is a sleep hormone that can help with nodding off, especially if you are jetlagged or have been working shifts [37]. Preliminary research suggests probiotics can also help with sleep quality and reducing sleep disruption for those with depression, insomnia, and work-related stress [38, 39, 40, 41].

Check Up on Your Heart Health

Your heart health is so important it’s a really good idea to have regular blood pressure and blood cholesterol checks.

There’s no need to be obsessive, but for healthy adults, getting a blood draw once a year (and checking up on your blood pressure every three months or so) is about right. With your doctor, you can then monitor what is happening with your heart health over time and discuss any issues.

A useful at-home test that can assess how fit and strong your heart is the Cooper run test, explained fully here. In this test, you run as fast as you can on a treadmill, or outside, for 12 minutes and plug your results into a calculator which will estimate your VO2 max. This shows how efficiently your heart and lungs are working together to get oxygen to your muscles.

It’s informative to repeat this as you start to get fitter, so you can keep an eye on your heart health progress.  

Heart Health Maintenance: Pulling It All Together

Your heart health is vital to all aspects of your health and well-being. Eating healthily, getting a good balance of cardio and strength exercise, plus enough good quality sleep, will all help to keep your heart in good condition. 

For more personalized help with any health or fitness goal you can book an in person or online appointment at the Ruscio Institute.