Stanols and sterols. Good plant cholesterol in foods like the spread Benecol helps your arterial health by displacing the lousy cholesterol in your arteries.
YOU Tip: Get Your Clothes Wet. We may not like to see sweat on treadmills or public speakers, but we want to see it on you. While we recommend different kinds of physical activity in different circumstances (including resistance exercise, walking and stretching), the way to improve heart function is to sweat more than a kid in the headteacher’s office. Why? Cardiovascular activity lowers both the top systolic (the pressure being exerted when your heart contracts) and the bottom diastolic (the pressure in the arteries when the heart is at rest) numbers of your blood pressure. Cardiovascular exercise may also be helpful because it makes your blood vessels more elastic by forcing them to dilate. In addition to thirty minutes of daily walking, aim for a minimum of sixty minutes a week of cardiovascular or sweating activity – ideally in three twenty-minute sessions – in which you raise your heart rate to 80 percent or more of its age-adjusted maximum (220 minus your age) for an extended period of time.
We recommend low-impact activities like swimming, cycling or using an elliptical trainer to get your heart rate up without compromising the quality of your joints in the process (and to change activities, so you don’t get repetitive use injuries from doing the same activity over and over). We also recommend interval training – that is, alternating periods of maximum effort with periods of recovery – for the maximum benefit of your heart. (Check with your doc beforehand; she may want to try it in the controlled setting of a stress test first.) Even doing one minute at the end of every ten with maximum effort can be beneficial.
One way to do it: after warming up, go for maximum effort for a minute, and then slow down to 60 percent of maximum (recover) for two minutes. Then go to 80 percent of maximum for seven minutes. Then cool down. As you progress, you can do intervals, alternating between intense effort and effort that allows you to recover – one minute fast, two minutes slow, and so on.
YOU Tip: Kick Yourself in the Aspirin. Of all the things that you shovel down your throat, we think aspirin should be one. As a huge anti-inflammatory agent, aspirin works as the chief of the fire crew called in to put out the inflammation response. Speak with your doc about making it part of your regular routine, just like brushing your teeth or walking the dog. We recommend half a regular aspirin or two baby aspirins (162 milligrams total) every day if you’re a man over thirty-five or a woman over forty. Why? Many studies of primary prevention have shown that two baby aspirins decrease the risk of heart attack by 36 percent. It’s thought to work by making platelets less sticky to avoid clotting, and by decreasing arterial inflammation. You can reduce potential gastric discomfort by drinking half a glass of warm water before and after taking aspirin; the pills dissolve faster in warm water and are less likely to cause stomach irritation and ulcerations and bleeding. One note of caution: if you begin bleeding more during flossing or from a shaving cut, or if you notice that you’re more susceptible to bruising, the aspirin is the likely culprit, and you may have to cut back.
YOU Tip: Supplement Your Diet. These vitamins and supplements have the most potent effects on strengthening your heart:
| Pill | Do We Recommend It? | The Fine Print |
| Folic acid, vitamin B6, vitamin B12 | Yes | Folic acid, vitamin B6 and vitamin B12 work by reducing levels of homocysteine, a body chemical that’s related to increased risk of heart disease. You should get 800 micrograms of folate a day. Most people get half of that in their diet, so add an additional 400-microgram supplement. Get 50 milligrams of vitamin B6 and 800 micrograms of B12. |
| Coenzyme Q10 | Yes | Mitochondria convert glucose into electric energy, and one of the molecules carrying electrons in this process is coenzyme Q10. Taking it as a supplement seems to protect against heart failure and other inflammatory processes by improving the efficiency of the mitochondria. The usual dose is 200 milligrams a day (100 in the morning and 100 in the afternoon). It’s especially helpful for people who take statin drugs, because statins decrease levels of CQ10, which may be why statins can be associated with muscle cramps and pain – your arteries are literally being starved of energy and are crying for help. |
| Niacin (vitamin B3) | Sometimes | A dose of 500 milligrams can lower LDL cholesterol and lower triglycerides, and help raise HDL. Take it with aspirin when going to bed to help decrease the risk of hot flushes, a common side effect. You can take a higher dose but need to talk to your doc because higher doses often need to be prescribed (Niaspan). Niacin is rarely associated with liver problems. |
| Vitamin D | Yes | Recent research suggests that D isn’t just good for your bones and immune system, but is good for your heart too. Try 800 IU daily if under the age of sixty, 1,000 IU if age sixty or over. |
| Pantothenic acid (vitamin B5) | Yes | It’s a water-soluble vitamin that’s essential for metabolism and for forming HDL cholesterol. We recommend 150 milligrams twice a day. |
| Red yeast rice | Not necessarily | It’s been touted as a supplement that can help lower cholesterol and triglyceride levels, as well as increase healthy HDL cholesterol. The rumours are true because the active ingredient is identical to a commonly used pharmaceutical statin drug. But because herbs are harvested without tight controls, you don’t know exactly what you’re getting inside the pill. For the same cost, you’re better off using another supplement such as niacin or pantothenic acid. |
| D-ribose | Yes | It’s been shown to improve blood pressure and exercise tolerance in patients with congestive heart failure. It seems to work by getting ATP energy to heart and skeletal muscles. The dose is 5 grams once to three times daily. |
YOU Tip: Know the Ratio. We could spend an entire book talking about the fat around our waists (oh, wait, we already did that). But we also need to spend some time talking about the fat in our diet. Most of us know that dietary fats come in two general forms: either they’re good for us, or they’re more destructive than tank treads on armadillos. And most of us know that we should avoid the bad kinds the way we avoid telemarketers.
But if we dive a bit deeper into the story of good fats, we can also realize that it’s more than just a get-good/avoid-bad argument. Research suggests that omega-6 fatty acids (found in cereals, some nuts, whole grains and vegetable oils) can be harmful to us if we don’t have the proper ratio of omega-3 (found in oily fish, walnuts, certain algae and flax) to counterbalance those fats and provide a protective effect against heart disease. The ideal ratio: omega-3s, especially DHA, should be one-quarter of omega-6s.
YOU Tip: Get Between the Cracks. Despite the pleading from dentists,