[Risk Factors for Heart Disease, Part 1]
Let’s be real folks, cardiovascular disease (also known as heart disease, coronary artery disease or CAD) is the number one killer of human beings in the entire world. What's even more troubling though, heart attacks due to CAD are becoming more and more prevalent each year and there's no evidence to show that it is slowing down anytime soon.
Oh, by the way, before I get going, a big thanks to Matt and Lisa for inviting me to teach on this amazing forum of individuals ready to embark on a journey that will improve their health, wellness and overall state of mind. I’m very excited for all of you.
My name is David, I am a Certified Exercise Physiologist with over 4 years of clinical inpatient and outpatient experience treating, educating, training, motivating and bettering the lives of individuals diagnosed with various forms of metabolic and heart diseases. I’m also a wellness adviser and trainer for CEOs, business professionals, accountants and high school athletes. I’ve spoken about mindset, mindfulness stress reduction and meditation to nurses, EMTs, paramedics and medical doctors as part of their continuing education requirements. So who’s ready to learn?
When it comes to NOT dying of a heart attack, prevention is key. The first step is simply knowing the risk factors for heart disease. In other words, what are the various aspects of life and ways of existence that put you at a greater risk for developing the disease? In the medical field we call these “positive risk factors.” Confusing because positive risk factors are BAD.
I’m going to go through all 10 of these risk factors as part of a two-part series because, frankly, it is a lot of material to cover and I will be flying through each topic. I’m sure there will be questions so please ask away. Depending on everyone’s responses, I may also post more detailed articles on any topic you are most interested in or that you feel you need more clarification.
Also, with each teaching point, the ever-powerful tool of mindset will be incorporated in order for you to develop better control over these factors and ideally change positive risk to negative risk - significantly decreasing your chances of developing heart disease (amongst countless other problems that may occur on life’s journey).
THIS IS IMPORTANT! As you learn about your risk factors, the mindset will be to ask the right questions to yourself: “Do I personally have said risk factor already? How can I change it? What can I do or not do to prevent it?” Keep in mind, there are many factors here so when planning to change anything, moderation is the safest and healthiest way. Don’t be overwhelmed, and remember, everyone is different. Let's take a look at the first risk factor.
According to the American Heart Association (AHA), if your father or brother under the age of 55 or mother or sister under the age of 65 died of a heart attack or had known CAD at those respective ages, you have a positive risk factor which automatically puts you at higher risk.
Ok, mindset toolkit time… especially if any of the above are true for you.
How do I change my family history? Cue the blank stares...
My point is, time for some good old-fashioned acceptance along with a warm embrace of reality.
However, if you do have familial history you must also know that you are an individual who must be extra vigilant and mindful of your other risk factors: the ones that you can control.
I should know, I’m one of those folks. My family is riddled with heart disease, which is one of the main reasons I decided to go to school and specialize in physiology, nutrition and overall health and wellness. Also, I love teaching. Someone please kick out my soap box...
If you don’t have a family history, pat yourself on the back. But remember, there are still 9 other risk factors so that doesn’t mean you get to jump up and down and ignore the rest. AND, if you do eventually develop heart disease later in life, guess what, now it runs in your family and you just put your children and grandchildren at higher risk.
Men are at slightly higher risk than women for developing heart disease (and I do mean very, very slightly). Research shows that, in the near future, this risk factor will be taken out of the equation completely; ladies are leveling the playing field at an unprecedented rate.
Mindset? Despite the controversy and potential for political discussion, physiologically speaking, let's move on to the next risk factor.
The older you are, the more time you've had for the disease to develop and manifest in your coronary arteries (arteries that give your heart the oxygen in needs to function). More specifics on the nature of how and why the disease occurs in those arteries in a later topic.
You guys are already professionals at this mindset thing by now, am I right? You're probably wondering, “I can’t change my family history. I can’t change my gender. I can’t change my age. When am I gonna learn what I’m supposed to actually do?”
Not to worry, you don’t have to just accept that we are likely all eventually going to drop dead one day of a heart attack.
Now would be a good time to take notes. Age is a mathematical measurement based on how long you've been on this planet and it's a pretty good indicator of risk stratification. HOWEVER, in the language of biology and physiology you can actually get younger as time goes by. WHAT? How about a quick lesson in biology and the building blocks of what makes you, you: Chromosomes.
Think of your chromosomes in your DNA as shoelaces. The tips of those shoelaces are called telomeres. They protect the shoelace from fraying and becoming damaged over time. Telomere length can be measured. That measurement is how scientists determine physiological age. Generally, the trend is that telomeres shrink over time until the day you die. At that time, they are virtually gone.
A scientific study took over 500 individuals and split them into two groups. The study tracked and measured the telomere length of both groups over the course of 5 years.
One group was given dietary/nutritional education and guidelines along with regimented exercise programs to follow. The control group was left alone to their own devices. They wanted to see how lifestyle behavior could slow down the aging process. The prediction was that the experimental group would have less of a shortening of their telomeres.
At the end of the 5 years, the results were in. As expected with normal aging processes, the telomere length of the control group shortened significantly as a whole. The group that was following the diet and exercise programs, to the experimenters’ surprise, actually had LONGER telomeres as a whole than before!
What does that mean? It means that 5 years went by and the healthy eating and exercising folks were physiologically younger than they were at the beginning of the study. Truly amazing.
Ever wonder why some 50-year old’s look 40 and other 50-year old’s look 82? Now you know, telomere length. Good news for all of you in this program. Let's have a goal to slow down our aging process and maybe even start getting younger with time!
According to the AHA guidelines, a higher BMI is associated with greater risk for heart disease. There are varying degrees of risk based on how high your BMI is. Keep in mind, take this info with a giant grain of salt. Why?
BMI is a height to weight ratio and, in my most expert opinion, is a horrible indicator because it doesn’t take into account body tissue like muscle mass, bone density and everything else that contributes to increased weight. It is simply a height to weight ratio. That’s it. So, if you consider a fairly short, active, healthy eating, muscular person with very little body fat, by AHA guidelines, that person will be at extremely high risk for developing heart disease in terms of BMI. But really, they’re not at risk. They’re killin it. Here’s the formula and risk chart if you’d like to calculate your own.
body weight (kg) / height (m)^2
Mindset? In my opinion, don’t dwell on these numbers too much. I don’t like them. It’s much better to focus on eating better and exercising. How you feel and the way your clothes fit are much less stressful ways to determine whether you are getting healthier. Not just height and weight alone. The numbers will eventually take care of themselves if you are diligent and consistent. If you are the type of individual like the one I described earlier, don’t even look at this chart.
What about diets? I don’t like those either. Why? For one, what happens when your best friend Susy tells you she “went on a diet?”
Suzy: OMG! I’m loving this new diet where I eat nothing but apples and nuts and I’ve been on it for a month and I’ve already lost 8 pounds!
You: Wow that’s amazing good for you!
Inner you to yourself: Geez apples and nuts that sounds horrible.
2 months later...
You: Suzy, you look amazing how much weight have you lost in total?
Suzy: 17 pounds! I stopped my diet yesterday cuz 17 pounds was my goal and I feel great. Besides, I couldn’t keep it up it was too much of the same. I miss sandwiches.
5 months later… Suzy has gained all 17 pounds back, plus another 6 because her body was so deprived of the normal variety of nutrients that it felt it needed to hang on to an extra few pounds in fear of Suzy going on another diet.
Here’s the thing, DIETS DON’T WORK. As a rule in physiology, it is much more detrimental to go on and off diets and gain and lose weight periodically throughout your life. It is called yo-yo dieting and your heart doesn’t like it. It literally stresses your heart out, along with many other organs. It is much better to take a gentle, long term approach.
For example, if you want to start by reducing the amount of sugar in your diet, pick one food item that has sugar in it, let's say, soda, if you’re into that, and don’t drink any soda or for 21 days.
There have been countless studies on the power of 21 days and changes that happen in your brain. By the end of the 21 days you won’t have any major brain cravings for soda and you will be in control. Continuing on with your new superpower over soda, even if you were a very moderate soda drinker, you just eliminated a whole lot of sugar from your long term diet.
If you smoke, you are at a significantly higher risk for developing heart disease. If you don’t smoke, super cool, don’t start.
Mindset? Smoking is one of the most difficult habits to quit due to its complex effects on the brain. Everyone is different. Who’s to say it will be that hard for you? You can do this. There are many ways to quit smoking. If you need help, get it. YOU ARE NOT ALONE.
I’ve never been a smoker so I don’t know what it’s like to try to quit. I have studied and researched a lot in psychology and habit forming, so I will give one recommendation to try. And this method is proven to work for changing pretty much anything.
Let’s say you smoke one pack a day. Pick a reasonable number of cigarettes to eliminate from that pack each day and smoke the remainder of the pack for 21 days. Keep taking away a chunk of that pack every 21 days until its gone.
Also, AND THIS IS MOST IMPORTANT, do a little math and find out the day when you will be at zero cigarettes. Write it down somewhere you will see it every day. Then tell all your friends and family that you are in the process of quitting and on August 9th, 2018, you will be rid of smoking forever. Trust me, something magical happens in your brain when you write things down and make yourself accountable to the people you love.
Check out risk factors 6 through 10 in Risk Factors for Heart Disease: Part 2 as I talk about what else you can do to keep yourself younger, healthier and happier.
Certified Exercise Physiologist
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