Some excerpts from "12 Tips for Better Heart Health; Diet, sleep, fitness, and more -- how to strengthen and protect your heart right now"; by Denise Mann, WebMD the Magazine - Feature - February 2009 Issue; Reviewed by Brunilda Nazario, MD

There's more good news today for people who eat a traditionally Mediterranean diet. Americans whose diets are high in monosaturated fat, plant proteins, whole grains, and fish are significantly less likely to develop heart disease and stroke. Shifting to a Mediterranean-style diet means getting more protein from plant sources, such as beans and nuts, instead of meat. Fish should be eaten once a week, while red meat should only be eaten once or twice a month.

Researchers note that Americans may take a slightly different approach to the diet, which is traditional in Greece and Southern Italy. For instance, in those countries, olive oil, high in monosaturated fat, is the primary cooking oil and is even used for dipping bread at the table (instead of butter). In the U.S., Mediterranean-style dieters may get more monosaturated fat from canola oil or peanut butter.

"I think the Mediterranean diet is by far one of the easiest to follow because there are no extremes," researcher Teresa T. Fung, says in a news release. Fung is associate professor at Simmons College and adjunct associate professor in nutrition at the Harvard School of Public Health. "It does not require you to cut out something or eat only a few number of foods. The types of food common to the Mediterranean diet are pretty easy to get as well. It has a good amount of plant oils, so you are not cutting out fats."

How do you get a healthier heart, right now? The answer sounds too good to be true: By simply leading a healthier life,” according to Nieca Goldberg, MD, medical director of New York University’s Women’s Heart Program and author of Dr. Nieca Goldberg’s Complete Guide to Health.

That’s because even small, steady changes in your life mean a stronger, more efficient heart. “More than half of heart disease is preventable, and studies have shown that 90% of heart attacks in women can be prevented,” she adds. Further, the latest study in Archives of Internal Medicine shows that women who eat loads of veggies, fruit, whole grains, fish, and legumes; drink moderate amounts of alcohol; exercise; maintain a healthy weight; and don’t smoke have a whopping 92% decreased risk of having a heart attack compared with women with less healthy diets and habits.

An added bonus? “So many things we do to help our heart, like quitting smoking, eating more fiber, and moving more, also help other parts of our body, including our bones, colon, lungs, and skin,” Goldberg says. And February is Heart Disease Awareness Month, making this the perfect time to start improving your ticker -- and the rest of you.

1. Know your heart health numbers.
Establish a baseline to help plan every preventive step for the rest of the year. “You need to know if you are at risk before you can take action to lower your risk,” says Lori Mosca, MD, PhD, director of preventive cardiology at New York-Presbyterian Hospital and author of Heart to Heart: A Personal Plan for Creating a Heart-Healthy Family. Know your HDL or “good” cholesterol, LDL or “bad” cholesterol, total cholesterol, triglycerides, blood pressure, weight, and body mass index (BMI) numbers. And make an appointment now for a check-in next February to see if your new healthy habits are making the grade.

2. Target your triglycerides.
Shoot for a level of 150 or lower, says Peter H. Jones, MD, an associate professor of medicine at Baylor College of Medicine in Houston. “Doctors usually talk about good and bad cholesterol and most folks will have that down, but triglycerides are a better marker for high risk of diabetes and heart disease,” says Jones. Triglycerides are also much more responsive to lifestyle changes than other types of blood fats. “Your triglycerides can drop 30% to 50% just by reducing saturated fats and reducing your weight,” Jones says.

3. Go for nuts and plant sterols.
Your heart will love you if you eat six walnuts before lunch and dinner, according to Michael Roizen, MD, the chief wellness officer for Cleveland Clinic and chairman of the clinic’s Wellness Institute. Why? Because “walnuts are rich in omega-3 fatty acids, which help to decrease inflammation in the arteries surrounding your heart, so they keep your heart functioning longer and better,” promises Roizen,co-author of the best-selling You: Staying Young: The Owner’s Manual for Extending Your Warranty. “Walnuts will also make you feel fuller faster so you are less likely to overeat at meals.”

You may want to give pistachios a try as well. A recent study shows that a serving or two of pistachios each day may help reduce levels of LDL cholesterol, as long as you are mindful of calories. One cup of pistachio nuts has about 700 calories! Other nuts, such as peanuts, macadamia nuts, and almonds are a rich source of plant sterols, which block cholesterol absorption in the intestines. Studies have shown that eating foods enriched with plant sterols lowers LDL cholesterol. Eating 2-3 grams a day lowers LDL cholesterol by 6-15%, without affecting HDL cholesterol or triglycerides. Sterols are found in all plant foods, but the highest concentrations are found in unrefined oils, such as vegetable, nut, and olive oil. Some foods have also been fortified with plant sterols, including milk, yogurt, juices, and spreads.

4. De-stress your heart.
Unplug yourself from the news cycle and your email. It’s good for you and your ticker. And that begins with your PDA. “Start turning it off for 15 minutes at a time and work up to an hour a day to reduce stress,” Goldberg says. “Stress raises blood pressure, heart rate, and levels of the stress hormone cortisol,” she says. “These days, people are less and less capable of leaving stress at the office because everyone is connected 24/7.” Consider swapping your BlackBerry for another handheld gadget -- your iPod. “Put some relaxing music on your iPod, close your office door for 10 minutes, and listen and breathe.”

5. Get heart healthy social support.
You know exercise improves heart health by keeping weight down and raising levels of HDL cholesterol, but doing it with a friend adds benefits. “Finding an exercise buddy is really important because social support lowers your risk of heart disease and helps you stay motivated,” Mosca says. Build up to 60 minutes of exercise a day, but even 20 minutes is better than nothing. In fact, being married and having a strong social network may help protect against heart disease, according to a study of nearly 15,000 men and women. It turns out that people who have a spouse, go to church, join social clubs, and have a lot of friends and relatives have significantly lower blood pressure and other heart disease risk factors than loners.

6. Volunteer to fight heart disease.
People who volunteer tend to live longer than people who don’t. It’s that simple, Mosca says. “We think this is because volunteering reduces isolation and increases social connectivity.” Find a charity that means something to you and donate your time now.

7. Take a heart-felt approach to quitting smoking.
Smoking is a major risk factor for heart disease, but kicking this nasty habit can be much easier said than done. “If you smoke, talk to your doctor about some of the new therapies that are available,” Goldberg says.

Need an added incentive? Take this advice to heart: “You start to improve your heart health within minutes of quitting,” she says. And the heart health dividends keep growing. “After one year, your heart disease risk is cut in half -- and after 10 years of not smoking, your heart disease risk is the same as for someone who has never smoked.”

Secondhand smoke counts too. A recent study found that women who are exposed to other people’s smoke increased their risk of heart attacks by 69%, strokes by 56%, and peripheral artery disease (PAD) by 67%, when compared with women who did not hang out around smokers. Clogged arteries in the legs, abdomen, pelvis, arms, and neck are linked with PAD. “Tell your friends to quit, too, or make new friends,” Goldberg says.

8. Drink a little alcohol a day to keep heart disease away.
“For women, up to one glass of alcohol a day and, for men, up to two glasses a day can help reduce risk of heart disease,” says Goldberg. “Alcohol may help the heart by increasing levels of HDL cholesterol,” she explains. But keep in mind: More is not merrier. “Alcohol also has calories, and too much can cause high blood pressure, worsen heart failure, and cause heart rhythm abnormalities.”

9. Strengthen your heart with weight training.
“Strength training reduces your percentage of body fat, keeps your weight down, and increases your muscle mass and endurance for aerobic exercise,” says Goldberg. “Do some weight training with free weights twice a week, making sure to focus on both your upper and lower body,” she says. “As your aerobic capacity improves through strength training, your good HDL cholesterol levels will increase.”

10. Measure your waist size to gauge your heart health.
“Take a tape measure and measure your middle,” Goldberg says. “If your waist size is more than 35 inches in women or more than 40 inches in men, this tells you that you are at increased risk for heart disease and type 2 diabetes.” The best way to make a dent in that spare tire? “Get serious about being more active and get rid of simple sugar and white-floured foods in your diet,” Goldberg says, adding that these foods tend to take up residence right around the middle.

11. Reduce your blood pressure by reducing your salt.
High blood pressure is a major risk factor for heart disease, and reducing salt intake can help lower blood pressure. Cook with herbs in place of salt, and make sure you read food labels to see just how much salt is in prepared foods. “Aim for less than 2.3 grams [about a teaspoon] of salt per day,” Goldberg says. And keep up the good work when you are dining out, she adds. “Ask for the sauce and salad dressings on the side because restaurant food tends to be heavily salted.”

12. Sleep to your heart’s content.
People who sleep fewer than seven hours a night have higher blood pressure and higher levels of the stress hormone cortisol, making the arteries more vulnerable to plaque buildup, says Goldberg. In fact, the latest research shows that people who do not get enough sleep are more than twice as likely as others to die of heart disease. Try to avoid caffeine after noon, and develop a stress-free wind-down ritual before bed. Hint? Take a bath, and don’t pay your bills right before bed.

Copyright © 2009 Carol Stevens, Shaboom's Kitchen, All Rights Reserved