Six important things to know about heart health

1. The body is a temple

Monica Aggarwal, MD, FACC
Monica Aggarwal, MD, FACC

We don’t want to hear this when we’re younger, but it’s true that what we put into our bodies will eventually affect us later in life. The foods we eat directly impact how we feel, our energy levels and our risk of illness. All the food that enters into our bodies, goes into our gut. Our gut has millions of very important bacteria that have their own DNA (gene material). These bacteria have a role in making our happiness hormone (serotonin) and other hormones that make us feel energized or sleepy. These bacteria also have a role in making sure that the nothing bad gets into the bloodstream and triggers illness. When you eat foods that have lots of fiber and are primarily plant based, the gut remains strong with healthy gut bugs. You will find that when your gut is strong, you will have more energy, less inflammation and decreased risk of illness. When we eat foods that are high in fat, processed sugars and animal products, our guts become full of harmful bacteria and this makes us feel sluggish and often puts us at risk for illness. We have to be mindful everyday of what we are putting into our bodies to stay healthy.

In our youth, however, many of us feel a sense of invincibility and we can be more cavalier than we should be. Sadly, this belief continues to exist in many parents, who often tell me they feed their children ice cream and fast food because they feel their children are young and can afford it. I think parents often feel that when we don’t give them to our children, we are depriving them of their childhood. I would argue that when we don’t feed them these foods, we are giving them a future. My kids ask for apples, cucumbers and carrots for snacks. They don’t feel deprived.

When we are born, our heart arteries are smooth and completely clean. However, in autopsies of children who die of cancer at young ages, we also find plaque in their heart arteries!

If we teach our children how to eat well early, these will be the foods that they will grow to love. If we start early, they won’t be interested in those unhealthy foods. Ultimately, we need to teach our children how to eat for a lifetime.

What are the goals? We need to eliminate as much animal products as we can (meat, dairy, cheese). This is key. There is lots of data to show that animal products trigger heart disease and can increase risk of dying. We should work towards a plant-centric model. A focus on eating seven servings of fruits and vegetables per day and a diet full of beans, lentils and resistant starches such as plantains and sweet potatoes gives us filling meal options that are good for bodies. These meals strengthen our guts and decrease our risk of illness. Eliminate your meat and processed foods. Add back the good starches and plant fibers. You will notice the difference in weeks!  Give more detail/examples here. Why do parents think this way? How can we change it?

2. Being a patient is no fun

No one wants to be sick. Sometimes, as people, we forget this. We’ve also forgotten empathy and the knowledge that a person who is sick is a person who is suffering. Acknowledging someone’s sickness and fear of mortality is more real and helpful than ignoring the elephant in the room. Understanding that fear and sadness has made me a better doctor. So often as physicians, we come into the room in our fifteen-minute visit and leave after filling a few prescriptions. Did we make you better? Usually not. Most people just get more medications that they don’t want to take and often suffer drug interactions and significant side effects because of the polypharmacy. I find that spending more time with my patients understanding what worries them and what holds them back helps me find ways to get them better. Sometimes when we are sick, it is so hard to see the light. Reminding people how strong they are and what they have the power to control is important.  How? Why? More detail here.

3. Breathe

Sometimes as women, parents, and professionals, we feel we have to do everything. The constant need to keep going and be “on” has become a societal issue. With LED lights and our smartphones keep us awake with excess light and constant buzzing with social media. We try to accomplish more than is possible in the time we have. When we are always on, we are constantly using the part of our nervous system called the sympathetic nervous system. The job of the sympathetic nervous system is to keep us going. It is often called the “fight or flight” system which prepares us for running from a tiger or any other acute stresses we might have. During this sympathetic system overdrive, our stress hormone, cortisol, is high. Our blood pressure and heart rates remain elevated. This is necessary because so that we have adequate blood flow to our brain and muscles to handle the immediate stress. After stress however, our bodies need a chance to recharge. This activates our parasympathetic nervous system, also known as our “rest and digest” system. Everyone needs a balance between these two systems. Without that balance, and sympathetic overdrive, our bodies are at risk for burnout, sadness and illness. Sometimes, some of the most important stuff that I teach my patients is how to recharge.  Taking a moment to recharge by sitting in the tub, a long shower, deep breathing, or a run can be reinvigorating. That moment allows the body to reset itself. Our cortisol levels decrease and blood pressure and heart rate go down. Learning how to take deep breaths is super helpful. I recommend three counts of breathing in, a three-count hold, and a five-count breath out. Do this 10 times in a sitting. Between each breath, think of a mantra (a chant) that makes you feel good. It can be as easy as “I am loved” or “I am okay.” That deep breathing activates the parasympathetic nervous system and makes those stress hormones go down. Our blood pressure and heart rates go down and we have a feeling of calm and peace. It makes a world of difference.

4. Start small

We have all heard from our physicians that we need to exercise. In some people, that concept triggers visions of working out in a gym or body building. That is not the case. Exercise is very important to keep the blood vessels in your body open so that blood flow can go through. There is plenty of medical data to show the importance of exercise in decreasing your risk of illness. However, it doesn’t have to be hard. Get a fitness tracker and see how many steps you are doing in a week. People think they do more than they are. Then try to increase it by 2000 steps. Just 2000 steps has been shown to have health benefits. That 2000 steps is parking further in the parking lot at the grocery store and taking the stairs instead of the elevator. It is going for a walk at lunch. Another good exercise that I like is “Sun Salutation A”. This is a yoga exercise that you can do in your bedroom. It works on stretching and core muscle work with simple poses like ‘down dog’ and ‘up dog.’ It is also quite calming. I always tell people that exercise doesn’t have to be fancy and it doesn’t have to cost a lot. Small changes make a huge difference.

I would also consider that these things take time. Sometimes people coming in wanting to make all their changes at once. You can’t learn to run a marathon without first learning to walk. Change takes time. You have to allow yourself the time to get better but it takes work. Start by walking up the stairs and parking further away in the parking lot. Play football with your child. Walk in the pool. Don’t ignore the benefits of the medications you are taking and trying to get off all of them at once. Heal the body first and then try to slowly and cautiously come off of the medications.

5. Being sick doesn’t define you

When I became sick, I thought I didn’t tell anyone. I was so worried about being judged by my colleagues and friends. I thought that I was less of a person because I was sick. It took me years to understand that I am better because I have been sick.

When you get sick, it is something that you have but it is not everything and just because you have been sick doesn’t mean you always will be. Believe that you can get better. You might not ever be cured, but you can heal. Sometimes adding in lifestyle changes will allow you to come off of medications. Sometimes, they will help lessen side effects and can improve over sense of self. Change takes time, meticulous management, understanding your medications, respecting for your body’s abilities, and learning to challenge the body.

6. Sometimes the best prescriptions don’t come in pill form

I pride myself on being the doctor who takes people off of medications. My prescriptions are harder to fill. My prescriptions require learning to exercise, learning to sleep, and learning to eat right. We as physicians aren’t good about teaching people how to heal with lifestyle measures. There is so much we can do with our foods and activity to heal.

  • Start by eliminating the unhealthy foods: processed sugars, animal products (including dairy) and high fats. The more “instant” the food is, the more processed. If it comes in a box, it is likely very processed. Start with one thing at a time and every week remove one animal product. First red meat, then chicken and then dairy. If you want to keep any animal product, keep the fish.
  • Add back 5-7 fruits and vegetables per day. Add in beans and lentils 3- days per week. You won’t be hungry and your body will be wowed by the change.
  • Focus on sleep. Force yourself to turn off the lights and get 7-9 hours of sleep. Your body will thank you in the morning
  • Find a way to move more. A quick walk at lunch, taking the stairs or while taking a conference call at work do some squats or sit against the wall. Even 2000 steps makes a world of difference
  • Learn to breathe. Take ten deep breaths with the exhale longer than the inhale a few times per day. Focus on the breath. Think of a mantra. You will feel so much better.

The world has changed. We live in a world now where everyone is always on. We are moving so fast and always trying to keep up. Our social media buzzes throughout the night. The news is encompassing. We have more demands at work and at all times of the day. We are commuting long distances for work and sitting in cars/sedentary. We are tired and are looking for quick meals which often are heavily processed. We need to start over. Go back to the basics. Simplify.