Starting small, ways to prevent heart disease

The topic for the Feb. 7 Women of Wellness program was "Women and Heart Disease, Prevention with the Power or Mindfulness, Movement and Meals." The presenter, Kori Propst, Ph.D., vice president and wellness director for The Diet Doc spoke to a standing room only crowd in the conference room at Fallbrook Regional Health District's office.

According to Propst, heart disease can be a symptom, not necessarily the problem, of a person's health.

She said heart disease is the No. 1 killer of women. One woman will die every 80 seconds; 90 percent of women have at least one risk factor; two-thirds of women who die have no warning. While one in 31 women die of breast cancer, one in three die of coronary heart disease which is underdiagnosed and undertreated. Furthermore, 50 percent of women who have a heart attack never had prior symptoms.

According to Propst, there is a gender bias and stereotype when it comes to women with heart disease or stroke, so they have a worse prognosis than men do. Men get more testing and are diagnosed faster and more appropriately. With women, heart disease in not being detected or believed. "We need to demand the testing get done," Propst said.

Signs of a heart attack include nausea and vomiting, but it is key that women pay attention to symptoms that are not normal for them. She said, "Stress is a big risk factor; real problems are things we can actually control in our lives. We can influence cholesterol, nutrition (meals), exercise (movement), stress (mindfulness), smoking, weight, diabetes, blood pressure, excessive alcohol use.

"We cannot influence age, gender, heredity, race/ethnicity, auto-immune disease, menopause, hormone use or pre-term delivery," she said.

Besides weight, smoking is another major risk factor. She pointed out that 14 percent of people in the U.S. still smoke and explained that smoking causes plaque in the smoker's blood vessels which cuts off blood flow; it reduces good cholesterol; increases blood pressure and heart arrhythmia so smokers are more likely to die and die suddenly.

When people quit smoking, they lower their risk of coronary heart disease by 50 percent within one year. After 10 years, their risk of lung cancer drops by 50 percent and after 15 years their lungs are back to the level of a nonsmoker.

Living a healthy lifestyle can lower heart disease risk by 82 percent. In addition to not smoking, lifestyle changes that can help reduce heart disease risk include meditation, activity and healthy eating besides enjoying one's life with a sense of purpose, meaning and gratitude.

As for activity, "bodies are made to be ambulatory," she said. If sitting all day, Propst recommended starting small with getting exercise and to develop mindfulness. "Our minds produce about 68,000 thoughts per day and the majority of them are negative," she said.

"We notice the negative ones most," she explained as a survival response to threats. So, "become aware, 'I just had that thought, it could mean any number of things,'" she said, encouraging everyone to be aware of their mental chatter to develop a "level of awareness but not getting sucked into it."

She described attention training as empowering, "We need to train our minds, move our bodies, to take care of ourselves and have a level of compassion for ourselves."

To be present with one's thoughts and feelings, to get closer to what is real has a physiological impact she said. It increases one's immunity, decreases the stress response, enhances emotional regulation, decreases systemic inflammation, increases cardiovascular health and lowers blood pressure. It takes two minutes for the fight or flight response to develop, so she suggests taking a deep breath to regulate emotions. Breath, awareness and meditation can be a practice of mindfulness and concentrating on one's breathing is calming.

As far as exercise goes, she said 50 percent of people don't meet the recommended amount. Less than 5 percent of adults participate in 30 minutes of physical activity each day; only one in three adults do the recommended amount of physical activity in a week.

Movement reduces the risk of diabetes and increases blood sugar control, increases HDL (good cholesterol), can provide stress relief at low intensities, increases heart strength and stroke volume, has a carry-over effect to healthier eating, reduces blood pressure, causes sweating which is one of the body's cleansing mechanisms and increases connection and well-being through community.

To get moving, Propst encouraged people to do whatever kind of exercise they will actually do, moving for five minutes to start with and then adding a couple of minutes to that. Group exercise promotes accountability and community too. She suggested hiking, walking, running, cycling, strength training, surfing or paddleboarding. "Choose activities that can be fun," she said.

Weight is another problem as 70 percent of adults are overweight or obese. "We are overfed and undernourished; we are following a calorically dense diet that without the appropriate levels of of activity cause body fat accumulation," Propst said.

It is important "to know your numbers," she added, including blood pressure, body mass index, fasting blood sugar and total cholesterol/HDL. With these numbers a health care provider can determine one's risk for developing cardiovascular disease, angina, heart attack, stroke and peripheral artery disease.

She recommended colorful foods with nutrient dense vegetables being broccoli, artichoke hearts, mushrooms, yellow squash, bell peppers, kale and zucchini. Fresh ones are the best and cooking them in vegetable broth is best.

Propst said, "We don't need oil, fat or sugar; it's not complicated." Companies use lots of sugar, fat and salt to make food taste good and make consumers want more. So, "we consume too much food to be at a healthy weight," she added, and reducing sugar, processed carbohydrate and saturated fats along with increasing fibers from plant sources can increase heart health. She also suggested reducing one's eating time to 12 hours (between first and last meals or snacks) and choosing extra lean animal sources of protein. After age 65, the need for protein increases as people lose lean mass after that age.

Propst pointed out that saturated fat comes from animals, (except fish), cheeses and condiments like mayonnaise and sour cream. To lose body fat, one should reduce total fat consumption to 15-20 percent of total calories. Good fats include omega-3 sources of nuts, fish and avocado. Aiming for fiber totals of at least 25-35 grams per day will also help with weight loss as does reducing the amount of packaged and processed foods in one's diet.

In short, the path to preventing heart disease includes the power of mindfulness, movement and nutritious meals.