Most Americans know all of the traditional heart disease risk factors lack of physical activity, high cholesterol, high blood pressure, diabetes, obesity and smoking. Although these are important, there also are lesser-known risk factors. Ways to avoid them…
• Boost your HDL level
Though high LDL (“bad”) cholesterol has long been considered the major culprit in heart attack risk, low HDL (“good”) cholesterol actually is the bigger risk factor, especially in women. About 70% of women and half of all men with coronary artery disease (CAD) have low HDL cholesterol.
What to do: If you’re a woman with HDL below 55 or a man with HDL below 45, take steps to boost your good cholesterol. Engaging in regular, vigorous exercise can raise HDL levels by 10% to 15%. Limiting carbohydrates to less than 45% of your daily diet and increasing monounsaturated fats (which are found in olive, canola and hazelnut oils) can raise HDL levels by 10%. Cholesterol-lowering statin drugs also may raise HDL levels by as much as 10%. Taking 1,500 milligrams (mg) of the B vitamin niacin under the supervision of a healthcare provider can raise HDL by 25% to 30%
Note: At high doses, niacin can cause side effects, such as flushing, liver problems and irregular heart rhythm.
Warning: Low-fat diets invariably lower HDL levels, which may actually increase heart attack risk. To ensure a healthy cholesterol ratio, don’t simply eliminate fats from your diet. Monounsaturated and non-hydrogenated polyunsaturated fats should provide up to 30% of your total daily calories.
Good sources: Olive oil, canola oil, nuts and avocados.
• Determine your LDL size
LDL cholesterol particles come in two sizes large (type A) and small (type B). A predominance of the type B particles increases risk of CAD by 300% to 500%, even when LDL levels are normal (less than 100).
Reason: Small LDL particles pass through the inner lining of coronary arteries more easily, possibly triggering a heart attack
What to do: If you have low HDL cholesterol levels (below 45 for men and below 55 for women), particularly if any family members developed CAD before age 55, have your LDL particle size measured. This simple blood test is widely available, and many insurers now cover the cost.
The best way to decrease your type-B LDL count is to eat a healthful diet comprised of 30% fat, mostly in the form of monounsaturated fats, and limit carbohydrate intake to no more than 45% of total calories.
To boost your intake of beneficial omega-3 polyunsaturated fats, eat two to three seafood meals weekly. Choose the fattier fish, such as salmon and tuna.
Self-defense: Pregnant and lactating women should ask their doctors about limiting intake of fish due to its mercury content.
Avoid the trans-fatty acids and the omega-6 polyunsaturated fats found in margarine, fried foods, baked goods, corn and safflower oils.
• Know your birth weight
A low birth weight is a significant and independent risk factor for heart attack, hypertension and diabetes in adulthood. Research has shown that people who weighed less than 5.3 pounds at birth are three times more likely to develop CAD than people who weighed more than 7.5 pounds at birth.
What to do: Tell your doctor if you had a low birth weight (less than 5.5 pounds) and show him/her this article. Many health-care providers are unaware of the increased risks associated with low birth weight.
If you were a very small baby, ask your doctor to test regularly for other coronary risk factors, such as hypertension, elevated cholesterol, diabetes and LDL particle size. These factors should be treated aggressively to offset the unalterable risk of low birth weight.
• Choose heart-healthy beverages
The heart-protective benefits of alcohol have been well-established. When consumed in moderation (one glass daily for women and no more than two glasses daily for men), wine, beer and mixed drinks reduce CAD by 30%.
Researchers now are discovering that water also may play a role in preventing heart attack. Physicians at Loma Linda University recently reported that drinking five or more glasses of water daily (versus two or fewer) reduces fatal heart attack risk in men by 51% and in women by 35%.
Water seems to protect against heart attacks by making blood less likely to clot. Minerals in hard tap water, such as calcium and magnesium, also may help guard against heart disease.
What to do: Drink from six to eight 8-ounce glasses of water daily. Ask your local water utility if your water is hard (mineral rich) or soft even soft water from the tap may be a healthier choice than filtered bottled waters, which are generally stripped entirely of minerals.
Helpful: Consider installing a faucet-mounted home water filter that removes waterborne parasites from your water but doesn’t filter out the beneficial minerals.
Good brands: Moen and Culligan
• Take folic acid
This B vitamin has been shown to lower levels of homocysteine, a protein in the blood that significantly increases risk for cardiovascular disease when it is elevated. Folic acid also lowers the risk for heart attack and stroke.
In continuing research of more than 80,000 nurses, the risk for heart attack was reduced by about 6% for every additional 100 micrograms of folic acid in their diet.
What to do: Eat more folic acid-rich foods, such as spinach, asparagus, lima beans, wheat germ and fortified cereals. If your homocysteine level is greater than 9, you may need to take a folic acid supplement daily.
