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Day 1: Take green tea with you. Green tea contains several powerful antioxidants that reduce cholesterol and even may lower blood pressure. To make a day’s supply, bring 20 ounces of water to a boil, drop in three decaffeinated green tea bags, cover, and steep for 10 minutes. Remove the tea bags and refrigerate. When cool, pour the tea into a container, add ice if you like, and sip throughout the day.
Day 2: Recalculate your fat budget. Don’t let fat exceed 25 percent of your calories. If you already have heart disease, eat even less-15 to 20 percent should be your max. Get lots of monounsaturated and omega-3 fats. Avoid saturated and trans fats. Go easy on omega-6 fats such as corn oil.
Day 3: Take the Italian cure. In the world of fat, olives rule. Canola oil is good, but olive oil may be better. Substitute olive oil for butter or margarine at the table, drizzle it on salads, and use it to replace vegetable oils in baking wherever possible. Buy only cold-pressed, extra-virgin oil; it retains more of the olive’s heart-healthy antioxidants than other forms.
Day 4: Go nuts. Studies have found that those who ate more than 5 ounces of nuts a week were one-third less likely to have either heart disease or a heart attack. Just don’t overdo-nuts can pile on the pounds.
Day 5: Go fish. Meat’s saturated fat will clog your arteries. On the other hand, fatty fish such as salmon and mackerel are loaded with the omega-3 fatty acids that will help your heart maintain a steady rhythm. Having even one fish meal a week could reduce your risk of death from an unexpected heart attack by 52 percent.
Day 6: Rough up your diet. Studies show that the more fiber you eat, the less likely you are to have a heart attack. Load up on whole grain breads and cereals that contain whole wheat, wheat bran, and oats. Toss beans into casseroles, soups, and salads. Aim for at least 20 grams of fiber a day.
Day 7: Linger in the produce aisle. Eat at least five to seven servings of fresh fruits and vegetables every day. Emphasize cruciferous vegetables such as kale, brussels sprouts, broccoli, and cabbage, which are a gold mine of antioxidants and other heart-saving phytochemicals.
Day 8: Get juiced. Orange juice contains folic acid to help lower your levels of a heart attack risk factor called homocysteine. Grape juice is loaded with flavonoids and resveratrol, potent antioxidants that may discourage red blood cells from clumping together and forming the kind of artery-blocking clot that can trigger a heart attack. Make sure that you get a glass of each every day. Adjust for the calories.
Day 9: Slather your toast. The trans fatty acids in margarine and the saturated fat in butter both clog your arteries, so try one of the new spreads that contain cholesterol-lowering sterols instead-either Take Control or Benecol. Expensive, yes, but they can lower your cholesterol anywhere from 7 to 14 percent!
Day 10: Add flaxseed. Flaxseed is one of the most potent sources of heart-healthy omega-3 fatty acids. Canadian studies indicate that adding flaxseed to your diet on a regular basis can reduce the development of heart disease by 46 percent, while helping to keep red blood cells from clumping together and forming a clot that can block an artery. Sprinkle 2 tablespoons of flaxseed a day on your cereal or salad. Buy it preground, and keep it refrigerated until you use it.
Day 11: Have a drink. Research overwhelmingly shows that 1 to 3 ounces of alcohol a day significantly reduces your risk of a heart attack. Unless you have a problem with alcohol or high blood pressure, you can safely have one alcoholic drink a day.
Day 12: Pass the soy milk. Studies show that consuming soy protein helps reduce cholesterol.
Get Your Heart Pumping
Day 13: Move! Studies show that exercise reduces the risk of a heart attack by up to 50 percent – more than the best cholesterol-lowering drug can accomplish. And it doesn’t take much: just a few hours a week, according to research by Steven Blair, MD, of the Cooper Clinic in Dallas. Pick an easy exercise such as walking, and begin to integrate two or three 15-minute workout intervals into your day.
Once your body is accustomed to this routine, start working toward the optimal amount: 45 minutes of perspiration-promoting exercise, four or five times a week. And do it with a friend: A friend makes exercising easier and provides social support, which has been shown to reduce heart disease on its own.
Day 14: Experiment. The best exercise is one that you’ll continue to do. So every day, in addition to your regular workout, try something new just for fun-hitting a tennis ball against the house, shooting a couple of hoops with your kids, or dancing to a golden oldie on the radio. If you find something that you like, incorporate it into your daily workout.
Put Your Heart, Mind and Soul into It
Your mind can be as important to your heart as your cholesterol level. That’s because the chemical messages sent to your heart by feelings of stress, anxiety, depression, and anger constrict arteries, reduce blood flow to the heart, raise blood pressure, and increase heart rate – all of which increases your risk of a heart attack. This part of the Duke program helps counteract that.
Day 15: Be yourself. One of the biggest causes of stress is trying to live in a way that is not consistent with who you are. Ask yourself: Am I doing what I want to do? Am I getting my needs met? Every day, run a reality check on what you’ve done. When it says that your actions aren’t true to the kind of person you are, make sure you listen-and get real.
Day 16: Practice mindfulness. Practicing a form of meditation in which you focus awareness on the present moment and relax can reduce the effects of daily stressors. When stressful moments occur, they can be countered by simply closing your eyes and quietly focusing on your breathing for 5 or 10 minutes.
Day 17: Build a strong spiritual life. Studies indicate that those with regular spiritual practices who meet with a faith community-those who attend church or participate in synagogue, for example-live longer, live better, and are far less likely to have a heart attack. Get more involved in your religious tradition, or develop your own. Either way, sit down every day for 20 minutes, close your eyes, and focus on a particular word or phrase that you associate with something greater than yourself.
Day 18: Get some people in your life. Strong connections to family, friends, community, and God reduce anxiety and fight depression-two factors that increase your risk of a heart attack. So first thing in the morning, make a lunch date with a good friend, tell your family that everyone needs to sit down for dinner tonight, or plan to visit your place of worship. Resolve to make connecting with friends, family, and a power greater than yourself something that you do every day.
Day 19: Take control of your anger. Psychiatrist Redford Williams, MD, codirector of the Duke University Center for Integrative Medicine, discovered years ago that those who tend to have a hostile, angry attitude are four times more likely to die of a heart attack than those who take a more mellow approach to life. What’s more, researchers have found that losing your temper can double your risk of a heart attack within the next 2 hours! Next time your temper threatens to get out of hand, Dr. Williams suggests that you douse it by asking yourself these four questions:
Is what’s upsetting me really important?
Is what I’m thinking and feeling appropriate?
Is the situation modifiable?
Is taking action worth it?
If you get one no, calm down. If you get four yes answers, take action to change the situation.
Give Your Heart the Extra Edge
Here are some of the vitamins, minerals, antioxidants, herbs, and drugs that your heart needs. Since every person is different-and since some of these may interact with prescription drugs-ask your doctor to help you figure out exactly what you should take.
Day 20: Take a high-potency vitamin supplement with antioxidants. Research has found that those who regularly use multivitamins may reduce their risk of heart disease by 24 percent. Pick out a high-potency supplement that contains a minimum of 400 micrograms (mcg) of folic acid, 500 milligrams (mg) of vitamin C, and no more than 50 mg of vitamin B6.
Day 21: Give free radicals a partner. Free radicals are maverick electrons that have been torn away from their normal molecular partners. Unfortunately, they tend to tear up your cells as they go zinging through your body looking for a new mate. But vitamin E seems to offer enough temporary companionship that their damage to your heart from their cell-to-cell rampage is significantly reduced. Take 200 to 400 IU a day.
Day 22: Grab garlic. Just one clove a day – or 300 mg three times daily – reduces the risk of a heart attack at least three ways:
It discourages red blood cells from sticking together and blocking your arteries
It reduces arterial damage
It discourages cholesterol from lining those arteries and making them so narrow that blockages are likely
Day 23: Increase your selenium. Selenium is a powerful antioxidant that reduces the tendency of red blood cells to form life-threatening clots. It also balances the ratio between good and bad cholesterol in a way that reduces your chances of a heart attack. Take 100 mcg a day-but no more than 200 to avoid toxic effects.
Day 24: Top it all off with an aspirin. Studies show that a single 81-mg “baby” aspirin a day reduces the risk of a heart attack by 30 to 50%. So unless you have stomach problems or you’re allergic to aspirin, take one tablet a day with food. If your stomach feels a bit queasy, talk to your doctor about whether or not enteric-coated aspirins are an option.
Martin L. Sullivan, MD, is codirector of the Duke University Program in Integrative Medicine in Durham