AARP Smart Guide: Healthy Heart

Open the curtains

Soaking up bright morning light early in the day sets your body’s internal clock so you’ll feel drowsy and ready to snooze at night and full of physical and mental energy when the alarm clock blares.

In her 2018 study of 1,978 older adults, sleep researcher Jessica R. Lunsford-Avery, an assistant professor of psychology at Duke University Medical Center, found that those whose sleep schedules varied the most from night to night got 48 fewer minutes of bright natural light exposure during the day and were more likely to have heart risks like obesity, high blood sugar and high blood pressure compared to regular sleepers — even though both groups logged nearly the same amount of sleep per night.

An all-over-the-map bedtime may harm hearts by interfering with metabolism, by boosting depression and anxiety or by making you feel less inclined to be physically active and eat healthily, Lunsford-Avery says: “Irregular sleep patterns may negatively impact heart health even when someone is getting ‘enough’ sleep.” Duration and regularity are both important.

Make morning joe your only caffeinated cup(s)

Packed with cell-protecting, inflammation-cooling polyphenols, coffee is linked with lower odds for coronary artery disease in women, 43 percent lower risk of fatal heart disease in both sexes and lower risk for heart failure.

But after a cuppa, it takes nearly 10 hours for the caffeine to leave your bloodstream — meaning caffeinated coffee (or tea) after midmorning could jeopardize heart-healthy sleep tonight, says Cathy Goldstein, M.D.,  an associate professor of neurology at the University of Michigan Sleep Disorders Center.

Lighten your coffee without hidden trans-fats

After heart-threatening trans fats grabbed national headlines a few years ago, the U.S. Food and Drug Administration banned them from most foods by 2018. The catch? They may be still be lurking in that powdered coffee lightener or sweet, flavored nondairy creamer you dump into your morning mug, says Kate Patton, a preventive cardiology registered dietitian with Cleveland Clinic’s Center for Human Nutrition.

“Look for partially hydrogenated fat on the ingredient list,” she says. “Don’t rely on the Nutrition Facts label. By law, it can say ‘0 trans fats’ if there’s up to a half-gram per serving.” But a “serving” is just one teaspoon; you’ll consume plenty more of these nasty factory-made fats that boost “bad” LDLs and reduce “good” HDL cholesterol if you love your coffee extra-light or sip several cups a day. These can triple heart-disease risk.

Opt for a splash of low-fat half-and-half, milk or a plant-based half-and-half made with dairy alternatives like oat, soy or almond milk, Patton suggests: “Even regular half-and-half is better for your heart than creamers with trans fats.” It does contain saturated fat, so stick with a moderate splash.

Think beyond bacon, sausage and ham for breakfast protein

More than 1 in 3 adults age 50 and older don’t eat enough protein, according to an Ohio State University review, opening the door for accelerated muscle loss that makes everyday activities and formal exercise (two key components of heart-healthy living) difficult.

Getting protein throughout the day helped maintain muscle mass in older women and men in a 2016 study, but breakfast can be a real challenge.

Healthy foods like oatmeal and a little milk won’t get you there, Patton says. And breakfast meats are high in saturated fat, sodium and often preservatives. Even lower-fat versions can be salty.

Focus on fiber

Your heart loves produce and whole grains because they’re packed with fiber as well as nutrients that cool inflammation, regulate blood pressure, keep blood sugar levels healthier and more.  Adults need 21 to 30 grams of fiber daily; most get just 15. The U.S. Department of Agriculture recommends five cups of fruit and vegetables a day; most adults fall short — contributing to 1.8 million heart-disease deaths, according to a 2019 Tufts University study. But why stop with five cups, when more is better? In a recent Spanish study of 7,216 people, those who got nine servings of produce a day had a 40 percent lower risk for heart disease than those who got less than five.

Restore heart function

“If exercise were a pill, everyone would take it,” says cardiologist Benjamin Levine, M.D., director of the Institute for Exercise and Environmental Medicine at Texas Health Presbyterian Hospital Dallas and a professor of internal medicine and cardiology at the University of Texas Southwestern Medical Center.

For adults at any age, he notes, physical activity helps control or prevent high blood pressure, diabetes, cholesterol problems, stress, depression, weight gain and sleep problems. And, in 2018, Levine and colleagues found that in out-of-shape people, two years of a doable exercise routine transformed the functioning of their stiff, shrinking hearts.

“We restored their heart function to near-youthful levels,” he says. “Shrinking and stiffness are hallmarks of a couch potato’s heart.” They raise risk for the most common type of heart failure in older adults. “But if you start exercising in midlife or late midlife, you can make the left ventricular muscle of the heart more flexible again — like a new, stretchy rubber band — and increase the size of your heart’s left ventricle, which pumps blood out in your body.”

Make exercise a habit

The exercise routine, which Levine calls the Exercise Prescription for Life, includes 30 minutes of moderate-intensity activity two to three days a week; an hour of active fun once a week (like hiking, dancing, playing a sport); a set of high-intensity intervals once a week (four minutes of brisk activity plus three minutes of recovery at a moderate pace, repeated four times); plus strength training for 30 minutes once or twice a week.

You can get started with any part of the plan. But if you haven’t been exercising lately, talk with your doctor first, Levine advises. And make your first moves at your own pace.

“Take an easy stroll three days a week. After a few weeks, add more minutes or make it more intense until you’re up to 30 minutes at a pace where you can talk but not sing,” he says. “After a couple more weeks, add another day where you’re active for an hour. Then gradually add the other components. The idea is to build a habit. Exercise should be part of personal hygiene, like brushing your teeth or changing your underwear!”

Have fish for lunch

Heart-healthy omega-3 fatty acids act like a spa vacation for your arteries — reducing high blood pressure, nurturing artery walls, lowering heart-menacing triglycerides and even cooling inflammation.

But don’t buy the marketing hype about fish-oil capsules; several large studies have found few benefits. Start with fish. The American Heart Association recommends at least two 3.5-ounce servings a week, especially of fatty fish. It makes a difference. When Tufts University researchers tracked blood levels of a potent omega-3 fatty acid found in fish called EPA in 2,622 older adults for 22 years, they found high levels linked to 24 percent lower odds for “unhealthy aging” — including heart attacks and heart failure. While those fish lovers ate about 2.3 servings of seafood a week, the typical older U.S. adult gets a little more than one ounce of heart-friendly fin food per week.

It’s time to change that with a trip to the canned foods aisle. Canned salmon, canned tuna and canned sardines are good sources of omega-3 fatty acids that are quick, affordable and convenient, Patton says. Toss with a little mayo, some relish or mustard and your favorite mix-ins (grated carrot and corn kernels add juicy crunch). Bake into a quiche. Or enjoy sardines, mackerel or herring on whole-wheat crackers.

Add red, green and blue crunch

Boost your produce tally and supply your heart with protective phytonutrients. Toss together two cups of leafy greens, a cup of cherry tomatoes and a splash of olive oil. Sprinkle with blueberries and a few chopped pecans for crunch. Daily greens lowered heart risks 26 percent in that big Spanish study, while vegetables rich in lycopene (like tomatoes) reduced risk 25 percent. (Lycopene battles plaque and inflammation.) Eating berries three times a week cut heart attack risk 32 percent — perhaps thanks to purplish-blue compounds called anthocyanins that help keep arteries flexible, which can help control blood pressure. The nuts? They deliver fiber, nutrients and good fats, Patton says.

Log 1,000 easy, extra steps

Add a little hustle to your everyday activities: Stroll  around the house for five minutes every hour when you’ve been sitting at the computer or watching TV, sweep the hallway in addition to the kitchen, take out the trash, volunteer to walk Fido (he’d love to circle the block twice). It all counts as extra steps your heart craves. These activities could easily add 1,000 extra steps to the daily count your smartphone is probably keeping (check your health app to see). It’s the amount that lowered cardiovascular trouble by 5-21 percent in a 2020 Duke University review of 17 studies of more than 30,000 adults.

Have a hearty dinner

Start a pot of chili, a hearty bean soup … or grill a bean-based burger. The fiber, nutrients and plant compounds in beans make these meat alternatives great for your heart; the protein they pack makes beans a satisfying centerpiece at dinner time, Patton says. A cup of black beans, for instance, delivers 15 grams each of protein and fiber, along with cell protecting antioxidants that may explain why people who ate the most beans had a 10 percent lower chance of cardiovascular disease in a 2017 Italian review of 17 studies involving 18,475 people.

If you’ve tried bean burgers in the past and not been impressed, Patton recommends choosing another from the many brands in the frozen-food aisle. (Look for one that’s lower in sodium). There are so many out there, you’re bound to find one you like. Slide it onto a whole-grain bun, add your favorite toppings and enjoy. While the USDA recommends adults munch 3 cups of beans per week, most of us get less than a cup. Bumping up your beans could reduce heart disease risk up to 10 percent and high blood pressure by 9 percent, finds a 2019 review of legume benefits.

Stre-e-e-tch

Moves that stretch out your muscles — like gentle yoga or sitting on the floor or on a sturdy chair to stretch out your thigh and calf muscles — could do your blood pressure some good, too.

In a recent Canadian study of older adults with above-normal blood pressure, a daily stretching routine reduced blood pressure readings as much as seven points. Why it works: Lead researcher Phil Chilibeck , professor of kinesiology at the University of Saskatchewan, and his team say stretching your muscles also stretches arteries, improves blood flow and activates the parasympathetic nervous system that regulates the body’s relaxation response. People in the study stretched for 30 minutes a day, five days a week, for eight weeks. But Chilibeck says yoga or a few moves that stretch major leg muscles (you can do them while you watch TV) could have similar effects.

Click off devices two hours before you turn in

Turn off your smartphone, laptop and tablet computer (or switch the light setting to night mode or put on blue-light blocking glasses) at least two hours before bed, suggests sleep researcher Jessica R. Lunsford-Avery. Blue light emitted by devices with backlit screens suppresses secretion of the hormone melatonin, which regulates sleep and, it turns out, may also protect arteries and the heart by regulating blood fats and blood sugar and by curbing inflammation and protecting against cell damage. Your brain and body clock are especially sensitive to blue light at night; blocking it for two hours before bed improved sleep length and quality in a small 2017 Columbia University study of eight women with insomnia. (They wore light-blocking glasses.)

Alleviate work stress

In large studies, work-related stress boosted odds for cardiovascular problems 40 percent, and feeling stressed, regardless of the cause, increased risk for fatal heart disease 27 percent, according to a landmark 2021 American Heart Association report. Anger, anxiety, depression and pessimism all affeact the heart and arteries.

One reason is that they’re linked to higher odds for heart risks like obesity and lack of exercise, says cardiologist Glenn Levine, M.D., a professor at Baylor College of Medicine. You may also be less likely to take medications and make healthy lifestyle changes that control diabetes, high blood pressure and high cholesterol. To Levine, the most stunning lesson from the report is just how crucial good mental health is for heart health.

“What struck me was that there is very good quality scientific data that things as simple as optimism seem to have a very real bearing on one’s heart health,” he says. “They’re worth cultivating.” After the worries, stress and grief of 2020, that lesson may be more important than ever, he adds. “I don’t think anyone should feel guilty about feeling good now,” he says. “Improving your outlook and psychological health not only benefits you, it no doubt benefits those around you — your spouse or partner, your family and friends.”

Call a good friend or two

The pandemic has left an epidemic of social isolation in its wake, which could boost risk for a heart “event” by 50 percent, according to the American Heart Association. Break the silence by reconnecting with friends and family you haven’t chatted with, or seen in person, for a while. Get together for a socially distanced cup of coffee or outdoor lunch, take a walk, or if you’re both fully vaccinated, you may be able to pick up where you left off before the pandemic. Your heart will love the boost. Happiness and positivity, it turns out, are connected with a 22 percent lower risk for coronary heart disease problems.

Hug it out

If you’re comfortable doing so (and you have friends who also like hugs), embrace away. A recent University of Pittsburgh study of 404 adults suggests a regular hug routine can ease tension and negativity particularly at times (we all have them) when you and your partner, kids or even your best friend aren’t seeing eye to eye. Researchers found that the group of volunteers’ negative feelings were 40 percent higher when they had a misunderstanding with another person and didn’t hug, compared to days when they did have a disagreement but also shared a hug.

Positive feelings stayed higher on hug days, too, even when there were conflicts. Hugs helped between spouses, other relatives and friends. Reducing negative emotions and pumping up positive feelings have proven heart benefits.

Have a luscious pear

In that big Spanish study, people who ate a large apple or pear daily had a 50 percent lower heart-disease risk than those who rarely crunched on these sweet treats. Eat the skin, too — it contains most of the  fiber packed into a single apple or pear. Ten percent is soluble fiber, which helps rein in blood sugar.

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