PAMF Health Blog

Be Well, Be Well Informed

The Truth About Heart Health

Posted on Feb 19, 2014


We are bombarded with messages about heart health these days – on the TV, on radio, on billboards. But are they the right messages? Maybe not.

“There’s a lot of mixed information in today’s environment,” says Terence Lin, M.D., a cardiologist with the Palo Alto Medical Foundation in Fremont. “People get obsessed with fad diets, drinking coconut water, taking fish oil. But these things are not as influential as people think.”

Dr. Lin has seen young, trim software engineers who go to the gym regularly, but don’t know that the all-nighters they pull on an important project, fueled by six cups of coffee, is undermining their heart health.

He has seen well-educated professionals in their 50s take supplements to lower their cholesterol, but turn down statin medications or avoid the dietary changes that could really make a difference.

Advertising and fads can overwhelm good health sense, Dr. Lin says. He tries to keep his tips simple and very specific.

Burn as Many Calories as You Eat

“If you eat 2,000 calories a day, make sure you burn 2,000 calories a day,” Dr. Lin says. That means getting at least 30 minutes of moderate intensity exercise five days a week. Swim, spin or walk briskly. At a brisk pace, you can speak a sentence, but you don’t have enough breath to speak a paragraph or to sing. If you want to lose weight, you’ll need to burn more calories than you eat.

“Be meticulous about what goes into your body,” he says. Weigh or measure your food — especially the amount of fat and salt you’re eating. Salt can raise your blood pressure. Aim for 2500 mg a day, just over 1 teaspoon of salt. Saturated fat from cheese, meat and ice cream can clog your arteries. Try to keep calories from saturated fat to 7 percent or less of all calories you consume in a day.

Dr. Lin says people do themselves a disservice when they focus just on exercise or just on a healthy diet. “I’ve heard people say they exercise 40 minutes every day. It turns out they also eat a bowl of ice cream every day,” he chuckles. “Once in a while is ok, but I tell people to think of those things as treats, and not food.” Aim for equilibrium between the calories going in and the calories going out.

Keep Your BMI Under 30

Although the optimal BMI is 25 or lower, “the risk for heart disease really goes up after you hit a BMI (body mass index) of 30,” Dr. Lin says.

For those who want to lose weight, he advises, “Eat the weight you want to be. If you want to lose 10 percent of your body weight, eat 10 percent fewer calories. The weight will gradually come off.”

Slow weight loss is better than fast, he notes. He suggests losing no more than one pound a week, and cutting calories by 500. “Everybody is good for a month or so. It’s consistency that counts. I want to see consistent change over a year. That’s more likely to stick.”

If You Snore, Check for Sleep Apnea and Treat It

“Untreated sleep apnea seems to be a significant risk for heart disease,” Dr. Lin says. People with sleep apnea stop breathing periodically while they sleep, or they breathe shallowly. This decreases the oxygen level in their bodies. “It’s like somebody choking you at night and you’re just not aware of it,” he says. Studies show that people who have sleep apnea have a greater risk of developing high blood pressure.

Avoid Energy Drinks

More research is needed to confirm the link, Dr. Lin says, but energy drinks seem to raise the risk of heart disease in younger adults, and often cause high blood pressure.

“We see people who have heart attacks way, way earlier than they should, and the only factor we can find is overuse of energy drinks or stimulants,” he says. Overuse of any stimulant, from energy drinks to coffee to recreational drugs, raises a person’s risk of heart attack.

Know Your Family History

With medical care, most people survive their heart attack these days, and many live for decades more. If your grandfather died at 90 but had a heart attack he survived at 50, you have an increased risk of heart disease, too.

Certain groups of people, notably South Asians and East Asians, are at higher risk of heart disease, as well.

Dr. Lin suggests that people in their 20s see their doctor to assess their individual heart disease risk and test their cholesterol levels.

“Diet, exercise, not smoking – it can reduce your risk of heart disease by up to 30 percent — if you can get people to do it consistently,” he says. “People are often more motivated when they know their individual risk.”

Terence Lin, M.D., FACC, FSCAI, is a cardiologist at the Palo Alto Medical Foundation’s Fremont Center.LinT_2010