Healthy changes in the way we live, particularly diet and exercise, have been proven to:
- Dramatically reduce heart disease risk factors
- Stabilize plaques in the arteries so they are less likely to burst and trigger blood clots that block blood flow, causing heart attacks
- Reverse the progression of coronary artery disease, or atherosclerosis
In decades past, we physicians were trained in the diagnosis and treatment of coronary artery disease after it occurred.
However, the present epidemic of cardiovascular disease, diabetes, and their complications of heart attacks, strokes, heart failure, and sudden death have necessitated a change of focus to prevention. Prevention is emphasized in the American Heart Association and the American College of Cardiology’s statement “2013 ACC/AHA Guideline on the Assessment of Cardiovascular Risk.”1
Medications Vs Lifestyle
Certainly, the use of medications like statins, when appropriate, can be beneficial, but they should be an adjunct to lifestyle improvements rather than a replacement of personal responsibility for our health.
As a cardiologist, I have prescribed medications to lower cholesterol, blood glucose, and other heart disease risk factors, particularly for patients who will not change their lifestyle or for whom this change is not enough.
But time and time again, I have seen that my patients who take steps to improve their heart health naturally – with a healthy Pritikin lifestyle – look and feel better. Their quality of life is far superior. They’re thinner, more physically fit, more energetic, and happier.
What we can achieve, in short, from natural, lifestyle-based approaches like Pritikin has no drug substitute.
Essentially, the Pritikin Program involves:
- An eating plan based on natural whole foods like fruits, vegetables, beans, whole grains, nonfat dairy products, seafood, and limited lean meat
- Daily exercise with a three-pronged approach – cardiovascular conditioning, strength training, and flexibility
- Lifestyle education that focuses on practical real-world training such as cooking healthfully, as well as skills for stepping around stress and achieving optimal mental/emotional health.
Improving Heart Health Naturally
Here are 9 key steps for improving heart health naturally that my colleagues and I teach year-round at the Pritikin Longevity Center.
1 | Spend Less Time Sitting and More Time Moving
“I have two doctors, my left leg and my right,” wrote British historian and avid cross-country walker G. M. Trevelyan.
He was right. In hundreds of studies, regular exercise has been proven to have profound – and numerous – health benefits. States the Centers for Disease Control: “Regular physical activity is one of the most important things you can do for your health.”2 It can help:
- Control weight
- Decrease risk of heart disease
- Improve body composition (your fat-to-muscle ratio)
- Lower blood sugar and reduce risk of type 2 diabetes and the metabolic syndrome
- Lower blood pressure and reduce risk of hypertension
- Reduce risk of some cancers
- Strengthen bones
- Reduce stress
- Improve sleep
- Improve your ability to perform daily activities and prevent falls
- Increase your chances of living longer
Below are key recommendations of the Pritikin Exercise Program as well as a summary of exercise tolerance testing at the Pritikin Longevity Center. Particularly if you are at risk for a cardiovascular event like a heart attack, exercise tolerance testing is strongly advised before you begin an exercise program.
3 Key Types of Exercise
The Pritikin Program recommends a combination of all 3 plus additional steps throughout the day as part of your activities of daily living.
- Aerobic (cardiorespiratory)
Daily, a minimum of 30 minutes and optimally 60 to 90 minutes, alternating moderate-intensity days with vigorous-intensity days
- Resistance (strengthening)
Full-body resistance routine 2 to 3 times weekly
- Flexibility (stretching)
Stretching exercises daily to enhance overall flexibility and ability to exercise more freely.
EXERCISE TOLERANCE TESTING
At the beginning of their health retreat at Pritikin, each guest undergoes a graded exercise test (GXT), also called an exercise tolerance test, in addition to a complete blood chemistry panel and physician consultation on health and fitness goals.
The exercise tolerance testing gives us important information for creating each guest’s personal exercise prescription, including:
MAXIMUM HEART RATE
Our heart rate rises linearly with increasing workloads. There is, however, a point at which heart rate does not increase in response to an increased workload. This is termed the Maximum Heart Rate. It is dependent primarily on age because as we age, our Maximum Heart Rate decreases.
You can predict your Maximum Heart Rate by subtracting your age from 220. It’s called the Maximum Predicted Heart Rate (MPHR). An MPHR, for example, for a 50-year-old is 220 minus 50, or 170 beats per minute. But your MPHR can vary by as much as 10 to 15 beats per minute compared to your actual Maximum Heart Rate. Invariably, an exercise tolerance test is a better predictor of your actual Maximum Heart Rate.
TRAINING HEART RATE
Your Training Heart Rate is the range in which your heart should be beating during exercise to get optimum aerobic conditioning.
For moderate intensity, aim for a Training Heart Rate that is 60 to 75% of your Maximum Heart Rate.
For vigorous intensity, aim for a Training Heart Rate that is higher than 75% of your Maximum Heart Rate.
2 | Lose Excess Body Fat, Particularly Belly Fat
As our body weight rises, so does our risk for plaque build-up in our arteries and a heart attack.
Being overweight is linked with several major risk factors for heart disease, including high blood pressure, type 2 diabetes, and bad forms of cholesterol.
Obesity also can lead to heart failure, a very serious condition in which the heart is incapable of pumping enough blood to meet the body’s needs.
Numerous studies have found that belly fat is particularly dangerous. In fact, in one recent study3, a pot belly even in people who were otherwise normal weight dramatically increased the risk of dying.
Fat in the belly doesn’t just sit there, taking up space. It pumps out chemicals like cytokines that trigger chronic inflammation throughout the body. That’s a big problem because chronic inflammation is thought to be one of the major factors linking obesity to various life-crippling diseases, including heart disease.
Fat cells in the belly also produce chemicals, including steroid hormones, which make you more likely to gain fat. Yes, it’s a vicious cycle. The more belly fat you have, the more fat-storage hormones you produce, and the harder it is to lose weight.
There are more hormonal horrors. When belly fat reaches abdominal obesity levels (a waist greater than 35 inches in women and 40 inches in men), another very important fat-storage hormone called insulin is often negatively affected, creating more problems for our metabolism.
Optimal Way To Shed Fat
The optimal way to shed fat, including belly fat, and keep it off is with a healthy eating and exercise program like Pritikin.
With the Pritikin Eating Plan, you’re focusing on foods like whole fruits, vegetables, water-rich whole grains, and beans that naturally keep daily calorie intake low. You’re achieving satiety, or fullness, without going overboard on calories.
With Pritikin living, you’re also stay physically active, helping create a calorie deficit.
- Achieve/maintain a BMI (body mass index) between 18.5 and 25. Your BMI is a measure of body fat based on height and weight. To calculate your BMI, go HERE.
- Maintain a waist circumference (measured horizontally at the belly button) of less than 35 inches in women and less than 40 inches in men.
3 | Lower Non-HDL Cholesterol
For years, we in the medical community taught that lowering LDL (often called the “bad” cholesterol) was the primary treatment target for reducing cardiovascular events. And certainly, improving LDL is still very important.
But there is now growing consensus that non-HDL cholesterol is a better predictor of cardiovascular disease risk because non-HDL contains not only LDL but other “bad” particles that contribute to the build-up of cholesterol-filled plaques in the artery wall.
Nowadays, most standard lipid panels will tell you what your non-HDL cholesterol is.
With the Pritikin Program (and, if needed, medications), lower non-HDL cholesterol to 80 or below for people with clear evidence of coronary artery disease, or 100 or below for healthy individuals wanting to prevent the development of cardiovascular disease.
Did you know that in the U.S. alone, tobacco kills the equivalent of three jumbo jets full of people crashing every day, with no survivors.
Here is a sampling of the serious, life-threatening conditions that are the direct result of smoking:
- Heart disease
- Breathing problems
- Lung cancer
- Kidney cancer
Moreover, the science is strong and consistent that when you smoke, the people around you, especially children, are at risk for developing serious health problems.
If you smoke, talk to your doctor about various scientifically-proven ways to quit smoking, including prescription medications as well as nicotine replacement therapies in the form of patches, gums, sprays, inhalers, and lozenges.
Also, register for a smoking cessation program. We have a wonderful and effective program at Pritikin with our in-house psychologists. Every beginning is difficult, that often tell our guests who are quitting smoking, “but each day of your new life not only gets easier, it gets better.”
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5 | Lower Your Resting Blood Pressure To Below 120/80
It is vital to keep your blood pressure under control because the higher your blood pressure, the greater your risk of heart attack, stroke, congestive heart failure, kidney disease, impotence, loss of mental function, and dementia.
What’s more, dramatic increases in heart attack and stroke risk do not begin with readings of 140/90, the numbers that used to define high blood pressure. We now know that serious, life-threatening risks begin at much lower readings like 130/80. That’s why published U.S. guidelines state that high blood pressure is now defined as 130 and higher for systolic blood pressure (the top number), or 80 and higher for diastolic blood pressure (the bottom number).4
To lower your blood pressure, start with a heart-healthy, lifestyle-based approach like Pritikin.
Most people with high blood pressure, also called hypertension, can control their blood pressure without the need for medications by following the Pritikin Program. Those who still need pills usually require lower dosages and/or fewer pills.
Key guidelines we teach at the Pritikin health resort for lowering blood pressure naturally include:
- Eat at least 5 servings of vegetables and 4 servings of fruits daily
A vegetable- and fruit-rich eating plan helps ensure that you’re eating plenty of foods full of stomach-filling volume, yet low in calories, enhancing your weight-loss efforts. Losing excess weight is one of the most effective ways to lower blood pressure. Eating a lot of fruits and vegetables also means you’re eating rich sources of potassium, magnesium, and calcium. Many studies have found that foods abundant in these minerals help blunt some of the toxic effects of sodium.
- Cut back on calorie-dense foods loaded with fat, sugar, and/or refined grains
Doing so will also enhance your weight-loss efforts.
- Limit consumption of sodium to a healthy level
The physicians and other faculty at Pritikin agree with sodium guidelines established by the Centers for Disease Control and American Heart Association.5 Both recommend an ideal limit of no more than 1,500 milligrams of sodium per day for most adults.
Limiting salt intake really works, especially for those most in need. Many studies have shown that the higher blood pressure is and the more salt is restricted, the greater the fall in blood pressure.
- Limit alcohol drinking
Excess alcohol drinking (more than 3 drinks daily) has been shown to increase the risk of hypertension.
- Exercise daily
Daily physical activity promotes loss of excess weight, vital for controlling blood pressure. It also stimulates the body’s production of beneficial chemicals like nitric oxide that expand blood vessels and increase blood flow.
6 | Prevent or Control Diabetes
Preventing or controlling diabetes could save your heart – and life. Heart attacks occur two to four times more often in people with diabetes compared to non-diabetics. Strokes occur two to four times more often.
Other conditions, many life-crippling, caused by diabetes include blindness, kidney failure, peripheral artery disease (blockages in the major arteries that feed the legs), erectile dysfunction, diabetic neuropathy (burning pain and loss of feeling in the feet and hands), poor wound healing, gangrene, and amputations.
The sad news is that many countries worldwide are now suffering epidemic rates of type 2 diabetes because many people live in food toxic and sedentary environments.
The hopeful news is that since diabetes is largely a lifestyle-related disease, there is much we can do in the way of lifestyle changes to prevent the onset of this horrible, life-robbing disease.
Daily exercise and healthy eating, as our guests learn at Pritikin, can greatly improve blood glucose levels as well as help shed excess body fat, a major risk factor for diabetes.
Research published on people with type 2 diabetes who came to Pritikin illustrate how profoundly beneficial lifestyle changes can be. One study6 followed 243 people in the early stages of diabetes (they were not yet on medications). Within three weeks, their fasting glucose fell on average from 160 to 124.
With a healthy lifestyle like Pritikin, strive for a fasting blood glucose below 100 and/or an A1C below 5.7.
A1C (Hemoglobin A1C) is a measure of how well your blood glucose is being controlled over time – 120 days.
7 | Reduce Inflammation
Chronic inflammation in our bodies is often brought on by excess bad cholesterol and other lifestyle-related insults like high blood pressure, high blood glucose, being overweight, and smoking.
We want to quell these inflammatory “flames” because they often lead to the formation of fatty streaks throughout our arteries, which can eventually lead to plaque build-up, heart attacks, and strokes.
One key marker of chronic inflammation is high-sensitivity C-reactive protein, or hs-CRP. Your hs-CRP score measures a protein produced by the body when blood-vessel walls are inflamed.
Other markers of chronic inflammation include noxious chemicals released by both white blood cells and fat cells called inflammatory cytokines.
In research on children at the Pritikin Longevity Center, scientists at UCLA found that within two weeks, levels of inflammatory cytokines dropped markedly.11 Similar results published in several studies over the past decade have been observed in adults at Pritikin.
8 | Lower Triglyceride Levels
Triglycerides are fats in the blood. Immediately after eating a fatty meal, most triglycerides are temporarily packaged in particles called chylomicrons. If fact, blood drawn shortly after a fatty meal will appear creamy, like a strawberry milkshake. It takes hours for these fat-rich particles to be cleared from the bloodstream.
Research has found that high levels of chylomicrons nearly triple the risk of heart problems.12 Scientists refer to chylomicrons as “silent but deadly” because by the time we have a fasting blood test, their dirty work is done and they’re gone, and therefore undetected by the standard fasting blood lipid test.
The Pritikin Program has been proven13 to dramatically lower triglyceride levels, on average 33%, which means Pritikin living likely lowers chylomicron levels as well.
High triglyceride levels (greater than 150) are considered an additional risk for cardiovascular disease, especially when part of a cluster of conditions called the metabolic syndrome, which includes:
- High triglycerides
- Belly fat (a waist circumference more than 35 inches in women and 40 inches in men)
- Low HDL (less than 40 in men; less than 50 in women)
- High blood pressure (130/85 or higher), and
- Fasting blood glucose of 100 or higher.
If you have at least three of the above five criteria, you have the metabolic syndrome.
Key lifestyle actions to lower triglyceride levels are:
- Lose excess weight
- Eat less sugar and other highly refined and processed carbohydrates, like white breads
- Eat more fish high in omega-3 fats
- Drink very little alcohol
- Exercise regularly
With lifestyle-based strategies like the Pritikin Program, lower triglyceride levels to below 150. Ideally, aim for levels less than 100, according to the latest guidelines from the American Heart Association.
9 | Keep a Lid On Stress
The neighbor’s dog is barking at 3 am. The checkout line at the grocery store is 12 people deep. Your car battery just died. Your mother called with troubling news about her health.
How do you react to each of the above? Are you calm or crazy? When life’s hurdles get the best of us, it can contribute to everything from high blood pressure to irritable bowel syndrome.
The link between stress and our hearts is real. Studies have shown that earthquakes and Mondays double the incidence of heart attacks, and that heart disease kills men three times as frequently in the year following a wife’s death.
Feeling stressed can also lead to behaviors that increase heart disease risk, such as smoking, skipping exercise, and skipping out to our favorite fast food joint.
Do your best to manage stress naturally. Exercise, enjoy a healthy diet, get plenty of restorative sleep, don’t smoke, maintain a healthy weight, and maintain a positive attitude.
Focus on your lifestyle. Pills tend to have minimal benefit for stress relief. True, some people take tranquilizers to calm themselves when they are feeling acute stress, for example, before boarding an airplane if they fear flying, or in the days and weeks immediately following the death of a loved one.
But in the long term, it is far better to learn to manage stress through lifestyle-based interventions, including relaxation techniques like meditation, and yoga, all of which are taught at Pritikin.
At Pritikin, too, guests attend a 5-part lecture series focused on taking charge of stress and developing a healthy mind-set.
And certainly, look for stress management classes in your community, for instance, in hospitals, in cardiac rehab programs, at community colleges, or by calling a licensed therapist. An excellent treatment for stress management is cognitive behavioral therapy, or CBT, also taught at Pritikin.
Improving Heart Health Naturally | Summing Up
Lifestyle changes are the key to living a healthy, happy life.
It may be tempting to take small steps. Maybe you’re thinking of altering just one aspect of your life. But I strongly encourage you to embrace all nine steps in this article.
In doing so, you will find, as the more than 100,000 people who have attended Pritikin over the last four decades have found, that life gets appreciably better, and in so many ways. You’ll lose weight without feeling hungry, and you’ll likely feel stronger and more energetic than you’ve felt in years.
Now’s your chance. Take care of your heart. And launch a whole new life, a better life.
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- 1 Circulation, 2014; 129: S49.
- 2 http://www.cdc.gov/physicalactivity/basics/pa-health/
- 3 Annals of Internal Medicine, 2015; 163(11): 827.
- 4 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: Executive Summary. A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.
- 5 American Heart Association.
- 6 Diabetes Care, 1994; 17: 1469.
- 7 Journal of Applied Physiology, 2006; 100: 1657.
- 8 Journal of Applied Physiology, 2006; 100: 1657.
- 9 Metabolism, 2004; 53: 377.
- 10 Atherosclerosis, 2007; 191: 98.
- 11 American Journal of Physiology: Regulatory, Integrative, and Comparative Physiology, 2013; 305: R552.
- 12 Journal of the American College of Cardiology, 2013; 61 (4): 427.
- 13 Archives of Internal Medicine, 1991; 151(7): 1389.