HEALTHY LIVING
You’ll find information on the benefits of quitting smoking, nicotine replacement therapy, and the physical and mental effects that quitting can have on our bodies.
Benefits of Quitting
Smoking hurts. Whether you smoke, are exposed to secondhand smoke or are a nonsmoker, it is important to know the dangers of smoking. Smoking cigarettes not only affects the lungs, but it also harms nearly every organ in the body, including the heart.
Smoking is the most preventable cause of early death in the United States.
Consider these facts:
- Smoking is the second leading cause of cardiovascular disease, right behind high blood pressure.
- People who smoke are two to four times more likely to develop heart disease or stroke.
- Smokers are also up to six times more likely to suffer a heart attack than non-smokers.
- Smoking can shave off at least a decade of life.
- Secondhand smoke increases the risk of heart disease.
- “Social smoking” increases the risk of heart disease.
Even being exposed to secondhand smoke—breathing in smoke-filled air from a nearby smoker—is dangerous. What’s more, electronic cigarettes, or e-cigarettes, are often thought to be a safer alternative. But recent data suggest these may not be safe, according to the U.S. Surgeon General.
The good news is that quitting helps—even after years of steady or heavy smoking. When you stop smoking, carbon monoxide levels in your blood return to normal within 12 hours. Within just one year, your added risk for heart disease is cut in half. That’s a big deal for your health. Plus you’ll avoid breathing in known toxins—carbon monoxide, ammonia, arsenic, and formaldehyde to name a few—that are components of cigarettes!
Smoking and Heart Disease
We often hear about how smoking hurts the lungs. After all, smokers’ lungs take in more than 7,000 chemicals—70 of which are known to cause cancer—from cigarettes. But smoking cigarettes also affects the heart and blood vessels and remains one of the most preventable causes of heart disease.
When you smoke, your arteries tighten, which makes your heart work harder. Smoking also can trigger an irregular heart rhythm and raise blood pressure, which are leading causes of stroke.
According to the Centers for Disease Control and Prevention, smoking:
- Causes thickening and narrowing of blood vessels
- Raises triglycerides (a type of fat in your blood)
- Lowers HDL or “good” cholesterol
- Makes blood sticky and more likely to clot, which can block blood flow to the heart and brain
- Damages the cells that line the blood vessels; the cells become swollen and inflamed
- Promotes the buildup of plaque (fat, cholesterol, calcium and other substances) in blood vessels and even plaque rupture (resulting in an heart attack)
A recent study found smoking is also associated with a thickening of the heart and lowers the heart’s pumping ability—both of which are associated with heart failure. The longer and more cigarettes people without heart disease smoked, the greater the damage to their hearts’ structure and function. Former smokers had similar heart structure and function compared to people who had never smoked, which points to the importance of quitting smoking to help reverse any damage.
E-Cigarettes
Electronic cigarettes, or e-cigarettes, have been growing in popularity. Until lately, some also thought they were safer than traditional cigarettes. But electronic cigarettes may be as harmful to the heart as smoking cigarettes that contain tobacco, according to some data.
Research showed that using either e-cigs or regular tobacco led to similar levels of stiffness in the aorta, the main artery in the heart. Both raised blood pressure.
How to Quit
Quitting smoking isn’t easy, but it has major health benefits. Many people wrongly assume that kicking the habit won’t make a difference. They may tell themselves, “I’ve been a smoker all of my life, so there’s no point in quitting now.” Plus, it becomes part of their routine. But both data and experiences show it’s never too late to stop. In fact, some of the health benefits happen pretty quickly. Blood pressure, for example, drops fairly quickly after not smoking.
Need more convincing? Consider these milestones from the U.S. Surgeon General:
- Within 20 minutes of quitting, your heart rate will decrease.
- Within 12 hours of quitting, the carbon monoxide levels in your blood will decrease to normal.
- Within 3 months of quitting, your risk of a heart attack decreases and your lungs will begin to work better.
- After 1 year, your added risk of coronary artery disease is half that of someone who smokes.
Source: Department of Health and Human Services
Be part of one in a million. Each year, 1.3 million Americans quit smoking. You can do it. Today there are more former smokers than current smokers.
8 Steps to quit
If you want to stop smoking or help a loved one quit, take the time to map out a plan. Here are some steps you can take:
Set a quit date and plan
Commit to why
Know what makes you want to smoke
Make it public
Keep busy
Get help
Quit
Take it one day at a time
Slips and Relapses
Many people who try to quit smoking will take a puff or have one or two cigarettes after quitting (called a slip); others begin to smoke regularly again (called a relapse). Slips and relapses can be common in the early stages of quitting.
Don’t be too hard on yourself, and DO try again! Take the time to learn from any setbacks you might face. Take note of what might have pushed you to smoke again (for example, withdrawal symptoms, being in a certain place or situation, stress or weight gain).
It’s time to rally some additional support:
- Ask your health care provider if you need nicotine replacement medicine or a different product.
- Talk with former smokers about how to best cope with slip-ups.
- Remember to stay positive.
If you find yourself getting discouraged, remind yourself that quitting is hard, and think about whether speaking with a counselor would be helpful.
Many of us know that a healthy diet is important, but when push comes to shove, eating healthy is often easier said than done.
That’s why we’ve gathered tools and information that you need to understand healthy eating and how to incorporate it into your everyday life.
Whether you’re interested in losing weight, managing a health condition or just feeling better about what you eat, our tools can help you reach your goals.
Heart Healthy Diets
When it comes to heart-healthy eating, how do you know where to start? The good news is several healthy eating plans can help. Research shows these diets—really more of a way of eating than so-called diets—protect your heart.
These plans also help promote healthy eating overall, including how we choose to cook our foods. They also stress a diet rich in whole foods that is filled with fruits, vegetables, whole grains and unprocessed foods.
Below is a snapshot of several heart-healthy eating patterns. As always, be sure to talk with your doctor or heart team about what’s right for you.
Mediterranean Diet
What it is: Although there isn’t a single Mediterranean diet, this eating plan commonly emphasizes:
- Fresh fruits and vegetables
- High-fiber foods, whole grains
- Legumes, including peas, beans, certain nuts
- Some fish
- Some olive oil
Fats make up a greater proportion of this diet, but they are mostly from unsaturated oils, such as fish oils, olive oil, and certain nut or seed oils (canola, soybean or flaxseed oil), which are thought to have a protective effect on the heart. The Mediterranean diet is also light on dairy and meats.
Benefits: This diet has been linked to weight loss, a lower likelihood of developing diabetes, heart disease, or having a heart attack or second heart attack, improvements in blood pressure and blood cholesterol, and it may even help to slow memory loss.
In fact, a large trial of nearly 7,500 adults showed that following a Mediterranean diet with added olive oil or nuts reduced the number of cardiac events—stroke or heart attack—by nearly one-third among people already at high risk.
DASH Diet
What it is: The DASH (Dietary Approaches to Stop Hypertension) diet is a balanced eating plan that focuses on eating fruits and vegetables, healthy fats, whole grains, protein-rich foods, and low-fat or nonfat dairy. It is often recommended to help treat or prevent high blood pressure (hypertension) and stresses limiting the amount of sodium you consume each day to about a teaspoon of salt (about 2,300 mg). But certain people—those with high blood pressure, diabetes, chronic kidney disease or if you are older than 50—should aim for 1,500 mg or fewer.
Related tip: Many processed foods have unhealthy amounts of fats and sodium. Not eating enough foods with potassium, calcium and magnesium may contribute to high blood pressure, so it’s important to focus on eating a balanced diet.
Benefits: There is a link between eating salt and having high blood pressure. By focusing on foods and preparations that minimize salt, the DASH diet can help you eat healthier so you can prevent or reduce high blood pressure. African-Americans, older adults and people with diabetes who are at greater risk may benefit most from lowering their dietary sodium intake.
Vegetarian Diet
What it is: As it sounds, the vegetarian dietary pattern cuts out meat, sometimes seafood as well, and is rich in plant-based foods. Instead, these diets—and there are several—encourage eating more nuts, seeds and soy products, as well as fruits and vegetables and whole grains. Some people adopt what’s called the “flexitarian” approach to try to limit animal proteins, but still allow for some.
Benefits: There is evidence that a vegetarian diet can reduce blood pressure and may promote health benefits, including lowering the risk of death. This is likely due to the fact that many foods common in the vegetarian diet, including fruit, vegetables and nuts, have been shown to have many health benefits and improve heart health. Also, research has shown that reducing consumption of red meat and increasing consumption of fish and lean meats can help reduce heart disease risk. Vegetarian dietary patterns have been associated with reductions in atherosclerotic cardiovascular disease and many forms of cancer.
Related tip: Vegetarian diets can range from excluding meats to strictly vegan (no animal products). Following these diets means you may get lower amounts of protein, so it’s important to find alternative sources (e.g., beans, milk).
A number of other eating patterns, including the Therapeutic Lifestyle Changes diet, can help you lower cholesterol or other risk factors and make sense of how many calories, cholesterol, total fat, soluble fiber and other nutrients you need. As with some of the other eating plans, the TLC diet also focuses on other lifestyle changes, including getting exercise most days and weight loss, if needed.
Keep in Mind
- Try not to be too rigid with your eating pattern, and make sure it fits your lifestyle so you can stick with it.
- What’s on your plate and proportions of foods matter—aim to include a variety of colorful foods on your plate and remember portion control (for example, a serving of meat should be about the size of a deck of cards).
- Look for hidden sources of fats, sugar and sodium. Avoid processed foods because they tend to have these things in them!
- Ask your doctor or care provider whether you might need certain nutrients or vitamins or whether some are left out of prescribed diets (for example, you may get less protein with a vegetarian diet).
- Be mindful about ALL food choices—at home, while eating out and while shopping for groceries.
- Enlist the support of family members and friends to help you adopt and stick to a healthier dietary pattern.
- Try to cook your own food. This way, you know what is in it.
Benefits of Heart Healthy Eating
Even the healthiest among us can benefit from heart-healthy eating patterns, but adopting a healthy eating plan is especially helpful for people at risk for, or who already have, heart disease.
These patterns of eating are designed to help you get the nutrition you need, but also stay within your calorie limits and help manage cardiovascular risk. Heart-healthy dietary patterns have also been shown to lower the risk of many other chronic diseases, including dementia, diabetes and some cancers.
Of course, getting regular physical activity is also a key component of any effort to live healthier and prevent heart disease, diabetes and other health issues.
Questions to Ask
It’s important to talk with your health care provider about your diet; this includes any concerns or obstacles that may make healthy eating difficult.
It’s also a good time to discuss other important lifestyle issues such as stress management and sleep habits. Nutrition and healthy eating are also key parts of any cardiac rehabilitation program.
Here are some questions you might want to ask:
- How can I change my diet to make it more heart-healthy?
- Should I consult a dietitian or nutritionist? Who would you recommend?
- What types of foods should I eat, or avoid, to help prevent or manage cardiovascular disease?
- What are the best sources of fiber and omega-3 fatty acids?
- What are the most common sources of added sugars? How can I best avoid excess salt?
- Is there a specific diet you would recommend (DASH, Mediterranean or vegetarian)?
- Should I be taking any dietary supplements?
- Based on my cardiovascular risk factors, what is the most important change I can make to my diet?
- How can I create a dietary approach that fits my life and culture?
Whether you’re trying to shed a few pounds or have a larger goal in mind, losing weight takes time, energy, and most of all, commitment.
Achieving a healthy weight is well worth the effort. Losing even a few pounds can start to improve your heart health. Find tools and tips to help make your weight loss journey a little bit easier.
Obesity and Heart Disease
Obesity—having too much body fat—is pretty common. Today, obesity affects more than 1 out of 3 adults in the U.S. Being obese raises a person’s risk of many forms of heart disease, as well as other health problems.
But, your risk isn’t just about how much body fat you have. Where you carry the extra weight seems to matter, too. According to research, belly fat is of particular concern. In fact, even people who are not obese but have a large waistline show a higher risk for heart disease.
If you are obese or carry a lot of fat around your middle, take heart. Even small changes can make a big difference for your health. What is Obesity?
Obesity means that you are carrying too much fat on your body. This can hurt your health.
Obesity has been linked to:
- Heart disease
- High blood pressure
- High cholesterol
- Heart failure
- Heart attack
- Type 2 diabetes
- Obstructive sleep apnea
- Breast, colorectal and other cancers
- Dementia and Alzheimer’s disease
- Depression
- Chronic pain
Your Body Mass Index (BMI)
You can find out if you are obese by calculating your body mass index (BMI), a measurement based on your height and weight. A BMI of 25-29 means you are overweight and a BMI of 30 or higher means you are obese.
But BMI is not a perfect measurement and it doesn’t give a complete picture of your health. And we know that how your body fat is distributed can also affect your health risks.
BMI is often used in combination with knowing the size of your waistline. This is called your waist circumference.
In general, having a waist size of more than 40 inches in men or 35 inches in women raises a red flag and can be a concern. Learn how to measure your waist.
Recent research has found that having a large middle section can have negative health consequences, including a higher chance of developing diabetes or heart disease—and that’s regardless of your BMI. Our waistlines often expand as we age. Excess belly fat can also come from medical conditions such as thyroid problems. Even people who are not overweight or obese can suffer the negative health effects of belly fat, so it’s important to see your doctor regularly and keep your waist in check.
Small changes make a big difference!
Many people falsely believe that weight loss must be all or nothing. The truth is, every little bit counts.
Research shows losing just 3% of your body weight can lower blood glucose levels, and losing 5%-10% of your body weight can improve your blood pressure and cholesterol. If you weigh 180 pounds, that means dropping just 6 pounds to 18 pounds can make a measurable difference toward reducing your risk of heart disease.
To help protect your heart and overall health, make a plan to shed extra pounds. You’ll be surprised how much baby steps—simple changes like opting for the stairs instead of the elevator, reaching for a healthy snack, walking just a little farther—can add up.
What Causes Excess Body Fat?
Many factors play a part in the accumulation of extra body fat. For many people, a combination of eating habits and lifestyle factors cause a gradual increase in body fat over time. These same unhealthy patterns can also contribute to other obesity-linked problems, like stress and depression that can, in turn, make it more difficult to eat well and exercise.
Key factors related to weight gain include:
- Inactivity. Your body needs regular exercise to maintain a healthy weight. This includes not just occasional bursts of physical activity (such as a trip to the gym), but moving around throughout the day. Sitting for long periods each day is linked to higher rates of death and health problems—a condition known as “sitting disease.”
- Poor eating habits. You need lots of whole grains, fruits and vegetables, and healthy proteins. Foods in which more than 30% of the calories come from saturated fat are much more likely to cause your body to accumulate fat. Drinks with added sugar and alcohol can also be a source of wasted calories.
- Aging. Fat tends to accumulate as we age because of changes in hormones and metabolism, especially after menopause (in women). While you can’t stop aging, you can adjust your portions and eating habits as you expect this natural tendency.
- Genes. Certain genes have been linked with belly fat or obesity. In addition to being more likely to carry excess weight, people with these genes have been shown to face a significant risk of developing heart disease and diabetes.
- Stress, depression and sleep deprivation. These factors not only affect your mood—they also affect your body. Hormonal changes and other factors associated with stress, depression and insufficient sleep can change how your body processes and stores fat, making it more difficult to shed pounds. These factors also make it harder to maintain healthy eating and exercise habits.
Questions to Ask
Here are some tips on talking to your health care team about your weight:
- What do my BMI and waist circumference tell you about my health?
- Would you recommend losing weight? If so, how much should I aim to lose, and over what period of time?
- What’s the best way to reduce my caloric intake?
- What’s the best way to get a healthy amount of exercise? Are there any limits on the activities I can do?
- Will I need medications to help me lose weight?
- Do I need genetic testing, a thyroid test or other tests to assess the factors that may contribute to my body fat?
- How often should I come in for check-ins while I’m working to lose weight?
- Should I see a weight-loss specialist or dietitian?
Exercising is one of the single best ways to help improve your health. But many people feel that fitting in activity is not easy. Here you can find tools and tips to help you realize your fitness goals, whatever they may be.
No matter how active you are or how active you want to be, we can help educate and lead you on your journey to a healthier lifestyle.
Exercise and Your Heart
Regular exercise reduces the risk of many forms of cardiovascular disease, including heart attack, stroke, peripheral artery disease and coronary heart disease.
How? Exercise can:
- Lower blood pressure.
- Lower LDL (“bad”) cholesterol that can clog your heart’s arteries.
- Open blood vessels and gets your heart pumping, which improves circulation.
- Help you shed excess pounds, reducing the strain on your heart.
- Help your body maintain the right balance of hormones and other factors involved in clotting and inflammation that may promote fatty buildups in the heart’s arteries.
If You Have a Heart Condition
If you have been diagnosed with heart disease, then you have all the more reason to exercise! Regular exercise has been shown to help:
- Ease the symptoms of chronic heart conditions, such as coronary heart disease and heart failure
- Speed healing after a heart attack or stroke
- Help you live longer
Remember: Your heart is a muscle that needs to be strengthened. And it’s never too late to start.
How to Get the Exercise You Need
Optimally, you should get at least 2 1/2 hours of moderate-intensity activity (or 75 minutes of high-intensity activity) plus two sessions per week of strength training that engages all major muscle groups.
Here’s how to build a safe—and fun—heart-healthy routine.
Types of Exercises
Try to get a combination of aerobic (cardio) exercise and muscle strength training.
Aerobic exercises are those that make you breathe hard and get your heart pumping. They provide an energy boost and are terrific for heart health. Muscle-strengthening exercises are important for balance and bone health. Both types of exercise burn calories.
| Aerobic or cardio exercises | Stength training exercises |
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How to Avoid Overdoing It
Most people can safely exercise without any special medical evaluation. If you have chest pain, diabetes, high blood pressure, high cholesterol, previous heart attack, heart failure or another form of heart disease, talk to your doctor before starting an exercise program.
Know When to Stop!
Stop exercising right away and call 911 if you experience chest pain or discomfort, are short of breath even when you stop exercising/exerting yourself, have dizziness or nausea, or if you notice your heart racing or “skipping a beat.”
Exercise safety tips:
- If you’re new to exercise, start with shorter or less-intensive sessions and work your way up to five or more 30-minute sessions per week.
- Train your body and ramp up gradually before doing harder exercises.
- Before and after each workout, warm up/cool down with lighter exercises and stretches.
- Stay hydrated throughout your workout (if you have heart failure, ask your doctor about how much water you should drink).
- Learn your target heart rate and how to monitor your pulse. Research shows wrist-worn heart monitors aren’t always correct, so it’s best to learn how to check your pulse yourself.
- Listen to your muscles. It’s normal to feel some mild soreness after exercising, but it shouldn’t be too painful.
- Avoid exercising outside in extreme cold, heat or humidity, or on days with high levels of air pollution.
“Breathless with exercise should be gauged by the breath test,” says Andrew Freeman, MD, director of clinical cardiology at National Jewish Health in Denver. That means exercising to a level during which only a few words can be said.
“Anything more should be scaled back or signals you should seek a physician’s input. If you are feeling short of breath and turning pale, having chest pain or getting lightheaded, then exercise needs to stop. You may need to seek urgent care,” Freeman says.
Remember, if you have a heart condition or are recovering from a cardiac event, talk with your health care team to find the right routine for you.
How To Manage Stress
It’s important to remember that our minds can sometimes get the better of us, especially if we aren’t finding ways to lower stress. Prolonged stress can increase stress hormones and chemicals that promote inflammation in the body.
Exercise is a good way to counteract this and give your body a surge of the mood-enhancing chemicals called endorphins. Deep breathing and mindfulness-based meditation can also ease tension, helping to train your mind to focus on the present and turn your thoughts inward to what matters most to you.
Whether it’s through exercise, meditation, deep breathing, yoga, or other activities that help you unplug, it’s important to relieve stress and stay positive.
VISUAL AIDS
How do Cigarettes Affect the Body
For your health, bright future, find your motivation and stop smoking
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