Yeah, yeah, you already know the basics. Don’t smoke. Lay off the bacon-wrapped steak.
But when cardiologists hang up their stethoscope for the day and head home from the office, what advice do they give those closest to them – their family and friends – about heart health?
Ronald J. Scheib, medical director at the Pritikin Longevity Center and Spa in Miami, doesn’t shy away from inquiring about his kids diets or singing the praises of exercise.
“You kind of take that entire shtick home with you, because you live with it every day,” Scheib said.
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A common refrain on doctors’ spiel to patients: Trash the cigarettes.
“I badger them about their smoking,” said Robert Bonow, cardiologist and professor at Northwestern University Feinberg School of Medicine.
Bonow cautions that even though awareness about heart disease has increased, it’s still the leading cause of death. He worries that a less active younger generation – one that spends a lot of sedentary time on the Internet – might chip away at gains made in combating heart disease.
Here are a few tidbits that might sound familiar to cardiologists’ friends and families:
Monitor your numbers. “The key to all of this is to know your risk factor,” Bonow said. “Knowing your cholesterol is important.”
Even in your 20s and 30s, you should be able to recite your cholesterol and blood pressure stats. A doctor can tell you whether those numbers need work.
“The clock starts ticking very early,” Bonow said.
Cut the sugar. “I’m a very aggressive opponent of everything which contains sugar,” said Regina Druz, medical director at the Integrative Cardiology Center of Long Island.
Too much sugar can trigger multiple health problems, from excess weight to potential increases in blood pressure and triglycerides – a type of fat circulating in the blood – that can boost the risk of heart disease.
The American Heart Association recommends limiting your intake of added sugars – sugars and syrups added to many processed foods and beverages – to no more than 100 calories a day for most women (about 6 teaspoons) and 150 calories a day (about 9 teaspoons) for most men. That’s roughly the equivalent of a 12-ounce can of regular soda.
“There’s no soda in my house,” said Druz, who isn’t a fan of artificial sweeteners either. “It’s prohibited.”
Find a physical activity you enjoy. Experts often preach the importance of exercise. The key is to pick physical activity that you like. That way, you might even keep doing it.
“It all depends on finding something that is repeatable and that is enjoyable,” ideally with a low risk of injury, Scheib said.
At his center in Miami, for example, pool equipment allows people with problematic knees or backs to simulate a treadmill run in the water.
Speaking at his Chicago office, Bonow nodded to the nearby escalators.
“Take the stairs. Walk up the escalators,” he said. Get “a nice, brisk pace” going at least once a day.
Bonow gives his bicycle a workout during warm weather and hops on a stationary bike in winter.
Druz’s family takes bike rides together and goes for walks with the dog. Her three children are all active – they play tennis, volleyball and basketball and run track. Sometimes her daughter comes with her to zumba class.
“They have internalized already that this is the routine,” she said, “that it’s part of health maintenance.”
It’s all about moderation. Occasionally indulging in a bit of cheat food is fine, Bonow and Druz said. Druz lets her kids have tortilla chips, if they put some guacamole on top.
“Do they go for chips? Of course,” she said. “We can balance, perhaps, some bad with the good.”
Bonow said eating a little red meat isn’t a problem, adding that portion size is more important than what you’re actually eating.
“Keep your weight under control,” he said.
He doesn’t bug his two adult sons if they’re chomping down on pizza or burgers, he said.
“They eat all kinds of things I don’t eat,” he said. “I don’t badger them. Occasionally a sideways glance.”
Don’t worry too much – it’s stressful. Patients can be panicky, Bonow said, bringing in pages of print-outs from the Internet.
“They’re doing all the right stuff,” he said. But for some, it’s never enough. They still worry about other tests they think they should be taking, for example.
A stressful workload or lots of travel can take a toll on health, too. It’s important to balance that with things you enjoy.
Scheib’s son spends long hours at a desk but spearfishes on the weekends. One of Scheib’s daughters travels one week out of the month. She doesn’t eat as well on the road – “she gains 8 pounds,” he said – so when she comes home she steers clear of red meat and pizza.
Make sure you’re not compounding any health issues by adding extra anxiety.
Added Scheib: “Stress is an enormous trigger.”