You know how important taking care of your heart is — but knowing the exact steps to take to keep your heart healthy can be a tricky business.
How necessary is taking aspirin to reduce your risk of heart attack and stroke? Does more good cholesterol really help offset bad cholesterol? And are egg yolks heart healthy or not? Not knowing the answers to these questions is totally understandable, what with how quickly recommendations can change.
“It can be tricky to know what to do when it comes to improving your heart health because like all science and medicine, it’s an ever-evolving field of study,” Brittany Owen, a cardiologist at UT Physicians and Memorial Hermann in Houston, Texas, told HuffPost. “There’s a lot of misinformation on the internet too — like with most topics — so it can be hard to find the truth.”
Another obstacle: Every body is different, so you won’t necessarily respond to certain treatments or lifestyle changes the way someone else will. “For that reason, heart-healthy guidelines should be modified and patient-centered,” Lisa Moskovitz, New York-based registered dietitian and author of “The Core 3 Healthy Eating Plan,” said.
To help clear up some of the confusion, read on for the commonly believed heart health “rules” you can toss out once and for all, according to experts.
1. You should take aspirin daily.
Daily aspirin use may help prevent heart attacks and strokes in some people (by interfering with the blood’s clotting action, according to the Mayo Clinic), but the regimen isn’t for everyone. It comes with an added risk of serious side effects, such as gastrointestinal bleeding, which is why it’s no longer a general recommendation by the U.S. Preventative Services Task Force.
“Depending on your background and medical standing, this practice is something that can either be beneficial to your heart health or extremely risky,” said Michael Weinrauch, a New Jersey-based cardiologist and the chair of cardiology at Overlook Medical Center. “In most cases, it’s completely unnecessary.”
People age 40-59 who are at higher risk for cardiovascular disease and don’t have a history of it should decide with their doctor whether they should start taking aspirin — say, if you’re a 45-year-old smoker with diabetes. Meanwhile, people age 60 or older who don’t have heart disease shouldn’t start taking aspirin.
“If you’ve had a heart attack or stent or bypass surgery, you benefit from aspirin regardless of age,” Weinrauch said. “Similarly, if you haven’t had a heart attack, stent or bypass but have a high calcium score (a test that detects plaque in coronary arteries), you’ll probably benefit from aspirin.”
Bottom line: Don’t take aspirin every day before consulting your doctor — and if you suspect a heart attack, call 911.
2. Sea salt is healthier than table salt.
Sea salt is less processed than table salt and retains trace minerals, but the two have the same basic nutritional value.
“Your body also processes them the exact same way,” Owen said, so no matter the type of salt you prefer, too much is going to negatively affect your blood pressure and increase your risk of heart disease and stroke.
It’s recommended to limit your sodium intake to less than 2,300 milligrams — or 1 teaspoon — per day.
3. Coconut oil is healthier to cook with.
Although virgin coconut oil contains medium-chain fatty acids (thought to raise HDL — aka the “good” cholesterol) and has antimicrobial and antioxidant benefits, it’s still alarmingly high in saturated fats ― about 50% more than butter, according to the Mayo Clinic.
“By overconsuming saturated fats, individuals are put at high risk of stroke or other cardiovascular disease,” Weinrauch said, by raising serum LDL (or “bad”) cholesterol. “Instead, align your diet with recommendations from the American Heart Association, to engage in a diet that has 6% or less of your daily caloric intake made up of saturated fat.”
If you need an alternative, he added, try small amounts of extra virgin olive or avocado oil.
4. Vaping is better for you than smoking.
“Inhalation of hot air, whether from a cigarette, vape pen or burning building is never good for the lungs, no matter how you slice it,” Owen said. “With vaping comes toxic chemicals and oils that scar the lungs.”
And if you’re vaping with nicotine, you’re just trading your cigarette addiction for a vape pen addiction. “Nicotine is not only addictive, it can also raise your blood pressure and lead to hypertension,” Owen said. “None of this is good for your body.”
If you’re looking to quit smoking, Owen recommends discussing it with your health care provider, as they have many methods to aid in your success.
5. Coffee’s stimulating effects are hard on the heart.
It turns out drinking roughly two or three cups of coffee daily is associated with a lower risk of heart disease ― and this holds true for both people with and without cardiovascular disease.
Take heart though (pun totally intended) if you have an arrythmia or extra heartbeats (premature ventricular contractions or premature atrial contractions). “The caffeine in coffee can stimulate and worsen palpitations,” Owen said.
6. So long as I stay within the recommended daily amount of alcohol, my heart’s safe from damage.
According to the European Society of Cardiology, levels of alcohol consumption currently considered safe by some countries are linked with the development of heart failure. It’s suggested that if you do drink, limit your weekly consumption to less than one bottle of wine or less than three-and-a-half 500 ml cans of 4.5% beer.
Although red wine has been shown to improve heart health (it could be that the antioxidants it contains increase levels of good cholesterol and protect against bad cholesterol buildup), that’s not the whole story.
“Like most things, you have to consume alcohol in moderation and you can’t ignore the negative effects or risks of alcohol consumption,” Owen said. “If you develop heart issues, it’s not imperative that you start drinking red wine to improve your outcome.”
With regard to some heart conditions, such as heart failure, “alcohol has been shown to cause and worsen this disease,” Owen said. “One would argue that zero alcohol should be consumed by these individuals to achieve better heart health.”
7. Ten thousand steps a day can replace all cardiovascular activity.
“While it’s important to your overall health to avoid being sedentary, it’s not enough to walk 10,000 steps a day to prevent cardiovascular disease,” Owen said.
The key is to get moderate cardiovascular activity. So if you’re walking slow, you’re not reaping the benefits as much as you would if your activity was harder. If you prefer walks, try amping them up by increasing your speed or using light weights. The way to know you’re doing moderate-intensity cardio is when your heart rate goes up with exertion and you’re breaking a slight sweat.
“If you aren’t able to do that at your current fitness level, aim to slowly increase your activity level each week until you reach this goal,” Owen said.
8. It’s best to only eat egg whites.
This heart health rule goes back to the old belief that eggs (specifically, egg yolks) were bad because they’re a rich source of dietary cholesterol. But the yolk is also where all the other beneficial nutrients reside (such as lutein, folate, riboflavin and vitamins A, B12, D and K) many of which are essential and protective against diseases, including heart disease.
One study found that people who ate eggs regularly had more large HDL molecules in their blood, which help clear cholesterol from blood vessels and protect against blockages that can lead to heart attacks and stroke, while people who are fewer eggs had more harmful metabolites in their blood that are linked to heart disease.
“Although the yellowy center does have saturated fat (about 1-2 grams per egg), you can safely consume a certain amount, even on a heart-healthy diet,” Moskivitz said.
Eating eggs in moderation might look like three to five whole eggs per week, alongside plenty of cholesterol- and blood-pressure-lowering foods, such as oatmeal, avocado and fresh fruit and veggies.
9. All fats are bad for your heart.
There are four different kinds of fats in our foods and some of them are an important part of a balanced diet.
One type of fat to nix entirely for the sake of your heart? Trans fats — the ones found in many processed foods and baked goods. These fats raise bad cholesterol levels and lower your good cholesterol levels, according to the American Heart Association. (To steer clear, avoid any products that show “partially hydrogenated oils” on the ingredients label.)
The other to limit your intake of is saturated fats, which occur naturally in red meat, full-fat dairy products and tropical oils (coconut and palm, for example). They can also be found in fried foods and baked goods. Similar to trans fats, they raise bad cholesterol levels, increasing your risk of heart disease and stroke.
Monounsaturated and polyunsaturated fats, on the other hand, are thought to lower bad and increase good cholesterol levels, Moskovitz said. These healthy fats can be found in oils like olive and sunflower, nuts and seeds like walnuts and pumpkin, and can also be found in avocados and peanut butter.
Omega-3s fall into the category of polyunsaturated fat and are found in fatty fish, such as salmon and herring. Plant-based options include chia seeds, hemp seeds and Brussels sprouts.
10. Large amounts of good cholesterol can offset bad cholesterol.
Because good cholesterol absorbs bad cholesterol and carries it back to the liver to be flushed from the body, it would stand to reason the higher your good cholesterol levels, the better, to help offset the bad.
As it turns out, though, people who have extremely high good cholesterol levels appear to be at higher risk of heart disease. Researchers have yet to suss out the reasons behind why, but genetic factors may be at play.
“When it comes to good cholesterol, it appears it actually needs to be just right — not too low and not too high,” Owen said. “Ideally, your good cholesterol levels should be higher than 40 but lower than 90 to prevent heart disease.”
Things like exercising more, quitting smoking and managing your blood pressure and blood sugar can all play a positive role in increasing your good cholesterol levels — and, of course, maintaining a heart-healthy diet, a la the Mediterranean or DASH diets.
“Research shows that sugar may play a much larger role in elevated serum cholesterol as well,” Moskovitz said. “Instead of scanning the nutrition label for cholesterol, focus on total saturated fat and added sugar.”