By MultiCare Health System

February is American Heart Month. Heart disease is still the leading cause of death for men and women in the United States, but it’s preventable.

We posed heart-health questions to Bev Utt, wellness dietitian for MultiCare’s Center for Healthy Living & Health Equity, Kayla Kranz, clinical exercise physiologist for Pulse Heart Institute’s Cardiac and Pulmonary Rehabilitation Program and Katie Dunivan, personal trainer for YMCA of Pierce and Kitsap Counties.

Your heart and diet

How does fiber help my heart?

Fiber is the indigestible part of plants we eat. We get it naturally in whole foods like fruit, vegetables, whole grains such as brown rice and oatmeal, beans, lentils, seeds and nuts.

Fiber is heart healthy because it can lower LDL (bad cholesterol), total cholesterol, triglycerides and insulin levels. Fiber also helps manage blood sugar levels and maintain bowel health.

A high intake of dietary fiber has been linked to a lower risk of heart disease (40 percent, in some cases) in a number of large studies following people for many years.

Important to note: Processed foods containing added fiber may not give us all the benefits we get from whole foods.

Here are a few tips for increasing fiber intake:

• Eat whole fruit instead of drinking fruit juices

• Replace white rice, bread and pasta with brown rice and whole grains or whole grain products

• Choose cereals that have a whole grain as their first ingredient and are minimally processed, like steel-cut oats over rolled oats

• Snack on raw vegetables, nuts and seeds instead of chips, crackers or chocolate bars

• Substitute beans for meat two to three times per week

What foods should I eat to lower my cholesterol?

Eat more: fruits, vegetables, beans and lentils, whole grain foods (brown rice, oatmeal, quinoa), seeds and nuts, fatty fish (salmon, tuna, sardines) and olive oil.

Avoid or eat less: refined carbohydrates (chips, cookies, white bread and rice), added sugars and foods with saturated fat (red meat, butter, mayonnaise, cheese and coconut and palm oils).

How can there be “healthy” fats?

Newer research shows that when it comes to dietary fat, it is more important to focus on eating beneficial “healthy” fats and avoid harmful fats versus adopting a low-fat diet. What matters most is the type of fat you eat. Healthy fats are necessary and beneficial to our health.

Unsaturated fats are considered “healthy” fats, and saturated and trans fats are considered “bad” fats, based on how they affect our cholesterol. Saturated and trans fats increase LDL cholesterol, while unsaturated fats lower LDL cholesterol and lower your risk of developing heart disease.

LDL or “bad cholesterol” moves around our bloodstream freely, allowing for it to be easily deposited in our arteries, thus causing blockages that may lead to heart attack or stroke. HDL or “good cholesterol” removes LDL from the bloodstream, bringing it back to the liver to be utilized for other body processes.

Is salt really that bad for me?

We all need a little sodium – the primary element we get from salt – to do the vital work of nerves, muscles and proper water and mineral balance. Most Americans consume at least 1.5 teaspoons of salt per day, which is far more sodium than our bodies need.

Sodium and/or salt affects the body by holding on to more fluid, which can be detrimental to those with high blood pressure. As you limit the sodium/salt in your diet, less fluid will be held onto, thus decreasing blood pressure.

Too much sodium in the diet can lead to high blood pressure, heart disease and stroke.

The good news is that potassium has the opposite effect on heart health that sodium does – so high potassium intake can help relax blood vessels, excrete the sodium and decrease blood pressure.

If you are looking to lower your salt intake, consider these tips:

• Eat more fresh vegetables and fruits, which are naturally high in potassium and low in sodium

• Eat less bread, cheese and processed meat, as these and other processed foods are high in sodium and low in potassium

• Use food labels to assess the amount of sodium in your food products

• Limit processed foods (canned products, frozen products prepacked foods)

• Don’t add salt to the food while cooking, wait to add after you’ve tasted the meal

• Don’t bring salt to the table with you

Your heart and exercise

How strenuous does exercise have to be to benefit my heart?

Moderate intensity exercise is recommended for all adults. But how do you know you’re working at a moderate intensity?

While exercising, try the talk test. You should be able to hold a conversation with a partner. If you are becoming overly short of breath, you may be working too hard. If you could sing a song while exercising, you’re not working hard enough.

Most of us think that we have to be sweating to be working hard, or we follow the saying “no pain, no gain.” These are not accurate representations of workload intensity, so do not use these guidelines when exercising.

If you experience any chest pain or shortness of breath while exercising, stop exercising and call your primary care physician or cardiologist immediately for an evaluation.

What are the best exercises for the heart?

A complete workout program includes strength, flexibility and cardiovascular training. That being said, cardiovascular exercise is the type of training that most directly conditions the heart and lungs to efficiently deliver oxygen to your working muscles.

For a healthy heart, aim for 30–60 minutes of daily of moderate-intensity, cardiovascular activity. Keep in mind you can split up this total time into 10 minute chunks of activity throughout the day and still see the same benefits.

Cardio activity includes a variety of heart-pumping physical activity such as walking, dancing, swimming, ice skating, rowing, biking, skiing and so on.

What exercise should I avoid if I have heart disease?

If you have heart disease, always make sure to speak with your doctor before engaging in a new physical fitness program. If you experience regular chest pain and/or have recently had cardiac surgery, speak with your cardiologist about a referral to a cardiac rehabilitation program. There you can be individually set up for success based on your personal needs.

A few general safety precautions to keep in mind include:

• Always take time to properly warm up and cool down. Avoid the tendency to jump right in to a physical activity without a proper warm-up.

• Pay attention to the environment. Extreme heat, humidity or cold may make it more difficult for your body to regulate temperature and other physiological processes during exercise.

• Avoid high intensity physical activity and instead maintain moderate intensity. While target heart rate can be calculated by a fitness professional, be sure to ask your doctor as some medications such as beta-blockers and calcium channel blockers can affect your heart rate.

• Avoid exercises that involves isometric contractions such as planks and wall sits, as these can increase both blood pressure and heart rate.

What pulse rate should I aim for?

General exercise guidelines suggest calculating your target heart rate by first calculating your maximum heart rate (MHR). Your MHR is 220 minus your age. For example, a 40-year-old person would have a maximum heart rate of 180 beats per minute (BPM).

Try to work within the zone of 50 to 70 percent of your maximum heart rate for general fitness. For a 40-year-old person, this would be 90-126 BPM. For athletic performance, work 70 to 85 percent MHR. For a 40-year-old exerciser, this would be between 126-153 BPM.

A fitness professional can help you calculate your target heart rate. Take time to ask your doctor as some medications such as beta-blockers and calcium channel blockers can affect your heart rate.

MultiCare Health System is a not-for-profit health care organization with more than 11,000 employees and a comprehensive network of services throughout Pierce, South King, Thurston and Kitsap counties.