During the early to mid 20th century, coronary  heart disease was at its
height as a cause of death in the United States (US).1 The death rate from coronary heart disease peaked in the 1960s, with the increase in prevalence
of coronary atherosclerosis (hardening of the heart’s arterial walls) being the primary cause. Atherosclerosis is the most common cause of strokes, heart attacks, and peripheral vascular disease.1 Researchers believe that the increase in smoking combined with dietary changes that increased serum cholesterol levels were the major contributing factors to the increase in coronary atherosclerosis—and ultimately coronary heart disease—during that time.1

Since the 1960s, the coronary heart disease death rate in the US has steadily declined, and continues to do so today. You might think this is because people are healthier today than they were in the 1960s. While it’s true that the smoking rate has drastically reduced in the US,9 the decline in heart disease isn’t because people are necessarily healthier; it’s due to major advancements in medicine, which have led to better heart disease interventions.1

The current poor dietary habits of the average American put millions of people in the US at risk for heart disease—a factor that hasn’t changed in 60 years.2 These days, the standard American diet consists of foods high in saturated and trans fats, processed  sugars, and sodium; most Americans exceed the daily recommended limit for each and do not satisfy the recommended daily amount of fiber, fruits, vegetables, legumes, and healthy fats in their diets.4 Poor dietary choices are directly linked to higher cholesterol levels and blood pressure, weight gain, obesity, Type 2 diabetes, hypertension, and inflammation—all of which can lead to cardiovascular disease.2-5 And if these unhealthy eating habits are instilled in children at a very young age, it is more likely they will continue these unhealthy habits well into adulthood.6

Luckily, heart disease and the factors that cause it can be prevented, treated, and even reversed with healthful lifestyle modifications.5 The American Heart Association suggests the following lifestyle modifications for individuals who want to protect and heal their heart at any age:7

CHOOSE A HEALTHY EATING PLAN

Limit (and eventually eliminate) the consumption of foods that are high in saturated and trans fats, refined sugars, and high levels of sodium, ingredients often found in highly processed foods. Eating

a diet rich in fruits, vegetables, legumes, whole grains, and healthy fats can lower cholesterol, reduce the inflammation that causes heart disease, improve blood flow to the heart, dissolve pre-existing plaque, and help maintain a healthy body weight.5

KEEP YOUR BODY ACTIVE

The US Department of Health and Human Services recommends we get at least 150 minutes a week of moderate-intensity aerobic physical activity, such as brisk walking, or 75 minutes of vigorous intensity aerobic physical activity, such as running, or a combination of both, every week. Children should be active for about 60 minutes every day. And it’s ok to break up your physical activity into small chunks of time (10 minutes of brisk walking around the office parking lot here, five minutes running up and down some stairs there etc) as long as your minutes each day add up to the total weekly recommended amount of time for physical activity.8

DO NOT SMOKE AND AVOID INHALING SECOND-HAND SMOKE

Thanks to years of anti-smoking awareness campaigns, most of us know the myriad of health risks that are associated with tobacco use and/or exposure to second-hand smoke. In fact, tobacco use
is the number one cause of preventable disease, such as coronary heart disease,
in the US.9 According to the US Surgeon General, cigarette smoking among American adults has decreased to only 14 percent.9 But for those14 percent, quitting can be very difficult. CDC data indicate that two-thirds of the people who smoke want to quit and have tried to quit several times.9 Thankfully, there are many evidence-based and proven smoking cessation tools that are available to help people successfully quite smoking. The Director of the CDC emphasizes that it is never to late to quit smoking, even if someone has been doing it most of his or her life, and quitting smoking at any age after any number of years can still result in health benefits.9

LEARN THE WARNING SIGNS

As discussed earlier, medical advances and better interventions exist today that can prevent or circumvent a heart attack and prevent death. If you experience any of the following symptoms on a regular basis, see your doctor:
• Constant dizziness or lightheadedness
• Extreme fatigue
• A fast heart rate (more than 100 beats  per minute)
• A new, irregular heartbeat
• Chest pain or discomfort during activity that goes away with rest
• Difficulty breathing during regular activities and rest
• A respiratory infection or cough that becomes worse
• Restlessness or confusion • Changes in sleep patterns • Loss of appetite or nausea

SEE YOUR DOCTOR REGULARLY FOR CHECKUPS AND BLOOD WORK

Get heart-health screenings done on a regular basis. Screenings should include measuring blood pressure, weight, waist circumference, cholesterol, glucose, and lifestyle factors. It’s never too late to make healthy lifestyle modifications to reduce your risk of heart disease. Talk

to your physician, who can assist you in developing a healthy diet and exercise plan, and make sure to get your blood work done annually.

REFERENCES

1. Dalen JE, Alpert JS, Goldberg RJ, Weinstein RS. The Epidemic of the 20th Century: Coronary Heart Disease. The American Journal of Medicine. 2014;127:807-812.

2. Centers for Disease Control and Prevention. Heart Disease Facts. https://www.cdc.gov/heartdisease/ facts.htm Accessed January 31, 2020.

3. McMahan CA, Gidding SS, Malcom GT. Pathobiological determinants of atherosclerosis in youth risk scores are associated with early and advanced atherosclerosis. Pediatrics. 2006 Oct;118(4):1447-55.

4. Office of Disease Prevention and Health Promotion. Dietary Guidelines 2015 – 2020. https://health.gov/ dietaryguidelines/2015/guidelines/chapter-2/current- eating-patterns-in-the-united-states/

5. Physicians Committee for Responsible Medicine. Heart Disease. https://www.pcrm.org/health-topics/heart- disease. Accessed January 30, 2020.

6. Funtikova AN, Navarro E, Bawaked RA. Impact of diet on cardiometabolic health in children and adolescents. Nutr J. 2015; 14: 118.

7. American Heart Association. How to Help Prevent Heart Disease at Any Age. https://www.heart.org/en/ healthy-living/healthy-lifestyle/how-to-help-prevent- heart-disease-at-any-age. Accessed January 30, 2020.

8. United States Department of Health and Human Services site. Physical Activity Guidelines for Americans. 19 Feb 2019. https://www.hhs.gov/fitness/be-active/ physical-activity-guidelines-for-americans/index.html. Accessed 10 Feb 2020.

9. United States Department of Health and Human Services. Smoking Cessation: A Report of the Surgeon General—Executive Summary. 2020 . https://www.hhs. gov/sites/default/files/2020-cessation-sgr-executive- summary.pdf.Accessed10Feb2020. NHR