When it comes to preventing heart disease, lifestyle rules. People who follow just five habits are significantly less likely to die of it than those who skip four or all five of them, an analysis of national health survey data has found. The habits: not smoking, getting regular exercise, avoiding obesity, eating well (with five or more daily servings of fruits and veggies), and enjoying one to seven alcoholic drinks a week. Strikingly, even though everyone started the study with normal blood pressure and cholesterol, that didn't protect the rule-skippers. "A healthy lifestyle is more powerful than medicine," says study leader Dana King, M.D., of the Medical University of South Carolina. Moving up from "pretty good" (three out of the five good habits) to "perfect" (all five) reduced people's mortality risk over the two-decade study period by a whopping 50%. It's a whole package: "Some women think they're safe as long as they don't gain weight, but that's not true. A good diet and exercise are separate elements that do a hundred other healthy things for you," says Dr. King. Here, based on the latest research, the best ways to start.
1. Set a brisk pace
If your bike, skates, and tennis racquet are collecting dust, now's the time to brush them off. In a large 10-year Dutch study, people who got at least moderate exercise reduced their risk of heart attack significantly, while those who did only lower-intensity walking and gardening did not. So grab your girlfriends and enjoy some grown-up playdates. When you walk, make sure your stride hits beneficial levels: Aim for 90 to 113 steps per minute (based on your height and fitness level) or, more simply, use the "slightly hard to talk" test (you can speak, but you wouldn't want to tell a long story).
If you like a heart-pounding sweat, go ahead and make your workout more intense. But it's not necessary — and research has shown that women are more likely to stick with their routine if it's moderate.
2. Enjoy life
If you're not happy with your job, family, sex life, or self, it can make your heart hurt — literally. In a long-term study of British government workers, those with lower levels of satisfaction racked up higher rates of heart disease. You don't need to be diagnosed with depression or anxiety, or have superhigh stress, for there to be an impact — just a lack of joy in key areas of your life could do it. So find ways to boost yourself out of the blah zone: In the study, every big step toward the positive — improving family relationships or finding more engaging work — was marked by lower heart disease risk.
3. Let greens outsmart your genes
Whether good or bad, you can't change the DNA your mom and dad passed on to you, but it turns out you can keep some dangerous genes from undermining your heart health. In two large international studies, researchers looked at heart disease rates in people with gene variations on chromosome 9 — known to significantly increase odds. Sure enough, people with the risky variations had more heart disease, but here's the kicker: That was true only if they also ate a crummy diet (the investigators referred to their eating as "non-prudent"). Those who followed the healthiest diets had no more heart disease than those without the risky gene variations. That involved consuming several servings a day of two out of the following categories — fresh vegetables, fresh fruit, and berries. The most powerful food: raw veggies. So pass the crudités before dinner, and slice plenty of raw carrots and cucumbers on your leafy greens.
4. Find out what the (eye) shadow knows
If you have trouble applying eye shadow or concealer smoothly because of yellowish eyelid bumps, the problem may be more than just cosmetic. In a long-term Danish study, people with lipid-filled bumps around eyes had a 48% higher chance of having a heart attack within the next three decades than those with smooth lids. The finding was especially true for women under the age of 55. In general, those with eyelid bumps also had higher levels of bad LDL cholesterol and triglycerides, and lower levels of good HDL cholesterol. But researchers were surprised to find that even when those blood tests were normal, heart attack risk was still elevated. So make sure your doctor takes a peek at your face while your eyes are closed. If she spies the eyelid sign, it may mean your body is prone to depositing cholesterol where it doesn't belong — including in blood vessels — and that you'd benefit from a more aggressive approach toward all your risk factors.
5. Get a wake-up call
People who get too little sleep (six hours or less a night), plus have poor-quality rest, face a 65% higher risk of heart disease, a Dutch study of 20,400 people found. So take your zzz's seriously. Tell your doctor if you're having trouble sleeping or if you're waking up without feeling refreshed. And adopt good sleep hygiene — no caffeine after lunch, regular bedtimes and wake-up times, plenty of exercise in the early part of the day, no television or computer in bed — to help you get the rest your heart needs.
6. Just say no...to soda
Sugary drinks aren't on anyone's good-health list, but in data reported last November, researchers noted that sweet sodas are particularly risky for women. A University of Oklahoma study of 4,166 women, age 45 and over, found that those who drank two or more sugar-sweetened beverages a day were nearly four times as likely to develop high triglycerides as those who drank one or fewer. They were also more likely to add to their waist sizes and develop impaired glucose levels, setting themselves up for diabetes. The researchers aren't sure why females are harder hit than males, but it may be as simple as calories — because women need fewer, two sodas make up a greater proportion of their daily calorie intake. But don't wait for the definitive why: Quench your thirst with water or unsweetened iced teas, and get your fizz from seltzer (add a spritz of lemon or lime if you like a little flavor).
7. Dose with D daily
In the latest installment of "Is there anything vitamin D doesn't do?" a new review of 75 studies found that not getting enough of the sunshine vitamin raises your chance of a heart attack and ups many cardiovascular risk factors, including high blood pressure, general inflammation, and metabolic syndrome (a triple whammy of hypertension, high triglycerides, and extra weight around your middle). You can get D from sun exposure, but depending on your skin tone and how far north you live, that can be tough in winter months (plus, toomuch sun ups your risk of skin cancer — and wrinkles).
Getting vitamin D from food is also a challenge — fortified milk, fatty fish, and eggs are recommended sources. Most of us will have to rely on a supplement to meet the goal of 600 IU a day set by the Institute of Medicine, or the higher amount — 1,000 IU — that many other experts advise.
Read more: How to Prevent Heart Disease - Ways to Prevent a Heart Attack - Good Housekeeping
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