By Dr. Mercola
If you have heart failure, it means your heart isn’t pumping as well as it should be and, as a result, your body is probably not getting enough oxygen. In other words, you have a weak heart.
Once-simple activities, like walking or carrying groceries, may become difficult, and you may also experience fatigue, shortness of breath, fluid build-up, and coughing.1
Close to 6 million Americans have heart failure, while more than 870,000 cases are diagnosed each year. Once you develop heart failure, there’s no known cure, and the condition typically becomes chronic.
There are some natural methods to improve your outcomes (for instance, optimizing your vitamin D levels may improve your survival rate2), however, your best option is to avoid developing heart failure in the first place.
Reduce Your Risk of Heart Failure with Exercise
Want a simple method to significantly lower your risk of heart failure? Get moving. Research presented at the American Heart Association's 2015 annual meeting in Orlando, Florida found you can reduce your risk of heart failure with even modest increases in physical activity – even if you start later in life.
The exercise habits of 11,000 Americans were followed, and their activity levels were assessed twice over a six-year period.
Those who reported engaging in the recommended 150 minutes of moderate exercise, or 75 minutes of vigorous exercise or more a week at both visits, were 33 percent less likely to develop heart failure than those who were inactive.3
Those who were less active, engaging in less than 149 minutes of moderate activity or 74 minutes of vigorous activity a week at both visits still benefited with a 20 percent lower heart-failure risk.
If you’re not currently an avid exerciser, listen up – previously inactive people who started exercising during the study period and reached recommended physical activity levels still were able to reduce their risk of heart failure by 22 percent.
And those who increased their activity levels from inactive to 30 minutes of walking four times a week, had a 12 percent lower risk. Study author Dr. Roberta Florido of Johns Hopkins University School of Medicine told HealthDay News:
"Many people get discouraged if they don't have the time or ability to exercise vigorously, but our findings demonstrate that every little bit of movement matters and that picking up exercise later in life is decidedly better than not moving at all."
Heart Failure Patients Often Get Too Little Exercise
Exercise is highly recommended for heart failure patients, as it strengthens your heart, helps your body use oxygen, and improves heart failure symptoms. Moderate exercise also lowers your risk of being hospitalized for heart failure4 and may slow the disease’s progression.
But despite the benefits, many patients do not exercise enough.
Research published in Circulation: Heart Failure examined why so many heart failure patients neglect to exercise. They found that social support played a major role, with those with high levels of social support averaging 118 minutes of exercise a week compared with 92 minutes for those with low levels.
People with barriers that may get in the way of exercise – such as financial issues, lack of child care, or transportation or poor weather – also exercised less – about 79 minutes – than those with the fewest barriers (who averaged 169 minutes of exercise a week).
Lead author Dr. Lauren Cooper, a fellow in cardiovascular diseases at the Duke University School of Medicine, said:5
"Patients, family members, and healthcare providers should work together to find solutions to the barriers preventing a patient from participating in structured exercise programs, because exercise programs can help patients manage their condition."
How Much Exercise Is Necessary to Protect Your Heart?
The featured study found the greatest heart benefits occurred in those getting at least 150 minutes of moderate exercise, or 75 minutes of vigorous exercise a week. A separate meta-analysis found slightly different results.
Among those working out for 30 minutes daily, the risk of heart failure was cut by just 10 percent. This increased to 20 percent among those working out for one hour daily and to 35 percent for those exercising two hours daily.6 Researchers explained:
“There is an inverse dose-response relationship between PA [physical activity] and HF [heart failure] risk. Doses of PA in excess of the guideline-recommended minimum PA levels may be required for more substantial reductions in HF risk.”
Yet, who has time to exercise for two hours every day? The good news is that a plethora of past research has shown working out at a higher intensity gives you greater benefits in a shorter amount of time.
Though the researchers didn’t specifically look into exercise intensity, they believe performing high-intensity interval training for 30 minutes would likely yield greater protection against heart failure than the same amount of moderate activity.
During HIIT, you exercise as hard and fast as you can for a short period, say 30 seconds, followed by a period of rest (such as 90 seconds). You'll want to raise your heart rate to your anaerobic threshold, and to do that you have to give it your all during the high-intensity 30-second intervals.
Briefly, my Peak Fitness HIIT routine includes the following, although it can be done with resistance training as well.
- Warm up for three minutes
- Exercise as hard and fast as you can for 30 seconds. You'll want to raise your heart rate to your anaerobic threshold, and to do that, you have to give it your all during these 30-second intervals. (As a general guideline, you can calculate your anaerobic threshold by subtracting your age from 220)
- Recover for 90 seconds
- Repeat the high-intensity exercise and recovery cycle seven more times
One reason why HIIT is so effective is because of the stress it puts on your heart, which ultimately makes it stronger. As noted in Men’s Health:7
“Interval training — workouts that alternate between high-intensity effort and lower-intensity effort — causes your heart rate to stay up for short bouts of time and then go back down over and over again. This ‘up-and-down’ format is what ultimately strengthens your heart.
That’s because it forces the muscle to work harder than if it had to consistently maintain the same steady beats per minute. And at the end of the day, a strong heart is one of the most important factors in decreasing your risk of heart failure … ”
Exercise Helps Prevent Heart Failure by Forming New Mitochondria
Another reason why exercise is so crucial for preventing heart failure has to do with its beneficial effect on mitochondria. Your skeletal muscle derives its energy from your mitochondria – the energy storehouse of your cells, responsible for the utilization of energy for all metabolic functions.
Mitochondria make up, on average, about 1 to 2 percent of your skeletal muscle by volume, but this is generally enough to provide the needed energy for your daily movements. Your cardiac muscles are similar to your skeletal muscle in that they are striated (banded) and use mitochondria for energy, but there is an important difference.
Your cardiac muscle may contain up to 35 percent mitochondria. This large volume of mitochondria supplies a steady source of energy right to your heart, and explains why your heart rarely needs to "rest" like your skeletal muscles do.
Your mitochondria are little powerhouse structures — found in the cytoplasm, or inside your cells — inside of which energy is formed. This energy is called ATP, and without ATP, the cell dies. Not only do your cells require oxygen in order to produce ATP, but coenzyme Q10 (CoQ10) and its reduced form, ubiquinol, are also an essential component to the mitochondria in facilitating generation of ATP.
(One of the primary mechanisms of harm from statin cholesterol-lowering drugs in general appears to be related to the reduction in the liver's ability to produce CoQ10, which can actually weaken your heart and eventually lead to heart failure.)
However, exercise also triggers mitochondrial biogenesis,8 or the formation of new mitochondria, a decline of which is common in aging. This reverses significant age-associated declines in mitochondrial mass, and in effect, stops aging in its tracks along with a number of chronic diseases.
A 2011 review in Applied Physiology, Nutrition, and Metabolism also pointed out that exercise induces changes in mitochondrial enzyme content and activity, which can increase your cellular energy production and in so doing decrease your risk of chronic disease.9
Further research published in the Journal of the American College of Cardiology noted that mitochondrial dysfunction appears to be a critical factor in the development of heart failure and mitochondrial biogenesis (which again is triggered by exercise) is one promising area for addressing this condition. 10
Low-Carb Diet May Benefit People with Heart Failure
Aside from exercise, eating a healthy diet is also a crucial part of preventing and managing heart failure. In research presented at the Mexican Congress of Cardiology 2015, just four months of following a low-carb diet and taking part in an aerobic and resistance exercise program reduced blood pressure and total body water in patients with heart failure.11
Dr. Arturo Orea, study author and cardiology service coordinator at the National Institute of Respiratory Disease in Mexico City told Science Daily:12
"These results indicate that a low carbohydrate diet and exercise are beneficial for patients with heart failure … This could be because the respiratory coefficient of carbohydrates is higher than fat and proteins which means they require more oxygen and respiratory effort to metabolize … Exercise improves endothelial function (increasing vessel diameter and blood flow), so there is better delivery of nutrients and oxygen to the cells plus removal of waste."
Interestingly, a separate study by the same group of researchers revealed heart failure patients who consumed higher amounts of sodium had a lower risk of dying from heart failure. Dr. Orea explained in Science Daily:13
“Our finding of a lower sodium intake in patients who died [from heart failure] might be explained by the fact that when sodium intake reduction is excessive, the renin-angiotensin-aldosterone system is more active, which can increase blood pressure."
In addition, those who consumed less than 200 milligrams (mg) a day of magnesium were nearly three times more likely to face hospitalization or death. The recommended daily amount of magnesium is 310 to 320 mg for women and 400 to 420 for men. Magnesium is crucial for healthy heart function and low levels may lead to abnormal heart rhythms or congestive heart failure.
Seaweed and green leafy vegetables like spinach and Swiss chard can be excellent sources of magnesium, as are some beans, nuts, and seeds, like pumpkin, sunflower, and sesame seeds. Avocados also contain magnesium. Juicing your vegetables is an excellent option to ensure you're getting enough of them in your diet.
A Healthy Lifestyle Will Help Keep Your Heart Strong
To keep your heart strong at any age, it’s clear that a healthy lifestyle is crucial. For a healthy diet that’s naturally low in refined carbohydrates and rich in beneficial heart-healthy nutrients like magnesium, see my nutrition plan. Professor Stephan Achenbach, European Society of Cardiology vice president for Global Affairs and Communications said in support of the research:14
"Heart failure is a growing epidemic across the world and clearly, medication alone is not a sufficient approach. Lifestyle modification must be a central part of management in heart failure patients, not only for treatment but also for prevention.”
There are many strategies that can protect your heart no matter what your age. Please don't wait until you experience heart attack symptoms or heart failure to take action because by then it may be too late. Do so now in order to prevent any long-lasting damage:
- Eat unprocessed saturated animal fats, and ignore the media, as you will benefit from these fats. Many may also benefit from increasing the healthy fat in their diet to 50 to 85 percent of daily calories.
- Avoid sugars, including processed fructose and grains if you are insulin and leptin resistant. It doesn't matter if they are conventional or organic, as a high-sugar, high-grain diet promotes insulin and leptin resistance, which is a primary driver of heart disease.
- Exercise regularly, as physical activity along with a healthy diet of whole, preferably organic, foods may be just as potent — if not more potent — than cholesterol-lowering drugs. Use a combination of high-intensity interval training, strength training, stretching, and core work.
- Avoid excess sitting; aim for three hours a day or less of sitting, and try to take 10,000 steps a day (in addition to your exercise program).
- Optimize your vitamin D levels, either through appropriate sun exposure, a tanning bed, or as last resort an oral vitamin D3 supplement.
- Regularly walk barefoot to ground with the earth. When you do, free electrons are transferred from the earth into your body; this grounding effect is one of the most potent antioxidants we know of and helps alleviate inflammation throughout your body.
- Manage your stress daily. One of my favorite tools for stress management is the Emotional Freedom Techniques (EFT).