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Can Proper Diet and Exercise Guarantee You Won't Have a Heart Attack?

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Story at-a-glance -

  • It’s possible to have a heart attack even if you eat right and exercise, but such cases are the exception rather than the rule
  • Women who adhered to six healthy lifestyle guidelines, including healthy diet and exercise, lowered their heart disease risk by 92 percent
  • Five similar healthy lifestyle habits were found to prevent nearly 80 percent of first-time heart attacks in men

By Dr. Mercola

You may have heard stories of that person who eats right and exercises regularly, yet suffered from a major heart attack nonetheless. Maybe you know someone personally who has had this experience. Maybe you have had this experience.

The fact is, no matter how perfectly you eat or how fit you are, there's no guarantee that you'll remain heart attack-free.

CNN described the story of one 37-year-old man who exercised daily and ate right, yet suffered a major heart attack.1 Luckily, he was able to get help quickly and recovered, but many are not so fortunate.

The most common symptom of heart disease is sudden death from a heart attack. The condition can strike suddenly, even in people without known risk factors.

However, such cases are the exception and you can significantly reduce your heart attack risk by leading a healthy lifestyle. This will also greatly improve your chances of surviving a heart attack should one occur.

Exercise Increases Your Chances of Surviving a Heart Attack

Researchers from the Henry Ford Health System, in Detroit, and Johns Hopkins, in Baltimore, found that people who were physically fit were 40 percent less likely to die within a year following their first heart attack compared to those who were out of shape.2

Physical fitness was measured using an exercise stress test. The fitter the person, the lower their likelihood of dying from a heart attack became. Specifically, for each level of increased fitness reached during the stress test, the risk of dying in the year following the first heart attack dropped by up to 10 percent.

The association was so strong, the researchers compared low fitness to other traditional risk factors, such as smoking, high blood pressure and diabetes, for early death following a heart attack.

Top 6 Factors That Predict Your Heart Attack Risk

If you want to reduce your risk of a heart attack, you should absolutely pay attention to your diet and exercise habits. These, along with four other habits, were said to basically make young women "heart attack-proof," according to research published in the Journal of the American College of Cardiology.3

Women who adhered to all six guidelines lowered their heart disease risk by 92 percent. Based on that, researchers estimated that more than 70 percent of heart attacks could be prevented by implementing the following:

1. Healthy diet

2. Normal BMI (body fat percentage is actually more accurate)

3. Getting at least 2.5 hours of exercise each week

4. Watching television seven or fewer hours per week

5. Not smoking

6. Limiting alcohol intake to one drink or less per day

With respect to BMI, it should be noted that your waist-to-hip ratio is a more reliable risk predictor because it reflects visceral fat. And more reliable still would be an accurate assessment of body fat percentage.

Still, the results of this study echo the results of a 2014 study concluding that essentially the same health habits could prevent nearly 80 percent of first-time heart attacks in men.4

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5 Lifestyle Changes Could Prevent 80 Percent of Heart Attacks

Research conducted at the Karolinska Institutet found that engaging in five healthy lifestyle habits could prevent nearly 80 percent of first-time heart attacks in men. Even the researchers were surprised at how powerful a healthy lifestyle could be, noting:5

"It is not surprising that healthy lifestyle choices would lead to a reduction in heart attacks … What is surprising is how drastically the risk dropped due to these factors."

The 2004 INTERHEART study, which looked at heart disease risk factors in over 50 countries around the world, also found that 90 percent of heart disease cases are completely preventable by modifying diet and lifestyle factors.6

Unfortunately, most people are not using these lifestyle habits to their advantage. The Karolinska Institutet study involved men aged 45 to 79, and only 1 percent of them engaged in all five of the "low-risk" behaviors that could prevent a heart attack. So what are the five healthy lifestyle habits?

  • A healthy diet
  • Being physically active (walking/bicycling ≥ 40 minutes/day and exercising ≥ 1 hour/week)
  • Healthy waist circumference (waist circumference < 95 centimeters)
  • Moderate alcohol consumption (10 to 30 grams/day)
  • No smoking

Saturated Fats Do Not Cause Heart Disease

When you hear "healthy diet" in reference to heart health, you may assume this means limiting your intake of saturated fats from animal foods. But, contrary to popular belief, refined carbs, sugar, and processed foods are the real enemy — not the saturated fats found in foods such as butter, lard and eggs.

Part of the confusion on fats revolves around their impact on LDL cholesterol, often referred to as "bad" cholesterol. According to the conventional view, high LDL is correlated with heart disease, and saturated fat does tend to raise LDL. However, there are two kinds of LDL cholesterol particles:

  • Small, dense LDL cholesterol
  • Large, "fluffy" LDL cholesterol

The latter is not "bad" at all. Research has confirmed that large LDL particles do not contribute to heart disease. The small, dense LDL particles, however, do contribute to the build-up of plaque in your arteries, and trans fat increases small, dense LDL. Saturated fat, on the other hand, increases large, fluffy — and benign — LDL.

More importantly, research has also shown that small, dense LDL particles are increased by eating refined sugar and carbohydrates, such as bread, bagels, and soda. Together, trans fats and refined carbs do far more harm than saturated fat ever possibly could.

Last year, a meta-analysis again found no association between high levels of saturated fat in the diet and heart disease, stroke, or type 2 diabetes.7

Unfortunately, when the cholesterol hypothesis took hold, the food industry switched over to low-fat foods, replacing healthy saturated fats like butter and lard with harmful trans fats (vegetables oils, margarine, etc.), and lots of refined sugar and processed fructose — the latter of which is a prime "heart-attack diet."

Mounting scientific evidence supports saturated fat as a necessary part of a heart-healthy diet and firmly debunks the myth that saturated fat promotes heart disease. For optimal health, eat real food — this means plenty of saturated fats and little to no refined fats, especially refined vegetable oils and synthetic trans fats.

Statins May Make Heart Health Worse

Research shows that three-quarters of people have normal cholesterol levels at the time of their first heart attack.8 So you need to be very careful in putting your faith in cholesterol-lowering statin drugs as a way to lower your risk. There is also evidence showing that statins may make your heart health worse and only appear effective due to statistical deception.

One report published in the Expert Review of Clinical Pharmacology concluded that statin advocates used a statistical tool called relative risk reduction (RRR) to amplify statins' trivial beneficial effects.9 If you look at absolute risk, statin drugs benefit just 1 percent of the population. This means that out of 100 people treated with the drugs, one person will have one less heart attack.

This doesn't sound so impressive, so statin supporters use a different statistic called relative risk. Just by making this statistical sleight of hand, statins suddenly become beneficial for 30 to 50 percent of the population.

If You Take a Statin, Be Sure to Also Take CoQ10 or Ubiquinol

Further, statins deplete your body of coenzyme Q10 (CoQ10), which is used for energy production by every cell in your body, and is therefore vital for good health, high energy levels, longevity, and general quality of life. CoQ10's reduced form, ubiquinol, is a critical component of cellular respiration and production of adenosine triphosphate (ATP). ATP is a coenzyme used as an energy carrier in every cell of your body.

When you consider that your heart is the most energy-demanding organ in your body, you can surmise how potentially devastating it can be to deplete your body's main source of cellular energy. So while one of statins' claims to fame is warding off heart disease, you're actually increasing your risk when you deplete your body of CoQ10. The depletion of CoQ10 caused by the drug is why statins can increase your risk of acute heart failure.

If you take a statin drug, you MUST take Coenzyme Q10 as a supplement. If you're over 40, I would strongly recommend taking ubiquinol (CoQ10's reduced form) instead of CoQ10, as it's far more effectively absorbed by your body.

Heart Disease Is the Leading Cause of Death in the U.S.

It's important that you take your heart health seriously. In the U.S. 735,000 Americans have a heart attack every year. Most of these (525,000) are a first heart attack.10 Further, 1 out of every 4 U.S. deaths is due to heart disease, the most common form of which is coronary artery disease (CAD). CAD can lead to a heart attack.

A heart attack occurs when blood flow to a part of your heart becomes blocked. This is often the result of plaque build-up inside your arteries (atherosclerosis), which may rupture and form a blood clot that blocks blood flow. If the blockage isn't cleared quickly, a portion of your heart muscle will begin to die and be replaced with scar tissue, which can cause severe problems in the future.

For instance, a previous heart attack (especially if a large area of your heart was damaged) is a risk factor for sudden cardiac arrest,11 which is caused by abnormal heart rhythms and can be fatal. It's important to be aware that not everyone experiences chest pain or discomfort during a heart attack. Other signs and symptoms include:

  • Upper body pain or discomfort in your arms, back, neck, jaw or upper stomach
  • Shortness of breath
  • Nausea
  • Lightheadedness
  • Cold sweats

If you think you or a loved one is having a heart attack, seek emergency medical attention right away. Your chances of survival are greater if you get emergency treatment quickly.

How to Protect Your Heart Health

Poor diet and physical inactivity are two of the primary risk factors for heart disease. As mentioned, it's possible to have a heart attack even if you eat right and exercise, but you're far more likely to have one if you do not. If you're healthy or even if you've had a heart attack in the past, the time to act to protect your heart health is now. Here are some of my top recommendations:

  • Reduce, with the plan of eliminating, grains and sugars in your diet. It is vitally important to eliminate gluten-containing grains and sugars, especially fructose.
  • Consume a good portion of your food raw.
  • Make sure you are getting plenty of high-quality, animal-based omega-3 fats, such as krill oil. Research suggests that as little as 500 milligrams (mg) of krill per day may improve your total cholesterol and triglycerides and will likely increase your HDL cholesterol.
  • Replace harmful vegetable oils and synthetic trans fats with healthy fats, such as olive oil, butter, avocado, organic pastured eggs and coconut oil (remember olive oil should be used cold only, use coconut oil for cooking and baking).
  • Include fermented foods in your daily diet. This will not only optimize your intestinal microflora, which will boost your overall immunity, it will also introduce beneficial bacteria into your mouth. Poor oral health is another powerful indicator of increased heart disease risk.
  • Optimize your vitamin D levels, ideally through appropriate sun exposure as this will allow your body to also create vitamin D sulfate — another factor that may play a crucial role in preventing the formation of arterial plaque.
  • Exercise regularly. Make sure you incorporate high-intensity interval exercises, which also optimize your human growth hormone (HGH) production.
  • Avoid smoking or drinking alcohol excessively.
  • Be sure to get plenty of high-quality, restorative sleep.
  • Practice regular stress-management techniques.