Maintaining heart-healthy habits can be tricky when there are a lot of myths floating around. Should you avoid fats due to cholesterol? Is red wine heart-healthy or not?
With new research being conducted and new guidelines being announced regularly, it’s normal for some of these answers to change over time. Below, cardiologists debunk myths about heart health that you should know now:
Myth: You should not worry about your heart health if you are young
If you’re under 50, you may think you don’t need to worry about your heart health and that your chance of getting heart disease is low. While it’s true that your risk of heart disease increases with age, it can start early as it’s directly affected by lifestyle habits.
“The seven major modifiable risk factors for heart disease include smoking, inactivity, high cholesterol, high blood pressure, high blood sugar, excess weight and poor diet,” Dr. Elizabeth Klodas, a cardiologist and chief medical officer of Step One Foods, told HuffPost.
When it comes to monitoring your heart health, measuring risk factors like cholesterol, blood pressure and blood sugar require a physical evaluation and lab testing.
“Assuming your ‘numbers’ are good, my rule of thumb is that people should have these tested twice in their 20s, three times in their 30s, four times in their 40s, and then yearly after age 50,” Klodas said.
Myth: You should only focus on increasing HDL (or ‘good’) cholesterol for cardiovascular health
Cholesterol, a waxy substance that helps us construct healthy cells, is not completely harmful. We have two types of cholesterol: high-density lipoprotein (HDL) — known as “good” cholesterol, as it carries cholesterol to the liver where it can be removed from our bloodstream ― and low-density lipoprotein — known as “bad” cholesterol, as it takes cholesterol directly to our arteries.
“High levels of LDL cholesterol increase the risk of heart disease because there is more plaque circulating in the bloodstream that can deposit on the heart arteries,” Dr. Joyce Oen-Hsiao, the director of clinical cardiology at Yale Medicine, told HuffPost. You may think that increasing your HDL cholesterol may offset your LDL cholesterol and lower your risk of heart disease.
“However, the idea of increasing your HDL cholesterol for good cardiovascular health is incorrect and very outdated,” said Dr. Danielle Belardo, a cardiologist based in Newport Beach, California. “Research shows that increasing HDL cholesterol has no relation to lessening the risk of major adverse cardiac events.”
In some individuals, high HDL cholesterol levels can be a risk factor for heart disease. While this is still being investigated by researchers, studies thus far have suggested a genetic connection.
“Nonetheless, we do know what does lower cardiovascular risk, and this is lowering LDL cholesterol,” Belardo said.
Factors like eating a diet high in plants and fibre but low in saturated fat can play a positive role in lowering your LDL cholesterol levels. In certain scenarios where individuals have existing coronary artery disease or genetic dyslipidemia, they may also require medication too, Belardo added.
Myth: All fats are bad for heart health
While it’s true that intake of trans and saturated fats raises your risk of heart disease, a low-fat diet isn’t necessary for optimal heart health. Research shows that healthy fats — such as monounsaturated and polyunsaturated fats — are key to a balanced diet and lower disease risk.
“No one food, in one dose, will cause chronic disease, but substituting foods higher in saturated fat, like red meat and butter, for foods lower in saturated fat and higher in polyunsaturated and monounsaturated fat, like olive oil and avocado, can reduce your risk of cardiovascular disease,” Belardo said.
Understand that if a fat is plant-based, that doesn’t necessarily mean it is heart-healthy. Coconut oil, for instance, is mostly saturated fat — about 50% more than butter, according to the Mayo Clinic.
“Individuals should aim for a dietary pattern that achieves 5% to 6% of calories from saturated fat, about 13 grams of saturated fat per day,” Hsiao explained.
Myth: Red wine is good for heart health
Red wine is famously known for being heart-healthy, but before you start prescribing yourself a glass or two, understand that the link between drinking alcohol and improved heart health remains unclear.
“Antioxidants in red wine called polyphenols may help protect the lining of blood vessels in the heart. However, if you don’t drink now, I don’t recommend starting to drink just because you think drinking red wine is good for your heart,” Hsiao said.
In fact, no amount of alcohol has been found to cause a cardio-protective effect, according to the World Heart Federation.
“Overall, reducing alcohol intake will likely reduce cardiovascular risk in all individuals. I recommend limiting alcohol to two drinks or less in a day for men or one drink or less in a day for women, on days when alcohol is consumed,” Belardo said.
Myth: Taking aspirin daily is good for heart health
Heart disease is an ongoing crisis in our country, as it is the leading cause of death for adults annually. Therefore, it’s no surprise that health care providers are recommending steps for primary prevention to decrease risk of heart attack and stroke in adults ages 40 to 59 who have never had heart disease.
One common recommendation is the use of low-dose “baby” aspirin daily, which reduces the clotting action of platelets in the blood, possibly preventing a heart attack. According to the American College of Cardiology guidelines, low-dose aspirin (75-100 milligrams daily) may be considered for primary prevention of heart disease among select higher-risk adults aged 40-70 who are not at increased bleeding risk.
However, taking aspirin daily can be harmful as it puts individuals at higher risk of ulcers and bleeding in the stomach, intestines and brain. “The risk of bleeding increases with age and can be dangerous for individuals,” Belardo said.
In fact, the U.S. Preventive Services Task Force — a panel of health experts — recently recommended that clinicians stop routinely prescribing a daily regimen of low-dose aspirin to adults over 60 as the potential harms of bleeding outweigh the benefits of heart disease prevention.
“This does not apply to individuals who have already had a heart attack, a stroke, or known atherosclerotic coronary artery disease. Talk to your doctor about your individual risk and treatment,” Belardo said.
Myth: Only cardio-based exercise is good for heart health
Ever heard that cardio exercises like running or swimming get your heart pumping? Cardio, or cardiovascular conditioning, is a form of aerobic exercise. This means your heart and breathing will increase while engaging in those activities.
Although many studies have shown that good aerobic cardiovascular exercise is beneficial for heart health, it’s not the only activity that provides cardio-protective effects, Hsiao said. Strength training has numerous health benefits, including improving cardiovascular risk factors such as blood pressure reduction.
The American College of Cardiology guidelines recommend adults should engage in at least 150 minutes per week of accumulated moderate-intensity or 75 minutes per week of vigorous-intensity aerobic physical activity (or an equivalent combination of moderate and vigorous activity) to reduce heart disease risk.
Bottom line: At the end of the day, the key is consistent exercise with a mix of intense and moderate activities — whether it’s walking or strength training to benefit your heart health.
Myth: If you follow a healthy diet and exercise, you will never have a heart attack
Even though healthy lifestyle modifications, such as following a healthful diet, exercising regularly, and not smoking, are incredibly important in reducing risk of heart disease, there are various different genetic factors that may impact your cardiovascular health. These factors influence your risk of high blood pressure, heart disease and other related conditions.
Moreover, your risk for heart disease can increase even more when heredity combines with unhealthy lifestyle choices, such as smoking cigarettes and eating an unhealthy diet.
“Prevention is the best intervention for cardiovascular disease. Make sure to know your family history, and know your numbers: know your blood pressure, your cholesterol, and be sure to discuss other important cardiovascular risk factors such as diabetes, and other chronic diseases,” Belardo said.