Your Healthy Heart Playbook

Research has found evidence of plaque buildup in the arteries of people as young as 18, so start taking action now.

Your Healthy Heart Playbook

That fist-size wonder that keeps your body working 24/7, speeds up when you see someone you love, and beats hard when you watch a scary movie or do jumping jacks? It deserves basic maintenance. Too often we don't provide that, which explains why heart disease is the number one killer of women. But here's the hopeful side: "Your lifestyle makes up about half of your heart disease risk," says Nieca Goldberg, MD, medical director for NYU Langone Medical Center's Joan H. Tisch Center for Women's Health.

Adds Dr. Oz, "You have a huge opportunity to affect how your heart performs for you — you can make it stronger and younger by the way you eat, exercise, and respond to life." Don't worry about where to start. Just pick and choose from these pointers. Eventually, you'll be doing them all and feeling better than ever.

Go Ahead, Eat (the Right) Fat

Yes, fat really is on a good-for-your-heart menu. People who don't get enough tend to go overboard on carbs and sugary foods, and your heart doesn't like that at all. Experts say that the rich, flavor-revving stuff can make up between 25 and 35 percent of your day's calories. Just skew toward healthier fats.

How Much Fat In a Day

This is how much you can eat of the various types of fat:

  • Unsaturated Fat: 27%
  • Saturated Fat: 7%
  • Trans Fat: 1%
  • All Other Good Groups: 65%

Up to 35 percent of your daily calories can be fat, but at least 27 percent should be heart-healthy unsaturated. (Even more would be better!) You should only have 7 percent saturated fat (max). And yes, the type found in butter and steak is OK in moderation; keep it to this percentage of your day's calories. Only have up to 1 percent trans fat. Ideally, get it to zero.

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Unsaturated Fat

Eating unsaturated, "healthy" fat — that's the type found in avocados, fatty fish, and the other foods at right — in reasonable amounts may reduce your risk of heart disease as much as 42 percent. Why? These fats help lower bad LDL cholesterol. (For people who prefer to think in grams instead of percentages, here's the deal: If you eat 2,000 calories daily and make all your fats unsaturated, you can have up to 78 grams of them a day.)

Find It Here

The foods below, as well as nuts and various vegetable oils, contain mostly unsaturated fats. While fried food is often made with veggie oils, it's high in calories, which may be why people who ate it more than four times a week had a higher heart disease risk.

  • Olive Oil: 11 g per Tbsp
  • Peanut Butter: 6 g per Tbsp
  • Farmed Atlantic Salmon: 7 g per 3 oz
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Trans Fat

This stuff increases heart attack risk by doing exactly the wrong thing to cholesterol: It sends the bad kind up and the good kind down. Processed foods can contain up to .5 grams of this fat and still claim "zero trans fat!" on the label, so scan the ingredients lists for the red flag words "partially hydrogenated." As little as 2.2 grams puts you over the limit.

  • Frozen Pies: .83 g per serving
  • Ready-to-Eat Frosting: .75 g per serving
  • Cream-Filled Cookies: .5 g or less each (But how often do we eat only one?)

The 411 On Cholesterol

Two main types of cholesterol circulate in your blood: LDL is the bad kind (think L as in lousy) because it collects on blood vessel walls and builds hard deposits that can clog blood flow or break off and block vessels, causing heart attacks or strokes. HDL is the good kind (healthy) because it sweeps away LDL cholesterol from the arteries.

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Saturated Fat

Wait — butter, steak, and cheese are allowed? Yes, your heart doesn't mind if you get up to 7 percent of calories from saturated fat. This fat isn't entirely off the hook — it's still believed to raise LDL cholesterol and damage arteries, so eat it sparingly, says Sharonne N. Hayes, MD, founder of the Women's Heart Clinic at the Mayo Clinic in Rochester, MN. In a 2,000-calorie-a-day diet, your sat-fat max is 16 grams. This T-bone: 7 grams per 3 ounces.

Find It Here

Saturated fat is in red meat, egg yolks, full-fat dairy, palm oil, and these:

  • Butter: 7 g per Tbsp
  • Bacon: 28 g per 2 strips
  • Cheddar Cheese: 5 g per oz
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It's sweet on your tongue but rough on your body. A JAMA Internal Medicine study found that people who got about 25 percent of their calories from added sugar — the kind that's poured into drinks and processed foods — were nearly three times more likely to develop heart disease than those who kept it to less than 10 percent of their calories. Even the amount in one daily can of a sugary beverage is enough to raise the risk of heart attack by 20 percent. Sugar damages your arteries and organs, lowers your good HDL cholesterol, and can pack on the pounds — which raises heart disease risk even more, explains Goldberg.

How Much to Eat

The American Heart Association recommends that you cut it down to 5 percent of your daily calories. This means women on a 2,000-calorie-a-day plan should aim for less than 100 calories, or 25 grams, of added sugar a day. The sweet stuff often hides in foods that aren't dessert — check the list at left to find how much is tucked into seemingly unlikely places.

Daily Allowance on Added Sugar

You get 12 cubes — that's 25 grams or 100 calories.

Not-So-Sweet Surprises

It's in dessert — and so many other foods. See where the sugar in your diet really comes from.

  • Soda: 40 g sugar in 12 oz (20 sugar cubes)
  • Fruit Yogurt: 32 g sugar in 6 oz (16 sugar cubes)
  • Barbecue Sauce: 7 g per 3 oz
  • Reduced-Fat French Dressing: 5 g sugar in 2 Tbsp (2 ½ sugar cubes)
  • Ketchup: 4 g sugar in 1 Tbsp (2 sugar cubes)

Dr. Oz Says...

I often see arteries filled with creamy paste and crunchy plaque from many years of "cheats." But the beautiful reality is that arteries can remodel themselves if you treat them right.

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Best Exercise Rx

The ideal fitness routine is at least three workouts a week: one each of interval and strength training, and one of your choice, says exercise researcher Martin Gibala, PhD, at McMaster University in Hamilton, Ontario. Interval training — short bouts of effort followed by recovery periods — forces your heart to work harder and pump more blood with each beat, says Gibala. Science has seen people get just as fit with these hard bursts as with longer, steady-pace sessions. To do them, simply switch between speeding up for a minute and backing off for a minute. Building muscle strength is important too — it can lower blood pressure and help stave off weight gain.

Also Good...

Brisk walking or another moderate-intensity exercise, like the options at right. Get 150 minutes a week, says James H. O'Keefe, MD, of the University of Missouri-Kansas City.

Still Helpful...

A short, brisk walk. Even 10 minutes can help your ticker. But 10 minutes, three times a day is even better.

What to Aim For

The harder you work, the less you need to do. Aim for moderate exercise — 150 minutes per week or vigorous exercise 75 minutes per week.

What's Moderate Exercise?

  • Tennis: playing doubles
  • Biking: 5 to 9 miles per hour
  • Swimming: at a light rate
  • Jogging: 15 minutes per mile
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It's not just about clocking hours in bed. When it comes to sleep, quality matters as much as quantity, says David Rapoport, MD, director of the Sleep Medicine Program at NYU Langone Medical Center. If you get seven to nine hours per night but don't wake up feeling rested, you're probably not sleeping as deeply as you should. Sometimes it's easy to finger the culprit — prowling cat, dinging cell phone, squawking TV you fell asleep to, perhaps? Then you can make the appropriate changes. (Put that TV on a timer.) But if your best attempts make little difference, see your doctor to rule out an underlying condition, such as sleep apnea, which can drive up heart disease risk.

Say Cheers

Raise a glass — and it doesn't have to be red wine. People who sipped any kind of alcohol saw these benefits: 3-7 drinks per week reduce your risk of heart attack by 32 percent.

"The advice is up to one serving a day for women," says Goldberg. The exception: If you're at higher risk for breast cancer, speak with your doctor about how much alcohol is OK, since smaller amounts can raise your risk of this disease.

Let's Talk About Stress

If your heart were in charge, it would ask you to nix stress altogether. Since that's not going to happen, aim to get better at dealing with tension. "Your reaction, not the situation, controls your body's stress response," says Donald Edmondson, PhD, of Columbia University's Center for Behavioral Cardiovascular Health. Cursing out traffic — instead of taking it in stride — hurts your heart by making it beat faster and by triggering the release of inflammatory hormones such as cortisol. So what to do when you're white-knuckling life? We asked our heart docs to offer their best personal tips:

"No matter how busy my day, I make exercise a priority. After work, my husband and I will watch an episode from a favorite TV show while on the elliptical machines before dinner. It's like a date night!" —Sharonne N. Hayes, MD

"I keep a gratitude journal. Taking time to acknowledge what you're thankful for keeps everything in perspective." —James H. O'Keefe, MD

"Stress is often caused by worrying about something in the future. Practicing mindfulness, even with something as simple as appreciating the breeze on my face, helps me stay in the moment." —Donald Edmondson, PhD

This story originally appeared in the December 2015 issue of Dr. Oz The Good Life.

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