ow that you have an idea about your risk factors, be reassured that
there are certain specific actions you can take to greatly reduce or
prevent your risk of cardiovascular disease. The three most impor-
tant are exercise, dietary modification, and learning how to manage
stress. As usual, always consult with your doctor before undertaking
any exercise or nutritional modifications in your lifestyle.
Strategy 1: Exercise for Heart Health
Although I discuss the benefits of exercise fully in chapter 11, be
aware that doing the right kind of exercise is one of the best pre-
scriptions for gaining and maintaining a healthy heart and cardio-
vascular system. I will just hit the high points in this chapter.
According to an excellent ten-year study done at the Ochsner
Heart and Vascular Institute:
• Regular exercise is associated with marked reductions in the
long-term risks for major cardiac events such as heart attack or
stroke, and death from heart disease.
• People who exercise regularly, at least three times per week,
reduced their chance of a cardiac event from 30 to 50 percent.
• A study from the Cooper Clinic shows that physical fitness is
directly correlated with increased life span and fewer deaths
from cardiovascular causes and cancer.
• Even for obese individuals or for people with several coronary
heart disease risk factors, physical fitness strongly decreases
the chance of developing symptoms of heart disease.
The Ochsner Heart and Vascular Institute has found that the fol-
lowing types of exercise are most effective in treating people with
cardiovascular disease, or for people wishing to avoid developing
• Dynamic or aerobic exercises, which include walking, running,
cycling, swimming, aerobic dancing, cross-country skiing, and
using elliptical machines.
• Light isotonic exercises such as using handgrips or weight lift-
ing (frequent repetitions with low amounts of weight).
The Pro Circuit Exercise Program, which I describe in chapter
13, fills this prescription perfectly in that it alternates periods of aer-
obic exercise with periods of isotonic (weight training) exercise.
But before beginning any exercise program, if you are a healthy
but sedentary woman over the age of fifty or a man over the age of
forty, remember that the American College of Sports Medicine rec-
ommends that you should always consult with your physician and
have a preexercise medical examination. This is even more impor-
tant if you have high blood pressure, chest pains, high cholesterol,
or any serious risk factors for heart disease, or if you are a smoker.
Strategy 2: Eat Right and Take the Proper
Supplements for Heart Health
In general, the best food program for cardiovascular health is what is
loosely referred to as the Mediterranean diet—lots of fresh fruits,
vegetables, lean meats, and cold-water fish such as salmon, trout, or
mackeral that are rich in omega-3 and omega-6 fatty acids. I have
included in chapter 10 an extensive food program for readers to adapt
to their needs. Here, however, I’d like to list some of the recommenda-
tions that Ochsner cardiologist Dr. Carl J. Lavie uses with his patients,
since these are specific for improving or maintaining cardiovascular
1. Consume alcohol in moderate amounts. Excess alcohol has delete-
rious effects upon the health, including alcoholism, cirrhosis
of the liver, various cancers (particularly breast cancer and
colon cancer), hypertension, stroke, family stress, and acci-
dental death from causes such as automobile accidents. How-
ever, a recent analysis of fifty-one major studies has shown
that individuals who drink up to 20 grams of alcohol (one or
two drinks) per day had a 20 percent lower risk of major coro-
nary events when compared to those who abstained from
drinking. Other studies have shown that moderate alcohol
consumption can lower the risk of heart disease from 25 to 40
percent. Other benefits include the lowering of risk for dis-
eases such as strokes from blood clots, hardening of the arter-
ies in the limbs, congestive heart failure, and type 2 diabetes.
While the mechanism behind alcohol’s protective role is
still somewhat unclear, it seems to be related to increasing
HDL levels (good cholesterol), preventing blood clotting,
and having beneficial effects on insulin activity. Studies have
shown that having a low HDL level is one of the most impor-
tant risk factors in heart disease.
Wine, particularly red wine, is more effective in reducing
heart disease than beer or other types of alcoholic beverages.
The reason for this is that red wine contains a number of
chemicals that have antioxidant effects.
2. Eat lots of fiber. Many studies have shown that dietary fiber, par-
ticularly soluble fiber, has a number of beneficial effects on
the cardiovascular system. Fiber also reduces the risk of colon
and breast cancer. Dietary fiber reduces not only levels of cho-
lesterol but it also reduces:
• High insulin levels
• High glucose values
• Various clotting parameters.
(See chapter 10 for ways to include fiber in your daily diet
and for suggestions on the best types of fiber to eat.)
3. Lower cholesterol and increase immunity with soy. The American
Heart Association recommends that people eat 20 grams of
soy protein per day to lower their cholesterol levels. Soy is also
helpful in the production of hormones and can stimulate
estrogen production in menopausal women. Other studies
indicate that soy may actually help the immune system and
protect against cancer. Societies such as Japan that ingest
large amounts of soy protein in their diets have significantly
lower levels of cancer than we do in the United States.
Soy is found in tofu and cheeses made with soy protein. I
recommend to many clients soy protein powder, which can be
made into a delicious shake by adding milk or juice.
4. Reduce your risk with omega-3 fatty acids. Many studies have
shown that patients with cardiovascular disease who ingest
omega-3 fatty acids (EPA and DHA fish oils), either taken as
supplements or in cold-water fish such as salmon or mackeral,
have seen a marked reduction in their risk for cardiovascular
disease. According to Dr. Carl J. Lavie, studies published in
recent years have shown that heart patients who take omega-3
fatty acids show some improvement in cholesterol levels and a
20 to 70 percent reduction in death rates. Dr. Lavie prescribes
1,000 mg combined of both EPA and DHA for his heart
5. Strengthen your heart health with antioxidants. The oxidation of
LDL cholesterol by free radicals plays a major role in the
formation, progression, and rupture of plaques involved in
heart attacks and stroke. Antioxidants include vitamin E
(400 to 800 IU/day), vitamin C (500 to 1,000 mg/day), sele-
nium, coenzyme Q10, lycopene, and falconoid. Several stud-
ies have shown that antioxidants have the potential to
interfere in each step of these processes by inhibiting oxidant
formation in the first place, by interfering in the oxidant
activity that has already taken place, and even by helping to
repair areas of oxidation-induced injuries to the walls of the
However, the jury is still out on whether antioxidants are as
strong a force to prevent heart disease as the media generally
purports. Studies have shown that people who take antioxi-
dants also consume large amounts of fruits, vegetables, and
dietary fiber; eat lower amounts of saturated fats; are often
more physically active; and have healthier living habits. How-
ever, as Dr. Carl J. Lavie says, there is no harm in taking
antioxidants and possibly some positive benefits, particularly
for patients with high levels of oxidative stress. But antioxi-
dants should be considered only one dietary factor in the
treatment and prevention of heart disease.
6. Reduce your homocysteine level. The evidence supporting the
importance of the relationship between levels of homocys-
teine, an amino acid that circulates in the blood, and the risk
of cardiovascular disease has been increasing in recent years.
Homocycsteine is affected by three important B vitamins:
folic acid, B6, and B12. Numerous studies have shown that
patients with heart disease have higher levels of homocysteine
and lower levels of B6 and B12 than healthy people. The risk
of vascular disease significantly increases when levels are in
the 12 to 13 micromoles/liter, and especially when levels
reach higher than 15.
The best way to lower levels of homocysteine is to supple-
ment your daily diet with folic acid. The typical person in the
United States ingests an average of 50 to 100 micrograms of
folic acid per day, just in the foods he or she eats. Dr. Carl J.
Lavie suggests supplementing that with an extra 400 mg,
which can be accomplished by taking a commercial multivita-
min such as Centrum, Theragram, or one recommended by
your local health foods store. Although B6 and B12 are avail-
able in small amounts in most commercial multivitamins, Dr.
Lavie highly recommends taking Folgard from Upsher-Smith.
This vitamin contains not only a significant amount of B6 and
B12 (greater than other multivitamins), but also contains 800
mg of folic acid. Or you may wish to ask your doctor to pre-
scribe a multivitamin for you, since pharmaceutical-quality
supplements are superior to over-the-counter medications.
Exercise also decreases the levels of homocysteine in the
Turn Your Life Around
Every day in my Performance Enhancement Program at Elmwood
Fitness Center, I am inspired by the number of people who prove
that making intelligent lifestyle changes can make a significant dif-
ference in their overall health and quality of life.
Forty-five-year-old Ray has a high-profile, high-pressure position
with a local telecommunications company. When he first came to me
he was overweight, suffered from the effects of stress, had borderline
high blood pressure, and had gout. He was also experiencing
chronic exhaustion. “By the end of the day when I got home, I would
be totally wiped out,” Ray lamented. He knew it was time to make a
lifestyle change if he wanted to reclaim his health, reduce his risk of
cardiovascular disease, and improve his quality of life and perform-
Ray joined my program at the Elmwood Fitness Center and
started with a full health evaluation. Then we placed him with a per-
sonal trainer and made an appointment for him to meet with a nutri-
tionist to set up a food program. “Within the second month of the
program,” Ray said, “I really started to see results, and by the third
month, the changes were really dramatic.” Ray, who is six feet two
inches, went from 225 pounds with a body fat percentage of 26 to a
lean 200 pounds with a body fat percentage of 12. He got off the
gout medication, dropped his blood pressure to within acceptable
levels, lowered his cholesterol and triglycerides, and began to experi-
ence a tremendous increase in energy.
While Ray sometimes cheats a little on the nutritional program,
he always goes back to eating right because of the way it makes him
feel—great. And he’s religious about doing his weekly workouts. At
this point he’s even doing more than I recommend, up to an hour
and a half, four days a week. “I’m in the best shape I’ve been in since
high school,” he enthused. “Some of my friends have been walking
up to me, grabbing my arm, and saying, ‘Man, what are you doing?’
They can see that I’ve bulked up pretty good. It’s a great program
and it’s just so easy to get into the flow of the work. And before you
know it, you’re seeing results.” Recently Ray entered the race for
mayor of his hometown and won. This man is a winner on all fronts.