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Reducing Heart Disease Risk
What Do We Know Now?

by Bonnie Bruce, DrPH, MPH, RD

Heart disease increases the risk of heart attacks and strokes and is still one of the major causes of death in the United States. Scientists have long known that damage to the heart and blood vessels can be caused by too much glucose in the blood. This makes heart disease an even greater concern for people with diabetes, who must take steps daily to manage their blood glucose levels. Having diabetes is a major risk factor for heart disease. People who have diabetes are two to four times more likely to suffer from its consequences.

However, the story of heart disease and diabetes is not all bleak. There are medication-free, lifestyle-related approaches that can help reduce the risk, slow its progression, and help avoid aftereffects. Indeed, modification of lifestyle habits is not only at the heart of public health approaches for reducing heart disease risk, but it can also help to reduce the impact of diabetes.

“Lifestyle factors” are things that are in your control and things that you have the power to do something about, like eating and exercising. This is in contrast to things you can’t control, such as who your grandparents are, your age and gender, and for women, menopause, all of which also have influences on heart disease risk.

However, relying solely on lifestyle-related strategies may not be enough, or feasible for everyone. Some people may additionally need to take medicines. This is a decision that they and their health-care professionals will have to make. Also, before you choose to make any changes in your current lifestyle, you should first check with your doctor or other health-care professional.

That being said, no matter what you decide, one of the most important things you can do is to start today. The clock for heart disease can start ticking in the teenage years, long before there is any hint of diabetes or other health problems. Alarmingly, recent studies have reported that young teenage boys and girls are showing beginning signs of unhealthy levels of blood fats related to heart disease. Further, autopsy studies have showed that young soldiers in their twenties had signs of heart disease at much younger ages than expected. Thus, the earlier you get started doing something, the more opportunities you will have to lower your risk, and the better off you will likely be.

Scientific knowledge about lifestyle factors for reducing heart disease risk has advanced considerably over the latter part of the 20th century, since the time when steaks and cigarettes were part of mainstream culture and associated with status and the good life. As evidence has mounted, the focal points of lifestyle approaches for reducing heart disease risk have become being tobacco free, being physically active, eating well, and aiming for a healthy weight.

There is no doubt that the one lifestyle change with the greatest payoff is stopping smoking, if you smoke now. It is no secret that smoking is bad for your health, and it is considered by some to be the most hazardous and leading risk factor for heart disease. Not only are people with diabetes who smoke doubly at risk for heart disease, smoking reduces the beneficial effect of other risk factor changes, such as exercising or eating well.

Once you quit, your risk of heart disease dramatically drops within just one year. For some people, however, smoking can be one of the toughest habits to change. But there are numerous methods and resources available for help and support, such as the American Lung Association and American Cancer Society.

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