Ready for some exciting health news? "Ninety-nine percent of heart disease is preventable by changing your diet and lifestyle," says Dean Ornish, M.D., a clinical professor of medicine at the University of California at San Francisco and author of Dr. Dean Ornish’s Program for Reversing Heart Disease.
What's more, scientists are discovering that we don't have to ban all fat and salt to stay healthy. Instead, you just need to cut back on saturated fat (which comes from meat and whole-fat dairy) and trans fats (found in partially hydrogenated oils in fried and many processed foods). These types of fat seem to increase levels of "bad" LDL cholesterol, which lines arteries with plaque and can cause a heart attack or stroke.
Good fats, on the other hand -- such as monounsaturated (think olive oil and avocados) and polyunsaturated fats, like omega-3 fatty acids (found in sunflower oil, soybeans, and some fish) -- lower LDL levels and raise levels of "good" HDL cholesterol. Meanwhile, a 2011 study in the Journal of the American Medical Association challenges the notion that we all need to slash our salt intake, suggesting that going low-sodium is more important if you're at high risk of heart disease -- say, you have a family history of the condition, you have diabetes or you smoke.
Whether or not you have these risk factors, though, prevention is key. And it starts on your plate. See how three women staged their own heart-healthy dietary interventions, and follow in their footsteps to keep your heart pumping strong now and in the decades to come.
Build a better diet
Lily Lin, 31, recently got a serious health wake-up call: She was diagnosed with prehypertension at 30, then prediabetes the next year -- both conditions that up your chances of developing heart disease. She was placed on blood pressure medication as a result. Then her maternal grandmother died from a stroke. Lin knew that her dad had high blood pressure and her mother had high cholesterol -- heart disease risk factors that she had a chance of inheriting. "I'd thought I had years before I needed to worry about those things," she says.
Lin, a business analyst in New York City, decided to take charge of her health and went to the Pritikin Longevity Center in Miami, which focuses on reversing heart disease and other conditions through lifestyle changes. Pritikin doctors advised Lin to lower her intake of animal protein, due to its saturated fat content, so she traded her deli meat lunches for tofu, beans, and grilled fish.
Lin also learned to limit refined carbohydrates, including muffins and her 100-calorie cookie snack-pack breakfasts. Moderate to heavy consumption of simple carbs like these can double your risk of heart disease, a 2010 Archives of Internal Medicine study suggests. Instead, she now fills up on fiber-full complex carbohydrates such as oatmeal. "I learned that fiber carries cholesterol out of my body instead of into my bloodstream," Lin says.
Adding in more fruit made a difference, too; in fact, scientists have just discovered that the effects of the gene most closely linked with heart disease can actually be modified by eating plenty of fruits and raw vegetables.
Lin's efforts have paid off: She was recently told she could stop taking her blood pressure meds. "I've never felt so good," she says. "My friends and family see the changes in me. I used to live to eat, but now I eat to live."
Moves to make in your 30s: Talk to your M.D. about your family history of heart disease, and ask about any other personal risk factors to watch for. For example, if you had gestational diabetes or preeclampsia when you were pregnant, your risk of heart disease is at least doubled. If you're at low or no risk, get your blood pressure checked every year and get a cholesterol baseline, too. "If results are normal, you can wait till your 40s to repeat the test," says Jacob DeLaRosa, M.D., author of the Heart Surgery Game Plan.
Go for the best new tests
At 45, Stephanie Corn looked and felt healthy. Her cholesterol tests were normal. But because her mother had suffered three arterial blockages and undergone open-heart surgery in 2008, her doctor decided last year to go beyond the standard screenings and give her a new type called an LDL particle test which, while not routine, can give a fuller picture of heart-disease risk.
In fact, major organizations like the American College of Cardiology and the American Diabetes Association now believe that your concentration of LDL particles -- which adhere to the arterial wall and deposit cholesterol there -- is a better predictor of heart disease risk than high LDL cholesterol levels in and of themselves.
The verdict: Corn's particle number was about 1,700. The ideal number is under 1,000 -- meaning she was at high risk of heart disease. "I just about cried," says Corn, a finance officer for the city of Claremont, North Carolina. To get her out of the danger zone quickly, Corn's doctor put her on statins -- drugs that lower cholesterol -- but for long-term results, he encouraged her to change her diet, which, for this Southerner, meant saying good-bye to her beloved fried fish and its trans fats.
He also warned her to stay away from soda: A 2011 study from the University of Oklahoma shows that women who drink two or more sweetened beverages a day are more likely to gain weight, increase waist size and develop other risk factors for heart disease. In just one year, Corn brought her particle number down to 900 and is no longer at high risk. "I wouldn't have known I was in any danger without the test," Corn says. "It saved my life."
Moves to make in your 40s: If your chances of getting heart disease are above average, ask for a blood test to measure your LDL particles in addition to a standard cholesterol test. Women without risk factors should still get a standard cholesterol test at least every five years beginning at age 40, since plaque on your arterial walls can become more problematic with age. Being overweight or obese ups your odds of getting heart disease, too, so now's a good time to get your diet in check to help halt the middle-age spread.
Eat your superfoods
Maryann Chiaro, 54, of Valatie, New York, had gotten a clean bill of health at every checkup for decades. So when she saw a new doc last year, she was surprised to learn that her total cholesterol was high. "He told me that if I didn't get my levels down, I'd be going on Lipitor," says the upstate New York mom. Chiaro does have a family history of hypertension; her mother suffered a heart attack at age 62. She'd thought being a vegetarian was keeping her healthy, but, she admits, she was only getting in two veggies a day -- "barely." Instead, she built meals around her favorite food: cheese.
To avoid following in her mother's footsteps, Chiaro worked with her doctor and a dietitian. They identified superfoods that Chiaro makes sure to eat every day, including oatmeal, dark green veggies, nuts and olive oil. "I'm eating kale, turnips -- things I'd never had before," she says. She also lowered her saturated fat intake by giving up cheese entirely, getting her protein instead from hummus, beans and salmon.
In only five months, Chiaro has lowered her cholesterol from 181 to 138 -- without medication. Those are results anyone can achieve: "The more you change," Dr. Ornish says, "the more your heart health improves."
Moves to make in your 50s: Have your cholesterol and blood pressure checked every year, and ask your doctor about getting a blood-sugar test to rule out diabetes. On a daily basis, simply eating well and staying slim will go a long way toward keeping the cardiologist away.