Special Section: Health Matters

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HEART DISEASE CONTINUES TO BE THE No. 1 killer of men in the United States, according to the American Heart Association. In fact, cardiovascular diseases claim more lives each year than all forms of cancer and chronic lower respiratory disease combined. It doesn’t have to be that way.

As a cardiologist, Dr. Jason Evanchan knows prevention is always better than treatment— even with recent advances in cardiac care.

“The vast majority of heart disease is preventable,” says Evanchan, who works for Mount Carmel Heart and Vascular Specialists. “Somewhere upward of 80 percent is preventable. And the No. 1 way of preventing heart disease is lifestyle modification with diet and exercise.”

Despite his busy schedule, Evanchan practices what he preaches.

“I exercise on a regular basis,” he says.

“It’s hard because I work a lot and I have three kids, but now my kids are getting to the age where they can come with me. While I’m running, for example, my son will ride his bike. That makes it kind of fun.

“I also try to watch what I eat,” he says.

“I will tell you from personal experience that it takes about six months until the fries and chips you eat don’t taste as good anymore. It takes that long until it really becomes part of your lifestyle.”

MOVE IT

By Nancy Byron

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How to keep your heart healthy at any age

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THE BEAT GOES ON

According to a 2019 report by the American Heart Association, only 26 percent of men are getting enough physical activity to maintain good heart health.

The association recommends at least 150 minutes per week—less than 22 minutes per day—of moderate-intensity physical activity.

Brisk walking, recreational biking or active yoga would generally fall into that category, but the fitness of the individual determines what constitutes “moderate.”

“If you can talk to someone in a full, unbroken sentence or paragraph while exercising—or if you’re singing—that’s not a moderate-intensity exercise,” Evanchan says.

“You’re not working hard enough.”

Those willing to do more vigorous exercise such as jogging, swimming laps, intensive biking or playing singles tennis can get by on just 75 minutes per week—or less than 11 minutes per day.

“Start slow,” Evanchan says. “Just get up and move. Park farther away from the store in the parking lot. Take the stairs instead of the elevator.”

“Doing something, even a few minutes a day, is better than doing nothing,” agrees

Dr. Jim Liu, a cardiologist with Ohio State University’s Wexner Medical Center.

When choosing an activity to increase heart health, men shouldn’t just focus on cardio.

“It’s important to incorporate strength training exercises,” Evanchan says. “Especially strengthening your core.”

For men in their 60s or beyond, adding balance and flexibility exercises is also wise, since those skills decline with age.

“In any age group, you should be doing what you’re comfortable with,” Liu says. “There should be no severe shortness of breath.”

After all, shortness of breath is a top symptom of heart failure.

“Men don’t always have the classic symptoms,” Evanchan says. “Sometimes it just presents as shortness of breath. Other times, it’s just fatigue or sweatiness. If you have chest discomfort when you exert yourself, but it gets better when you rest, you should seek help for that.”

YOU ARE WHAT YOU EAT Regardless of age or gender, the American Heart Association recommends consuming more vegetables, fruits, nuts, whole grains and lean proteins to promote heart health. Red meat, trans fats, cholesterol, sodium, refined carbohydrates, sweetened beverages and processed meats like ham, bacon, salami and hot dogs should be kept to a minimum.

“In general, the higher your cholesterol, the higher your overall cardiac risk is,” Liu says. “If someone is an avid bacon or sausage eater, don’t overdo it. No one is saying to cut those items out completely, but moderation is the way to go.”

Portion control is where many men run into trouble. Men only need about 56 grams of protein per day, according to the Centers for Disease Control and Prevention. A 3-ounce piece of meat has about 21 grams of protein. In comparison, a Wendy’s double hamburger has 49 grams of protein, and the 12-ounce ribeye at Outback Steakhouse has 65 grams.

A plant-rich diet is better for the heart, which many people think means all vegetables and salads. It doesn’t. Peanut butter, whole-grain breads, cashews, beans—and, of course, vegetables—are all fair game.

“Focus on lean meats and fish,” Evanchan says. “Make sure you’re getting a large quantity of fruits and vegetables and watch the white carbohydrates,” which includes white

rice, potatoes and foods made with white flour or refined sugar.

He suggests trying the Mediterranean diet, which includes seven to 10 servings of vegetables and fruits per day, whole-grain breads and pastas, olive oil instead of butter, herbs and spices rather than salt, and just a smidge of dairy and red wine.

“Alcohol can affect the heart in various ways,” Liu says, so moderation is key. “The official recommendation is men shouldn’t have more than two drinks per day.” A standard drink contains about 14 grams of alcohol, according to the National Institute on Alcohol Abuse and Alcoholism, which equals 12 ounces of beer, five ounces of wine or 1.5 ounces of liquor.

WEIGHTY MATTERS Obesity increases the risk for high blood pressure, high cholesterol, coronary heart disease and other serious heart-related illnesses, according to the Centers for Disease Control and Prevention.

“Patients are concerned about body image,” Evanchan says. “But it’s not just weight; it’s visceral fat in your abdominal cavity. That’s a risk factor for heart disease and diabetes.”

A body mass index (BMI) under 25 is considered normal for men. Males with a BMI between 25 and 29.9 are considered overweight, and 30 or higher is considered obese.

“Being obese really increases cardiac risk,” Liu says. “It increases the risk for high blood pressure and the risk for sleep apnea, which can cause issues with the heart.”

In the United States, nearly 70 percent of adults are classified as overweight or obese. If current trends continue, obesity may overtake cigarette abuse as the leading cause of preventable diseases, according to the surgeon general.

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Smoking causes approximately one-fourth of all deaths from cardiovascular disease, the surgeon general says.

“Smoking is one of the most modifiable risk factors for heart disease,” Evanchan adds. “Your family history, you can’tchange.

But you can change whether you smoke or not.”

Chemicals in cigarette smoke cause blood to thicken and form clots, which can block arteries and lead to heart attacks.

“When people are younger, they don’t often have as many risk factors [for heart disease], like diabetes or high blood pressure, but we do see a lot of smoking in younger people,” Liu says.

That’s worrisome, as is the rising use of e-cigarettes, which haven’t been studied enough to know the potential long-term effects on heart health.

TAKE CONTROL Blood pressure, cholesterol and even sleep can also dramatically impact men’s heart health.

“Screening and treating high blood pressure can prevent strokes and heart attacks,”

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Evanchan says. “Cholesterol screening and management is also very important.

It’s almost up there with smoking as a risk factor.”

Short sleep duration—defined by the American Heart Association as less than six hours per night—and waking up several times during the night can also jeopardize cardiac health.

“Screening for sleep apnea is important, as there is an association between obstructive sleep apnea and cardiovascular disease,” Evanchan says.

“It’s the quality and duration of uninterrupted sleep,” Liu adds. “If you don’t get good sleep at night—if anything is keeping you up—that can be a contributor to high blood pressure.”

AN AGELESS ISSUE Although health can change as men age, heart-healthy habits should not.

“Whether you’re 30 or 60 or even older, you still should focus on everything—lifestyle, blood pressure, cholesterol, exercising,” Liu says. “Things can change as people get older; you can [develop] diabetes or

high blood pressure, which you then have to monitor more closely.”

That’s why regular check-ups are vital for men of all ages.

“Screening for all these things should start at the age of 20,” Evanchan says.

“How they do on that panel may determine how often they need to be screened [moving forward].” The American Heart Association says measuring traditional risk factors at least every four to six years after age 20 is reasonable.

“Between the ages of 40 and 50, that screening should become more frequent, and by 50, it should be annual,” Evanchan says.

“Some people think they’re healthy and don’t see a doctor,” Liu says. “Then they present later in life with a pretty serious condition that could’ve been prevented or reversed if it was diagnosed earlier.”

At the end of the day, the old adage about the best defense being a good offense rings just as true in heart health as it does in sports.

“It’s much better to prevent heart disease,” Evanchan says, “than to have to treat it once it arrives.”

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