this cardiologist practices what she preaches

how this cardiologist keeps herself and her patients heart-healthy

BY DONNA MORIARTY

BY DONNA MORIARTY

If you want to know how to achieve and maintain a healthy heart, ask a cardiologist—preferably a healthy one.

Dina R. Katz MD, FACC, FASNC, is a senior attending cardiologist at Phelps Hospital Northwell Health and an inaugural member of Northwell’s Katz Institute for Women's Health. And boy, is she healthy.

fainting? These major indicators of heart disease almost always frighten people into thinking about their heart health, some for the first time in their lives.

A former college athlete, Katz is a selfconfessed gym rat and runner who works out at least an hour a day, seven days a week. Why? “Because it makes me feel great, and it might help me live longer,” she says. After years of following a hearthealthy diet of mostly fish, nuts, seeds and pressed oils, Katz recently switched to a plant-based diet that she swears by. “The health benefits are massive, primary among them a lower risk of heart disease and certain cancers,” she says. Katz reviews their personal and family health history, ferreting out the four major risk factors for heart disease: high blood pressure, high cholesterol, diabetes and obesity. Some risk factors can be lowered through changes to diet and lifestyle, while others—say, a family history of diabetes—cannot. (Note: Several studies have shown that, while you can’t change the cards you are dealt by your genes, improved habits may help alter your health outcomes. See sidebar below.) intervention. But Katz never waits long before having The Talk. Every patient she sees, no matter their age, health condition or risk factors, must confront their lifestyle choices. “It’s easy to place a stent in a clogged artery to get blood flowing again,” she says. “The hard part is sitting down together to figure out what got them into this mess and begin to treat it.”

ANOTHER BIG FOUR: LIFESTYLE Katz asks four more questions to determine her strategy. First up: Do you smoke? “If the answer is yes, I ask when they want to quit.” Katz educates her patients on the benefits of quitting, using “an arsenal of tools” to help them do so. These range from medications For some very sick patients, treatment that help ease psychological depenBut what about us mere mortals? What might require medication or a surgical dence to nicotine replacements that does it take for a person to willingly allow them to taper off tobacco. adopt a heart-healthy lifestyle that includes regular exercise and eliminates guilty pleasures from our diet? CHANGING THE OUTCOME FOR INHERITED RISK FACTORS Some prefer to quit cold turkey, or want to try acupuncture or another method, but she never proIf you have a family history of heart disease, it’s ceeds without a firm commitment. Unfortunately, it usually takes a case closed, right? “If I don’t get a definite 'yes,' I tell health scare. them to call me when they have a Not necessarily, says cardiologist Dina R. Katz, M.D. quit date,” she says. Typically, Dr. Katz sees a patient for the first time after they or someone At a 2017 conference at the Nestlé Research Cen- Next she’ll ask: What do you do in their life has had a heart attack or ter in Switzerland, an esteemed body of health ex- for exercise? The most common received a dire warning from their pri- perts convened to explore the epigenetic impact of answer is, not enough. While aumary care physician. While a fair num- diet and lifestyle on individual health. Epigenetics thorities like the American College ber of her patients are over 60, with is the study of the ways in which different biological of Cardiology and the American symptoms or conditions that put them and environmental signals affect gene expression. Heart Association recommend all at higher risk for heart disease, that The group posited the idea that various components adults exercise a total of 150 minpopulation has been shifting slightly. of diet send these signals throughout the body and utes per week, that’s a lot to ask Patients of all ages come to her for may influence gene expression. Scientists are now of someone who’s been sedentary. prevention, bringing in articles they’ve investigating how eating habits might impact the in- After taking a detailed exercise hisread or questions about their risk fac- herited genetic structure we are born with. tory, Katz follows up at subsequent tors. They, too, may be motivated by visits to review how it’s going, “to a health scare—if not their own, then Dr. Katz puts it more plainly, “Even though you can’t keep them accountable,” she says. that of a relative or co-worker. “They change the genes you’ve inherited, you can influ- The key is to start small and build start to realize they are vulnerable,” ence your gene expression through better nutrition a habit gradually until they become says Katz. “They want to do better.” and exercise.” To illustrate, an individual with an hooked on the benefits. (See side-

THE HEART HEALTH BIG FOUR inherited gene that produces LDL, or “bad” cholesterol, is not necessarily doomed to a heart attack. By cutting out red meat and saturated fats, she can bar on the next page.) Katz’s next question can be a Katz asks new patients four ques- lower her cholesterol and thus her risk for heart dis- game-changer for many: What tions: Have you had any chest pain, ease. “So don’t give up the ship just because of your do you eat? Regardless of the shortness of breath, palpitations or family history,” concludes Katz. answer, she encourages every

patient to see a nutritionist after keeping a food log for a few days. If their eating habits are unhealthy, now they can see it in black and white, and the nutritionist can craft an individualized nutrition plan they can stick with.

Finally, she asks about stress, reviewing mitigating factors such as adequate sleep, strong relationships, and activities that bring joy, connection and meaning to their lives. “I cite studies that show yoga and meditation can lower blood pressure and improve heart rate variability. I recommend free apps they can use any time of day—before bedtime, in their car before going into work. Even just a few minutes a day can help,” she says.

Dr. Katz preparing a vegan meal at home.

DR. KATZ’S PRESCRIPTION FOR OPTIMUM HEALTH

EXERCISE. As a cardiologist, Dr. Katz sees a lot of people who hate to exercise. But regardless of a patient’s health status or risk factors, she always starts a conversation about diet and exercise early, “before taking out the prescription pad.”

While the generally accepted guideline for most ablebodied Americans is 150 minutes a week of moderate exercise (75 minutes if the activity is vigorous), Katz knows better than to rigidly insist on such a lofty goal from someone who’s been sedentary for decades.

Ever the cheerleader, she tells her patients to pick something they enjoy and commit to it for six weeks. She recommends a minimum of 20 minutes a day, which they can break into 10-minute increments.

Her theory: Give me six weeks and I guarantee you’ll be hooked. She says her patients who try actually start to look forward to the exercise and hate to miss it. They love how they feel. “That’s how you develop a healthier lifestyle,” asserts Katz.

If they need more motivation, this cardiologist reminds her patients: “Regular exercise helps you move better, it strengthens your muscles and eases your joints, reduces stress so you can sleep better, and helps your heart pump more efficiently.” And she’s not just talking the talk.

Katz exercises every single day, rain or shine. She likes to mix up her workouts, incorporating stints on her Peloton bike (or her road bike, depending on the weather), along with yoga, Pilates, strength training, tennis and the occasional swim “if I’m injured.”

Many readers might wonder who’s got that kind of time. “I hear that a lot,” she says. “So I tell my patients to sneak it in. If you’re not the type to hit the gym before or after work, stash a pair of sneakers in

Though she spends a good half hour with every patient, Katz says these conversations about smoking, diet and exercise are “just the tip of the iceberg.” If poor habits are deeply ingrained or include several risk factors, she encourages them to start with small your desk and walk or run steps. “A big part of my job is on your lunch hour.” being a cheerleader. I tell them, it took you X number of years to People who have retired get to this point, so don’t expect face a different problem, all that to change overnight. Be says Katz. “Ironically, with- patient with yourself.” out a structured daily routine, it’s almost impossible Coming from a board-certified to find the time to exercise.” cardiologist, Katz’s next piece She coaches her schedule- of advice may be unexpected. fluid patients in setting up a An avid consumer of research routine that includes mod- studies, she mentions severate activity, getting them eral that show a link between outdoors whenever possible. prayer and a lower risk of heart “I tell my patients to put it in their schedule and make it an enjoyable part of every day.” disease. People who believe in something—whether it’s a deity or marriage or friendship or How much exercise is too community connections—fare much? Katz’s definitive re- better. "I tell my patients, surply: “In the general popula- round yourself with people who tion, over-exercise should make you feel good. Do things not be an issue.” She main- you enjoy. Think about what tains the benefits of exer- gives meaning and makes you cise far outweigh the risks. happy. It’s good for your heart.” Rare incidents of a workn n n out bringing on a cardiac event are more commonly Donna Moriarty is a lifelong writer, editor and attributed to high perfor- author who writes about mance athletes. “Exercise education, wellness, and should be challenging but personal development. never painful,” says Katz. She and her husband “If something doesn't feel are Ossining residents, with three right, stop and discuss with grown children and two elderly dachsyour physician.” hunds. Learn (and read) more at www.silversmithwriting.com westchesterseniorvoice.com 24 summer 2021

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SUNDAY, OCTOBER 24, 2021