It’s no secret that lifestyle choices—diet, exercise, and other habits within your control—have a significant impact on heart health and may even prevent a heart attack. But research is increasingly demonstrating just how big the impact is—and how even small changes in lifestyle can have a meaningful benefit.
For example, a 2014 study from the Journal of the American College of Cardiology followed nearly 21,000 middle-aged and older Swedish men over 11 years. Researchers found that men who ate well, did not smoke, were active, kept a trim waistline, and drank in moderation were 86 percent less likely to suffer a heart attack, vs. men with none of those habits.
What’s more, it didn’t take a strict diet or grueling workouts. Men with a “low-risk” diet aver- aged about five servings of fruits and vegetables and four servings of whole grains each day, and had fish twice a week; they also favored beans, nuts, and low-fat dairy. But they did not have to eschew red meat or desserts altogether. It was more important that they consistently ate heart-healthy foods, vs. banishing less-healthy fare completely.
As for exercise, men met the heart-protecting threshold even if the bulk of their physical activity was incidental, rather than a scheduled workout. Heart attack risk was reduced among men who walked or biked for at least 40 minutes over the course of a typical day, and got just one hour of dedicated exercise each week.
Similarly, the other protective factors were attainable: Refraining from smoking, having no more than two drinks per day and maintaining a waistline trimmer than 37 inches. If every man in the study had met those five goals, about four out of five heart attacks could have been prevented.
The findings drive home the power of lifestyle choices, at least for men. But what about women? There’s good news: In a study done several years ago, the same research team found nearly identical results among more than 24,000 middle-aged and older women. There are caveats, however. Both Swedish study groups were fairly homogenous, so it’s not clear whether the findings would apply to all racial and ethnic groups. Both studies also focused on people who were initially healthy.
But other clinical evidence does show that lifestyle choices matter for people with risk factors for a heart attack. A large study of U.S. men focused on the same five lifestyle factors described earlier. It found that even among men on medication for high blood pressure or high cholesterol, those healthy choices could have prevented more than half of the heart attacks that struck the group over 16 years.
Here’s another reason lifestyle is so important, even if you’re on medication to control your heart attack risk factors: You stand to improve your overall health and well-being. Another recent study, for example, found that adults with the healthiest habits gained some protection against not only heart attacks but also other major diseases, such as diabetes and certain cancers.
Again, a healthy lifestyle meant not smoking, getting moderate exercise, maintaining a normal weight, and following a Mediterranean-like diet (rich in fish, fruits and vegetables, whole grains, and healthy fats). At a minimum, those people gained two extra years of good health over a lifetime.
Luckily, you don’t have to make substantial lifestyle changes overnight in order to prevent a heart attack. In fact, it’s more likely you will sustain changes if you start with manageable steps, such as adding more walking time to your daily routine, or including more fruits and vegetables in your meals.
Our advice. If you’re facing some bigger challenges—like quitting smoking or losing a significant amount of weight—ask your doctor for help. Changing ingrained habits can take some time and effort, but it can be done—and is well worth doing.