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How to improve your heart health and that of your family: be physically active, watch your salt and laugh out loud, a cardiologist says

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Deaths from cardiovascular disease have risen in the past 30 years from 12.1 million in 1990 to 20.5 million in 2021.

The Covid-19 pandemic didn’t help: a large study found that in the year post-pandemic, people were 1.5 times more likely to have a stroke, and at nearly twice the risk of a heart attack. This could in part be explained by the finding that 20 per cent of people sent to hospital for coronavirus infection developed high blood pressure.

September 30 is World Heart Day. Boon Lim, a consultant cardiologist at Imperial College London in the UK and author of Keeping your Heart Healthy, says that health-awareness dates encourage us to take stock of our overall well-being – and to “reboot” our motivation.

The first World Heart Day was launched by one-time World Heart Foundation president Antoni Bayés De Luna in 2000, to urge us to review our own heart health – and that of others.

Dr Boon Lim, a consultant cardiologist at Imperial College London in the UK, offers tips to safeguard heart health.

Heart health awareness is poor, Lim says. People don’t appreciate how much our lifestyle choices contribute to heart disease: more than half of all heart disease worldwide is linked to modifiable risk factors such as body-mass index, high blood pressure, cholesterol levels, smoking and stress.

Lower those risks to boost heart health: by losing weight through diet and exercise, managing blood pressure levels, changing your diet, not smoking, and managing stress.

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It is up to you to help yourself – and those you love. Here’s what some experts suggest.

1. Children need exercise

For generations, children were encouraged to play outside, says Lim. Now, with our device-led lives, and in the wake of a pandemic that saw many of us quarantined and isolated, children are far more comfortable sitting at home.

During the pandemic, children became used to staying inside and playing video games instead of getting outdoors to exercise. Photo: Shutterstock

As a consequence, says Lim, physical activity is highly reduced at a critical time in a child’s life – when their bodies enjoy the flexibility, strength and endurance to develop into an adult. The opportunity to develop the “ideal musculoskeletal support structure” for heart health is impaired, as is a healthy attitude to movement and exercise.

Having a healthy body weight and good muscle bulk improves insulin sensitivity and reduces the rising risk of diabetes, Lim says. So don’t let your kids develop bad habits early. Get them moving and protect their hearts.

2. Hold the salt

We know too much sugar and too much wrong fat are bad for our hearts. Less is said about how bad too much salt is for our hearts.

Know how much salt you’re eating. A cup of seemingly healthy cornflakes can contain 300mg of sodium. Photo: Shutterstock

A recent study by the European Society of Cardiology found that a high salt intake could double the risk of heart failure. People who consumed more than 13.7 grams (0.5oz) of salt daily were at twice the risk of heart attack as those who had half that amount.

Having too much salt causes the body to retain more water.

This increases the blood volume, forcing the heart to work harder, leading to a rise in blood pressure.

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We do need some salt, though. The United States Federal Drug Administration recommends a daily maximum of 2.3g, a little less than a teaspoon.

Limiting it to 1.5g would be better; if you’re trying to lower your blood pressure, aim for just 1g.

Even that scant amount might sound like a lot until you know how sneakily salty your food really is.

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Hong Kong nutritionist Diane Tran says ultra-processed foods (UPF) aren’t just loaded with sugar, fat and additives, they’re high in salt, too.

A hot dog can contain as much as 0.7g, some seemingly healthy vegetable juices have 0.9g a serving, and – here’s the surprise, because you can’t even taste the salt in them – a cup of cornflakes has almost 0.3mg.

3. Weekend workouts compensate

Weekend warriors need to work harder to pack in the same amount of activity others do over a whole week in an abbreviated time. Their hearts and muscles must do more to compensate.

Even if you don’t have time to exercise from Monday to Friday, at least try to fit in a brisk walk every day to blow the cobwebs away.

Laughter is the best medicine for the heart, helping to reduce inflammation and stress. Photo: Shutterstock

4. Laughter is the best medicine

Ever notice how relaxed and relieved you feel after you’ve had a really good laugh?

A study in Brazil found that laughter really is the best medicine. Researchers found that laughing causes the tissues in the heart to expand, which in turn increases the flow of oxygen around the body.

Laughter also releases endorphins – our happy hormones – which reduce inflammation. So laughing doesn’t just help us to relax, it makes our heart and blood vessels relax, too.
Lim hits the ski slopes for some heart-healthy exercise. Photo: Dr Boon Lim

5. What a cardiologist does to stay healthy

Lim says there are many heart-healthy diets to follow, but they work only if you can maintain them.

Lim adopts a time-restricted eating pattern, also known as intermittent fasting. He fasts for 16 hours a day and has his meals within an eight-hour window. He also limits carbohydrates, processed foods and refined sugars, while having more healthy fats.

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He plays tennis and runs at the weekend and walks whenever he can during the week – getting off the train a stop early so he can walk the last block or two briskly.

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