Heart Disease in Women: Lifestyle Interventions

As this year's American Heart Month comes to an end, it seems appropriate to point out a new guideline from the American Heart Association about to be published next month regarding the prevention of cardiovascular disease in women, as heart disease remains their number one cause of death, far out pacing all cancers combined, including breast cancer.

Specific recommendations include not only cessation of tobacco use but also avoidance of environmental tobacco smoke (which may not be the easiest thing to do given one's work situation - which therefore makes it imperative that we step in from a legislative perspective).

The AHA recommends 150 minutes/week of moderate exercise, 75 minutes/week of vigorous exercise, or some combination of the two.  Additional cardiovascular benefits can be obtained by increasing moderate-intensity exercise to 300 minutes/week or 150 minutes/week of vigorous-intensity physical activity.  All this is supported by Class I, B Level of Evidence.

As for nutrition, the AHA recommends a diet rich in fruits & vegetables; whole-grain, high fiber foods; and oily fish (at least twice weekly), while limiting intake of saturated fats, cholesterol, alcohol, sodium & sugar, and avoiding trans-fatty acids completely.

There is a specific recommendation for 1,800mg/d of EPA (a specific form of omega 3 fatty acids) in those with hypercholesterolemia (high cholesterol) and/or hypertriglyceridemia (high triglycerides) for both 1o and 2o prevention.  Please note, however, that most omega 3 products, eg fish oil capsules, are only 30% pure and thus only contain 300mg EPA+DHA out of 1,000mg fish oil.  And of that 300mg EPA+DHA, typically only 180mg are EPA (the other 120mg being DHA).  So, unless you look for higher grade supplements, you'll need to consume at least 10 capsules of standard over-the-counter fish oil daily to meet AHA recommendations.

None of the above is shocking or a revelation.  But we have to empower the women in our lives to act upon this information, if not for them, then selfishly, at least for us.