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HEART Insight:
doi: 10.1097/01.HEARTI.0000432807.23969.d7
Departments: Life's Simple 7

Modest Lifestyle and Behavioral Changes That Can Improve Your Health

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Beware the Salty Six!

We've all heard about the dangers of eating too much salt. Excess salt in your diet can lead to high blood pressure (hypertension) and increase your risk for heart disease and stroke. While it's a good idea to limit adding salt to foods when you're cooking or at the table and to avoid salty treats like French fries and potato chips, you may not realize that there's a lot of sodium packed into some of your favorite foods—much more than the 1,500 milligrams or less daily recommended by the American Heart Association.

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Watch out for the Salty Six! These six common foods are the top sources of sodium in today's diet:

1. Breads & rolls. Even though each serving may seem low in sodium, remember that you may be eating several servings of bread a day–a muffin in the morning, two slices of bread with a sandwich at lunch, and a dinner roll in the evening. Add them all up and you've got a sodium overload! Check the labels on the bread you buy to find lower-sodium varieties.

2. Cold cuts & cured meats. One 2 oz. serving—that's just 6 thin slices—of deli meat can contain over 750 milligrams of sodium. That's more than half of your daily recommended intake! If you're going to choose meat from the deli, ask for lower-sodium varieties.

3. Pizza. Everybody's favorite takeout food can send your sodium intake into overdrive. Just one slice of pizza with several toppings can contain more than half of your daily recommended dietary sodium. Next time you order, limit the cheese and meat toppings and ask for veggies instead.

4. Poultry. Sure, lean chicken or turkey is a good alternative to fatty meats, but check out the poultry before you buy it. Depending on how it's been prepared, it could contain a lot more sodium than you need. Read labels before buying and choose wisely.

5. Soup. Canned soup can be a sodium nightmare—one can of your favorite soup may contain up to 940 milligrams of sodium! There are many lower-sodium alternatives out there, however, so read labels carefully.

6. Sandwiches. Do you know how much sodium is in a sandwich or burger from a fast-food restaurant? One sandwich can contain more than 100 percent of your daily recommended dietary intake. When you're grabbing food on the go, try half a sandwich with a side salad instead. Remember salad dressing may add sodium, too, so use it sparingly.

Keeping the Salty Six in mind when you're grocery shopping or eating out can help you choose foods that are low in sodium. One good way to avoid excess sodium is to look for the AHA's Heart-Check Mark. When you see this mark on a product, you can be sure that it's been certified to meet nutritional criteria for heart-healthy foods, including sodium. Also be sure to check a product's Nutrition Facts label and choose those foods that contain less sodium.

Taking steps to reduce sodium will not only help your heart—you'll also start to appreciate foods for their true flavor. You'll look forward to how food really tastes when all that extra salt is gone.

The Salty Six are lurking where you might not expect them—but now that you know where they like to hide, you can avoid them and make heart-healthy choices!

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Calculating your target heart rate

Wondering if you're doing too much or too little during workouts? You can figure this out by checking your target heart rate.

You get the most benefit out of physical activity when you exercise at your target heart rate. It's also important to know if you're going over your target heart rate so you don't over-exercise and hurt yourself. Knowing where your target is will help you get the most out of your physical activity.

First, you need to know your resting heart rate, or pulse. This is the number of times your heart beats when you're at rest. To determine your resting heart rate:

* Place the tips of your first two fingers (not the thumb) on the inside, or thumb side, of your wrist or on the side of your neck.

* Press lightly with your fingers until you feel the blood pulsing.

* Looking at a clock or watch with a second hand, count the beats for 10 seconds.

* Multiply this number by 6 to find your beats per minute. For example, if you counted 10 beats and multiply it by 6, you have a resting heart rate of 60.

A “normal” resting heart rate is from 60 to 80 beats per minute, but it's usually lower in physically fit people and rises with age.

Now you need to know your maximum heart rate, which is the highest beats per minute you should go when engaged in physical activity. Your maximum heart rate is calculated by subtracting your age from 220. So a 40-year-old person's maximum heart rate would be 180 beats per minute (220 − 40 = 180).

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Your target heart rate should be between 50 percent and 85 percent of your maximum heart rate. So, using the example above, if your maximum heart rate is 180, you want to keep your target heart rate between 90 (180 × .5, or 50 percent) and 153 (180 × .85, or 85 percent) beats per minute while you're exercising to get the most benefit. Check your pulse periodically while exercising to keep track of your heart rate.

If your heart rate is too low, push yourself to exercise a little bit harder. If you haven't exercised in a while, aim for your lower target rate (60 percent). Then slowly work your way up to your higher target rate, around 80 percent. If you find your heart rate is going above your maximum, slow down.

If you have a heart condition or are in cardiac rehab, or are taking medicines for high blood pressure, talk to your doctor about what your target heart rate should be and what physical activity you can engage in safely.

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Life's Simple 7 in a Nutshell

Cardiovascular health encompasses two basic components: ideal health behaviors and ideal health factors.

The behaviors include not smoking, maintaining a healthy weight, meeting or exceeding AHA recommendations for physical activity and eating a healthy diet.

The health factors include blood pressure, fasting blood glucose and total cholesterol levels that are within the AHA's recommended range—preferably without needing medication to keep them there.

Modest lifestyle or behavioral changes can move you in the right direction. And those who make behavioral changes before developing any serious health risks can look forward to a better quality of life and moving toward excellent heart health.

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Food for thought: Dear diary…

Whether you're trying to lose or maintain your weight, writing down what you eat is a good way to get a snapshot of the good habits (like eating three daily meals and choosing healthy snacks) and the bad ones (like snacking too much or drinking too many sugary drinks) you're following. Keeping a food diary can help you keep track of what you're eating and when so you can make healthy changes.

There are a few ways to keep track of what you eat. The American Heart Association has a food diary that you can download and print out, which is available online at heart.org/FoodDiary. It provides spaces for you to write down the times you eat, the foods you eat, portion sizes/calorie counts and notes about what you were doing or feeling at the time. There are also several apps available for your smartphone or tablet, such as MyFitnessPal or LoseIt, so you can carry your food diary with you wherever you go. An advantage of these apps is they supply calorie counts automatically when you choose a food so it's easy to keep track of how many calories you're eating each day. Search the app store for your device to find one that will work well for you.

Write down everything you eat (be honest!) for an entire day and at the end of the day, review your food diary and ask yourself these questions:

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If you're trying to control hunger:

* Did I eat three meals?

* Did I eat filling foods and water with every meal or snack?

* Did I eat at least four to five servings each of fruits and vegetables?

If you're trying to lose weight:

* Did I eat when I wasn't hungry? (If so, think about what you were feeling or doing that made you eat.

* Did I keep cooked meat, chicken, fish or shellfish to 3 oz. per portion (the size of a deck of cards)?

* Where can I cut calories?

Another way to keep track of what you're eating, along with your food diary, is to practice what's called mindful eating. How many times have you sat down in front of the television with a snack and before you know it, the food is gone and you don't even remember eating it? Mindful eating helps keep you attuned to what you are eating and helps you experience the pleasure that food can bring. And when you're aware of what you are eating, you may find yourself eating less of it and enjoying it more.

Next time you sit down to eat, pay close attention to what you're eating or drinking. Turn off the television and stop talking. Look at the food you're about to eat and notice its color and smell. Put a forkful of food in your mouth, and put the fork down. Chew slowly and notice the texture of the food, the flavor, even the temperature. Savor what you're eating. You might just find that you're truly enjoying your food and eating a bit less.

Keeping track of what you eat with the help of a food diary and mindful eating can help you get on track to eating healthy and feeling good.

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Can beta blockers affect physical activity?

If you're taking a beta blocker because of a heart condition, you're probably aware that the medicine slows down your heartbeat. But does that mean they affect your ability to exercise?

Beta blockers help your heart by decreasing how hard the heart muscle contracts and reduces blood vessel constriction in the heart, brain and the rest of your body. They're used to treat abnormal heart rhythms and angina, lower blood pressure and prevent future heart attacks in patients who've already had one.

Beta blockers and exercise actually have similar effects on your body—when you exercise regularly, your heartbeat slows and your blood pressure lowers, which is what beta blockers do, too. But that doesn't mean you can skip physical activity because you're taking beta blockers. Because beta blockers slow your heart rate, you may not be able to get to your target heart rate during physical activity. But that doesn't mean you can't get cardiovascular benefits from physical activity while you're taking beta blockers.

Because beta blockers affect each individual differently, ask your doctor about getting a stress test before you start a physical activity program. This test will determine your target heart rate while you're taking beta blockers so you can get the proper benefits from exercise without overdoing it. Another way to monitor your intensity during physical activity while taking beta blockers is to make sure you're not exhausted. You can exercise hard, but not too hard—if you reach a point where it's hard to talk, you're probably working out too hard and should slow it down.

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How quitting smoking will change your life

Giving up smoking isn't easy, but the changes it will make in your life will make a big difference in your future health. And the changes start immediately—you'll start seeing some of the benefits within 20 minutes of quitting!

So how will quitting smoking change your life? Take a look at just a few of the benefits you'll enjoy once you give up tobacco for good:

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* Your heart rate and blood pressure, which increase while smoking, will go back down.

* Levels of carbon monoxide in your blood, which reduces the blood's ability to carry oxygen, will go down.

* Your heart doesn't have to work as hard and your cardiac function will improve.

* Your sense of smell will return to normal, and food will taste better.

* Your lung function will steadily improve and everyday activities won't leave you out of breath.

* One year after quitting, you'll have cut your risk of heart attack and stroke in half.

* Within 10 to 15 years of quitting, your risk of lung disease will decrease.

* You'll save a lot of money: If you're a one-pack-a-day smoker, you could save over $15,000 in 10 years, and you'll pay less for health and life insurance.

* Your breath, clothes and hair will smell better and your fingers and fingernails will no longer look yellow. Your stained teeth will get whiter, and you'll have improved oral health.

* Because the chemicals in tobacco can constrict the blood vessels in your face, leading to a yellowish pallor and a breakdown in elasticity, quitting can help you look younger.

* You'll live longer: On average, continuing to smoke cuts 13 to 14 years off your life.

These are just a few of the many benefits you'll enjoy once you decide to quit. For help with quitting, contact the American Heart Association at 800-242-8721 or visit educationpackets.heart.org to request a Stop Smoking packet. You can do it!

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Resources

Life's Simple 7® Assessments

To understand the steps you may need to take to improve heart health and quality of life, visit heart.org/mylifecheck

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Track your heart health

To track your blood pressure, blood glucose, weight, cholesterol and more online, visit heart360.org

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Quit smoking

To find support and resources for quitting smoking, visit naquitline.org

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Get physically active

For ideas on how to incorporate physical activity into your life, visit startwalkingnow.org

© 2013 by the American Heart Association

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