How do you take care of your heart after 40?


As you find yourself hitting 40, you may start thinking about health issues you previously didn’t concern yourself with. Should heart health be one of them? 

Well, it’s no coincidence that many studies on heart health recruit participants between 40 and 75 years old. At 40, many of us start asking what we can do live a healthier life, and the heart is a great place to start. Here are a few things to know about your heart and how to keep it healthy.

Talk to your physician about your heart — and know what to ask

Make it a priority to talk with your physician about your heart. If you don’t have a primary care physician, now’s the perfect time to get established with one. Often when we see our physician, the conversation can be dominated by a checklist of other concerns, such as hair loss, weight gain or a nagging ache, and the topic of heart health gets pushed to the bottom of the list. You should plan to make it a specific item on the agenda of your next visit to discuss your risk for heart attack and stroke. Simply let your physician know that you’d like to devote five minutes to discussing your risk. It’s a good conversation to have, and age 40 is the perfect time to start having it.

Commit to an active lifestyle

Making a commitment to physical activity is an important component to a healthy heart, and you don’t have to put on spandex or purchase an expensive gym membership to accomplish it. It can involve moderate activities done through the course of your day. The American Heart Association recommends 150 minutes of activity accumulated over a week. Activities such as walking at a moderate to brisk pace or bicycling on level terrain are a great place to start. You may be able to work up to jogging or more vigorous activity, such as jumping rope.

Don’t discount the benefits of activities we do in our daily lives, either. You can park a little farther away, take the steps instead of the elevator, use a push mower instead of riding and carry your laundry up the stairs. Those things accumulate and add to your overall volume of physical activity. It all impacts your overall fitness and extends beyond heart and vascular benefits. It benefits the whole body.

And don’t discount the benefits of wearable fitness devices. It can be motivating to close those rings, get those steps in and commit to physical activity.

Consider reframing your diet

Diet can be a challenging aspect of a good discussion regarding heart health, and it’s a conversation we constantly have at Ohio State’s Cardiovascular Risk Reduction and Lipid Clinic, where we counsel patients on managing their diet and other risk factors that lead to cardiovascular disease. I recommend focusing on reframing your diet to include more healthy options instead of worrying about what you can’t eat.

For example, change your expectation of including a meat with every meal. Try substituting red meat  several days each week with poultry, fish or plant sources of protein. Cutting down the amount of red and processed meats in our diet is a good thing for the heart and cardiovascular system. If there’s a food to consciously avoid, for most it would be processed carbohydrates. This is the rapidly absorbed food such as white rice and white bread that can lead to blood sugar increases and weight gain among susceptible people, including those with prediabetes or diabetes. Whole grain options generally have gentler absorption and more fiber, both of which offer health benefits.

Also, reduce the number of calorie-containing beverages in your diet. Sweetened sodas and fruit juices contain a great deal of sugar.

A last word on diet would be dieting to achieve weight loss. As many approach their 40s, weight loss can become a major focus. However, some diets can have an unforeseen impact on heart health. Take the ketogenic, or keto, low-carb diet for example.

While carbohydrate reduction can help many people lose weight effectively, you have to be careful what you’re replacing those carbs with. For most, the healthful way to do it is to consume more plant oils, plant proteins, fish and seafood. When someone on a keto diet replaces carbs with too many animal-product meats containing saturated fat, their LDL (bad) cholesterol can really rise. Discuss any dietary change with your physician to make sure you don’t negatively impact your heart health or trigger other conditions such as digestive or kidney diseases.

Add other elements of a healthy lifestyle

There are a couple more things to consider to keep your heart healthy.

For starters, there’s smoking. Tobacco avoidance is key to good heart and lung health. Smokers have a tremendously higher risk of developing cardiovascular disease, so if you’re smoking at 40, consider putting stopping smoking at the top of your list of lifestyle changes.

While tobacco avoidance is an absolute, moderation is key for so many other things in life. We’ve already discussed moderation in our diet. Now let’s talk about moderation in alcohol consumption.

Drinking too much alcohol can increase your risk for many health problems, including high blood pressure and stroke. So try to keep it to one to two drinks per day for men and one drink a day for women. Any higher than that can reach at-risk levels of drinking that can have implications on blood pressure, cholesterol and body weight.

M. Wesley Milks is a cardiologist and clinical lipidologist at The Ohio State University Wexner Medical Center.