By Dr. Mercola
Close to 800,000 Americans die each year from heart disease, strokes and other cardiovascular diseases combined, making heart disease the leading cause of death in the US. An estimated 920,000 Americans will have a heart attack each year as well, with half of them occurring suddenly without any warning signs.1
The notion that you could be going along with your life one day, struck with a heart attack and then, just like that, be gone tomorrow, is unsettling but, sadly, not uncommon.
The most common symptom of heart disease is sudden death, which is why it's so important to take steps to protect and support your heart health now.
For instance, research conducted at the Karolinska Institutet found that engaging in healthy lifestyle habits could prevent nearly 80 percent of first-time heart attacks in men.2
The 2004 INTERHEART study, which looked at heart disease risk factors in over 50 countries around the world, similarly found that 90 percent of heart disease cases are completely preventable by modifying diet and lifestyle factors.3
Unfortunately, most people are not using lifestyle habits to their advantage. The Karolinska Institutet study involved men aged 45 to 79… and only 1 percent of them engaged in five "low-risk" behaviors that the study found could prevent a heart attack. In many cases, people may believe their heart health is just fine, when it's far from it.
This is where a new measurement tool to calculate the actual age of your heart could be invaluable, as it's been found to be more motivating to people than standard measures of heart risks.
Most Americans' Hearts Are Older Than They Are
If you think knowing your heart age isn't important, think again. Research published in the US Centers for Disease Control and Prevention's (CDC) Morbidity and Mortality Weekly Report (MMWR) revealed that among Americans aged 30 to 74, most have hearts that have aged beyond their chronological years.
Specifically, average predicted heart age for adult men and women was 7.8 and 5.4 years older than their chronological age, respectively.4 Further, one in two men and two in five women had a predicted heart age that was at least five years older than their chronological age.
Finding out this score could prove to be far more useful than knowing your 10-year cardiovascular disease risk (CVD) risk, which is the current tool used by many physicians to predict a person's chance of having a heart attack in the next 10 years.
The 10-year CVD risk calculator is based on your age, gender, total cholesterol, HDL cholesterol, smoking status, and systolic blood pressure. Total cholesterol is a near-useless measure of your heart risks, which is why this risk assessment is flawed.
It's also not very impacting to give a person a 10-year risk assessment; it seems so far in the future that it might not motivate the immediate changes that are necessary.
In a study comparing 10-year CVD risk and heart age on motivating people to make heart-healthy changes, the latter was found to be far more effective. According to MMWR:5
"One study comparing the effect of using absolute CVD risk versus heart age on participants' risk perceptions and intention to make lifestyle changes suggested that heart age messaging led to significantly higher perceived risk and was more emotionally impactful for participants at higher actual CVD risk levels.
A randomized intervention trial concluded that communicating CVD risk using heart age versus absolute risk resulted in a greater reduction in CVD risk over the 1-year intervention period."
How Is Your Heart Age Calculated?
The Heart Age Predictor evaluates your sex, age, systolic blood pressure, and current health status, including whether you're receiving treatment for high blood pressure, are a current smoker or have diabetes.
It also uses your body mass index (BMI), which is not the most accurate in terms of assessing your weight-related health risks.
BMI, a formula that divides your weight by the square of your height, is a flawed measurement tool, in part because it uses weight as a measure of risk, when it is actually a high percentage of body fat that increases your disease risk.
BMI also tells you nothing about where fat is located in your body, and the location of the fat, particularly if it's around your stomach (visceral fat), is more important than the absolute amount of fat when it comes to measuring certain health risks.
Your waist-to-hip ratio is a more reliable indicator of your future disease risk because a higher ratio suggests you have more visceral fat, but this was not incorporated into the heart age predictor.
So it's important to take the results with a grain of salt, especially if you have reason to believe that your BMI is misleading and has incorrectly categorized you as underweight, normal weight, overweight or obese.
Still, if you are the type of person who's motivated by a good challenge, finding out your heart age, and then taking steps to lower it, makes sense. Simple lifestyle changes can have a profound effect to reduce your heart age and keep you "young at heart." According to MMWR:6
"Adopting a healthy lifestyle could have a profound effect on reducing excess heart age. For example, a male smoker aged 50 years with untreated systolic blood pressure of 140 mm Hg, no diabetes, and a BMI of 30, has a predicted heart age of 72 years (74 years for a female with similar characteristics).
Quitting smoking for 1 year alone would have reduced predicted heart age by 14 years (15 years), reducing systolic blood pressure to 120 mm Hg alone would have reduced predicted heart age by 6 years (10 years), and removing both risk factors would have lowered predicted heart age by 19 years (23 years).
At the population-level, the use of predicted heart age might be an effective way to communicate CVD risk, to identify geographic regions and populations most in need of CVD risk factor improvement, and to stimulate action at the state, county, or community level."
5 Health Tests to Help Reveal Your Actual Heart Disease Risk
Using the online calculator to gauge your heart age is something you can do right now to get an idea of where your heart health stands, but if you want a more accurate estimation the following tests can give you a far better assessment of your heart disease risk than the online calculator or your total cholesterol level alone:
- HDL/Cholesterol ratio: HDL percentage is a very potent heart disease risk factor. Just divide your HDL level by your total cholesterol. That percentage should ideally be above 24 percent.
- Triglyceride/HDL ratios: You can also do the same thing with your triglycerides and HDL ratio. That percentage should be below 2.
- Your fasting insulin level: Any meal or snack high in carbohydrates like fructose and refined grains generates a rapid rise in blood glucose and then insulin to compensate for the rise in blood sugar.The insulin released from eating too many carbs promotes fat accumulation and makes it more difficult for your body to shed excess weight. Excess fat, particularly around your belly, is one of the major contributors to heart disease
- Your fasting blood sugar level: Studies have shown that people with a fasting blood sugar level of 100 to 125 mg/dl had a nearly 300 percent increase higher risk of having coronary heart disease than people with a level below 79 mg/dl.
- Your iron level: Iron can be a very potent oxidative stress, so if you have excess iron levels you can damage your blood vessels and increase your risk of heart disease. Ideally, you should monitor your ferritin levels and make sure they are not much above 80 ng/ml. The simplest way to lower them if they are elevated is to donate your blood. If that is not possible you can have a therapeutic phlebotomy and that will effectively eliminate the excess iron from your body.
Do You Know Your Fitness Age?
Another health tool that might give you some motivation to make healthy changes is your fitness age. Your fitness age may predict premature death better than risk factors like being overweight, having high blood pressure, or smoking, and as such it might be even more useful than knowing your heart age.
Fitness age is based on the concept of VO2max, which is the maximum amount of oxygen you can take in while exercising. Your VO2max can be used as a measure of cardiovascular endurance; if yours is below average compared to other people your age, it means your fitness age is actually greater than your chronological age.
On the other hand, a better-than-average VO2 max could mean your fitness age is younger than your age in years. Even better, it's possible to improve your VO2 max, which means your fitness age can actually get younger as you get older… The primary problem with using VO2 max to gauge your longevity is that very few people know what theirs is, and finding out typically requires high-tech testing on a treadmill.
Researchers at the Norwegian University of Science and Technology, however, were able to develop an algorithm based on the aerobic capacity, waist circumferences, heart rate, and exercise habits of nearly 5,000 people. This has yielded a method for estimating, quite accurately, a person's VO2 max.7 Next, the researchers explored whether or not VO2max actually correlated with lifespan. They analyzed the VO2max, fitness age and chronological age of more than 55,000 adults and found a strong association.
Those with the worst readings for VO2max (85 percent or more below the average for their age, which means they had a high fitness age) had an 82 percent higher risk of dying prematurely than those whose fitness age was the same as, or lower than, their chronological age.8 The Norwegian researchers created an online calculator for determining fitness age, which you can use yourself.9 By inputting just a bit of information (such as your age, gender, waist size, height, and exercise habits), it will estimate your level of fitness, giving you both your VO2max and fitness age.
I'm 61 years old, and when I took the test my fitness age was that of an average 31 year old. If, however, you don't like what you see, the good news is that you can change it (as you can also do with your heart age).
Is Your Heart Age or Your Fitness Age Too High?
Poor lifestyle choices are primarily to blame for increased heart disease risk, such as eating too much refined sugar and processed foods, getting too little exercise and movement, lack of sun exposure, and rarely or never grounding to the earth. These are all things that are within your control, and don't cost much (if any) money to address. On a dietary level, if you want to protect your heart, you need to address your insulin and leptin resistance, which is the result of eating a diet too high in sugars and grains. To lower your heart disease risk, adhere to the following suggestions, which are explained in detail in my nutrition plan.
- Avoid sugar, processed fructose, and grains. This effectively means you must avoid most processed foods
- Eat a healthy diet of whole foods, ideally organic, and replace the grain carbs with:
- Large amounts of vegetables
- Low-to-moderate amount of high-quality protein (think organically raised, pastured animals)
- High-quality healthy fat (saturated and monounsaturated from animal and tropical oil sources). Most people actually need upward of 50 to 85 percent fats in their diet for optimal health — a far cry from the 10 percent currently recommended. Sources of healthy fats to add to your diet include:
Avocados Butter made from raw grass-fed organic milk Raw dairy Organic pastured egg yolks Coconuts and coconut oil Unheated organic nut oils Raw nuts, such as almonds, pecans, macadamia, and seeds Grass-fed meats
Balancing your omega-3 to omega-6 ratio is also key for heart health, as these fatty acids help build the cells in your arteries that make the prostacyclin that keeps your blood flowing smoothly. Omega-3 deficiency can cause or contribute to very serious health problems, both mental and physical, and may be a significant underlying factor in up to 96,000 premature deaths each year. You can do this by avoiding most vegetable oils and increasing your intake of small wild-caught oily fish (sardines and anchovies) or taking a high-quality krill oil supplement.
Exercise for Heart Health and Lower Fitness Age
While virtually any type of exercise can improve your VO2max and lower your fitness age, one of the most efficient ways to do so is to engage in high-intensity interval training (HIIT), which will have the additional benefit of boosting your heart health. If you use the online calculator for determining fitness age, you'll notice that one of the questions asks about the intensity of your exercise. Reporting that you sometimes "go all out" when you exercise likely improves your fitness age tremendously because it boosts your body's natural production of human growth hormone (HGH), which will help address the muscle loss and atrophy that typically occurs with aging (among other benefits).
Another question asked on the online calculator relates to your resting heart rate, with a lower resting heart rate being preferred for longevity. HIIT, which includes short bursts of high-intensity activity followed by periods of recovery, has been found to improve both VO2max and resting heart rate – even if you start after the age of 40. Even 12 minutes of HIIT a week can markedly improve your VO2max.10
Research has even shown that four minutes of exercise performed at extreme intensity four times a week may improve your anaerobic capacity by 28 percent, and your VO2 max and maximal aerobic power by 15 percent in as little as six weeks. For comparison, those who performed an hour of steady cardiovascular exercise on a stationary bike five times a week only improved VO2 max by 10 percent, and their regimen had no effect on their anaerobic capacity.
Do You Want to Stay Young at Heart?
There are many strategies that can protect your heart and virtually eliminate your risk of heart disease. If you calculated your heart age and weren't happy with the number, please don't wait until you experience heart attack symptoms to take action because by then it may be too late. Do so now in order to prevent any long-lasting damage:
- Eat unprocessed saturated animal fats, and ignore the media, as you will benefit from these fats. Many may also benefit from increasing the healthy fat in their diet to 50 to 85 percent of daily calories
- Avoid all sugars, including processed fructose and grains if you are insulin and leptin resistant. It doesn't matter if they are conventional or organic, as a high-sugar diet promotes insulin and leptin resistance, which is a primary driver of heart disease
- Exercise regularly, as physical activity along with a healthy diet of whole, preferably organic, foods may be just as potent — if not more potent — than cholesterol-lowering drugs. Use a combination of high-intensity interval training, strength training, stretching, and core work
- Avoid excess sitting; aim for three hours a day or less of sitting and try to take 10,000 steps a day (in addition to your exercise program)
- Avoid statins, as the side effects of these drugs are numerous while the benefits are debatable. In my view, typically the only group of people who may benefit from a cholesterol-lowering medication is those with genetic familial hypercholesterolemia. This is a condition characterized by abnormally high cholesterol, which tends to be resistant to lifestyle strategies like diet and exercise
- Optimize your vitamin D levels, either through appropriate sun exposure, a tanning bed, or as last resort an oral vitamin D3 supplement
- Regularly walk barefoot to ground with the earth. When you do, free electrons are transferred from the earth into your body; this grounding effect is one of the most potent antioxidants we know of and helps alleviate inflammation throughout your body
- Manage your stress daily. My favorite tools for stress management are the Emotional Freedom Techniques (EFT)