We're going to shock you with astonishing facts about the top health threat to women. Because what you don't know about heart disease really can hurt you.

By Gina Roberts-Grey

1. Sugar is the new salt.

Unfortunately, what's good for your sweet tooth is bad for your heart. "Excess sugar adheres to proteins in your blood, causing them to be thick or sticky," explains Jonny Bowden, Ph.D., coauthor of The Great Cholesterol Myth. "Those proteins get lodged in your arteries, which can eventually lead to inflammation, plaque buildup and other serious risks for heart attack."

The American Heart Association recommends limiting added sugar intake (that's the kind that doesn't naturally occur in food) to 6 teaspoons a day for women and 9 for men—less than what you'd find in a single bottle of sweetened iced tea. However, Bowden suggests restraining yourself even more. "Sugar is the most destructive ingredient in the American diet, but it's impossible to avoid completely," he admits. Start by committing to these smart habits: Don't add sugar to coffee or tea, skip eating sugary breakfasts and snacks, avoid drinking sodas and juices, and try not to overindulge in breads and pastas. The sweet stuff also is found in unlikely places, like ketchup and jarred tomato sauce, granola, baked beans, packaged oatmeal and dried fruit, so read nutrition labels and check ingredients lists carefully.

2. The flu shot cuts your risk in half.

Protecting yourself against an acute respiratory infection (which often accompanies influenza) might also offer defense against plaque in the arteries, heart attack and stroke.

3. Comfort food can be good for your heart.

Guilty pleasures like burgers and pizza are go-tos when you need to get dinner on the table fast or the kids are having a bad day. But they're also dietary land mines thanks to their high saturated fat and sodium content. "What you buy and how you prepare food is the difference between preventing heart disease and causing it," says Janet Bond Brill, R.D., author of the best-selling book Cholesterol Down. These simple substitutions can make comfort food healthy and delicious.

Fish and Chips

  • Bake your fish. Packed with lean protein, white fish like cod, halibut, flounder or haddock are great, but people who eat fried fish more than once a week have a 44% greater risk of stroke than those who rarely fry their fish.
  • Swap sweet potatoes for white potatoes, use extra virgin olive oil to roast them and sprinkle with fresh rosemary, cinnamon or other herbs and spices instead of salt for flavor.

The difference?

  • A medium order of fast-food fish and chips (Jack in the Box): approximately 830 calories, 1,680mg sodium, 4g saturated fat
  • One 4-ounce wedge of oven-baked cod and a serving of eight sweet potato "chips": 358 calories, 153mg sodium, 2.5g saturated fat

Pepperoni Pizza

  • Opt for a whole-grain crust instead of one made with white flour. The fiber in the whole grains improves digestive health. And choose a thin crust, not deep-dish.
  • Load it with veggies like eggplant, spinach, bell peppers and broccoli instead of pepperoni. You'll significantly increase the vitamin and mineral power of your pizza as well as up your intake of powerful disease-fighting antioxidants and fiber.
  • "Ask for half the cheese and extra sauce to reduce the amount of fat and up the antioxidants from the tomatoes," says Brill.

The difference?

  • One slice of a 12-inch thin-crust pepperoni pizza: 200 calories, 610mg sodium, 4g saturated fat
  • One slice of a 12-inch thin-crust vegetable pizza: 180 calories, 530mg sodium, 3g saturated fat


  • Replace beef with ground turkey breast or salmon. If beef burgers are all your family will eat, make sure to use 95% ground beef, which usually has the least fat.
  • Or opt for veggie burgers, but read the label. Some have as much as 1,000mg of sodium, which is two-thirds the American Heart Association's recommended daily amount. Consider Dr. Praeger's California veggie burgers or MorningStar Farms' spicy black bean burgers. They have between 250 and 350mg of sodium per patty.
  • Pair your burger with a slice of low-fat or soy cheese and eat it on a whole-grain bun.

The difference?

  • One 8-ounce beef burger: 530 calories, 200mg sodium, 14g saturated fat
  • Two 4-ounce salmon burgers: 340 calories, 660mg sodium, 2g saturated fat
  • Two 4-ounce ground turkey burgers: 280 calories, 540mg sodium, 2g saturated fat
  • Two 3-ounce veggie burgers: 200 calories, 560mg sodium, 0g saturated fat

4. Heart meds and prescriptions often end up in the trash can.

You would never let your kids skip a dose of their medicine. Then why are so many adults nixing their prescriptions? "Statin drugs are the most effective treatment to reduce cholesterol levels and related cardiovascular disease, but up to 75% of statin users stop taking their medicine during the first year," laments Eliot A. Brinton, M.D., director of Atherometabolic Research at the Utah Foundation for Biomedical Research. Even more shocking: the fact that 50% of Americans on blood pressure medication are not at their goal pressure. The same holds true for tackling LDL (or "bad") cholesterol, with only about one-third of adults with high cholesterol having their levels under control. And experts say failure to take medicine as prescribed is to blame.

Some patients may miss a dose or two of their medication, or avoid filling prescriptions at all, because of side effects like nausea and muscle aches, explains Dr. Brinton. The cost of the medicine is also a factor. But blood pressure and cholesterol that rage out of control greatly increase your odds of dying from a stroke or heart attack. If side effects are an issue, talk to your doctor, who may be able to prescribe remedies or switch your medication. Combat cost by asking your M.D. for a cheaper alternative or checking with the maker of your prescribed drug to see if they offer low- or no-cost options based on income.

5. Meditation knocks five points off your blood pressure.

Experts believe the systolic (top) number takes a dive because time spent deep in thought helps you relieve stress and decrease anger. Participants in this research study meditated for 20 minutes twice a day.

6. This woman's story could change your life.

Jill Starishevsky was riding home on the subway one night when she witnessed a man standing directly in front of her have a heart attack. "He turned very pale and fell to the floor—hard," says Starishevsky, 42, a New York City prosecutor and mom of three kids, ages 8, 6 and 1. "I'll never forget seeing him lying there and feeling overcome by helplessness." Everyone in the train car froze, staring at the tall man in his sixties reduced to a lifeless heap on the floor. The car doors opened and police arrived on the scene within seconds, but she later learned he died. "They said it was a massive coronary and nothing could have saved him," laments Starishevsky, who was so rattled by the experience that she signed up for an EMT training program and served as a volunteer in her neighborhood. "I had to do something. It could have been my father who collapsed, and what if there wasn't anyone around to assist him?"

Starishevsky says even though the event happened years ago, it's a vivid reminder of the benefits of a heart-healthy lifestyle. "I don't smoke and I make sure my children know how harmful and addictive the habit is," she says. "I do my best to keep our weight down, we eat lots of fruits and vegetables, and I've sworn off red meat. That experience also made me realize the importance of making sure anyone who watches my children is trained in emergency first aid, including aiding someone who is choking," says Starishevsky. "When they're older, I'll encourage my kids to be trained in CPR too, so they never have to feel like I did on that train."

7. It's possible to cook away cholesterol.

Use sesame and rice bran oils instead of vegetable or canola oil. A recent study found that people who consumed about 2 1/2 tablespoons of a blend of sesame and rice oil a day—in salad dressings, for sautéing and baking—lowered their bad cholesterol by 26%.

8. Your kid's heart needs you now more than ever.

He's not too young and it's never too early to get heart smart. Nearly half (43%) of all teens have at least one biological risk factor for cardiovascular disease, such as high blood pressure or a high body mass index. And that number doesn't include sneakier issues that put them in danger, like hereditary illnesses or being a closet smoker. Nearly 45% of American high school students have tried cigarettes, and one preliminary study showed artery wall damage in tweens and teens who reported smoking anywhere from at least once a week to once a month.

"Heart disease takes decades to develop before it can show up as a heart attack," says Suzanne Steinbaum, D.O., director of Women and Heart Disease, Heart and Vascular Institute at Lenox Hill Hospital in New York City and author of Dr. Suzanne Steinbaum's Heart Book: Every Woman's Guide to a Heart-Healthy Life. "Don't wait until your child is diagnosed with high blood pressure or gets sick to have his heart checked out. Everyone needs an ounce of prevention in the form of annual cholesterol and blood pressure screenings." Keep your kid's blood pressure in check at home with a diet that's low in sodium, saturated fats and sugars. And make sure your child gets at least 60 minutes of daily exercise, says Dr. Steinbaum. "Go for a walk, hike or bike ride with your kids every day," she adds. "Do everyone's heart some good."

Originally published in the February 2013 issue of Family Circle magazine.

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