1. Ten Steps for Heart Health Paul Oh, MD MSc FRCPC FACP Medical Director, UHN - TRI Cardiac Rehab

2. ① Healthy weight ② Cholesterol ③ Daily fruits and vegetables ④ Normal blood sugar ⑤ Normal blood pressure ⑥ Regular alcohol consumption ⑦ Smoking ⑧ Stress and Psychosocial Factors ⑨ Sleep ⑩ Physical activity Ten Steps For Heart Health

3. 1. Healthy Body Composition Process vs. Outcome –Be patient as changes in body composition take time Waist vs. Weight –Focus on losing fat and gaining muscle –Do not focus on your weight as muscle weighs more than fat 1. Healthy Weight

4. 2. Cholesterol Targets Maintain a healthy cholesterol level by limiting the following in your diet: –Saturated and Trans fats –Sodium –Sugar –Choose lower-fat dairy products or alternatives –Avoid deep fried foods Increase the following foods in your diet: –Eat vegetables and fruit with every meal –Good Fats Omega-3s Fibre (whole grains and plant foods) 2. Cholesterol

5. 3. 3. Daily Fruits & Vegetables It is recommended that Women have 7 to 8 servings of fruits and vegetables a day –That is only 7 to 8 pieces of fruit or vegetables I.e.1 Banana + 1 Green Pepper = 2 Servings It is recommended that Men have 7 to 10 servings of fruits and vegetables a day –Fore more information about the size of a serving visit the Canadian Food Guide Canadian Food Guide

6. 4. Glucose and CV Events 4. Normal Blood Sugar High levels of blood sugar can increase your risk of getting diabetes and heart disease The World Health Organization, The Canadian Diabetes Association and The American Heart Association recommend adults consume less than 10% of total calories from added or free sugars. –Free sugars include all added sugars plus sugars naturally present in honey, fruit juices and syrups. For women, this means having less than 24 grams (6 teaspoons or 100 calories) of added sugars each day For men, this means having less than 36 grams (9 teaspoons or 150 calories) of added sugars each day

7. 5. Normal Blood Pressure Over time, high blood pressure can damage the walls of the arteries of the heart, which is why it’s critical to maintain a normal blood pressure. To reduce your blood pressure a DASH Diet is recommended. DASH stands for “Dietary Approaches to Stopping Hypertension”. DASH Diet Breakdown: Food GroupDaily Servings ( Based on Canada’s Food Guide) Grains and grain products7-8 Vegetables4-5 Fruits4-5 Low Fat Dairy2-3 Meats, Poultry, and Dish2 or less Fast and Oils2-3 Nuts, Seeds, Legumes4-5 per week

8. 5. Normal Blood Pressure 6. Regular Alcohol Consumption If you consume alcohol beverages do so in moderation: –For Men: no more than 1-2 drinks per day or less than 14 drinks per week –For Women: no more than 1 drink per day or less than 9 drinks per week

9. 5. Normal Blood Pressure 7. Smoking Talk to your doctor about quitting smoking and identify your triggers to smoke Cravings to smoke can be trigged by three things: –Nicotine withdrawal –Habits –Memories To avoid giving in to your cravings do the following: –Remind yourself it will pass –Do another activity, like exercise –Take deep breaths –Avoid activities that you associate with smoking

10. 5. Normal Blood Pressure 8. Stress and Psychosocial Factors Learn relaxation techniques to reduce stress, including: –Deep Breathing –Progressive Muscle relaxation –Visualization –Mediation As well, distract yourself by doing things you enjoy such as: –Playing or listening to music –Reading –Watching TV –Hobbies

11. 9. Sleep Your cardiovascular system needs a regular routine of rest each night Ensure you get 7.5 hours of sleep every night When you have disruptions in your sleep, there is a breakdown in the “rest and restore” period, which leaves your heart and other body systems in “over-drive”. – Lights, computers and T.Vs contribute to keeping you alert well into the night Disruptions in your sleep put you at a greater risk of weight gain, high cholesterol levels, high blood pressure and greater risk of making a heart disease worse 9. Sleep

12. 10. Physical Activity Are you active for at least 30mintes per day? Tips to becoming more active: –Include aerobic and resistance training ( weights or exercise bands) in your exercise program. This will help with: Decreasing body fat Increasing lean muscle Improving blood glucose levels Improving your fitness level –Avoid sitting for long periods of time Get up every hour and move or stretch

13. Ten Steps For More Information Visit www.cardiaccollege.ca