I developed and facilitated a Group Lifestyle Balance Follow-Up Session for active duty personnel, dependents and retirees. I provide background information, statistics and informational resources pertaining to heart health. I worked with patients to develop individualized strategies to meet their lifestyle goals.

1. Heart HealthMarissa Yovetich MS, HE

2. Heart Health
 What is it?
 Current Statistics
 Signs & Symptoms
 Eating for heart health
 Exercising for heart health

3. What is it?
 The human heart is the body’s engine. It is roughly the size of the owner’s
clenched fist. It resides securely in the middle of the chest behind the breastbone
and between the lungs.
 Composed of “involuntary” cardiac muscle
 Composed of 4 chambers, upper/low on left/right sides
 Blood pumps through upper portion, atrium, to lower ventricle and up through pulmonary
artery to the lungs to receive oxygen
 Aorta transports freshly oxygenated blood to the body, “A” and away
 Veins bring blood to the heart

4. At the Heart of the Matter

5. What is it?
 The heart pumps blood through a 60,000 – mile – long network of vessels
 Beats ~ 70 – 80 x per minute, 100,000 x per day, 40 million x per year, 3 billion x per life
 Blood supplies oxygen from the lungs to organs and tissues, while removing carbon
dioxide.
 Blood facilitates nutrient distribution, immune system regulation, hormone delivery and
delivers waste products to the kidneys and liver to be filtered.

6. What is it?
 Heart Disease: an umbrella term for several types of heart conditions
 Coronary Artery Disease
 Heart Attack
 Other Related Conditions (i.e. angina, arrhythmias, atherosclerosis)
 Coronary Artery Disease (CAD): caused by plague buildup in artery walls that
supply blood to the heart.
 The most common type of heart disease in the United States
 Cholesterol deposits accumulate creating plaque, which narrows the arteries and
reduces blood flow

7. At the Heart of the Matter

9. Heart Disease Risk Factors
 Existing health conditions, lifestyle choices, age and family history can increase one’s
risk of heart disease
 Key Risk Factors:
 High blood pressure
 High cholesterol
 Smoking
*47% of Americans have at least one of these risk factors
 Controllable vs. Non – controllable risk factors
 Behavior/Conditions/Family History

10. Interconnected Diseases

11. The Pulse of The Nation
 Heart disease is the leading cause of death for both men and women
 Coronary Heart Disease (CHD) is the most common
 Nearly 80 million adults in the United States have at least one form of heart disease
 Roughly 610, 000 people die of heart disease every year in the United States
 1 in 4 deaths due to heart disease
 Every year 735,000 Americans have a heart attack
 71.4% are first time sufferers
 28.5% are second time sufferers
 In the United States, someone has a heart attack every 34 seconds. Someone dies of a
heart disease – related event every 60 seconds, in the United States.

12. Alarming Numbers

13. The Pulse of The Nation
• Prior to age 75, a higher proportion
of CVD events attributable to CHD
occur in men than in women. A
higher proportion of events
attributable to stroke occur in
women than in men.

14. The Pulse of The Nation
 Direct and indirect costs
associated with heart disease
amount to more than $320.1
billion.

15. The Pulse of The Nation
• “Life’s Simple 7”
• The American Heart
Association defines “ideal
cardiovascular health” as
the absence of disease
and presence of seven
key health factors and
behaviors.

16. By The Numbers…

17. It’s a Women’s World
 More than 1 in 3 female adults has some form of cardiovascular disease
 In 2013, CVD accounted for 1 death every 80 seconds among females. This is
equivalent to the number of female deaths from cancer, chronic lower respiratory
disease, and diabetes combined.
 Approximately 3 million females are living with heart failure (HF). 475,000 new
cases of HF are diagnosed each year.
 23% of women 45 years of age and older who have an initial heart attack die within
a year compared to 18% of men

18. Signs & Symptoms
 The common signs and symptoms for cardiovascular disease include, but are not
limited to:
 Chest pain (angina)
 Shortness of breath
 Pain, numbness, weakness or coldness in your legs or arms due to narrowing of blood
vessels
 Pain in the neck, jaw, throat, upper abdomen or back
 Signs and symptoms may manifest differently in men and women. Men are more
likely to experience chest pain, while women are more likely to experience
shortness of breath, nausea and extreme fatigue.

19. Signs & Symptoms

20. Healthy Measures

21. Eating For Heart Health
 To maintain weight, caloric consumption must equal caloric expenditure
 Dependent on resting metabolic rate (RMR), activity level and existing conditions
 Limit foods rich in saturated fats, trans fats and sodium
 Reduce consumption of “nutrient – poor foods”, those high in calories but low in nutrients – limit
alcohol consumption to no more than one drink/day for women and two drinks/day for men
 Select lean cuts of red meat, chicken/poultry and fish
 Consume vegetables in abundance – (yay fiber!)
 Consume fruits in moderation

22. Periodic Table of “Real” Food

23. Eating For Heart Health
 Quality over quantity!
 Eating from a 8.5 inch plate vs. a 12 inch plate saves approximately 400 calories
 Increase consumption of foods rich in Omega – 3’s

24. Daily Dose of Goodness

25. Fatty Acid Frenzy
 Fatty acids are formed when fat is metabolized or broken down
 Insoluble in water
 Used as energy by most cells in the body
 Can be monounsaturated, poly – unsaturated, or saturated
 Help move oxygen through the body, aid cell membrane development, strength, and
function
 Help rid the arteries of cholesterol build up, “plaque”
 Promote proper clotting
 Assist in blood pressure regulation

26. Fatty Acid Frenzy

27. “O” Is For Omega!
 There are 3 main types of fatty acids, omega – 3, omega – 6, omega – 9
 Omega – 3 and Omega – 6 are “essential” fatty acids - NOT produced in the body
 The typical American diet consists of 10 x more Omega – 6 than Omega – 3
 Results in reduced metabolism and secretion of blood and tissue omega – 3’s
 Promotes inflammatory response within the body
 Reducing dietary ratios of omega – 6 to omega – 3 fatty acids has been shown to
prevent death after a heart attack

28. “O” is For Omega
 Omega – 3 Poly Unsaturated Fatty Acids
 Composed of EPA and DHA
 Have been shown to have anti – inflammatory effects
 “polyunsaturated” = two, three, four or more carbon – carbon double bonds
 Naturally occurring fatty acids assume cis configuration, both hydrogens are on the same side of the
double bond.
 Trans fatty acids, link to heart disease, have hydrogens on opposing sides of the double bond.
(i.e. margarine, liquid vegetable oils)

29. Omega – 3 Rich Foods

30. “O” is For Omega
 Omega – 3 fatty acids have a higher oxidative rate than saturated fatty acids
 Omega – 3 fatty acids, specifically EPA and DHA have been shown to:
 Increase the body’s ability to breakdown fatty acids
 Suppress the formation of new fat (lipogenesis)
 Support insulin sensitivity
 Regulate appetite
 Direct nutrients, amino acids and glucose, toward lean body mass and away from fat mass

31. Recommendations
 The American Heart Association recommends that healthy adults consume fish at
least two times per week
 Fish rich in omega – 3’s include: catfish, halibut, salmon, striped sea bass, and albacore
tuna
 The World Health Organization recommends a daily EPA and DHA intake of 0.3 –
0.5 grams
 Fish oil dosage can vary widely, depending on existing health conditions. Consult
your primary care physician for dosage recommendations.

32. Recommendations
 Things to keep in mind when looking for a fish oil supplement:
 Make sure that the supplement is fresh
 (old supplements may contain high levels of peroxidation – breakdown of fats)
 Molecularly distilled and pure
 Lowest possible levels of heavy metals and organic contaminants
 Supported by third – party testing and clinical research
 www. Labdoor.com supplement rating/verification site
 Omega – 3’s are derived from FISH forms
 Plant derived forms are popular in supplements, due to lower cost to produce. However, the body does
not convert plant omega – 3’s as efficiently as fish forms

33. Exercising For Heart Health
 The age old adage, “if you don’t use it, you lose it” applies to heart health
 Strengthening the heart allows it to work more efficiently and longer
 Both cardiovascular and muscular strength training are needed as the heart is a muscle
and the “heart” of our cardio system
 Regular cardiovascular and muscular strength training can decrease cardiac
demands of muscular work and slow age – and disease – related declines in
muscular strength and mass
 A lack of cardiovascular and muscular strength training can result in a loss of up to
30% muscle mass between the ages of 50 – 70

34. Exercising For Heart Health
 Muscular Strength
 2 + days/ week
 2 – 3 sets, 10 – 15 repetitions
 20 + minutes for 5 – 6 muscle groups
 Target major body parts: 3 – 4 exercises & minor body parts: 1 – 2 exercises
 Perform major body part (large muscle) exercises before minor body part exercises!
 Use free weights, machines, body weight, medicine ball, resistance bands, etc.

35. Exercising For Heart Health
 150 minutes of “moderate” intensity physical activity or 75 minutes of vigorous
activity, or a combination of both, is recommended each week
 For cardiovascular benefits, aim for physical activity sessions that last at least 10
minutes
 To lower cholesterol and or blood pressure, the American Heart Association
recommends 40 minutes of aerobic exercise of moderate to vigorous intensity
three to four days per week

36. References
 American College of Sports Medicine. (2010). ACSM's Guidelines for Exercise Testing and Prescription (Eigth ed.). Wolters Kluwer Health.
 Centers for Disease Control and Prevention. (2015, August 10). Heart Disease. Retrieved August 26, 2016, from http://www.cdc.gov/heartdisease/about.htm
 Lopez, H. L., Nelson, M. T., & Bibus, D. M. (2013). Fat. In A. E. Smith, PhD, Cscs*D, CISSN & J. Antonio, FNSCA, FISSN, CSCS (Authors), Sports Nutrition & Performance Enhancing Supplements
(pp. 111-164). Linus Learning.
 Mayo Clinic. (2014, July 14). Heart Disease. Retrieved August 26, 2016, from http://www.mayoclinic.org/diseases-conditions/heart-disease/basics/symptoms/CON- 20034056
 Mayo Clinic. (2015, March 18). Heart - Healthy Diet: 8 Steps To Prevent Heart Disease. Retrieved August 26, 2016, from http://www.mayoclinic.org/diseases-conditions/heart-disease/in-depth/ heart-
healthy-diet/ART-20047702
 Mayo Clinic. (2013, November 1). Omega - 3 Fatty Acids, Fish Oil, Alpha - Linolenic Acid. Retrieved August 29, 2016, from http://www.mayoclinic.org/drugs-supplements/ omega-3-fatty-acids-fish- oil-alpha-
linolenic-acid/dosing/hrb-20059372
 Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, Das SR, de Ferranti S, DesprésJ-P, Fullerton HJ, Howard VJ, Huffman MD, Isasi CR, Jiménez MC, Judd SE, Kissela BM, Lichtman
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 National Geographic. (n.d.). Heart. Retrieved August 26, 2016, from http://science.nationalgeographic.com/science/health-andhuman- body/human- body/heart-article/
 The American Heart Association. (2015, August). The American Heart Association's Diet and Lifestyle Recommendations. Retrieved August 26, 2016, from
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 The Heart Foundation. (2015). Heart Disease: Scope and Impact. Retrieved August 26, 2016, from http://www.theheartfoundation.org/heart-disease-facts/heart-disease-statistics/
 U.S. Food and Drug Administration. (2011, February 8). Eat for a Healthy Heart. Retrieved August 26, 2016, from http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm199058.htm
 WiseGeek. (n.d.). What are Fatty Acids? Retrieved August 29, 2016, from http://www.wisegeekhealth.com/what-are-fatty-acids.htm