6 Numbers to Save Your Life
Here are six measurements that will provide a multifaceted view of where you stand in your battle against the six main heart attackers. How easy? Three are totally do-it-yourself and the others are standard doctor’s-office procedures.
1. Daily Calorie Needs
Know Your Requirements
Okay, this isn’t technically a measurement, but it’s a number that, if you pay attention to it, can have a huge influence on your health.
How much food should you eat in a day? Few people know the answer to this question. Here’s a basic formula for calculating your calorie needs: from 13 to 15 calories per pound of body weight per day, depending on your activity level.
How much food do you actually eat? Many of us nibble and nosh our way through the day without any real sense of how much we’re consuming. In most cases, we are eating much more food than we need.
In a perfect world, the difference between your daily intake and your daily needs would be zero-that is, you’d eat just enough to provide fuel for your body. If you were trying to lose weight safely, you’d eat roughly 500 calories less than your body requires. The reality is, though, that many of us eat from 100 to 1,000 calories more than we need.
It sounds simple, but no health number is as important-and as instructive-as the one that helps you understand your daily food needs and whether you’re exceeding them. The obvious reason is that overeating leads to weight gain, and becoming overweight is among the worst things you can do for your heart and health. The less-than-obvious reason is that eating too many calories usually means eating unhealthy foods, since they’re so much higher in calories than natural, healthy foods because of all the fat and sugar in them. It’s almost impossible to get too many calories if you focus on eating lots of fruits and vegetables. And having a diet rich in produce means you get loads of vitamins, minerals, antioxidants, and other nutrients essential for heart health.
Most women need approximately 1,800 calories a day for good health. Men typically need about 2,100. That usually equates to 300 to 400 calories for breakfast, 400 to 500 for lunch, 500 to 600 for dinner, and two or three snacks of roughly 100 to 200 calories each.
But don’t rely on such broad estimates. Your daily calorie need isn’t a static number; it can change over time. If you are exercising more, healing from disease, or in a high-stress period, your body may need extra fuel. If you’ve lost weight, chances are your body requires less fuel than it once did. Then there’s metabolism-some of us burn calories more efficiently than others.
The main message: All adults should have a good understanding of how much food they need to eat each day for optimal health, energy, and weight. The trick is how to do that. Calories are the simplest statistical measure, but steak doesn’t have its calorie count stamped on it anywhere, and who wants to look up everything they eat in a calorie counter and keep a tally of it all? The next best way-and the one we recommend-is visual training: learning what, for example, a 300-calorie breakfast looks like.
2. Waist Circumference
A Top Way To Monitor Body Fat
Surprised? It turns out that of all the ways to measure whether your weight is affecting the health of your heart, waist size is among the best.
Remember that fat cells aren’t just storage lockers for extra calories your body can’t burn off. When body fat is packed into your abdomen-literally in and around your internal organs-the fat cells act as thousands of dangerous little hormone pumps that churn out inflammatory chemicals and out-of-whack levels of appetite-controlling proteins. The result? Your risk of heart attack soars as inflammation speeds up atherosclerosis.
Plus, your risk for insulin resistance and metabolic syndrome rise as inflammatory substances interfere with the way muscle and liver cells function. Meanwhile, your natural appetite-suppressing system is thrown off, leading to even more overeating and more abdominal fat. Unless you have access to sophisticated laboratory scanning equipment that can view fat directly, checking your waist circumference with a tape measure is the best indicator of how much abdominal fat you have inside.
For women, the health risk begins to rise with a waist circumference of more than 31 inches; over 35 is a serious threat. For men, risk increases with a measurement of more than 37, with over 40 being serious.
How to check: Wrap a tape measure around your body in the middle of your abdomen, at or near your belly button. Keep it snug but not tight-and don’t suck in your gut. (No one else has to know your number!)
How often to check: Every two weeks. (A note for women: Try not to measure in the week before and during your menstrual period, when water retention may bloat your belly and give a false measurement.)
Why it’s important: Regular checks will help you track your progress as belly fat melts away.
3. LDLs and HDLs
Cholesterol Counts Do Count
We’ve “cheated” here and included two numbers in one category-for two good reasons. First, it’s important to know not just how high or low your “bad” LDL cholesterol levels are but also whether your “good” HDLs are up to the challenge of mopping up extra LDLs to protect your arteries.
Second, we want to be certain you ask for and receive a detailed cholesterol report each time your doctor checks your blood lipids. Knowing only your total cholesterol won’t give you the specifics you and your doctor need to accurately assess and reverse heart risk.
We recommend that you strive for LDLs below 100 mg/dl, especially if you have a history of heart attack or known heart disease. Levels up to 130 are considered nearly optimal; above 130 is high. For women, healthy HDLs should be 50 to 60 mg/dl or higher; for men, their HDLs should be 40 to 50 mg/dl and above.
How to check: Your doctor will check your cholesterol after you’ve fasted for 8 to 12 hours. We recommend doctor’s-office checks instead of home cholesterol test kits, which are usually less accurate and can’t give you those all-important LDL and HDL numbers.
How often to check: Once a year if your LDLs and HDLs are within healthy ranges or as often as every three months if your cholesterol is high and you’re working actively to lower it.
Why it’s important: LDL and HDL levels are among the strongest predictors of heart attack risk. Regular checkups will help you notice trends (Are your LDLs steadily rising? Your HDLs slowly falling?) and give you a chance to take steps to correct problems before they happen.
4. Blood Pressure
An Indicator of Artery Health
Blood pressure-the force of blood against the walls of your arteries-rises and falls naturally during the day. When it remains elevated, you have hypertension and with it, a higher risk of atherosclerosis, heart disease, and stroke.
A reading of 140/90 mm/Hg or more is considered high, but if it’s between 120/80 and 139/89, you have prehypertension and should take steps to prevent the development of hypertension.
How to check: If your pressure is normal, the standard advice is have a retest every two years. But a new study published in the Journal of the American Medical Association found that 13 percent of people whose pressure seemed normal in the doctor’s office actually turned out to have high blood pressure when they checked at home. We suggest talking with your doctor about the pros and cons of getting a home blood pressure monitor (she can help you figure out which type is best for you) and getting instructions on how to use it.
How often to check: If your doctor doesn’t recommend a home test, ask for a blood pressure check at every doctor’s visit. Also take advantage of other opportunities to check it-at community blood pressure checks, workplace health fairs, and even blood pressure testing machines at the drugstore. These aren’t substitutes for doctor’s-office checks, but they’ll help you track your personal BP trends.
Why it’s important: Regular checks will help spot a potential problem early, when lifestyle changes are more likely to resolve high blood pressure.
The Other Type of Fat to Watch
Triglycerides are chemical packages that contain extra calories your cells can’t burn right after a meal. They’re made from the carbs and fats you eat, which are converted into a form that can be stored in fat cells.
Triglycerides are also released from fat tissue when the body needs extra energy between meals. It’s normal to have some triglycerides in your bloodstream, but extra-high levels are linked to coronary artery disease, especially in women. When you have high triglycerides paired with low HDLs, your risk of insulin resistance and metabolic syndrome may be elevated.
A normal triglyceride reading is less than 150 mg/dl. Borderline high levels are 150 to 199 mg/dl, and over 200 is high.
How to check: A triglyceride check is usually done with the same blood sample your doctor draws for a fasting cholesterol test.
How often to check: Test triglycerides once a year if your levels are normal or as often as every three months if they’re high.
Why it’s important: Regular checks are an important early warning system for your heart.
6. Morning Pulse Rate
Know If Your Heart Is Strong
Your pulse is the number of times your heart beats in 1 minute. Regular monitoring of your resting pulse, first thing in the morning, will help you see if your exercise program is strengthening your heart. It will also help you spot problems that can’t be found with the other checks mentioned in this chapter.
For example, a normal resting pulse rate is 60 to 90 beats per minute. Normally, people in better physical condition have lower resting rates because their heart muscles are in good shape, and each beat is strong and forceful. If you’re not a regular exerciser and your heart rate is lower than the normal range, tell your doctor-it could be a sign of heart disease. When checking your pulse, also notice how the beats feel.
A healthy pulse feels soft yet firm against your fingers; a weak pulse feels faint and could indicate heart failure. If your pulse feels hard and pounding, it could be a sign of atherosclerosis, and an irregular rhythm could be a sign of a heart abnormality. Tell your doc if you notice anything unusual about the “feel” of your pulse.
How to check: You’ll need a clock or watch with a second hand. The pulse is best measured at the wrist or neck, where an artery runs close to the surface of the skin. To measure the pulse at your wrist, place your index and middle fingers on the underside of the opposite wrist. Press firmly with the flat of your fingers until you feel the pulse. For a neck measurement, gently press your index and middle fingers against your neck in the hollow just below and in front of the back corner of your jawbone.
After you’ve found your pulse, count the beats for one minute (or count for 30 seconds and multiply by two). The result is your pulse rate in beats per minute.