Heart disease is multifaceted, and many behaviors and health conditions can contribute to it. While genetics plays a role, in most cases lifestyle plays a bigger part.

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ON NUTRITION

As you are likely aware, February is American Heart Month. You might think, “Don’t we all know about heart health by now?”

It’s true that many people know how to recognize a heart attack or what they can do to prevent heart disease — but the kicker is that they don’t act on that knowledge. They brush off the subtler signs of a heart attack, if it happens, and eat and live in a way that doesn’t support heart health, or general health.

Heart disease is multifaceted, and many behaviors and health conditions (high cholesterol, high blood pressure, type 2 diabetes, obstructive sleep apnea and atherosclerosis) can contribute to it.

While genetics plays a role, in most cases lifestyle plays a bigger role. The day-to-day choices you make about what to eat, how much to move, whether to smoke, how much alcohol to drink, when to go to bed and how to handle stress all add up, for better or for worse.

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One of the common threads is chronic inflammation. I’ve written previously about the role of your intestinal microbiome in inflammation, and it’s no coincidence that a lifestyle that supports a healthy population of bacteria in your gut also supports a healthy heart.

A heart-healthy, anti-inflammatory, microbiome-friendly diet includes an abundance of fiber-rich, nutrient-rich, phytochemical-rich plants, including vegetables, fruits, whole grains, legumes (beans and lentils), nuts and seeds. That’s one reason why Mediterranean-style diets have been shown to be effective for preventing heart disease and its complications.

A heart-healthy diet is also about quality. Whole grains are linked to lower rates of heart disease, while the opposite is true for sugar and refined carbohydrates (i.e. white flour and products made from it).

Just as not all carbs are created equal, neither are all fats. Excess saturated fat is still linked to high total and LDL (“bad”) cholesterol, and trans fats are even worse. But last year the Dietary Guidelines Advisory Committee stopped recommending that we limit total fat. That’s because some fats — including nuts, olive oil, avocados and oily fish — are heart-healthy, provided that you aren’t eating more calories than your body needs.

Now we’re back to knowledge vs. action. You know which foods will show your heart some TLC, but what are you doing with that information? If your answer is, “not much,” I challenge you to pick at least one of these suggestions and start integrating it into your life — today.

• Eat more vegetables. Aim for 4 cups per day, paying special attention to deeply colored vegetables, as they tend to be richer in nutrients and phytochemicals.

• Eat fish at least twice a week (about 8 ounces total), giving preference to oily fish like salmon and sardines, which are rich in omega-3 fatty acids.

• Cut back significantly on foods and beverages that contain added sugars. “Sugar” includes corn syrup, concentrated fruit juice, honey and anything ending with an -ose (sucrose, dextrose, fructose, maltose). Note: This does not include fructose found in whole fruit and lactose found in milk and dairy products.

• Swap refined grains for whole grains. For example, brown rice instead of white rice, whole-wheat flour instead of white flour, regular or thick-cut oats instead of instant oats.

• Cook at home, from scratch, more often. This is the best way to cut back on sodium, added sugars and low-quality fats, all of which don’t do your heart — or the rest of your health — any favors.