3 Underrated Tips To Prevent Heart Disease, From A Cardiologist

How should you care for your heart health? Perhaps you immediately think of cardio workouts to get your blood pumping and exercise those heart muscles or maybe a clean Mediterranean diet to prevent plaque buildup in your arteries.

However, according to board-certified cardiologist Michael Twyman, M.D., who focuses on the prevention and early detection of heart disease, there are some more underrated habits to keep in mind. On this episode of the mindbodygreen podcast, Twyman dives into everything you need to know about maintaining optimal heart health—below, find his three nonnegotiable tips:

"The most important metric is how well you sleep," says Twyman. "That's when your mitochondria are recovering. If you don't heal your mitochondria at night, it almost doesn't matter how well you eat or how much you exercise; your body has broken mitochondrial engines, and you're not going to make energy as efficiently." 

When you sleep, your body goes into "repair mode," focuses on cellular rejuvenation, and your brain flushes out waste. It's like you're charging up your batteries for a long day ahead, and according to Twyman, that recharge is essential for mitochondrial (and cardiovascular) health. "If you have chronic fatigue, you're just dragging all the time, your mind is foggy, you get chronic infections all the time… That's a sign that your mitochondria are not efficient at making energy for you," he explains.

It's no wonder studies have shown that sleep habits play a role in the development of cardiovascular disease (CVD). One study found that short sleepers (aka, those who slept less than seven hours each night) had a higher prevalence of overweight/obesity, Type 2 diabetes, and high blood pressure.

While there's no "magic hour" you have to sleep (it's more about quality than quantity!), Twyman argues you should generally fall asleep three to four hours after the sun sets. If you have trouble winding down, feel free to take a peek at our favorite science-backed sleep aids.

On the subject of sleep, Twyman also stresses the importance of living in tune with your circadian rhythm. Your circadian biology is so significant for overall health, in fact, that he even considers it step No. 1 on the road to optimal well-being. "Your circadian biology dictates how your nutrients get processed in your system," he explains. "So you have to get your circadian biology right first." 

That said, in addition to setting yourself up for a good night's sleep, he also recommends getting natural, bright light first thing. "The morning sun hits the receptors in your eye called melanopsin. That blue light detector tells the suprachiasmatic nucleus1 in your brain that it's daytime, and you start making different hormones and neurotransmitters to wake you up for the day. Then when the sun sets and that receptor doesn't see blue light anymore, the body knows it's nighttime. Cortisol will start dropping, melatonin will start to rise. That cascade has to happen to have optimal health," he notes.

In terms of cardiovascular health, we know that cortisol has a significant effect on your thyroid hormones, which affect the metabolism of the food you eat. When cortisol drops in the evening, your metabolism simultaneously slows down, which makes it more likely that your body will store the food you eat as fat.

Perhaps that's why night owls (or those who go to bed late) may have a reduced ability to use fat for energy, which can result in fat accumulation and subsequently, increased risk for disease. Early birds, on the other hand (or those who wake up with the morning sun), have been shown to use more fat for energy while exercising and at rest, compared to night owls. "We have to get that stuff right first before people can really dive into the nutrition question," Twyman adds. Here are some tips to optimize your circadian rhythm, if you're looking for a guide.

The protein topic can get tricky: If you're familiar with the cardiovascular health conversation, you probably know that too much red meat has been associated with cardiovascular risk, depending on your biology. That's why many experts recommend eating plant-based if you have a higher risk of CVD. However, "getting enough protein is critical," says Twyman, but getting enough protein can be difficult without adding animal sources.

"You always want to focus on whole food protein if possible," he continues, like eggs and fish. He's also a big proponent of omega-3 fatty acids for heart health, so he recommends prioritizing cold water fish like salmon, mackerel, anchovies, sardines, and herring (also referred to as SMASH). "But if you can't get enough eggs or fish in your diet, then I'm not opposed to protein powders," he notes. "If you're going plant-based, you're probably going to [eat] a lot of pea protein because the other ones are not as bioavailable." See here for our favorite pea protein powders on the market, if you'd like to make the switch.

Optimal heart health requires way more than working out and eating clean. Diet is important, no doubt, but you want to set your mitochondria up to be able to process those nutrients as best they can. And when your mitochondrial health runs smoothly, every other function (cardiovascular included) tends to perform at tiptop shape.

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