Eat better, drink less, exercise more, sleep enough: its common advice for heart health and its frequently ignored. Few North American adults meet the standards for healthy levels of physical activity, consumption of fruit and vegetables, body fat and smoking, according to recent study.

But a major lifestyle overhaul isnt the only way to help your heart, studies suggest. Even small changes can make substantial differences.

Eventually, little changes can add up, says David Goff, director of the cardiovascular sciences division at the National Heart, Lung, and Blood Institute in Bethesda, Md.

"Any small change you make in a positive direction is good for you," he says. "Its not an all-or-nothing phenomenon."

Physical activity is a perfect example, Goff says. Official guidelines, which recommend 30 minutes of moderately intense activity on most days, are based partly on evidence of substantial health benefits from doing 150 to 300 minutes of exercise each week, according to a 2011 review study by researchers at the University of South Carolina at Columbia. Those benefits include reduced risks of coronary heart disease, stroke and high blood pressure.

But the guidelines also come out of an assessment of what is obtainable for most people, Goff adds. And while it would be ideal to get at least 150 minutes of exercise weekly, getting less than that also has benefits. When the researchers looked at deaths from all causes, they saw the sharpest drop in mortality when exercise jumped from half an hour to an hour and a half each week.

Just getting up for a minute or two to interrupt bouts of sitting may also improve health, the study noted. And moving for as little as eight minutes a few times a day provides the same cardiovascular benefits as 30 uninterrupted minutes.

"If you cant find 30 minutes a day, try to find five or 10 or 15," Goff says. "Anything is better than nothing."

The "some is better than none" philosophy applies to dietary improvements, too, Goff says. According to the National Institutes of Health, an ideal meal plan includes lots of fruit, vegetables and whole grains, with limited amounts of fatty meat and tropical oils.

But eating an imperfect diet with more of the good stuff is better than giving up entirely. Thats a conclusion from a 2016 study that created food-quality scores from the self-reported diets of about 200,000 people. Over about 25 years, the study found, people whose diets scored lowest had a 13 per cent higher risk of coronary artery disease than did people in the second-worst group.

Even just switching out soda and other sugar-sweetened beverages can help eliminate a couple hundred calories a day and control weight. That helps lower blood pressure, levels of harmful cholesterol and the potential for diabetes all risk factors for heart disease, Goff says. Large long-term studies have shown that people who average one sugary drink a day have a 20 per cent higher risk of heart attack than people who rarely drink any.

Its not just food and diet, adds Michael Miller, director of the Center for Preventive Cardiology at the University of Maryland School of Medicine and author of Heal Your Heart: The Positive Emotions Prescription to Prevent and Reverse Heart Disease. Heart strength can also come from battling stress by boosting emotional health in simple and unexpected ways, he says, such as enjoying a good laugh.

In a small 2005 study, Miller played movie clips for 20 people. When participants watched a scene that made them laugh, 19 of them experienced dilation of the blood vessels. In contrast, a stressful scene led to constriction in 14 of the 20 viewers. Since then, Miller says, other small studies have found similar results, including one showing that vessels stayed dilated for 24 hours. Dilation allows more blood to flow, decreasing blood pressure and heart rate.

"Cross-talk" between the brain and heart explains the potential long-term benefits of laughter, Miller says, particularly when laughter is intense enough to induce crying. Belly laughing releases endorphins, triggering receptors in blood vessels to produce nitric oxide, which in turn, dilates blood vessels, increases blood flow, reduces the risk of blood clots, and more.

People are far more likely to laugh when theyre with friends, Miller adds, adding yet more evidence of the health benefits of being social.

Accumulating evidence suggests that another easy and enjoyable way to help your heart is to listen to music. During recovery from surgery, several studies have shown, listening to relaxing music leads to a reduction in anxiety and heart rate. And in a 2015 study, Greek researchers found reductions in how hard the hearts of 20 healthy young adults were working after 30 minutes of listening to rock or classical music.

"I tell my patients to dust off their old LPs now that LPs are coming back and listen to a piece of music they have not heard in a long time but in the past made them feel really good," Miller says.

Also on his list of recommendations: mindfulness meditation and hugging. Both, he says, look promising in studies of heart health and heart repair.

"Considering that stress probably accounts for a third of heart attacks," he says, "it can have a dramatic effect if you do all of these things in sync."

The Washington Post

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