By Brianna Wolfe, RD, CD

February is American Heart Month, a time to give special attention to taking care of our hearts and preventing heart disease. Not all risk factors for heart disease are controllable (like age, family history, and race and ethnicity), but many others are. High cholesterol, high blood pressure, and being overweight are all risk factors for heart disease that can be prevented or improved through healthy lifestyle changes.

Heart Disease Defined

The term heart disease refers to not only diseases of the heart itself, but also diseases of the blood vessels. Many of these diseases begin with atherosclerosis, which is the build-up of plaque in the walls of the arteries. This build-up narrows and hardens the arteries. If a blood clot forms and blocks a blood vessel, this can result in a heart attack or a stroke (if it's a vessel that feeds the brain). High blood pressure can further damage blood vessels because it puts added force on the vessel walls.

Healthy Lifestyle

A healthy lifestyle, which includes regular physical activity, not using tobacco, managing stress, and eating healthfully, can certainly lower the risk for heart disease.

--Physical activity: The American Heart Association recommends at least 150 total minutes per week of moderate-intensity aerobic activity, or 75 minutes per week of vigorous activity. In addition, muscle-strengthening activity should be performed at least two days per week. If you are currently inactive, it is important to slowly work up to this level of activity.

--Tobacco use: Tobacco damages blood vessels, temporarily raises blood pressure, and reduces exercise tolerance. Quitting all tobacco products has a positive impact on heart disease risk and overall health, whether someone has been using tobacco for a few days or many years.

--Managing stress: Stress is an inevitable part of life; however, chronic unmanaged stress is linked to increased risk of heart disease. Stress itself can raise blood pressure. Additionally, stress can lead to engaging in other unhealthy habits such as overeating, under-exercising, or using tobacco. If you cannot find ways to manage stress on your own, seek out stress management classes or resources.

--Healthy diet: A diet that is considered "heart-healthy" is truly a diet that everyone can follow, regardless of existing heart disease. While it's true that nutrition recommendations seem to change frequently, basic tenants of a heart-healthy diet are rooted in common sense:

• Since excess weight contributes to heart disease risk, it's important to make sure that portion sizes and total calories per day are not excessive for your daily activity level. Follow your hunger and satiety cues and avoid oversized portions of less healthy foods.
   
• Eat plenty of fruits and vegetables. They're full of fiber as well as vitamins and minerals, including antioxidants. Fruits and vegetables are also good sources of potassium. Potassium can lessen the negative effects of sodium on blood pressure.
   
• Replace refined grains with whole grains. In the processing of refined grains, parts of the grain kernel are stripped away, thus removing most of the fiber, B-vitamins, and iron. The term "whole grain" means that the entire grain kernel is intact, as are the nutrients. The fiber in whole grains can help lower blood cholesterol levels.
   
• Reduce sodium intake. Most Americans consume much more than the recommended 1,500 mg of sodium per day. Most of the sodium in our diet comes from processed foods and restaurant foods. Check nutrition facts labels and choose food items with less than 20 percent of the daily value for sodium. Reduce the amount of salt used in cooking and at the table.
   
• Be choosy about protein sources. Research shows that poultry, fish, legumes, nuts and seeds are optimal protein sources. Higher-fat meats, such as dark meat poultry and red meat, can be included, but in reasonable portions. Avoid processed meats like hot dogs, luncheon meats, bacon, and sausage.
   
• Include heart-healthy fat sources. Fatty fish (salmon, mackerel, trout, sardines), walnuts and walnut oil, canola oil, and flaxseed all provide omega-3 fatty acids, which are cardio-protective. Nuts, nut butters, olive oil, and avocado are also healthy sources of fat. Avoid trans fat, which is found in processed food items.

 Cholesterol. Cereal boxes claim a bowl a day can lower it. Television ads tell us their drug can shrink it. But what is it, exactly?

In a nutshell, cholesterol is a fatty substance that flows through the blood and is stored in the body's cells. It's produced naturally in the liver and is also found in some foods. The body needs a small amount of cholesterol in order to function properly. It helps produce hormones, vitamin D, and digestive acids. Too much cholesterol, though, and from the wrong sources, can lead to a long list of medical problems.

The body has "good" and "bad" cholesterol. LDL (low-density lipoprotein) or "bad" cholesterol can build up on the artery walls, restricting the amount of blood traveling to the heart. HDL (high-density lipoprotein) cholesterol is considered "good" because it helps get rid of bad cholesterol.

The goal for a strong heart is to limit LDL cholesterol while maintaining an adequate amount of HDL. The trouble is, the typical American diet is overloaded with LDL sources such as meat, dairy, fish, and fowl-creature food. Foods grown in the garden or orchard, however, do not contain cholesterol or saturated fat and should be our predominant source of nutrition.

You can keep cholesterol from taking over your body. Start today by making an appointment with your doctor to test your levels. Even if you're on track, family history and the aging process can affect your cholesterol down the road. If your levels are less than stellar, work together to map out a nutrition and exercise plan tailored to your needs.

By Derek Bell, health promotion and wellness consultant

Your heart loves exercise. That is good news since exercise is a major factor in improving heart health. But to gain the most benefits and decrease opportunities for soreness and fatigue, you need to make sure you don't overdo it. Pushing too hard can deprive your muscles of needed oxygen, which leads to feeling pain and over-exhaustion, and can increase the likelihood you will stop exercising. There's a simple way to make sure you get the most out of your exercising and improving your heart health-reaching your target heart rate zone.

What is your target heart rate zone? It is when you have reached 60-80 percent of your maximum heart rate. It is advisable to not exercise above 85 percent of your maximum heart rate. This can increase cardiovascular and orthopedic risk and doesn't add any extra benefit. In addition, your benefits lessen greatly if you exercise below 60 percent of your maximum heart rate. It is also advisable to exercise within your target zone for 20 to 60 minutes per session, with activities like walking, biking, swimming, or using equipment like an elliptical trainer or stair climber. If you are targeting weight loss, or are measuring performance, then you will want to sustain your target heart rate zone for 45-60 minutes.

How to find your target heart rate zone:

 1. The Talk Test

You've found the right intensity if you can carry on a brief conversation while exercising with taking a few extra breaths. If you can easily carry on a long conversation, try pushing a little harder. If you are struggling to talk, then you're reaching the top end of your target heart rate zone.

 2. The Formula

For those who prefer the scientific method, follow this simple formula: 220 minus your age, multiplied by .60 to .80. In other words, your target heart rate is between 60 percent and 80 percent of your maximum heart rate.

For example, for a healthy 40-year-old, target heart rate is between 99 and 153 beats per minute.

220 - 40 = 180 (max heart rate)

180 x .55 = 99

180 x .85 = 153

Be aware these numbers are for the average person. Seasoned athletes or people with a heart condition may follow different guidelines. Ask your doctor what's right for you. You might find it difficult to monitor your target heart rate while engaging in high intensity exercise. If you want to monitor your heart rate and keep tabs on your pulse and minutes spent in your target zone, then you might want to consider purchasing a heart rate monitor. 

By Heidi Hayes, wellness account specialist

We all know healthy employees make a more productive workplace. So how can you encourage fitness among your team-during the work day? Try these helpful ideas.

1. Getting There - Make the most of your commute

Encourage employees to walk, bike, or if riding the bus get off a few blocks earlier. Studies have shown that people with active commutes have fewer risk factors for heart disease. They also have lower blood pressure, triglyceride, and insulin levels and are less likely to be overweight.

2. Fitness Break - Urban exercising

Sitting at a desk for 8 to 12 hours, 5 days a week doesn't sound so appealing. Many people actually become less productive when sitting in the same place for long periods of time. Take small fitness breaks during the day to get out of your slump and re-energize yourself! Take a couple laps around the office or find the stairs and start climbing. Doing this with a coworker makes it more enjoyable and also adds some good positive interaction. Keep a fitness band at your desk to work on some upper body strengthening exercises. You can easily strengthen your upper back, chest, arms and shoulders in just a few minutes two or three times a week.

3. Take a Stand

Instead of going about your whole day in a seated position, try standing! A 45-minute conference call can be turned into a 45-minute extra calorie burn. Try getting a high work table at a height that is comfortable for you. For a change in your lunch routine, try eating lunch while standing! Studies show you are less likely to overeat when you are on your feet. The bottom line is, the more you stand the more calories you will burn!

4. Tired of your chair? Trade it in!

If your job permits it, try using a firmly inflated exercise or stability ball instead of your chair - if you can safely balance on the ball. By sitting on an exercise ball, you will be constantly working on your balance while also engaging and toning your core. Take small breaks during the day and try incorporating the ball with leg lifts and other easy exercises to get your heart rate up.

5. Moving meetings

Meetings are conducted every day on a variety of topics. Many of us can say we have also tried to fight off those sleepy eyes and brilliant daydreaming sessions during those meetings. When it's practical, try a walking meeting or brainstorming session either outside or by taking laps around the office. This will help engage employees better, and they might even offer up more ideas. Bring a handheld recorder with you to record ideas and have fun! Just think of all the calories you are burning while having a walking discussion instead of sitting in the conference room!

6. Make the most of your lunch break

Try organizing a lunchtime walking group. After eating lunch, take a stroll outside and enjoy the great outdoors while burning calories and taking in some sunshine and vitamin D. Most employees have between a half-hour and hour to eat. Take 10-15 minutes to enjoy your meal and then spend the rest on a walk. If the weather isn't cooperating, take to the stairs if your building has them. You can incorporate a stretching routine or even a short yoga session. There are also short 15-20 minute fitness videos you could do to help get the blood pumping. When you come back after lunch, you will feel more refreshed and ready to take on the rest of your day.

Exercise in winter? It can be done! All you need is a little childlike spirit. Become a kid again with these fun cardio activities that burn calories and work your muscles--all while having tons of family fun.

Ice skating: Strap on the skates for some healthy figure-8's. Ice skating burns approximately 500 calories per hour.

Snow shoeing: Take the family on a winter nature walk! Trekking through the snow burns 400 or more calories an hour.

Cross-country skiing: This excellent sport works muscles you didn't even know you had, burning more than 400 calories in an hour.

Downhill skiing: Feel the exhilaration of brisk air in your lungs while you zoom downhill to the tune of 300 calories per hour.

Build a snowman or snow fort: Aw, come on, who doesn't love a snowman? This fun family activity can be good for your mental and physical health. Rolling and trudging through snow in the yard burns 285 calories an hour.

Sledding: Climbing uphill is great exercise -- burning nearly 400 calories an hour -- all for the bonus reward of whizzing back down with happy kids shrieking in your ear.

All calculations are based on a 150-pound person.

What's the best thing you can do to decrease your risk of heart attack? Stop smoking.

Tobacco use is the single most modifiable risk factor for heart disease. Quitting tobacco will do more to reduce your risk of a heart attack than anything else, including medication or surgery.

On the flip side, not stopping smoking may limit the ability of medications and procedures to prevent heart attacks. And of the several risk factors for heart disease-genetics, age, male gender, high blood pressure, diabetes, high cholesterol, and obesity-quitting tobacco is the one factor that you can control.

How does smoking hurt your heart? The chemicals in tobacco smoke damage blood cells, heart tissue, and blood vessels. Smoking also lowers HDL or "good" cholesterol, and raises blood pressure. These factors increase the risk of developing atherosclerosis, or plaque build-up in the arteries, which leads to heart disease. Furthermore, smoking a cigarette can generate acute damage to an artery, which could potentially trigger a heart attack.

The only real way to diminish the effects of smoking on the heart is to stop. Even an occasional cigarette can be harmful, so it's best to eliminate tobacco completely.

Many tools are available to help you stop smoking, such as nicotine patches, medications, and tobacco cessation classes. Talk to your doctor about the best options for you.