how can I keep my heart strong?

5 Steps To Keep Your Heart Healthy

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Struggling to keep your heart healthy or just worried about how strong it is? Then this article is for you.

When it comes to our health, it is important that we take the right steps to make sure we are well. In India, our busy lifestyles mean that we often have insufficient time to exercise regularly to keep ourselves healthy.

One of the most important aspects of staying healthy is having the determination and drive to do so. While it is easy to blame a lack of time to exercise, deep down inside we know that it is just pure laziness and a whole ‘I can’t be asked…’ attitude.

Get the attitude right, set yourself some goals, and plan your weekly routines well, and you are on your way to a healthy life.

Okay, this post is not going to be one that is meant to inspire you, but one that will advise you on what you can do to maintain a healthy heart.

I have always strongly believed that there are just 5 simple steps to keep your heart healthy that will get you on your way to a healthy life. These steps are meant for people with or without any medical illnesses.

I like to call it ‘HEART’.

5 Steps To Keep Your Heart Healthy

H = Healthy Eating

The Indian diet is rich in carbohydrates, sugars and fats. We enjoy rice, bread and a variety of fried foods, and love to end our meals with a sweet dish.

While these dishes are no doubt delicious, they can in the long term lead to obesity, high blood pressure and diabetes.

Combine that with smoking and a family history of heart disease and you are looking at a heart attack or stroke at some point in your future.

What can we do about this?

In the western world, a new dictum of ‘5 portions of fruit and veg a day’ has caught on, and depicts what exactly one should be doing to follow a healthy diet.

If we are looking to live a long and healthy life, then consuming a diet that is rich in fruits and vegetables is essential.

FoodI generally recommend the same to patients. Consuming a good quantity of fruits and vegetables everyday is extremely important.

Of course, patients with diabetes should make sure they speak to their doctor or their dietitian regarding what the best diet is for them.

Vegetarian diets are rich in carbohydrates, dietary fiber, vitamins and minerals, but can be low in protein, vitamin B12 and zinc. Clinical studies have shown that vegetarian diets can reduce the chances of dying from heart disease, though this benefit appears to be modest at the most (Kwok et al).

While vegetarian diets are healthy, there do appear to be certain misconceptions regarding its true benefit. Vegetarian food in India tends to be cooked with a lot of oil (which is not necessarily a good quality oil), which can be harmful to health.

The vitamins and minerals in vegetables can help maintain a healthy body, but these positive effects can be negated by the way the food is cooked.

Vegetarian diets are very low in iron and vitamin B12, and many vegetarians can suffer from anemia (low hemoglobin) due to lack of these nutrients.

The protein content in vegetarian diets is also low, and legumes and pulses can provide some protein, along with nuts and seeds. Soya protein is an excellent source of protein.

That being said, vegetarian diets can provide a majority of the essential nutrients and fiber the body needs.

Bearing this is mind, it is important that food is prepared with very little oil and salt. In addition, when eating food, make sure you do not overeat and maintain a healthy portion size.

But is non-vegetarian food bad?

Not really, but it depends.

Non-vegetarian food can also be very good for health, provided it is the right kind of food and is cooked the right way.

Lean meat like chicken and fish are packed with calcium, vitamins, protein and essential amino acids, all of which can keep muscles healthy and bones strong. Red meat is a good source of protein, but is unfortunately high in saturated fats which can be harmful.

Eggs are probably the most wholesome non vegetarian foods these is. It contains very high quality protein in it, and the yellow yolk does have a lot of good fats.

So what is recommended?

  • Maintain a diet that is rich in fruits, vegetables and lean meat and low in fats and sugar.
  • Make simple changes like missing the sweet after your meal and having a piece of fruit instead.
  • Eat wholegrain products.
  • Keep intake of rice and rice based products (idli, dosa etc.) to a minimum.
  • Enjoy dairy products, but avoid ones high in fat like cheese and butter.
  • Opt for low fat varieties of ready dairy products if available (but watch out for the sugar content in these).

The Mediterranean diet is believed to be the healthiest diet in the world and has been shown to keep the heart healthy.

However, following that diet in India can be hard given how much we love our spices, but you could use the same concepts in your daily cooking to keep your diet healthy.

E = Exercise Regularly

If you are looking to lose weight and become ‘slim and trim’, then exercise is the only solution. A diet will help no doubt , but combining it with a good exercise routine will is a sure fire recipe to keep your heart healthy.

There are currently no recommendations made regarding how much exercise must be performed to lose weight that is tailored to the Indian population.bigstock-Young-lady-running-on-a-rural--45934126

However, the American Heart Association is very clear on this, and recommends 150 minutes of moderate intensity aerobic exercise a week. That amounts to 30 minutes of exercise 5 days a week. You even get 2 days off a week!

Just of note, moderate intensity aerobic exercise includes brisk walking, jogging, swimming and sporting activities like tennis. All these get your heart pumping, thus keeping your heart healthy and circulation efficient.

Medical bodies believe that while this amount of exercise may be sufficient to maintain the body weight, it is not sufficient if one is looking to lose weight.

Depending on the age of the patient as well, exercising at ‘moderate aerobic intensity’ can be quite hard. I feel that younger patients should attempt harder exercises such as jogging outside, swimming or running on a treadmill as opposed to simple walking and yoga.

Older patients may find it hard to lose weight, but can attempt to do so with activities such as brisk walking.

Individuals with knee pain looking to lose weight can consult a physiotherapist or their doctor regarding ‘aquatic’ therapy, which involves exercising in a swimming pool.

There are other simple steps that one can follow to get their daily ‘dose’ of exercise. Using the stairs instead of the elevator is one of them. Walk to your local shop – don’t drive.

Remember – any exercise is better than no exercise. A recent study found that even short walks add up to good exercise and can protect your heart.

Even if you find 10 minutes in a day to do some exercise, grab that opportunity.

Tip –  Join a running group or a local health club. Join the gym with a motivated friend. Grab a friend and go for a walk. Anything and everything goes when you want to exercise!

A = Avoid Smoking

Cigarette smoking is rampant in urban India, and beedi smoking is the same in rural India.

Smoking is the number one cause of heart disease and stroke. We all know it, yet many of us still smoke.

Here is the deal with smoking –

Cons (Harms)

  • Smoking increases the chances of developing heart disease and heart attacks.
  • Smoking increases the risk of stroke
  • Smoking increases the chances of developing lung cancer
  • Smoking increases the chance of asthma and chronic lung disease
  • Smoking increases the changes of developing cataracts and blindness
  • Smoking increases the chances of impotence and sexual dysfunction
  • Smoking increases the chances of developing diabetes
  • Smoking increases the chances of developing tooth disease
  • Smoking increases the chances of developing bone disease and fractures
  • Smoking increases the chances of developing problems with pregnancy and conception
  • Smoking increases the chances of developing high acidity and stomach ulcers

Pros (Benefits)

  • Makes you feel good for a few minutes
  • Nothing else.

Clearly, smoking has a number of harmful effects on the body, and many of us choose to ignore it.

Smoking at an early age has become a ‘fashion’ and peer pressure means that the younger generation feel they are ‘cool’ or can fit into their group of friends only if they smoke.

No Smoking SignBut here’s the kicker – Each cigarette you smoke shaves off 11 minutes of your life (Shaw et al).

Lets put this into perspective. Say for example you have been a smoker for 10 years, and have been smoking 10 cigarettes a day every day of the year.

That’s a total of around 3650 cigarettes a year, and in 10 years that will be 36,500 cigarettes in total.

At 11 minutes per cigarette, that 11 x 36500 = 4,01,500 minutes.

That’s a total of 279 days less of your life.

Add that total to the reduced years from diabetes, high blood pressure and lung disease that results from smoking, and you are most certainly looking at a few years being taken off your longevity.

Now let’s look at cost.

Each cigarette pack costs an average of Rs. 100. At 3650 packs in 10 years, that will be a total spend of 100 x 3650 = Rs. 3,65,000.

That’s nearly 4 lakh rupees on something that will put a spot on your lung, give you a heart attack, make you suffer from a stroke and even make you impotent. To paraphrase, you are paying to become sick!

Isn’t it time to stop?

If you worry that you have become addicted, or have a family member that is requesting that you stop, it is most certainly time for you to do so. There is no right or wrong time – the time is NOW.

Just cutting down on your cigarettes does not help. Scientific evidence suggests that reducing the number of cigarettes by half still has no effect on decreasing the chance of dying from heart disease. Positive effects are only seen when this is stopped completely.

I recommend the following steps if you are looking to quit –

1. Set yourself a date when you want to stop smoking. This must be a few days from today.

2. Make sure you have the support of friends and family. If a family member smokes as well, ask him/her to also quit with you. Take the journey together – it makes it easier.

3. Avoid the company of people who smoke. If they are friends of yours, request that they kindly not smoke in your presence.

4. Avoid stress and situations that trigger the lighting of a cigarette. Find alternate routes for stress management. If needed, see a therapist.

5. Attempt the use of nicotine replacement products. These should be available at your local pharmacy. Make sure you speak to your doctor before you start using them.

If you wish to learn more about how you can stop, check our 10 tips on stopping smoking. You can also check out our brief information video on smoking and it’s ill effects on health.

Stop smoking today, and you can save yourself a lifetime of bother and health troubles!

R = Restrict Salt, Sugar and Fats

The Indian diet is rich in nutrients, but at the same time is loaded with a lot of ‘bad stuff’.

This bad stuff can include high levels of salt, sugar and fats. These can together contribute to the development and poor control of high blood pressure, diabetes and obesity.

Restricting these 3 ‘devil foods’ is essential for those looking to lead a healthy life. But before we talk about how you can cut down, lets look at the why.


The salt that we eat contains sodium in it. Sodium can increase the risk of developing high blood pressure, stroke, stomach cancer, kidney stones, heart failure and bone thinning (osteoporosis).

These problems can make it difficult to keep your heart healthy.

Sodium has a property of holding onto water bigstock-Too-much-salt-concept-Also-av-15284918that we consume. This water can accumulate under the skin and in the body, causing weight gain. The face may appear swollen.

According to Professor Srinath Reddy, President of the Public health Foundation of India, we currently consume between 10 to 12 grams of salt a day!

The recommendations are that we consume no more than 5 to 6 gm of salt per day. This is equivalent to 2.4 gm of sodium.

Those with high blood pressure need to keep this number a lot lower. In fact, some doctors recommend that individuals with high BP should eat no more than 1.5 gm of sodium (3.75 gm of salt) per day. Maintaining this number even for healthy people is recommended.

It is interesting to know that vegetarians tend to add less salt to their food than those who are non-vegetarians. This means that their blood pressure also tends to be a little lower.

It is simple to keep salt intake low. Take a look at the AHA guide to low salt intake for more information.


High sugar intake has been associated with the development of diabetes and an increase in body weight.

A study that was published in the Journal of the American Medical Association in the United States showed that eating high amount of sugar everyday can increase the chance of dying from heart disease even if you are not overweight (Yang et al).

In the Indian diet, the highest sources of sugar include sweets, sugar in tea/coffee/juices, soft drinks (coca cola etc.) and rice and rice based products. Not to forget foods like ice creams, chocolates, biscuits…the list goes on.


But how exactly does sugar affect the body?

Well, sugar is considered to be ’empty calories’ – these are calories that are generated in the body but are not used for any purpose.

Empty calories get converted to body fat. In addition, sugar can act on the liver, causing it to release fat into the blood stream.

Sugar also has a link to the development of high blood pressure. In patients with diabetes, sugar is harmful.

How much sugar can you eat daily?

There are no clear guidelines on what the average Indian should consume. The American Heart Association recommends that men eat no more than 9 teaspoons per day while women no more than  6 teaspoons.

To put this into perspective, one can of Coca cola contains just over 9 teaspoons of sugar!! One large Coke at your local fast food joint contains a whopping 85 gm of sugar!!

The Indian diet has a lot of sugar in it, and the introduction of fast food joints and eateries has greatly increased this number. It is important that all of us do our very best to cut down as much as possible.

Cutting down is simple. Just avoid sugar rich foods. Exercise regularly to burn body fat.


The oils we consume are high in different kinds of fats. Broadly classified, there are saturated and unsaturated fats. Saturated fats are bad; unsaturated fats are good.

Saturated fats can increase cholesterol levels and the chances of developing heart disease. Unsaturated fats do the opposite – they reduce cholesterol.

Fat in the diet also provides energy, but energy that is not utilised gets converted to body fat that deposits around the waist. As the saying goes – ‘A minute on the lips, a lifetime on the hips’!oils

The current guidelines recommend that men consume no more than 30 grams and women no more than 20 grams of saturated fat per day.

Another type of fat that is of concern is called ‘trans’ fats. These are present in high quantities in oils that are reused for cooking. Hydrogenated vegetable oils can also contain them. These days, there is a strong move to reduce the amount of trans fats in ready foods as these can ruin the health of your heart.

Cutting down fat intake is simple.

  • Stop using butter, ghee and unhealthy oils such as coconut oil and palm oil in your diet. Use sunflower oil, rice bran oil or olive oil instead, but in moderation. Remember, at the end of the day, these too are oils and have saturated fats in them, though they are in lower quantities.
  • If you are non-vegetarian, try and cut down the intake of red meat. If you have to eat red meat, try and trim all the fat off the meat before cooking it. Eat oily fish and chicken instead as these are lean and low in bad fats.
  • Use low fat milk.
  • Avoid cheeses and similar dairy products.
  • Avoid eating sweets made with ghee and butter like sweetmeats and cakes.

T = Take Your Medication

Medication is prescribed for a reason – for you as a patient to take it so that your health improves. Please make sure you take the medication that your registered health care practitioner has prescribed for you.

There is plenty of scientific evidence that supports taking prescribed medication regularly and good long term health outcomes.

Studies have shown that nearly 6 out of 10 patients do not comply with the medication that their doctor prescribes to them (Kravitz et al). Affordability, poor socioeconomic status, lack of sufficient motivation and lack of a ‘visible’ benefit are factors that have been cited.

It is understandable that taking a lot of medications can be a bother sometimes. Furthermore, too many medications can be confusing.

In such circumstances, use a medicine box, sometimes called a ‘dosette box’. This can help you put out your tablets for the entire week according to the time of day, making it simple to remember to take what tablet and when.

You can check out a selection of medicine boxes here.

Either way, please make sure you stick to the medication that your doctor has prescribed for you. If you wish to stop treatment, do not do yourself without consulting your doctor.

Closing Remarks

It just takes a few simple steps to keep your heart healthy. Just give these a go and in no time you will start to feel better and a lot more energetic!

Check out this video that summarises this article for you!


Follow these 5 steps, and you are on your way to a long, healthy and happy life!!




1. Kravitz, Richard L., et al. “Recall of recommendations and adherence to advice among patients with chronic medical conditions.” Archives of internal medicine 153.16 (1993): 1869-1878.
2. Shaw, Mary, Richard Mitchell, and Danny Dorling. “Time for a smoke? One cigarette reduces your life by 11 minutes.” BMJ 320.7226 (2000): 53-53.
3. Yang, Quanhe, et al. “Added sugar intake and cardiovascular diseases mortality among US adults.” JAMA internal medicine 174.4 (2014): 516-524.
Dr Vivek Baliga B
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