Some women may not know that they can do a lot to combat heart disease with simple healthy eating and exercise habits. But to many women, “diet” is a four-letter word.  And the exercise recommendations recently laid out — 60-90 minutes, every day — are intimidating. What’s a girl to do?

Easy — keeping the recommendations in mind, find something that’s realistic, say the experts. Here, Sharonne N. Hayes, M.D., director of the Women’s Heart Clinic and Dalene Bott-Kitslaar, RN, MSN, F-CNP, both of Mayo Clinic in Rochester, MN, translate official recommendations into simple, easy-to-live-by tips on eating well and staying active.

Heart-healthy eating (Diet)

Many popular, commercial diets claim that their method is the best and most effective. “I always ask, ‘Well, best at what?’” says Hayes. “Best for weight loss? For lifelong health? Living longer? Heart health?” All foods aren’t created equal — particularly when it comes to heart health. Hayes outlined different eating plans, their benefits and drawbacks.

Low-fat, high carb: What went wrong?

“Twenty years ago, we thought that fat was the bad actor in the food equation,” says Hayes. Food manufacturers reacted by taking fat out of everything. But to maintain taste, they often had to add simple sugars and carbs back in, resulting in little or no calorie difference from the fatty versions. What’s worse, foods stripped of fats are less filling, often resulting in greater calorie consumption because you have to eat more to feel full. The result? A rising obesity rate in American despite an explosion of low-fat foods.

Two extremes: Ornish vs. Atkins.

These diets represent two extremes of the diet spectrum: The Dean Ornish diet is strict vegetarian and very low-fat; the Atkins diet allows up to 40% fat. Both diets have tight restrictions — the Ornish diet severely limits fats, and the Atkins diet severely limits carbs, including grains and beans. Both have fairly rapid weight loss results, but as you can imagine (or have experienced), both are difficult to adhere to in the long-term. Any diet with severe limitations will be difficult to maintain, says Hayes.

However, it is important to note that the Ornish diet is one of the only lifestyle plans that has been proven by research to reduce cardiovascular events. In other words, it’s good for your heart. While most people will not be able to maintain the strict plan forever, Hayes recommends looking at the plan and deciding what you might be able to incorporate into your personal eating plan.

Mediterranean-style.

While not a specific diet, these eating habits (and a Mediterranean diet pyramid) are based on studies done in Greece on the island of Crete. “It was basically this group of people who smoked and had other risk factors, but ate this diet basically dripping in olive oil — and they had the lowest risk of cardiovascular disease of any place in the world,” says Hayes.

Mediterranean food is described as “peasant food,” because much of it comes straight from the ocean or straight from the ground. Basic components include:

Whole grains and complex carbs

Olive oil

Fish and shellfish

Legumes, beans

Fruits and vegetables

Daily physical activity

Alcohol in moderation

Little dairy or processed foods

Very little meat

Researchers know a few reasons that explain why the Mediterranean-style diet is so heart-healthy. Olive oil has been shown to lower cholesterol and LDL. Whole grains also lower cholesterol. Alcohol raises HDL, and it’s a mild blood thinner (it inhibits platelet stickiness). Omega-3 fatty acids, plentiful in fish and shellfish, have anti-arrhythmic effects on the heart, and larger amounts (eating fish 3-4 times a week) have mild blood-thinning effects, lower triglycerides and blood pressure, and have some anti-inflammatory effects.

Along with the Ornish diet, the Mediterranean-style is the only other diet proven to decrease cardiovascular events and disease. If you’re looking for more specific recommendations for this type of diet, the “maintenance” plan of the South Beach diet most closely approximates Mediterranean eating habits.

Other tips for heart-healthy eating.

• Functional foods. Functional foods are those that have been chemically modified to include health benefits beyond what the food itself might provide.  A good example is cholesterol-lowering margarines. In these products, plant stanol and sterol esters, which look chemically similar to cholesterol, “fool” the body into shedding excess cholesterol.
• Supplements.  While a few supplements might be beneficial, several unresolved problems still exist. First, they’re not regulated, so manufacturers don’t have to prove they’re safe or effective, and there are no manufacturing standards. Additionally, much of the research supporting supplement effectiveness has evaluated not the effect of the supplement itself, but diets or foods rich in Vitamin C or E, for example. More recent research has shown that distilling those elements and putting them in pill form often does not have the same health benefits. “The most important thing is to tell your doctor which supplements you’re taking,” instructs Hayes. Some supplements interfere with heart medications like blood thinner, making your necessary heart medications less effective.
• Portion control.  Don’t get intimidated by a recommendation of 5-10 servings of fruits or vegetables a day, says Hayes. A serving of veggies is a half-cup, or the size of a tennis ball, while a serving size of meat is 3 ounces, or about the size of a deck of cards.
• Don’t “waste” your calories.  It’s OK to splurge sometimes, Hayes says, admitting a personal preference for cheesecake. “But if I’m going to have cheesecake, it had better be really good,” she says. “If you take a bite of a cookie and it’s just so-so, just put it down. Don’t waste those calories on something that doesn’t truly bring you joy.”

Making exercise work for you

Exercise is a little simpler (in theory) than eating habits – we just know that we should do it. “It’s as important as some of the medications we take,” says Bott-Kitslaar. Particularly in women age 45 and over, daily exercise is important to maintain a healthy weight and overall good health. In addition to aiding in losing weight, exercise:

• Protects against diabetes
• Improves cholesterol
• Boosts overall health
• Reduces risk of another heart attack by 35-45 percent
• Can lower stress levels
• Helps with sleep issues

Bott-Kitslaar mentions the government’s recommendation of 60-90 minutes per day, but acknowledges that can be challenging for most women. “Realistically, we can find 30 minutes a day for ourselves,” she says. “Aim for 30 minutes at least five days a week. Care for yourself so you can better care for others.”

Exercise tips

The most significant barrier to exercise is not what to do, but finding the motivation to do it. Experts recommend setting short- and long-term goals, or having a very specific plan in place. What else can you do to keep up your routine?

• Focus on perceived exertion.  Heart rate can be a fairly inaccurate measure of how hard you’re working, particularly if you’re on medication for your heart. “We recommend the walk-and-talk test to tell if you’re working hard enough,” says Bott-Kitslaar. Basically, you should be working hard enough (whether walking or another activity) that you can’t easily carry on a conversation – you have to stop and catch your breath while talking.
• Don’t sell walking short.  Measure your daily steps by wearing a pedometer all day, and try to get your step count up to 10,000 per day. Keep bumping the number up by 1,500 steps a day until you reach the goal. Walking this amount each day can make a real difference – and you only need comfortable clothes and a good pair of shoes.
• Individualize your routine.  “What works well for one doesn’t work for others,” says Bott-Kitslaar. “Pick something you enjoy. Tap dance – or ballroom dance! As long as you’re moving, your heart is benefiting.” Some women enjoy variety, picking different activities throughout the week to work different muscle groups.
• Find a “personal trainer” to stay motivated.  Sometimes this can be a personal trainer at your health club, but use what you have available – Bott-Kitslaar’s “personal trainers” are her dogs, who don’t let her sit down after work without their daily walk. “Find someone or something in your life – your dog, your child, your husband or mother – to motivate you to take care of yourself,” she says.