the HAES files: you gotta have heart!

by Health At Every Size® Blog

by Jeanette DePatie, ASDAH Vice President, in consultation with ASDAH member Sandy Dixon, RN, MS, Cardiopulmonary Rehabilitation Manager



Valentine’s Day has just passed us by and February is American Heart Month.  So it should come as no surprise that this blog post is going to talk about the Health at Every Size® approach to a healthy and happy heart. 

Many of us have had our poor hearts broken by medical professionals who have railed on us to lose weight for the sake of our cardiac health.  Fat and heart disease are associated–meaning that people who are fat may be somewhat more likely to experience heart disease.  But does this mean being fat causes heart disease?  Can you effectively prevent heart disease and maintain a healthy ticker using a Health At Every Size Approach?

There is a lot of new evidence indicating that healthy behaviors have a far greater impact on heart health than weight.  In fact a significant study recently published in Circulation magazine (The Journal of the American Heart Association) indicated that healthy behavior—specifically exercise had a far greater impact on heart health and mortality from heart disease than body size.  This was not a small or isolated study.  It followed over 14,000 subjects for over 11 years.  But the outcome was clear—fitness trumps fatness in terms of longevity and heart health.

So, there are a variety of Health At Every Size® behaviors that we can adopt to keep our tickers in tip top shape.  Here are five good ones to get you started: 

  1. Exercise Joyfully: As indicated by the study referenced above, fitness is one of the most important factors in maintaining heart health.  You don’t need to be a marathoner or a professional athlete.  We’re looking for a total of 150 minutes per week or 30 minutes on most days of the week.  Even as little as 75 minutes per week can have a positive impact on heart health.  It doesn’t need to happen all at once, it doesn’t need to be hard core and it doesn’t need to happen at a gym.  Work in the garden.  Walk the dog.  Park a little further away from your favorite outlet mall.  Find pleasurable and manageable ways to work fitness into your life.
  2. Manage your Mood: Some studies indicate that your emotional outlook on life can significantly impact your cardiac health.  People with Type-A personalities, depression and unexpressed anger seem to be more prone to heart problems than those with a happy-go-lucky approach.  Luckily there are positive steps you can take to cope with that stress.  One step is mentioned above.  Exercise enhances mood and helps cope with both depression and anger.  Other techniques include relaxation techniques like breathing exercises and meditation.   And if you’re having difficulty managing stress, anger or depression your own, seek the services of a qualified mental health professional.
  3. Care for your Teeth:  There is a lot of recent evidence linking dental health with heart health.  Gum disease can lead directly to heart disease, infecting the inner lining of the heart (endocarditis).  Some research also suggests that heart disease, clogged arteries and stroke may be linked to oral bacteria, possibly due to chronic inflammation.  So do like your mom told you—brush, floss and see your dentist regularly.
  4. Know your Numbers:  It’s important to be aware of your key cardiac indicators including your cholesterol and blood pressure levels.  That means seeing your doctor regularly.  And since you’re seeing that doctor regularly, it’s smart to pick one that doesn’t raise your blood pressure through the roof.  White coat hypertension is a well documented phenomenon which causes some people to exhibit significantly elevated blood pressure in their doctor’s office.  So try to pick a doctor you can respect, who respects you and with whom you can communicate effectively.
  5. Eat Colorfully Close to Nature:  I’m not suggesting the dreaded “D-word” here, (You know, the one that starts with “die” and ends in agony and frustration.)  But there is a lot to be said for eating a variety of delicious foods, from both land and sea, that are close to a natural state.  Heavily processed foods tend to be very high in sodium and other chemicals.  For some (but not all) people, high sodium levels lead to higher blood pressure.  Fruits, vegetables, whole grains and seafood can help maintain a healthy heart and can also be quite delicious.  So make your heart happy while you pump up the variety in your diet with a colorful plate of fabulous foods.

 A downloadable version of this Health At Every Size Tips for a Healthy Heart is available here.

12 Comments to “the HAES files: you gotta have heart!”

  1. Can you point me to a source for ideas about how to talk with medical professionals about my choice to get off the diet treadmill and return to intuitive eating? I know I need to find a new doc — mine is so obsessed with my weight that she actually seemed to think a cut on my leg (that I got having a great time in the surf!) was somehow connected to my size. I leave her office every time upset, and it’s time to leave her behind.

    I have been reluctant to look for a new one, though, partly because my insurance makes that hard, but mostly because I dread “kissing all those frogs!” What are some tips for finding the right primary care physician?

  2. …and “eat with enjoyment, gusto, and pleasure” bringing the joy back into our relationship with food.

    Thanks for this treatise, Jeanette!

  3. @Rabbiadar: What a great question. I would also be interested in knowing the quick, efficient way to find a primary care physician who looks beyond BMI to the person. Is there a database of HAES-oriented docs?

    When I read this latest article, I couldn’t help thinking about an extremely heavy woman I saw using a wheelchair at the grocery store last night. I have no way of knowing what her specific health problem was, but it made me wonder how many people suffer joint-related mobility problems due to extremely high BMI. That would impact a person’s ability to heed your first recommendation to ‘exercise joyfully.’ What do you recommend to people whose weight impairs their ability to engage in generally health-sustaining behaviors?

    I’ll be honest here: I did feel some silent judgment sneaking into my consciousness and I even found myself looking to see what she was buying. That–while also having a substantial weight problem my whole life, myself.

    • Dear Linda,

      There is a list at fatfriendlydocs dot com. I don’t know how current or accurate it is, but it might be a good place to start.

      As to your second question, there are things that people with “an extremely high BMI” can do to exercise even if they suffer joint-related mobility problems. I have successfully worked with many students in this situation and depending on the recommendations of their doctors, sports medicine specialists, Physical Therapists, Podiatrists and other members of their health care team, I’ve worked with them via water aerobics or water resistance training programs, cycling, chair dancing, isometric exercises and other exercise programs. Naturally, the fitness program needs to be tailored to the specific needs and goals of each exerciser.

      Hope this helps!


  4. Reblogged this on Varietea and commented:
    What’s better for your heart health, being slim or being active? Neither? Both? In honor of Heart Month check out the answer on the Health at Every Size blog.

  5. Managing your mood? Great, I’ll get right on that.

    I mean, wow, I can’t believe I’ve been battling this crippling depression for 4 years, when all I needed to do was exercise and do relaxation techniques. So glad to finally be told this, cause I sure haven’t been told 5-fucking-thousand times that exercise and a “positive outlook” can cure this shit if I just stop being so lazy and, well, depressed.

    Sorry, I’m not venting or being mad at you specifically, but every time I hear someone proclaim like it’s news to me that depression is bad for you and that I really should consider “taking a walk” and “thinking positive” an angel kills a puppy in a murder-suicide fire.

    • Dear Sasquatch,

      Depression can be an extremely difficult and crippling disease. I have battled it myself for most of my life. I didn’t mean in any way to suggest that a person who is coping with major depression will get better if they “just go for a walk”. That’s why the post said that those who are having difficulties managing stress and depression on their own should “seek the help of a qualified mental health professional”. A walk certainly didn’t make me all better. I don’t think any amount of walking or breathing techniques would have been enough to lift me out of a major depression. I had to get the right help and the right medications first. I can say that exercise and stress reduction techniques are an important part of my current regimen. But only a part.

      Despite the lack of understanding displayed by many friends and family members, my depression was not about laziness. It was about a chemical imbalance in my brain. Over time and with trial and error, my medical team and I have successfully treated this imbalance and I’m feeling much better. But in my case at least, it was a long and difficult and expensive journey to get here.

      I hope that you have found some great people to help you cope with this very difficult situation. And I apologize if the post over-simplified. I certainly don’t want to be the cause of any more canine, angel double homicides.

      Wishing you the best,

  6. I just wanted to add something – make sure your blood pressure gets measured with an appropriately-sized cuff 🙂

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