Many Black Americans have environmental factors that get in the way of heart-healthy living.
When you look at risk factors for heart disease, you’ll often see race listed. Statistically, Black Americans have double the risk of dying from heart disease compared to Asian Americans (who have the lowest rates), according to the Centers for Disease Control and Prevention.
However, these statistics can be a little deceiving. Being Black doesn’t mean that you’re born with an unhealthy heart and blood vessels. Instead, Black Americans and African Americans often deal with environmental factors that make a heart-healthy lifestyle more difficult or less accessible.
This is known as social determinants of health. The conditions of where you live, work, learn, and play can affect your health and quality of life. Examples include:
- The availability of safe, stable, and well-paying jobs
- Your access to high-quality and affordable health care
- Your access to high-quality education
- The opportunities for healthy living in your neighborhood, such as safe sidewalks, clean air, grocery stores with fresh food, and affordable gyms
- Cultural and community support for providing social bonds and encouragement for healthy living
Lifestyle Changes for a Healthy Heart for Black Americans
To put it simply, a healthy lifestyle to prevent heart disease for Black Americans is no different than what is recommended to other Americans. However, Black Americans may face unique challenges when trying to make lifestyle changes.
Here’s what’s recommended:
1. A heart-healthy diet
Many Black Americans live in food deserts, which are areas that have no or limited access to healthy foods. They may have to rely on fast food restaurants or convenience store foods. These foods tend to be high in trans fats, saturated fats, and sodium, which are three major contributors to heart disease.
For a heart-healthy diet, it’s important to:
- Limit fried foods: When eating at restaurants, choose grilled or steamed options instead of fried.
- Limit sodium: Whenever possible, avoid packaged foods, which are automatically higher in sodium. If that’s not possible, look for reduced-sodium options, such as canned beans with no salt added.
- Limit trans fat: You can often find these in packaged cookies, cakes, and crackers, as well as peanut butter and frying oil. One way to avoid these is by checking the ingredients list for “partially hydrogenated oils.” Learn more about trans fats here.
- Limit saturated fat: Saturated fat is the type of dietary fat that can hurt cholesterol levels and increase the risk of heart disease. You can limit saturated fat by choosing lean proteins, reducing your intake of high-fat dairy (like cheese and butter), and cooking with vegetable oils instead of butter.
- Increase your intake of fruits and vegetables: If fresh fruits and vegetables are hard to access, look for frozen, canned, or jarred options. Make smoothies from frozen fruits, add frozen peas to pasta, enjoy unsweetened applesauce as a snack, etc.
- Choose whole grains: As much as you can, incorporate whole grains into your diet. Try brown rice, whole-wheat pasta, whole-wheat sandwich bread, and so on.
2. Quit smoking (or don’t start)
Cigarette smoking is harmful to both the heart and the lungs. Although many people associate it with lung cancer, smoking is also responsible for a third of deaths from heart disease, according to the American Heart Association.
Smoking damages the blood vessels, making them stiff and less flexible. The carbon monoxide in cigarettes increases cholesterol on the artery walls, which makes them harden. The nicotine can narrow the arteries and increase blood pressure. All of these effects force the heart to work harder, causing it to weaken over time.
3. Exercise regularly
Exercise is an important part of a good lifestyle for heart health, but you might live in an area where regular exercise is a challenge. You may not have easy or affordable access to fitness centers. Your neighborhood may lack safe and functional sidewalks and bike lanes, robbing you of space to walk, jog, or bike.
The recommendation is to aim for 150 minutes of moderate activity or 75 minutes of vigorous activity a week. You can space this out over the course of several days. It may help to try HIIT workouts, which often only require a few feet of space and no special equipment, so you can do it in your bedroom or living room. HIIT workouts use moves like squats, lunges, planks, donkey kicks, clamshells, jumping jacks, etc.
4. Maintain a healthy weight
Overweight and obesity statistically increase the risk of high blood pressure, type 2 diabetes, stroke, and heart attacks. Weight loss through healthy lifestyle changes may help reduce your risk. Talk to your doctor about healthy, safe, and sustainable ways to lose weight. Avoid fad diets that promise rapid weight loss, which is often unsustainable and may lead to yo-yo dieting.
5. Know your numbers
Being more aware of your health measures might help you play a more active role in your heart disease prevention. Cardiologist David Anstey, MD, recommends knowing three key numbers:
- A1C: This is a measurement of your average blood sugar over time. Chronic high blood sugar can damage the blood vessels, increasing your risk of heart disease.
- Blood pressure: Learn more about healthy blood pressure numbers here.
- Cholesterol: High cholesterol means you may have plaque developing in the arteries, which may harden and stiffen over time. This increases the risk of a heart attack. Learn more about healthy cholesterol numbers here.
Making Small but Effective Changes
Changing your lifestyle for your health can be overwhelming. Some people might even think it’s impossible and not try—but it’s important to know that small changes can make a big difference. You don’t have to change everything at once. Focus on small steps, like reducing the number of cigarettes you have in a day, adding one more serving of vegetables to your daily diet, or going on a 10-minute walk every day. These might seem small, but small changes add up over time.
David Anstey, MD, is a cardiologist at Columbia University Irving Medical Center.
- Health, United States spotlight, racial and ethnic disparities in Heart Disease. Atlanta, GA: Centers for Disease Control and Prevention. (Accessed on June 29, 2021)
- Healthy lifestyle. Dallas, TX: American Heart Association. (Accessed on June 29, 2021)
- How smoking and nicotine damage your body. Dallas, TX: American Heart Association. (Accessed on June 29,2021)
- Social determinants of health. U.S. Department of Health and Human Services. (Accessed on June 29, 2021)