Take a Hike
It can be painful to watch someone you love negatively impact their health and increase their chances of heart failure. We’ve been told over and over again that the easiest way to avoid heart failure is to combine a healthy diet with physical exercise. If you’re anything like me, however, it’s not difficult to think of a friend or loved one who gets home from work every day, eats a big dinner, climbs onto the couch, watches television, grabs an unhealthy snack and then goes to bed.
If we know better, why do we still continue this vicious cycle? How can we break the chain without damaging our relationships or offending those we love? How do we disrupt an unhealthy nightly cycle and encourage those we love to exercise when that big bag of chips is staring at them from the cabinet? According to the American Heart Association’s “Heart Failure Lifestyle Sheets,” the solution may be five simple words away: “Let’s go for a walk!”
According to the American Heart Association, 1 in 5 adults over the age of 40 will develop heart failure. 
The major risk factors for heart failure are:
- Coronary Artery Disease (Atherosclerosis, which has dyslipidemia, tobacco use, family history, and the next 3 on this list, as its own risk factors)
- Hypertension (High Blood Pressure)
- Sleep Apnea
- A Previous Heart Attack
- Structural Disorders (typically heart or heart valves)
Most of these are or have modifiable risk factors and, again, we’ve been told repeatedly that there’s an easy fix: healthy diet and increased physical activity. Although simple on the surface, in reality, it is very difficult for many in the at-risk population to initiate and sustain these lifestyle changes. The changes, however, don’t have to feel big to have big results.
The four risk factors that are easiest to change are:
- coronary artery disease,
- obesity, and
- diabetes (adult onset)
Let’s toss our imaginations into the soft cushions of our living room couches and imagine an all-too-common nightly cycle…
Your favorite show is on and a big bag of chips is resting on your lap as you sink deeper into your sofa. Your eyes are locked on the screen as your hand slides in and out of the bag, carrying handfuls of salty, crispy, deliciously addictive chips.
High sodium (salt). High fat. High calorie.
Unfortunately, with every handful you’re negatively affecting all four risk factors. A high sodium diet is linked to hypertension, as increased amounts of salt cause the body to hold onto more water and raise one’s blood pressure.  High fat diets are associated with blood cholesterol levels. Excess blood cholesterol can clog arteries, which can cause or worsen atherosclerosis. Lastly is the issue of caloric intake. As a loved one’s body-mass index grows, his/her desire to get out and be active diminishes. Obesity can lead to prediabetes as well as full-blown diabetes.
It is often said that the first step is the hardest; the longer someone stays on the couch, the truer that statement becomes. It is important to help those we love take the first steps to healthier lifestyles and help cultivate their desire to change.
Physical activity can help the heart beat more efficiently, lower blood pressure and increase fitness levels. It can increase metabolism and decrease the risk of diabetes and obesity. There is another aspect of physical activity, however, that is also important to keep in mind: simply put, it creates distance between your loved ones and their snacks.
I often translate the old saying, “idle hands are the devil’s workshop” to “idle stomachs are obesity’s plaything.”
It’s far too easy for us to reach for the things we want, especially when they’re just a few steps away. My loved one, for example, has often said, “I know the snacks are there. It’s always in the back of my mind and I will get them if I want them.” Reaching for the things we want, especially those in an unhealthy nightly routing, is often too easy. When distance is created, however, grabbing an unhealthy snack becomes less mindless.
Eliminating a bad habit is hard enough. It’s made even more difficult if we can’t find something to replace it with; not only to distract us, but to motivate us.
My loved one decides to eat healthier and stop for about a day. We get rid of the unhealthy snacks and we won’t buy more but, around the third day, the resistance to unhealthy snacking is met with anger.
It becomes a battle of wills instead of a team effort for health. This is NOT a successful approach.
I recommend not dragging someone unwillingly out of his/her nightly routine, no matter how strong your desire to do so may be. If the emotion that becomes connected to physical activity, such as a nightly walk, is anger and/or resentment, desirable habits will not continue. We can be most successful when driven by the love and desire we have to spend more time with our healthy loved ones.
Although we can be a motivator, long-lasting change must come from within. The American Heart Association encourages individuals at risk for heart failure to use the buddy system to promote and sustain increased physical activity.  I’ve often wanted to do more than simply “be the buddy.” It can be difficult to motivate without being overbearing. I’ve believe the most effective technique is inclusion mixed, oddly enough, with a bit of guilt.
Knowing a relative with a history of heart disease has led to the selfish thought that I now have a positive “family history of heart disease.” This can be an excuse to get off the couch and away from snacks to reduce risk. While around my loved one, I try to explain this concern and invite them to come along for a walk.
It is important to establish and maintain a routine. Try to exercise at the same time every night. If possible, change the activity to keep things fresh – swimming, biking, or hiking can be exciting alternatives. Learning a new sport or game can increase the motivation to continue exercising. 
Again, the first step out the door is the hardest. Additionally, that first step is not the way to get others to continue to exercise and improve their lifestyles. It can, however, be a start. Ultimately, our loved ones are responsible to take charge of and improve their own health. With enough love and encouragement, however, we can be vital supporters in their change towards a healthier lifestyle.
Osteopathic Medical Student - 1st Year (OMS1)
College of Osteopathic Medicine
Pacific Northwest University of Health Sciences