02.28.2007

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Living the Heart Healthy Life

As much as nearly all of us want to end up living the "heart healthy" lives glorified by hip commercials where "Gramps" surfs off of Venice Beach in his gnarly wetsuit, the realities of cardiovascular health are less upbeat for the millions of Americans who suffer under the umbrella ailment known as heart disease. Heart disease, as the American Heart Association (AHA) so faithfully reminds us in its social marketing campaigns, is still "the number-one killer of Americans." To thwart this "silent killer" the AHA has for years maintained that Americans need to eat less saturated fat, improve diet and exercise habits, monitor cholesterol and blood pressure, and resist smoking. Recently, the AHA expanded its heart healthy lifestyle message to including the following:

• Eat a diet rich in vegetables, fruits and whole grain foods;
• Avoid use of and exposure to tobacco products;
• Achieve and maintain healthy cholesterol, blood pressure and blood glucose levels;
• Reduce saturated and trans fatty acids in the diet;
• Minimize the intake of food and beverages that contain added sugars;
• Emphasize physical activity and weight control;
• Keep sodium intake below 2,300 mg per day.

If these recommendations sound familiar, it's because they echo recent guidelines also presented in the new food pyramid. If they sound just slightly utopian, that's true as well, mainly because despite the fact that the average consumer retains many of these basic ideas when it comes to trying to define what "heart health" means to them, incorporating this list of recommendations into modern lifestyles is challenging to say the least - especially when heart health as a concern or topic of interest may compete with allergies, arthritis or the myriad of other ailments and diseases impacting the population. This is not to say that consumers aren't trying to incorporate such practices into their lifestyles so as to specifically benefit cardiovascular health, it's just that the health and nutrition game board shifts regularly enough that "keeping track" of "what's in" in terms of benefits and "what's out" in terms of health threats has become the central and energy-depleting wellness riddle of modern living. As an example, the AHA's guidelines, revised in 2006 from those presented in 2000, no longer support soy protein as a recommended ingredient used to lower LDL cholesterol.

If we set aside the most common conundrum of wellness, that which centers on the great divide between "wanting" or "trying" to eat healthier and exercise compared to the realities of modern diets and sedentary behavior, we can look closer at what "heart health" means to consumers today. The AHA might be relieved to see that both attitudinally and in conversation, recent research conducted by The Hartman Group shows that American consumers, when asked what the term "heart health" means to them, respond in broad terms by saying "eating right and exercising." More specifically, in language used to define "heart health" itself, diet and exercise are intrinsically linked to significant and common concerns about cholesterol followed by blood pressure - neither of which are big surprises given the level of incidence of these ailments in the population coupled with the size of the prescription drug market that treats (and promotes itself to) such conditions. Beneath this umbrella of key behaviors and concerns to "watch for," are a series of measures taken that focus on preventing or minimizing cardiovascular problems. These phrases, which focus on "taking care of the heart" are typically spoken in the lingo of "maintenance:" Keeping, preventing, and making sure that the right foods are consumed, exercise is attempted and that cholesterol and blood pressure are monitored.

Perhaps of interest to the current public discussion on how consumers navigate in this era of consumer nutritionism and the now macro trend of seeking out "real food," are the more specific beliefs among consumers that heart health (absent of any severe conditions such as managing life post-heart attack) is best defined, in descending order of relevance, as starting with a diet based on simple, unprocessed foods, and continues down a line of thinking to a focus on doing away with behavioral and dietary "negatives." Thus, for many consumers, the term means:

• Maintaining heart health through a proper diet of whole grains, fruits and vegetables, olive oil, fish and "low fat" meats

• Watching levels of cholesterol and blood pressure, and treating (depending on severity of cardio conditions) with dietary supplements and/or prescription drugs

• Exercising "as much as possible" (loosely defined as walking, and less commonly running)

• Cutting back or "managing": Smoking, alcohol, "fat", "sodium," "fast food," "sugar," and "stress"

Challenges to living a heart healthy lifestyle

If this list looks familiar, it may be because it resembles the AHA guidelines cited earlier; what's missing, however, is the relative "volume" or strength of importance in some of the words in terms of what challenges they present on what it truly means to live a "heart healthy lifestyle." When asked about the meaning of what a "heart healthy lifestyle" means, consumers talk primarily about "exercise and being active" so as to "keep the blood pumping" as central characteristics, with subordinate linkages made to "eating the right foods." Ironically enough, while exercise moves to center stage as the defining characteristic of cardio-friendly lifestyles, it is also the Achilles heel of heart healthy aspirations: As many have observed, for the average citizen finding time or having the necessary resolve to exercise in modern lifestyles has become one of the defining difficulties of "living healthy" (much less heart healthy). Thus, the most significant barrier to living heart healthy lifestyles is a lack of exercise. Despite the chasm between the realities of sedentary modern life and the difficulties of staying active, consumers are well versed in what the idea heart healthy lifestyle means. In the words of one consumer, a heart healthy lifestyle means:

"Being able to enjoy life, getting out, exercising, hiking, biking and doing thing without worrying about running out of energy...It's also about eating the right kind of foods that help the heart function: oatmeal, fruits, veggies, low-fat meats."

Aside from the challenges of sedentary lives, other barriers to living heart healthy include:

• Stress: When defining what a heart healthy lifestyle means to them, stress is mentioned as a subtle but powerful threat and barrier to cardiovascular health. The consumer focus on stress and behaviors enacted to thwart it, in the context of heart health, speaks worlds to the fact that much of the public has become increasingly aware of the ill-effects of anxiety on the health of their cardiovascular system.

• Sodium, fat and to a lesser extent sugar: The presence of sodium, fat and to a lesser extent sugar in various processed and "fast foods" are considered barriers by consumers to living a heart health lifestyle. Heart health concerned consumers confess to spending considerable effort avoiding and "watching" for these ingredients.

Taking action - but when?

While fairly facile at defining what heart health means, our upcoming Pulse Report Heart Health from a Consumer Perspective underscores the fact that most Americans take heart health for granted - that is until shocked into reality through a sudden perceived cardiovascular vulnerability or a diagnosed condition. High cholesterol, high blood pressure, heart attacks or the death of a loved one due to heart disease are springboards for action and more than likely lead to becoming "heart health concerned": Two-thirds of consumers that diet, exercise or limit their stress level do so out of concerns for cardiovascular health. Yet, while citing attitudinally that they diet and exercise because they are concerned about heart health, much of the consumer language surrounding the topic derived from discussions about heart health focuses on prevention or risk aversion rather than improvement of heart function and performance. This sheds light on the fact that overall consumers are struggling to visualize what the end-game of heart health can be.

The common cultural mindset is that cardio health means "eating right and exercise" combined with a more nebulous notion of "protecting" a life-essential organ. The separation between cardio health aspirations and the realities of modern diet and "the exercise challenge" signals to manufacturers and retailers that significant opportunities exist in assisting consumers with living a heart healthy lifestyle. More importantly, the fact that consumers appear to be giving so little attention to ways by which they can improve heart function (as opposed to simply maintaining a power plant that wears down over time) shows that there is ample need for cardiovascular-oriented information, products and services that suggest ways in which the heart can be invigorated with energy and vitality.

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