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WATCH YOUR DIET AND YOUR WEIGHT Obesity is a complex problem that involves many factors, including genetics, food choices, portion sizes, and cultural and socioeconomic issues. It is an epidemic in the U.S.: The average American adult typically gains one to two pounds every year. But controlling your weight through diet and exercise benefits not only your heart, but your entire body. It's OK to be modest about your goals: Losing even a little excess weight has many health benefits for your heart and the rest of your body. Treatment for obesity often requires professional help, but one thing you can do is closely monitor your carbohydrate intake. We tend to take in too many carbs from simple and refined sugars and processed foods. These raise your insulin levels, which may lead to diabetes and heart disease. Replace many of the carbohydrates in your diet with fruits, vegetables, healthy fats such as olive oil and nuts, and fish—Mediterranean-type diets such as this are popular for a reason. Also limit your intake of saturated fat from animal products as well as trans fats found in processed foods. As for alcohol, drink it in moderation and not every day—it, too, is a carbohydrate that raises your insulin levels and blood pressure and leads to weight gain. Also limit the amount of sodium (salt) you eat; it is a significant risk factor for developing hypertension and is hidden in many prepared foods. And, of course, don't smoke. Even if it curbs your appetite, the dangers that smoking poses aren't worth it. Words to remember: Waist size itself is a risk factor for developing diabetes and heart disease. Men who have a waist size greater than 40 inches and women greater than 35 inches are at increased risk. LEARN TO REDUCE YOUR STRESS High levels of ongoing stress raise your blood pressure—a risk factor for heart disease. Stress also increases your tendency to do unhealthful things like overeat, smoke, drink too much alcohol, use drugs and neglect exercise. As with healthy eating and moving your body, you need to make relaxation and stress relief part of your daily lifestyle. This means getting enough sleep (poor sleep has been shown to lead to obesity as well), exercising regularly and trying practices such as yoga (which has a lot of physical as well as mental benefits), meditation and mindfulness exercises. These and other relaxation techniques have been shown to reduce stress and blood pressure. Words to remember: If you suffer from chronic high stress, seek help from a mental health professional. Therapy, self-help techniques and, sometimes, medication can often relieve the toll on your mind and body. GET THE SCREENINGS YOU NEED Follow your doctor 's recommendations on how often you need heart-health-related screenings such as cholesterol tests. These are usually given at least once a year, but there are many exceptions. Stress tests are no longer routinely recommended unless you have symptoms of heart disease. Even if you have no symptoms, talk to your doctor about a CT coronary calcium scan which identifies plague in the arteries that can lead to blockage and increases the risk of heart attack. Another test that might be appropriate is the C-reactive protein (CRP) blood test, which measures inflammation in the body. Words to remember: Know your numbers and make sure they are under control. These include your blood pressure, cholesterol, weight, waist size and hemoglobin A1C, a measure of long-term blood sugar levels. TAKE ONLY THE MEDICATIONS YOU NEED When it comes to cholesterol-lowering drugs or other medications for your heart, follow your doctor 's advice. If you are prescribed medication, take it exactly as directed. Guidelines and recommendations change on a regular basis, such as the new recommendation that daily aspirin intake may not be for everyone as previously recommended, especially in people over 60. In addition, while store shelves are filled with herbal and other supplements designed for "heart health," there is limited research documenting benefits. Plus, many of them can interact in known and unknown ways with medications your doctor has prescribed for you. Words to remember: Keep a list of your medications with you at all times so there is no confusion about what you are taking, and update your doctor regarding any supplements you take. To request an appointment with our expert physicians, call 1-888-HEALING. Dr. Benjamin Simon 6 | Health Matters: Providence Cedars-Sinai Tarzana Medical Center

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