Year after year, heart disease remains the leading killer of Americans. More than half of the 700,000-plus people expected to die of heart disease in the coming year will be men. In fact, more than a quarter of all American males who die will succumb to some heart-related ailment, the most common of which is coronary artery disease. Although heart disease is highly preventable, it runs rampant through the population, due in large part to our lifestyle choices. We've put together a collection of common sense tips that will encourage heart health in easy, achievable ways.

The top risk factors for developing heart disease are high cholesterol, high blood pressure, diabetes, smoking, obesity, poor dietary choices, inactivity and alcohol use, according to the Centers for Disease Control. These risk factors almost always are controllable with lifestyle adjustments.

Eat right

Dr. Judy Loper, executive director of the Central Ohio Nutrition Center, says men should avoid salt, although it's not easy considering it can be cleverly hidden in almost any processed food or restaurant dish.

"Too much sodium can cause high blood pressure, which leads to increased risk for heart disease and is a major factor for stroke," she says. Snack foods, canned vegetables, processed meats and cheeses and prepared foods are often dangerously high in sodium. Adults only require a minimum of 500 milligrams of sodium to maintain health, but Americans consume an average of 4,000 to 6,000 milligrams every day. "Not using the salt shaker is not enough," Loper says.

She recommends that all people select fruits, vegetables, low-fat dairy products and whole grains for the bulk of their dietary choices. Aside from reducing salt, fresh food choices will help men increase their fiber intake, which will have a host of health benefits, including lowered cholesterol levels. Because fiber creates a feeling of fullness, guys will eat less and potentially see the numbers on the scale drop.

While increasing fruit and veggie intake, it's important for men to maintain adequate calcium levels. This essential mineral can be found in spinach, celery and even oranges, and it is readily available in yogurt and milk. It's also in almonds and cheese, but those calories are more dense, which can undo the weight loss benefits of a plant-based diet.

It is important to include good fats in the diet, which can increase good cholesterol. Loper recommends olive oil, other mono-
unsaturated plant oils and fish oil capsules. In general, a fat that is liquid at room temperature will be less likely to clog the arteries.

Diet is linked to almost all heart disease risk factors, and a healthy diet follows a natural path to reducing body weight. Even small changes can mean the difference between life and death.

"Even a decrease of 5 to 10 percent in body weight can mean a 30 percent decrease in triglycerides," Loper says. "Just a small weight loss can make a big difference." So a 250-pound man can whittle his weight down by as little as 12 and a half pounds and look forward to a pleasing report at his next physical.

There is endless information out there, and a lot of it is wrong, if not downright dangerous. Loper recommends asking the family doctor or visiting a nutritionist to have a health expert lay out an eating plan that will work for each person's specific body chemistry and health concerns.

Sleep tight

Americans get way too much salt, fat, sugar, time on the couch-you name it. One thing most of us don't get nearly enough of is sleep. Sleep is restorative and therefore absolutely necessary. During sleep, the body kicks into high gear to perform repairs, and people who are chronically sleep deprived eventually will feel the cumulative effects.

Dr. Asim Roy of the Ohio Sleep Medicine Institute says a lack of sleep has not been definitively linked to heart problems, but there are anecdotal associations. Doctors suspect a more concrete link will be established in time. "It is difficult to establish a causative relationship, but studies have shown that, over time, sleep deprivation is related to cardiovascular issues, including high blood pressure and a higher risk of heart attack," Roy says.

Roy says sleep experts recommend establishing healthy sleep habits. That begins with allowing time for an adequate amount. That could mean six hours for some people or 10 for others, but Roy says the average adult will function best after seven to nine hours of sleep.

Maintaining a regular schedule is essential, even on weekends. Don't sleep in more than an extra hour, or use the weekend to cram in everything that couldn't be done during the week. Try to maintain normalcy so the body can learn to depend on its own signals.

For some people, getting to sleep is difficult. The mind races, and the to-do list is looming. Roy recommends unwinding before bed, then moving into a calm, serene sleeping area. Keep the bedroom cool and free of televisions, iPads and cellphones that may buzz during the night and disrupt sleep. Darkness is helpful while falling asleep, but morning light also may help the body awaken naturally. If the sun and the work schedule don't coincide, a device that provides white noise at night and simulates a morning sunrise may help keep body rhythms in sync.

If there is a sleep disruption, don't wait for it to develop into a full-blown problem before consulting a professional. "If it is not addressed quickly, it can develop into more of a chronic issue," Roy says. Start with the primary care physician, and move on to a sleep specialist if the problem is not yet solved.

Get moving

It's no secret that Americans are too sedentary. From toddlers to retirees, our girth is growing and our hearts are complaining about the added strain.

Tory High, a wellness coach with the Central Ohio YMCA, loves the feeling of a good workout, but more than that, he cares about people. As a YMCA liaison to several corporations, he spends his days helping professionals fit fitness into their busy lives. The key, he says, is not to expect perfection, but to jump in exactly where you are and start moving.

"Anything more than what you are doing right now is a step in the right direction," he says. Just remember to start out sensibly. "As men, we often think in extremes: I'm going to get back into game-shape or I'm going to run a marathon in three months after five years of doing nothing." While those goals are completely achievable, they can't happen overnight, he says. Getting the heart rate up through cardiovascular exercise will condition the body, as long as it is done consistently. The American Heart Association recommends at least 30 minutes of cardio activity per day, five days per week.

"If you are just getting started, feel free to break this time up into segments of no less than 10 minutes each," High says. "It won't be long before you see improvements in your ability, stamina and, most importantly, those numbers at the doctor's office."

High says doing the things you love best will lead to the greatest success. "Jog, swim, bike, hike, canoe, climb a wall or chase down some Frisbees with your friends at the park like you did in college," he says. "Heart health doesn't have to be a victorious epic conquest of grueling physical exhaustion. It's pretty simple. Do stuff you like that's going to get the blood pumping until you get tired. If you enjoy the activity, chances are you'll easily surpass your recommended 30 minutes per day and easily rack up 150 minutes per week." When the heart is pumping quickly, but conversation is still possible, you've found a perfect cardio activity.

Excuses for not being fit come in all shapes and sizes, but lack of time is one everyone can relate to. There is always a way to squeeze in better habits, even in the office. "Rather than sending an e-mail that could just as easily be verbalized, walk down those few flights of stairs and tell them," High says. "Then walk back. If you got your heart rate up in that 10 minutes of walking and stair climbing, count it, then make a habit of it."

He also suggests using a push mower this summer and walking the dog or, if you don't have one, offering to walk the neighbor's dog. Joining a gym is another possibility. Working out can be an oasis at the beginning or end of the day-one filled with time for quiet introspection or potential new acquaintances who are pursuing the same goals. When choosing a gym, be bold and ask plenty of questions, High says. If you don't get a clear enough answer, ask again. It's a relationship that may last for years, and it should be a good one from the start, he says.

Even Superman has a weakness

For most American men, that weakness is a tendency to put off medical attention. "Men generally don't seek medical care," says Dr. Ken Gatto, a cardiologist with Doctors Hospital. "More than 70 percent of healthcare decisions are directed by women. While they may urge their husbands to go get looked at, men really should be taking charge of their own health."

While men may feel invincible, statistics show that just isn't the case. "From a preventive standpoint, it is important that men be followed," Gatto says. "Heart disease is more common among women than we once thought, but men are still more likely than women to develop it."

John Larry, a cardiologist and associate professor of medicine at Ohio State University, agrees that men need to make a commitment to staying healthy by doing three things: getting regular physicals, maintaining healthy body weight through proper diet and exercise and not smoking at all-something he says doubles the risk for heart
attack.

"The problem with coronary heart disease is that people can be asymptomatic for many years," Larry says. "A patient can go from asymptomatic to sudden death very quickly-that's the reason prevention is so important."

Find inspiration before you need it

Jon Kyle Ezell was a self-described "hardcore meat eater, butter lover, cream-in-my-coffee kind of guy." In January 2010, at the age of 40, he experienced what could have been heartburn after a spicy Mexican dinner. It wasn't heartburn, though, but turned out to be a 100 percent blockage that caused a major cardiac incident. After suffering through emergency medical procedures, a grueling recovery process, depression and despair, Ezell decided to take control of his life.

With no athletic background, he decided to become a marathon runner. He has completed numerous 5Ks, two half-marathons, two full marathons and other events in the two years since his heart attack. He also wrote Becoming Bionic: The Little Book of Hope for Heart Patients and recently visited patients at the rehab center where his life was changed forever. He's currently training for his next marathon, in which he plans to wear a T-shirt emblazoned with: "$@#% my heart attack."

Ezell lived with excuses before, but no longer. He has some strong words of advice for men headed down the same path he was on. "Go buy two pairs of good running shoes, sign up for a marathon and get off your ass," he says. "If you don't like the idea of getting your heart rate up, think about this: You'll do it now or, if you live through your heart attack, you'll do it in cardiac rehab. So run now instead of crawling in rehab later. It's an easy choice, and it's one that I wish I'd made a lot sooner."

Kristin Campbell is a freelance writer.