Five pervasive half-truths, and the reality behind them.

Everything you thought you knew about heart disease? It may be wrong. The latest research is disproving some of our long-held beliefs about what causes cardiovascular disease-and you might be surprised at what we’ve learned over the last decade. Here, five long-standing myths and the real truth behind each one.

Myth: Reducing homocysteine levels can protect against heart disease.

Truth: The connection isn’t nearly as clear as we once thought. In the late 1960s, Harvard researcher Kilmer McCully reported that inflammation was the primary cause of atherosclerosis, a disease of the arteries marked by the formation of plaques, and that elevated homocysteine was the cause of this inflammation in at least 40 percent of cases. Other studies had also identified homocysteine as a strong predictor of cardiovascular disease, and claimed that treating homocysteine with a combination of folate, vitamin B6, and vitamin B12 could reduce the risk of heart attack and stroke.

But recent research appears to contradict these earlier findings. One large study of 116,000 people-all of whom had a genetic condition that caused a 20 percent rise in homocysteine levels-found that none of them were at increased risk of heart disease. And over the past 10 years, a number of studies have found that reducing homocysteine did not reduce risk of cardiovascular disease-so, while elevated homocysteine may mean you’re at higher risk, lowering it won’t protect you.

What you can do: Because the jury’s still out-and because the treatment protocol is safe, easy, and inexpensive-some doctors recommend supplemental B6, B12, and folic acid. If you go this route, choose folate (the natural form) instead of synthetic folic acid, and if your homocysteine levels are elevated, realize that’s only one predictor of heart disease risk.

Myth: Heart disease is a guy thing.

Truth: It’s the leading cause of death in women over age 65, and kills five times as many women as breast cancer. Postmenopausal women are thought to be at higher risk for heart disease, partly because heart-protective estrogen levels decline and partly because other risk factors, such as weight gain and high blood pressure, become more prevalent. But there is some evidence that younger women are at an even greater risk.

While overall mortality rates from heart disease have declined, some studies suggest that the disease is increasing among women age 29-45. One reason: risk factors such as high blood pressure, diabetes, and obesity are affecting women at a younger age. Younger women are generally more stressed, a significant risk factor. And while smoking has declined among older women, young women still smoke.

What you can do: Start now to protect your heart. Get your blood pressure checked, stop smoking, get active, and eat a heart-healthy diet. And consider supplements for an added boost. Some to try:

• Omega-3 fatty acids have been shown to decrease risk of arrhythmias (abnormal heartbeats), lower triglyceride levels, inhibit arterial plaque formation, and reduce blood pressure.
• Turmeric has been shown in to reduce inflammation, which is a risk factor for heart attack and stroke.
• Vitamin D may help reduce inflammation and prevent thickening and hardening of the arterial walls.

Myth: Regular, vigorous exercise will prevent heart attacks.

Truth: While earlier studies suggested that lengthy, high-intensity workouts several times a week were necessary for heart health, more recent studies suggest that 30 minutes of moderate exercise-such as a brisk walk-5-7 days per week can improve heart health. What’s more, the effects are cumulative; repeated, shorter bouts of activity, such as a 10-minute swim or carrying moderately heavy boxes up and down stairs, all count toward that 30-minutes-per-day measure. Other studies show that high-intensity interval training (HIIT)-concentrated, intense bursts of energy for only a few minutes at a time, followed by short periods of recovery-is superior to continuous endurance training for reducing heart disease risk.

What you can do: If you don’t exercise, start-but start small. Choose an exercise that you can easily do for 15 minutes at a time, and work your way up to 30 minutes a day. Finding a workout that you love ensures that you’ll stick with it,. Some ideas: swimming, hiking, dance, and bicycling. And if you need a little help, try pain-reducing supplements such as arnica, MSM, and glucosamine and chondroitin.

Myth: Saturated fat causes heart disease.

Truth: this relationship is significantly more complicated than we thought. The link between saturated fat and cardiovascular disease was first noted in the 1950s, when researcher Ancel Keys launched the Seven Countries Study. His reported findings-that saturated fat increases cholesterol and thus causes heart disease-were the cornerstone for dietary recommendations for the next four decades.

However, researchers and nutritionists have pointed out flaws in the original study: Keys reportedly cherry-picked countries that proved his belief that saturated fat causes heart disease, and excluded countries where fat consumption was high but heart disease was low. Newer studies have found that the link between saturated fat and cardiovascular disease is confusing at best. A 2010 study in the American Journal of Clinical Nutrition found that there wasn’t enough proof to link saturated fat to either heart disease or stroke. In 2014, the Annals of Internal Medicine published a meta-analysis of 80 studies covering 500,00 people showing that those who eat more saturated fat have no more heart disease than those who eat less. And a 2000 Cochrane meta-analysis (a leader in rigorous analytic and diagnostic methods for evaluating meta-analyses) found that diets low in saturated fats have no significant effect on deaths due to heart attacks.

What you can do: Sorry, nothing sexy here-balance, as always, is the best approach. If your diet is based on vegetables, legumes, nuts, fruit, and modest amounts of grains and animal protein (unless you’re vegan), you won’t have a problem with too much saturated fat. And instead of eliminating saturated fat, cut out processed foods, especially sweets. Studies show that refined carbs and sugars increase lanolin resistance, raise triglyceride levels, and encourage the accumulation of abdominal fat, all risk factors for heart disease.

Myth: When it comes to cholesterol, lower is better.

Truth: Not necessarily. Like saturated fats, the relationship between cholesterol and heart disease seems to be more complicated than once thought. Typical cholesterol tests measure total cholesterol, LDL (“bad”) cholesterol, and HDL (“good”) cholesterol. But some studies suggest that the size of the LDL particle is just as important a measure. Small, dense LDL particles are thought to be more dangerous, since they can adhere to artery walls more easily than large, fluffy LDL particles. Additionally, smaller LDL particles may be more easily oxidized, and oxidation is a key factor in the formation of cholesterol plaques on artery walls. What this means: if you have normal or low LDL cholesterol, but the LDL particles are small, you may be at increased risk for heart disease. In one study, men with smaller, denser LDL particles had more than twice the risk of heart disease as men with larger LDL particles.

What you can do: Ask your doctor about low-density lipoprotein particle (LDL-P) testing (the test is not routinely ordered, but it’s available through a number of labs). And lower your intake of sugar and carbs: studies suggest that reducing refined carbohydrates decreases the number of small, dense LDL particles.

MAGNESIUM: TAKE IT TO HEART

Magnesium is essential to heart health, but most people don’t get enough. Clinical studies have revealed that blood levels below 0.85 mmol/L are linked to a higher risk of heart disease, including arrhythmias, spasms in the blood vessels, high blood pressure, angina, and blood clots. But according to researchers at the University of Milan, magnesium plays a direct role in maintaining healthy endothelial function, adequate levels help ensure healthy blood flow by inducing the synthesis of nitric oxide. This mighty mineral may also help promote the growth of collateral vessels in those with chronic ischemia-an inadequate blood supply to an organ or part of the body.

According to another recent study published in the journal Nephrology Dialysis Transplantation, magnesium can also reduce the formation of calcium deposits inside arteries. Turkish investigators found that adding magnesium to tissue cultures significantly reduced the presence of calcium phosphate-a salt that forms when phosphate levels are high. This, in turn, reduced the development of hard calcium deposits that can narrow arteries and reduce blood flow.

The best way to ensure you’re getting enough magnesium is through supplementation. Look for a powdered supplement that contains ionic magnesium citrate. Adding magnesium citrate powder to your water bottle and sipping it over the course of several hours can ensure absorption so you know you are getting the recommended 400 mg per day for optimal circulation.