Get to the matter of your heart

Don't expect the same old spiel about eating better, exercising more and lowering your cholesterol. When it comes to heart health, we know what to do - it's the practical application that's lagging.

The deepening disconnect between knowledge and action is disheartening for James Beckerman, M.D., a cardiologist with Providence Heart and Vascular Institute in Portland, Ore. But he's optimistic that if we slow down enough to really listen to - and learn from - ourselves, we can get to the heart of the matter: understanding why we make poor decisions, or none at all.

Mindlessness, he says, is the order of the day. We arrive at work and take the elevator instead of the stairs. We get hungry and opt for what's in the vending machine. At home, harried after a long day and needing to feed a family, we choose a meal of convenience - usually something prepared - instead of truly nourishing food.

Dr. Beckerman's charge is to help people become more mindful of daily decisions - and how each one influences your lifestyle as a whole. "When you can simultaneously recognize that those decisions affect you, and making those decisions differently could impact your risk, you're in a situation to do something really productive," he says.

Genetically speaking, humans certainly haven't changed in the past 50 years, yet obesity rates are skyrocketing - along with heart disease and other chronic illnesses that accompany unhealthy weight. Convenience reigns supreme, Beckerman says: we take public transportation or drive instead of walking; we favor processed foods over whole foods; we balk at exercising because it's raining out, or too cold.

"We evolved as a species in an environment where food was scarce and activity was unavoidable. Now, it's the opposite," Dr. Beckerman says.

We argue what we do is in service to convenience. But is it really?

For example, if you're rushing around in the morning, getting ready for work, you might tell yourself, I don't have time to pack a lunch. Beckerman figures that packing a lunch - presumably, something healthy - takes about seven minutes.

When lunchtime comes around, you head to the drive-thru for a quick bite. But you have to drive there and back, order your food and wait for it. Now you've spent those seven minutes you didn't have at the start of your day getting a less-than-satisfactory meal - all in the name of convenience.

So how do you begin to choose differently?

"The first step to being mindful is going through your day, your routine - to really look at what you do," Dr. Beckerman says. In this way, we can begin to sort our reasons from our excuses - and find our individual route to success, one small step at a time.

"We have to celebrate every small accomplishment and become motivated by it," he says, "rather than setting ourselves up to fail by believing it's all or nothing."

Make real change

Start small. Thinking big in terms of change can easily overwhelm you, and may sabotage progress. If you're training for a marathon, you wouldn't go out and run 26 miles on the first day, right?

Avoid the information deluge. Identify one thing that works for you, and implement it. Everyone always has something to say about "best practices." The best practice is the one you'll follow through on.

Celebrate your success. Don't measure yourself against what others are doing; pay attention to what you're doing and how that feels. "When you feel good about yourself for making one good decision, you're likely to keep making other good decisions," Dr. Beckerman says.

Mind the momentum. Sticking with one positive change can propel you to make another. "If you stick with something and keep moving, then it carries you," Dr. Beckerman says.

Keep track. Keep a food diary and weigh yourself every day. Doing these things isn't meant to be punitive. The acts of writing and weighing are meant to keep you connected to - and mindful of - the act of eating, and its effect on your body.

Check your motives. Is your "reason" for not exercising or for eating a pastry for breakfast really an excuse? Break down your daily routine into bite-sized pieces so you can really look at what you're doing - and why. Challenge yourself to think differently. Then take the next right action.