One of the most important questions I almost never get asked in the exam room is: “What’s the best thing I can do for my heart?” Why doesn’t this ever come up? Because we all know the answers. Stop smoking. Eat right. Exercise regularly. Get plenty of sleep. Actually following the recommendations, however, is not that easy. Work, family and daily life create stressors that can sabotage our well-meaning attempts to improve our heart health.

For the average non-smoker, THE most important thing you can do is manage your weight. According to the CDC, the obesity rate in the United States is 37.5% and climbing. In addition to heart disease, obesity increases your risk for many conditions, including stroke, Type II diabetes and some cancers.

But these are just statistics until they directly affect you. What I notice more often among my patients is gradual weight creep: those three to five pounds that sneak on each year. You know, the ones that are easy to rationalize away; flat out deny; or blame on the holidays, constipation or last night’s take-out. Or maybe you just really wanted to refresh your wardrobe with some new clothing that happens to be less tight around the waist.

While I wish, both personally and as a physician, that a couple pounds here and there wasn’t a big deal, the fact is that even if you only gain five pounds in a year, if you don’t do something to correct that trend, five years later you will be 25 (or more) pounds heavier. In 10 years, that’s 50 pounds. That’s a big deal, and we need to do whatever it takes to fix it.

So, where do you start?

1. Exercise. I like to ask my patients what they are doing for exercise. My favorite answers are: I bought a treadmill. Or, I joined a gym. Those are both great starts, but the hard part is what comes next: getting the treadmill set up and USING it, or actually taking the time to GO to the gym. What about the low-cost alternative of walking briskly outside? It’s likely raining or too dark, and maybe you have kids at home. How about jumping jacks, or walking up and down the stairs? It’s not difficult to work up a sweat 20 minutes a day, five to six times a week. The difficult part is starting. If you have injuries or joint problems that prevent you from exercising, talk to your healthcare provider or physical therapist.

Often there are creative ways to be active. Set your alarm for 15 minutes earlier and knock it off your to-do list first thing. You won’t regret having done your workout even if it’s short or boring, but you will regret having not done it at all. Check out the resources at the end for a twenty-minute home workout that doesn’t require any equipment.

2. Eat Right. Some people think that this means no snacking and just salad for lunch every single day. It’s counterintuitive, but sometimes that can work against what you are trying to achieve. You can only eat salads and avoid snacks for so long before you become ravenous. The end result is that you overeat the next time food is placed in front of you. Stick to regular, balanced snacks with carbohydrates, protein and a little bit of healthy fat. Eat when you’re hungry, but don’t eat when you’re not. Fill up on veggies first, and then get to your carbs and protein. You should eat a minimum of three to five servings of vegetables and fruit daily, and drink plenty of water so that you’re not eating when you’re actually thirsty. Pick one bad habit at a time to give up so that it’s not such a harsh transition. One week it might be soda, the next, deep-fried foods. The next week give up dessert at every meal. Have a plan so that you stay on track but remember that these are long-term changes. You don’t have to completely give up bacon or cake, but you don’t need to eat those things every single day.

3. Get enough sleep. This can be hard to do if you have a busy schedule and often put others’ needs in front of your own. At the end of the day, there is dinner to cook, the kitchen to clean up, the kids to put to bed, bills to pay and laundry to do. If you planned well, at least you already exercised! It may seem like an obvious statement, but your body and mind need rest in order to function at optimal capacity. There is disagreement on what the ideal amount of sleep actually is, and needs may vary according to individuals and throughout your lifetime. In addition, researchers are continuing to learn more about getting too little sleep can affect us. We know that sleeping too little can not only cause an increased risk of heart problems and diabetes, but it can also cause a greater likelihood of obesity due to an increased appetite caused by sleep deprivation.

Find someone who will partner with you as you strive to improve your health. Those who lose weight most successfully do so with support from friends and family. Include them, as well as your healthcare provider, in your plans so that you are held accountable. Keep your expectations realistic. A healthy, sustainable rate of weight loss is one to two pounds per week, which means that if you need to lose 10 pounds, it should take you a couple of months.

I realize that this is not a welcome message. But I want to make sure you’re getting it, because if you can improve your eating, exercise and sleep habits, not only will you keep weight creep in check, but you will feel like a new person. The secret is that there is no secret. There is no magic pill or fad diet that has been consistently shown to help people lose weight, keep it off and become healthier. In order to effect this change, you have to change your habits and commit these changes for the rest of your life. You don’t have to do it every single day, but you do have to do it most days.