I’m a cardiologist – the seven golden rules of protecting your heart in autumn

There is plenty to like about autumn: crisp mornings, warming dinners, the first excuse to put the heating on. But it is also the point in the year when many of the habits that are good for us start to become harder to maintain. We spend less time outside, move less without really noticing and lean more heavily into comfort food and evenings on the sofa. For our hearts, those small seasonal shifts can matter. Dr James Cockburn, consultant cardiologist at Nuffield Health Brighton Hospital, explains the habits worth keeping this autumn, and what to ditch… 1. Keep moving as the days get shorter The first rule is simple: don’t let darker days mean less movement. To protect your heart as you age, Cockburn advises aiming for “around 150 minutes of moderate aerobic activity per week, plus strength training on at least two days”. Shorts You don’t even have to be doing full workouts. “Brisk walking, cycling, swimming and gardening all count,” he says. “An effective strategy is to protect your morning or lunchtime walk before darkness and cold make outdoor activity less appealing.” As the temperature drops, he also recommends easing yourself into outdoor exercise rather than going straight into a hard effort. “Cold temperatures can constrict blood vessels and increase the workload on the heart, particularly in people with existing cardiovascular disease,” he explains. “If you experience chest tightness or a heavy, crushing sensation during physical activity, particularly if it spreads to your neck, jaw or arms, it could be angina and should be assessed urgently by a healthcare professional.” And remember that it isn’t only structured exercise that matters. “Sitting for long periods can be harmful even if you exercise regularly,” says Cockburn. “Try standing up and moving for a few minutes every 30–60 minutes during sedentary days.” 2. Make autumn food work for your heart Autumn may be synonymous with comfort food, but Cockburn says the season actually offers plenty of opportunity to eat well for your heart. He recommends building meals around apples, pears and berries, along with pumpkin, squash, carrots, beetroot and leafy vegetables. “Whole grains, beans, lentils and chickpeas, nuts and seeds, oily fish such as salmon, sardines or mackerel, and unsaturated oils such as olive oil are all worth adding too.” Nor do hearty autumn dinners need to be off the menu. “Soups, stews and casseroles can be wonderfully healthy,” he says, “although shop-bought versions can contain a surprising amount of salt.” When cooking at home, he suggests using “herbs, spices, garlic, ginger, citrus and vinegar rather than relying heavily on salt”. Dr James Cockburn is consultant cardiologist at Nuffield Health Brighton Hospital (Photo: Provided) Meanwhile, the arrival of autumn also means the return of hot chocolates, flavoured coffees and pumpkin spice lattes. “Tea and coffee themselves can generally fit into a heart-healthy diet,” Cockburn says, “but watch what gets added: sugar, syrups, cream and large amounts of saturated fat can turn a relatively modest drink into a substantial source of calories.” Still, his key rule is to focus on what you can put into your diet rather than simply what you should take away. “A useful principle is ‘add before you restrict’,” he says. “Rather than concentrating solely on avoiding saturated fat, salt or processed food, deliberately add fibre-rich plants, nuts, pulses and whole grains. This naturally improves the nutritional quality of the diet.” One particularly useful addition is soluble fibre. Found in oats, barley, beans, lentils and some fruit, Cockburn says it “can help reduce LDL – or ‘bad’ – cholesterol”. 3. Treat sleep as cardiovascular maintenance Sleep is one of the most overlooked parts of heart health. “When sleeping, your body enters a rest state and your heart rate and blood pressure fall, offering your heart and circulation a bit of a rest,” Cockburn says. “Aim for roughly seven to nine hours for most adults, with a consistent sleep-wake schedule. Autumn’s changing daylight can disrupt circadian rhythms, so getting natural outdoor light earlier in the day can be useful for maintaining a regular body clock.” There is one warning sign he particularly wants people to know about. “Persistent loud snoring, witnessed pauses in breathing or severe daytime sleepiness can indicate obstructive sleep apnoea, which is associated with hypertension and cardiovascular disease and is worth discussing with a clinician.” So if you are permanently exhausted despite apparently getting plenty of sleep – or a partner has noticed you stop breathing during the night – don’t simply put it down to the darker mornings. 4. Don’t underestimate seasonal mood changes It is easy to think of an autumn slump as something that only affects our mood, but Cockburn says mental and cardiovascular health are closely connected. “Chronic stress can contribute to unhealthy sleep, inactivity, overeating and elevated blood pressure,” he says. Your mood can change with the seasons (Photo: Cavan Images / Petar Dopchev Vis/G) That makes it worth being quite deliberate about staying connected and active once summer’s spontaneous plans start to disappear. “As daylight decreases, deliberately schedule things that keep you socially and physically engaged: walking with friends, exercise classes, hobbies or volunteering.” There is also a point at which feeling fed up about summer ending becomes something that deserves more attention. “If you notice persistent low mood, loss of interest, significant sleep changes or other symptoms of depression, don’t simply assume it’s the ‘autumn blues’ – seek professional advice.” 5. Look after your teeth and gums Autumn’s back-to-routine feeling is a good excuse to tackle the health maintenance we tend to put off – and that includes dental care. “Oral health is sometimes left out of heart-health conversations,” says Cockburn. “Regular brushing, cleaning between the teeth and routine dental care are good overall health habits, but there is a relationship between gum disease and cardiovascular disease through chronic inflammation.” That relationship doesn’t mean gum disease directly causes heart disease, but it is another reason not to let dental care slide. Alongside all the more obvious advice around exercise and diet, Cockburn’s message is that basic habits matter too: brush properly, clean between your teeth and keep up with routine dental appointments. 6. Stay up to date with vaccinations Likewise, seasonal vaccines may not sound like an obvious heart-health measure, but Cockburn says their benefits can go beyond avoiding an unpleasant bout of flu. “For appropriate people, influenza and other recommended vaccinations aren’t just about avoiding an unpleasant infection,” he says. Avoid flu by being vaccinated (Photo: Rawpixel/Getty/iStockphoto) “Respiratory infections can place substantial stress on the cardiovascular system, and influenza infection has been associated with increased cardiovascular events.” Autumn is therefore a sensible time to check what you are eligible for rather than waiting until winter is well under way. “Ask your GP or pharmacist which seasonal vaccinations are appropriate for you.” 7. Know your numbers Cockburn’s final rule it is one of the most important. “High blood pressure and high cholesterol can be completely silent,” he says. In other words, feeling perfectly well doesn’t necessarily tell you what is going on with some of the biggest cardiovascular risk factors. As such, he recommends periodically checking the things that don’t necessarily produce obvious symptoms, including “blood pressure, cholesterol, blood glucose or HbA1c when appropriate, weight or waist circumference, smoking status, physical activity and sleep quality”. There is no need to become fixated on every measurement. The advantage is simply knowing about a problem early enough to do something about it. “Finding them early gives you an opportunity to reduce cardiovascular risk long before a heart attack or stroke occurs.”