• Julie Kosteas Baker

Lonely hearts club

February is Heart Health Month. (It is also Black History Month - aka, the parts of American history that are left out of most textbooks... but I digress.) Heart health is more broadly defined as promoting healthy behaviors that can prevent or mitigate cardiovascular disease, which are conditions that affect the heart and blood vessels. A heart healthy diet and moderate exercise are the two most commonly discussed and supported, (through research and publications), health behaviors to prevent cardiovascular disease. There is also an abundance of literature in support of getting adequate sleep and minimizing stress to reduce blood pressure and cholesterol - the main culprits of strokes and heart attacks, respectively. What there isn't as much substantiated evidence for, but we know in our hearts to be true, is that loneliness and social isolation can increase your risk of cardiovascular disease. Queue Ricky Martin's Nobody Wants to Be Lonely.

Before we dive into this mind-body connection, it's important to distinguish loneliness from social isolation. Loneliness is the feeling of being alone, regardless of the amount of social contact or interaction one has. Social isolation is a lack of social connections, which can lead to loneliness. Nearly one year into the pandemic, I think almost all of us are experiencing social isolation, and many of us are experiencing loneliness as a result of limited social interactions. And some of us have been experiencing loneliness, regardless of the amount of social interactions we currently have or had in PC times (that stands for "pre-COVID", not "politically correct" - because what can be correct about politics??)

So how does loneliness and/or social isolation play a role in heart health? There are both direct and indirect pathways involved in this mind-body phenomenon. Leading the direct pathway route is cortisol. Feelings of loneliness and isolation raise one's cortisol levels - the nasty stress hormone that raises blood pressure and cholesterol, increases inflammation, weakens the immune system... all culprits in cardiovascular disease. Of course, a heart healthy diet and exercise are great ways to reduce cortisol, but here comes the catch-22...

Lonely and socially isolated individuals are less likely to take part in self-care. (Hey, I wrote about that: Self-care, as defined by the World Health Organization, is any action of behavior that helps one avoid health problems. Topping off the list, lonely and isolated individuals are less likely to engage in eating well and exercising. So back we go to continuously elevated cortisol levels.

If you don't believe me (you Grinch!), I've got the data to prove it. In a systematic review of 23 studies involving over 180,000 adults, published by peer-reviewed journal, Heart in 2016, the data showed that loneliness, social isolation, or both were associated with a 29% increased risk of heart attack and 32% greater risk of stroke. This is comparable to smoking 15 cigarettes a day!

Many health plans and systems are investing dollars and resources to tackle loneliness and social isolation, as it is affecting their bottom line, but as noted by one of my public health heroes, Dr. Sachin Jain, "we can't commercialize every single social problem that we have into a solution". We have an individual and collective responsibility to foster a sense of community in our own communities. I challenge you to take 30 minutes out of your day in the next week, to do one of the following in order to reduce your loneliness or social isolation and that of those near (but physically far) and dear to you:

1) CALL YOUR GRANDMOTHER (yes, I raised my voice). If you're fortunate to have grandparents that are still alive, give them a call. They will benefit from it as much as you. (This also goes for parents, aunts/uncles, and other older relatives that may be more socially isolated than younger family members.)

2) Start a virtual book club with friends. Kill two birds with one stone by getting your cognitive self-care on and your social-emotional self-care on.

3) Volunteer. Help organize a community food drive or support logistics for a mobile vaccination site. There are many volunteer opportunities available that allow for physical distancing, yet enable social connection.

4) Find an al-fresco yoga or HIIT class. (I know, I know - it's literally freezing across half of our country, Dallas included - so maybe hold off on this one for another month or two.) Outdoor class-style workouts have been popping up as a COVID safe gym alternative, but it looks like they're here to stay indefinitely!

I have hundreds of 80s and 90s songs with the word "heart" in the title going through my head right now as I think of how to cleverly (cornily) sign off, but I'll spare you because you got to the end of this post and there's no reason to penalize you for that. ;)

In good health,


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