Ditching old habits is the key to better heart health

Professor Robert Kelly is a man on a mission. While he is a consultant cardiologist and regularly puts stents into patients’ arteries to save their lives, he is equally as concerned with helping patients address the root causes of why they got sick in the first place.

“The problem is that some patients come back a year or so later with chest pain,” he says. “That’s because they haven’t addressed the issues underlying why they got heart problems in the first place – poor diet, stress, whatever.”

It was frustration with this ‘bounce-back’ nature of his work that led to his new publication The Heart Book: Making Positive Changes for a Healthy and Happier Life.

“I was frustrated that what I was trained to do wasn’t curing the problem,” he says.

“While surgery is vital, I felt that something more holistic and patient-centred was needed to give patients the tools to really change their bad habits so that the risk of future heart problems diminishes.”

Having a long-term interest in lifestyle medicine, Robert has now developed a Whole Heart Health programme, which involves coaching people after surgery to make the necessary changes. To date, he has coached over 150 patients, including farmers, via online sessions, post-surgery.

Robert’s younger brother, Dan, who died at the age of 20 due to sudden cardiac arrhythmic death has had a huge influence on his own career path and was the trigger for writing this book.

“His death was a life-changing experience,” he says, “and ultimately guided me to share my own professional and personal journey. That was in order to protect people insofar as possible from the tragedy of preventable loss. My father, also a surgeon, had always talked about the need for a book like this too. I suppose it comes down to wanting to make a difference in our health service.”

The current model of healthcare in Ireland is not working, he believes.

“Our health system is overwhelmed and mortality rates are not improving. The future must be about actively listening to patients and getting them involved in their own healthcare and collaborating with providers and clinicians.”

Challenging

Robert admits that it can be challenging for people to buy into making these lifestyle changes, however.

“If you tell people they’ll have a stroke, they get a little bit scared because they can see that there is a physical disability that comes with that,” he says, “but generally it is difficult to persuade people. Most patients want instant gratification and immediate solutions to reverse illness.”

Some people make a big burst to get fit in middle-age, often if a friend or colleague dies, he says, but this is not the answer.

“I have seen these people having heart rhythm problems, heart attacks, and sometimes a stroke from extreme exercise in the gym, and near-death after long-distance running and cycling events,” adds Robert.

“A balanced, slow and steady approach serves a person’s health better.

“Not having your heart health checked out before you do things like that is also a recipe for heart attacks.”

Farmers’ health is a concern for him also as they feature on his patient list.

“Research from 2020 has shown that farmers over the age of 45 are at higher risk of heart attacks than non-farmers. In that study, 74% of the male farmers had four risk factors for heart disease (high blood pressure, diabetes, high cholesterol, smoking, obesity and family history).”

“You have to ask what’s behind all that,” he adds.

“Most farmers are active but not all and, as they get older, many do less. They can also have poor diets and eat too much. Isolation can also be a mental health issue as well as weather, stress and financial worries.”

Making changes

How exactly do people sustain lifestyle change when old habits are so hard to ditch?

Robert talks about the six pillars of lifestyle medicine – not smoking, healthy eating, physical activity, sleep, stress management and social connection.

“These pillars account for 80% of chronic diseases and they are all reversible.”

He advocates using small steps for changing lifestyle behaviours and celebrating each time you make a positive change.

These changes, of course, should be preceded by medical assessments.

“With my patients, after surgery, I advocate an emotional assessment as well as a physical assessment. You have to look at the root cause of the heart problems, the patient’s health behaviours, their thoughts and emotions and their desire to change.”

The only cardiologist in Ireland to develop this type of programme, Robert then designs a personalised balanced lifestyle plan for the patient that addresses these factors. Online group coaching is also offered but there must be a real desire for change for it to work.

“The person must want to do it. Often I find that wanting to play with grandchildren and see them grow is a major driver for change.”

Smart goals

Key to his solution is using strategies familiar in the business world.

“You’re talking about having SMART goals to improve your health over time. SMART is an acronym that stands for Specific, Measurable, Achievable, Realistic, and Timely,” he says.

“Those kinds of goals help focus your efforts and increase the chances of achieving them. In the business community this is an exceptional way of changing behaviour and business people ‘get it’ but they have never applied it to their health.”

The goals you set must be easy to achieve, however.

“It’s one step at a time. Commit to doing one task at a time, getting used to having a glass of water with your breakfast, for example, or doing a small amount of exercise – walking 50 yards – then building on that over time. You then add more good health behaviours as you go, slowly but surely.

“You can manifest the changes with visualisation, goal-setting, saying affirmations like ‘I am living a healthy life’ and keeping a gratitude journal. Getting support from family and friends helps too.”

Bumps along the road will happen, Robert says, but success is achievable.

“Faith and persistence will help you reach your goals, even when you feel like giving up.”

He points out that many people love to blame others for their health problems or previously failed diets or having no time and so on.

“Many fail to realise these excuses are based on a story that they have created and choose to live,” he says. “You have to ask yourself what beliefs are holding you back, what is limiting you making changes? It’s about being fully committed and letting your new dreams replace all your fear and limiting beliefs.

Matthew Collier (63) is a suckler cow and sheep farmer from Camross, Co Laois. He had four stents inserted in June 2024 after experiencing shortness of breath and a lack of energy. After the procedure, he participated in Robert’s course.

“I found the course interesting and beneficial,” he says. “It makes you think. There’s a lot about the power of the mind in it and visualisation and setting a vision for yourself. I played hurling and managed teams and have always been a great believer in the power of the mind so I could see the sense in that. I suppose if, in your mind, you want to be healthy, you can be what you want to be.

I try to be more positive now and I look after my diet more and drink more water. Diet was the pillar I picked to concentrate on

“My goals were to improve my lifestyle, get more regular sleep and learn to say no, as I tend to get involved in a lot of organisations. It was about prioritising my health more than I used to.

“I try to be more positive now and I look after my diet more and drink more water. Diet was the pillar I picked to concentrate on. It’s about taking small steps and building on them.

“Another big thing in the course is the gratitude habit. If you feel grateful for what you have, you definitely feel better about everything.

“The course might not be for everybody, but I found it beneficial and the book will be helpful to a lot of people.”

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