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Do THIS. Never Have a Heart Attack?
If you want to do all you can to prevent having a heart attack, it might be as simple as this Rx: exercise and take a vitamin D supplement.

That's the word from researchers at Johns Hopkins University in Baltimore, Maryland, who have concluded there is a "synergistic" link between exercise and healthy vitamin D levels that appears to reduce the risk of cardiovascular disease, including stroke and heart attacks. They found that the two factors working together seemed to do more than either factor alone to protect the cardiovascular system.

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The study: Led by Dr. Erin Michos, the team used previously gathered information from the federally funded Atherosclerosis Risk in Communities study begun in 1987 and collected from 10,342 participants, all of whom were initially free of heart or vascular disease. Information about the participants was updated and followed until 2013 and included adults from Forsyth County, North Carolina; Jackson, Mississippi; greater Minneapolis, Minnesota; and Washington County, Maryland. The participants were an average age of 54 at the start of the study and 57 percent were women. Twenty-one percent were African-American, with the remaining participants identifying as white.

Participants self-reported their exercise levels, which were compared to the American Heart Association (AHA) recommendations of more than 150 minutes per week of moderate intensity exercise or 75 minutes per week or more of vigorous intensity. About 60 percent of the participants either did not exercise enough or did not exercise at all.

In addition, the researchers conducted blood tests to determine each participant's vitamin D level. One-third of the participants had inadequate levels.

The results: The most active participants who also had the highest vitamin D levels had the lowest risk for future cardiovascular disease, specifically a 23 percent lower chance of having a heart attack or stroke than those with poor physical activity who were also vitamin D-deficient. Interestingly, the same protection was not seen in those people who were either inactive or did not have enough vitamin D. It took both working together in synergy to provide the best protection.

How can you get enough vitamin D? Long called the "sunshine vitamin," our bodies naturally manufacture vitamin D when we are exposed to sunlight. Vitamin D is also found in such foods as salmon, milk, fortified cereal and fortified orange juice, as well as dietary supplements.

Important caveat: This was an observational study that does not prove cause and effect.

The study findings were published in The Journal of Clinical Endocrinology & Metabolism.

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