By Roberta H. Anding, MS, Baylor College of Medicine and Texas Children’s Hospital
Edited by Kate Findley and proofread by Angela Shoemaker, Wondrium Daily
Yes, eating healthy and being active both matter when it comes to heart disease prevention. However, being aware of non-modifiable risk factors such as genetics also plays a vital role. Professor Anding explains.

Family History and Heart Disease
When it comes to heart disease prevention, Professor Anding recommends investigating your family history.
“Your liver is a cholesterol-making machine,” Professor Anding said. “If you have a heart attack risk at an early age, you really need to pay close attention to that.”
Your family history plays a role in developing or dying from heart disease. People who have a known predisposition should be even more aware of their dietary choices and physical activity than the average person.
“Personally, my father had his first heart attack at 36,” Professor Anding said. “I can look at that in two ways. One, that’s obviously very bad news, but the good news for me is I know because he had early heart disease that I’m at increased risk. So I have worked very diligently my entire life to manage my cholesterol, and I had my children tested at a very early age to see if they inherited that genetic risk.”
Early heart disease before the age of 50 increases the likelihood that the disease is genetic and not necessarily caused by diet. For example, Professor Anding worked with a football player who had a heart attack at age 27.
Looking at his family history, his brother had a heart attack at 38 and his father in his 40s. Thus, if you have elevated cholesterol, members of your family should be tested, including children.
Fitness Alone Isn’t Always Enough
“My daughter had a cholesterol of 190 at 16, despite eating well and being athletic,” Professor Anding said. “She’s a very petite girl, but because she is related biologically to me and her dad, the challenge that she has is her cholesterol is elevated. Keep in mind the recommended values of cholesterol are lower in children than they are in adults, so 190 is actually relatively high for someone who is 16.”
According to Anding, just because you exercise and watch your weight doesn’t mean that you’re immune to heart disease. Examples from the athletic world illustrate this concept.
“Pete Maravich was a fabulous basketball player that played at my alma mater of LSU,” Professor Anding said. “He actually died on the basketball court in his mid-40s playing a pickup game of basketball in a gym. If you’ve ever seen Pete Maravich play, he’s an unbelievably lean, physically active guy. He just was unfortunate to be related to the wrong set of parents.”
Jim Fixx popularized the running movement in the United States, including the word “jogging.” He died of cardiovascular disease in his 50s. He lived slightly longer than his brother and his father, but he still had the heart disease gene.
Arthur Ashe, whom many consider to be one of the best tennis players ever, died of AIDS from a blood transfusion he got during coronary artery bypass surgery.
Role of Diet and Ethnicity in Heart Disease
For all the individuals who get media attention, there are many more individuals we don’t see.
According to some studies, NFL linemen have a shortened life expectancy due to heart disease—some dying in their mid-50s. This is due to the diet promoted for these young men.
“I actually had a coach say to me, ‘I told my player in order to gain weight, he needed to eat a tube of uncooked cookie dough every single day to add extra calories,'” Professor Anding said. “So to me, the abuse that has occurred in the NFL, and again, the promotion of these high-fat diets throughout their whole entire life, really has now led to an increased risk of heart disease and diabetes.”
Ethnic background can also make a difference. For largely unknown reasons, African Americans tend to have more severe hypertension and as such, a greater risk of heart disease.
The risk for heart disease is also higher for Mexican Americans, Native Americans, some Hawaiians, and some Asian groups. The driving factors in this case are obesity and diabetes.
Thus, diet and exercise are important for heart disease prevention, but you should also be aware of non-modifiable risk factors such as genetics and ethnic background. Being more susceptible does not necessarily mean that heart disease is inevitable, but having this extra awareness can motivate you to be more diligent when it comes to regularly monitoring your health.
This article was edited by Kate Findley, Writer for Wondrium Daily, and proofread by Angela Shoemaker, Proofreader and Copy Editor for Wondrium Daily.

Professor Roberta H. Anding is a registered dietitian and Director of Sports Nutrition and a clinical dietitian at Baylor College of Medicine and Texas Children’s Hospital. She also teaches and lectures in the Baylor College of Medicine’s Department of Pediatrics, Section of Adolescent Medicine and Sports Medicine, and in the Department of Kinesiology at Rice University.