What are some of the most important things a person can do to prevent heart disease?
Much of the risk for heart disease is genetic and there is absolutely nothing we can do about that other than to thank our parents.
Another large chunk of risk comes from something that we all know we should avoid — cigarette smoke. Everyone knows not to smoke, but some people might not know that exposure to second hand smoke conveys great risk as well. So if you live with a relative that smokes, ideally, you should get them to stop or at the very least you should make sure they smoke outside and far away from others.
Finally, there is the stuff that we all refer to now as lifestyle modifications. This means regular exercise, attention to weight and diet. These are complicated things and there is confusion about exactly which diet or what is the definition of being overweight. For exercise, I really encourage people to do something that gets their heart rate up (brisk walking or hiking up hills, jogging, swimming or biking) at least three times a week for at least 30 minutes at a time. Given how busy our lives are, it is often hard to make time for extensive exercise regimens, but I think we can all make room in our busy schedules for 90 minutes a week.
How do you define a "heart healthy" diet?
There is great confusion and disagreement over what is a "heart healthy diet" and even more so over what is the best diet to lose weight. I have a favorite that works well for a lot of my patients, but I am by no means married to it. The biggest thing to remember is that in order to lose weight, one must cut the number of calories they consume (or greatly increase the number they burn). Burning calories with exercise is difficult.
An average adult should not need to count calories. I think that it just helps to cut portions. That is, take what you would normally eat for a meal and cut the portion of each item by 20 percent. The choice of diet seems to be important in terms of mitigating hunger. My own favorite diet is a twist on what is called the "Mediterranean Diet." Specifically, I try to limit intake of fatty meats, concentrating on fish and poultry. I limit the intake of "white" carbohydrates and emphasize whole grains. I am a big fan of fresh fruit and vegetables and think snacking on healthy nuts such as raw almonds or walnuts is great!
What are some of the most common myths or misconceptions about heart disease?
People think that heart disease only occurs in people who are overweight or who smoke. People think that if they take really good care of themselves, they cannot have heart disease. People think that heart disease cannot occur in younger people.
Why did you decide to specialize in cardiology?
That is a very interesting question. People always assume that I went into cardiology because my dad is a cardiologist. In some ways, that made me want to do anything but cardiology as I did not want to always be seen as Jim Weiss's son. But the real reason I chose cardiology is that it was the thing that I could not stop thinking about. I guess it is like falling in love… I knew I was going to be a cardiologist when I started dreaming about it.
If you weren't practicing medicine, what would you be?
Ah! Well, if I had the talent, I would be a musician. I studied music in college and loved it, and both of my parents are serious musicians. But alas, I did not have the talent!
What do you do in your free time when you're not taking care of patients?
I spend most of it with my wife, Palmer, who is a very talented interior designer and my two little girls, Amelia and Ruthie (8 and 5). We like to hike, and ski, and we love music. I am also a bit of a sports nut and have been a pretty passionate Giants fan since moving to San Francisco. We have season tickets and go to lots of games, and I would guess that we will be celebrating the World Series in our house for the next 10 years.
What have been some of your most rewarding professional moments?
Oh, there have been many. That is one of the reasons I love my job so much. I cannot wait to come to work in the morning and I love the variety. I particularly like how well I have gotten to know some of my patients for whom I have been caring now for almost 10 years. I love being able to discuss my research with my patients and with students and residents.
What's the best part about practicing at UCSF?
UCSF is a place where there is a great spirit of collaboration. Whether it is with my lab research or if I have a difficult clinical question, I can always find a colleague who is eager to help. It is also a place where people are proud of their work and where people strive to do the absolute best they can.