Martha Jefferson Hospital
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Heart Healthy
Health Partnership
As we all know cardiovascular disease accounts for 1/3rd of all deaths in our nation, and to add to those somewhat glum statistics, one in three adults could have diabetes by 2050 if things go as they are. This will be staggering to this country. Already the direct and indirect cost of cardiovascular disease and diabetes is more than $535 billion per year.
A new partnership has formed between the American Medical Association and the YMCA pre-diabetes. They are going to work together to bring some programs to communities that will reduce disease risk. They will focus on helping folks work on lifestyle changes such as diet, weight loss and exercise.
Other diseases that the American Medical Association will target are cancer, depression and Alzheimer’s. All of these chronic conditions have a huge impact on quality of life and financial costs to individuals. One AMA goal is to increase YMCA membership by 10,000 people by July 2015. They’ll also get 10 million people to control their high blood pressure by 2015. These are pretty lofty goals, and it starts one person at a time. Perhaps this is a great time for you to take a few steps toward better health. Take a look at your usual food intake, and then level of activity.
Stroke Awareness Month
May signals Stroke Awareness Month. Strokes are the no. 4 killer in this country. A stroke occurs when the blood flow to the brain abruptly stops. The biggest risk factor is uncontrolled high blood pressure – remember, high blood pressure is called the Silent Killer for a reason. And researchers state that 80% of strokes could have been prevented with quick action at the first symptoms.
To prevent a stroke, act F.A.S.T.:
(1) Face drooping – ask the person to smile
(2) Arm weakness – ask them to raise both arms
(3) Speech difficulty – ask then to repeat “the sky is blue”
(4) Time to call 911 when you first see a symptom
Stroke Risk Factors:
- Uncontrolled high blood pressure (goal is 120 over 80)
- High blood cholesterol (goal is less than 200)
- Excess weight
Time to take action when you observe in a person or you yourself have:
- sudden numbness
- abrupt onset of confusion
- sudden trouble seeing
- abrupt onset of dizziness
- sudden severe headaches
The key to preventing strokes is to act FAST. Take action now and don’t wait. A person needs to get to the ER for early medication treatment to stop cold a stroke that might be coming soon.
TIA or transient ischemic attack is a “warning stroke” or “mini-stroke” that produces stroke-like symptoms. TIA symptoms usually only last a few minutes but, if left untreated, people who have TIAs have a high risk of stroke. Recognizing and treating TIAs can reduce the risk of a major stroke.
More information at www.americanheart.org.
Getting Cholesterol DOWN with Food
I am reminded each week, when I see patients for individual counseling, that some folks need to lower their cholesterol numbers by primarily diet. They may be unable to tolerate cholesterol-lowering meds, or there may be other reasons that the meds are just not right for them. So that means lifestyle is key!
To get cholesterol down, focus on healthy fiber foods at each meal:
- all fruits, especially apples, pears, and citrus fruits
- whole grains, especially oats and barley
- dried beans and peas (pinto, kidney, great northern, navy, split pea, etc.)
To get cholesterol down, focus on healthy fats each day:
- extra-virgin olive oil, canola and peanut oils
- nuts and nut butters with no partially hydrogenated fats
- oily fish such as sardines and salmon
- avocados
- ground flaxseed or oil
To get cholesterol down, focus on natural plant sterols in
- oil
- legumes
- avocados
Healthy ideas:
- homemade salad dressings with extra-virgin olive oil (healthy fat)
- rinse canned beans and add to soups, stews, casseroles and salads (high fiber)
- mash avocado to replace mayonnaise on sandwiches (healthy fat)
Other tips to get cholesterol down to reduce fatty plaque build-up in artery walls:
- select foods low in both saturated fat and trans fats
- the less animal protein the better although some fish is a heart healthy choice
- plan meals around fruits, vegetables, dried beans and peas
- include whole-grains, such as wild rice or a multi-grain pasta
Family Meals are the Best!
Family meals, no matter the hour or which meal, are important in many ways for children, young and old. This is my mantra – eat with your kids around the table – face to face. You get to chat with them, and hear their ideas, thoughts and dreams. They get to chat with you, learning about your work, the community that you live in, and the happenings in the world.
Here’s an idea – a family dinner menu featuring Old-Fashioned Turkey Meatloaf.
Ingredients
- 1 lb. lean ground beef or turkey breast
- ¼ cup egg whites
- 1/3 cup dry oats
- ½ cup finely diced squash, onions & carrots
- 1 small finely diced yellow onion
- 2 Tbsp. ketchup or skim milk
- herbs & spices to taste
Directions
- Stir together all ingredients in large mixing bowl.
- Pat into a loaf pan that has been coated with cooking spray.
- Bake in preheated 350 degree oven for 70 minutes. Let sit for 5 minutes before slicing.
TIP: Prep in the morn and bake off in the evening. Make 2 pans to have extra for sandwiches and quick dinners.
Family dinner sides to go with Old-Fashioned Meatloaf:
- The starch – baked sweet or white potatoes or smashed red skin potatoes
- The vegetables – spinach salad w/ mandarin oranges & honey mustard dressing
What can the kids to help with dinner?
- Dice the vegetables for the meatloaf
- Stir together the meatloaf ingredients
- Toss together the salad ingredients
- Shake the homemade dressing (older kids can measure out the ingredients, too)
- Set the table
Kids are pretty interesting. For sure, they do what we do, and not necessarily do what we say. So providing healthy meals and then modeling healthy eating habits, which means reasonable portions, is something they will be very tuned into. If we are drinking soda with a meal, they are going to want that. When our kids were at home, we all drank milk or water with the meal. No sodas at all. They are still milk drinkers today, as young adults.
Cleaning Out!
I think that the beginning of the year, and especially in February, which is heart month, it’s a great time to evaluate your health and to begin to make some lifestyle changes, if needed. As part of the freshening up, is this a good time to take stock of your food cabinets, and do some weeding out and replacing?
Cleaning up the cupboards… OUT with high-fat, salty snacks and IN with whole-grain crackers, unsalted pretzels, assorted nuts, and plain popcorn.
Cleaning up the cupboards…. OUT with candy, rich desserts, and sweet sugary sodas and IN with fresh fruit, simple homemade cookies, and good old-fashioned water.
Cleaning up the cupboards… OUT with sugary refined cereals and white processed grains and IN with whole-grain cereals (likes oats), brown and wild rice, whole-grain pasta, barley, and quinoa.
Okay, so you don’t need to change everything at once – use your foods up, and then as you run out of items, replace with a healthier version. Be well-stocked with legumes, sweet and white potatoes, healthy condiments such as reduce-fat mayonnaise, flavorful vinegars, oils and mustards. And then don’t forget a variety of herbs and spices to give flavor without added salt: thyme, rosemary, garlic, basil, oregano… the list is endless.
It’s Heart Month!
It’s Heart Month! The American Heart Association suggests “Life’s Simple 7” – seven reminders for living well.
The AHA “Life’s Simple 7”:
- Don’t smoke (of course).
- Get in regular physical activity.
- Maintain a healthy weight.
- Eat a healthy diet.
- Manage your blood pressure.
- Manage your cholesterol.
- Keep your glucose at a healthy level.
Eating healthy ala American Heart Association:
- Fruits and Vegetables: more than 4½ cups/day
- Oily fish, 2 or more/week
- Whole-grains with high-fiber such as breads, cereal, pasta and rice
- Healthy fats: oils, nuts and nut butters, avocados
- Decrease sweet beverages to less than 450 calories/week
- 4 servings or more/week of nuts, legumes, seeds
Also, some AHA cautions:
- Processed meats: 2 or less servings/week
- Keep sodium: <1,500 mg/day
Get Nutrition Help!
Making lifestyle changes for better health? There is help! If you have Pre-Diabetes or Diabetes:
- One-on-one nutrition counseling session with a Registered Dietitian or diabetes education with a Certified Diabetes Educator.
- Attend Diabetes Education Classes to help learn how to manage your diabetes. YOU are in charge.
- Attend our Ins and Outs of Pre-Diabetes seminar to work on diabetes prevention.
- Attend a monthly Diabetes Support Group session.
- Take advantage of my FREE Diabetes Supermarket Smarts Class at Giant Foods. (434) 654-7009 for more info.
Making lifestyle changes for better health? There is help! If you have Heart issues:
- Attend the Food for Thought healthy-heart nutrition class.
- Come to my FREE Heart Healthy Supermarket Smarts class at Giant Foods.
- We teach a Get Cholesterol DOWN seminar monthly.
- How about one-on-one nutrition counseling session with a Registered Dietitian.
- Try out the MJH Heart-to-Heart Support Group meeting. More info. at (434) 654-7009.
Making lifestyle changes for better health? There is help! If you have Weight Management issues:
- It can help to meet regularly with a Registered Dietitian to develop a healthy, balanced approach to eating well rather than “dieting”.
- For those who have had bariatric surgery, plan to attend our twice monthly Support Group sessions.
- There are plenty of online resources and support at Wt. Watchers, Spark People, and My Fitness Pal.
- Are you are a member at a gym? Ask about their workout classes geared towards folks working on weight loss.
Other health issues where a Registered Dietitian might be able to offer some guidance with your food choices:
- gastrointestinal (acid reflux, celiac disease, IBS, Crohn’s Disease, gastroparesis)
- allergies such as soy or dairy
- iron deficiency
- eating disorders
Our Nutrition and Diabetes Education Department will get a referral from the MD office. And YOU can call insurance to see if there is coverage. There is more coverage in disease prevention than ever before, so it is worth checking it out.
A recommendation on sodium intake has been made by the American Heart Association. It’s pretty aggressive. But these heart researchers feel very strongly that lowering sodium/salt intake can help the 76 million U.S. adults with high blood pressure, AND may prevent high blood pressure in millions of other Americans.
The average daily sodium intake: 3,400 mg. The USDA sodium guidelines: less than 2,300 mg, and the American Heart Association sodium guidelines: less than 1, 500 mg.
Sodium intake adds up quickly when you rely on convenience items. For example, a homemade spaghetti sauce has ~50 mg sodium in ½ cup but ½ cup jarred spaghetti sauce can be as high as 800 mg of sodium.
As much as possible, have dishes prepared from scratch, with flavorful herbs and spices for seasoning rather than salt. Remember, every time that you omit 1 teaspoon of salt from a recipe, you save 2,300 mg of sodium!! Holy cow!
Be alert when shopping. The Nutrition Facts label on each and every packaged food item MUST list the sodium content per serving. And the American Heart Association reminds us that reducing our sodium/salt intake can help keep the blood pressure of ALL family members in good control. And that will reduce cardiovascular disease risk!
Watch the EGGS!
For many years the American Heart Association has suggested that egg yolks be limited to 3 per week. A recent study 1,200 folks suggests that we might want to heed the AHA suggestions.
- For those people who ate 3 or more egg yolks per week, there was slightly more plaque in arteries.
- Folks who had 2 egg yolks per week or less had much less plaque.
There is nothing like a poached egg on toast or an egg salad sandwich. But many times, egg whites will work very nicely in place of the whole egg.
- In baking, 2 egg whites = 1 whole egg.
- ¼ cup commercial egg substitutes replaces 1 whole egg in recipes.
- Egg whites or commercial egg whites or egg substitutes can be used for meatloaf, meatballs, French toast, quick breads, muffins, pancakes, cakes and cookies.
This study published in the journal Atherosclerosis showed that independent of smoking, cholesterol, blood pressure having diabetes, and body mass index, eating more egg yolks per week slightly increased plaque in the arteries.
An Apple a Day!
An apple a day is an old saying that has some health merit to it. In a recent study, post-menopausal women who ate 2 apples daily (in dried apple form) saw total cholesterol and LDL-cholesterol drop! With more than $15.5 BILLION spent on statin drugs in a year, apples seem like an economical choice, too.
For the women who ate 2 apples/day, in 6 months, total cholesterol dropped 13%, from 250 to 218. The harmful LDL-cholesterol lowered 24% (!!) from 160 down to 132.
Why do apples seem to be fabulous for cholesterol reduction?
- In part, it’s the pectin fiber. Pears, oranges and grapefruit also have a good supply of cholesterol-lowering pectin fiber.
- Apples also have polyphenols, natural substances that reduce artery inflammation.
Apples, apples, apples….
- stir chopped apples into oatmeal, muffins, pancakes and bars;
- add sliced apples (with the peels) to tossed salads, fruit cups, stir frys;
- add apple chunks added to hearty soups, stews, casseroles; and if you are needing dessert, apple crisp with lots of oats on top!
In the U.S., 81million adults have cardiovascular disease, and over 800,000 die from this disease. Reducing cholesterol is one tool to lower risk. And a diet heavy on fruits, vegetables, whole grains, and nuts – all sources of dietary fiber – seem to be a health (and economical) way to get a handle on this disease.
