Tag Archives: Nutrition

Quality, not Quantity: the New Goal for Weight Loss

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IMG_8348rt5x7bwFor years, we have heard over and over that our weight is tied to the amount of calories we eat.  The prevailing wisdom was that if we could just reduce the calories taken in, then we could lose weight.  More recently, we are starting to understand that the type of food we eat, not just a total calories, may be more important to our health.  Now a major study confirms the concept.

These researchers, in a very careful and rigorous fashion, studied not just the total calories take it in, but also the quality and type of food eaten in a large group of test subjects whose weight, and overall health status, was tracked over a year. You can read the details of this extensive study here, but here are some of the key conclusions:

  1. Dieters who cut back on added sugar, refined grains and other processed foods, while also increasing their intake of vegetables and whole foods successfully lost weight, regardless of total caloric intake.
  2. This strategy applied equally to reducing fats or carbs, as neither strategy was clearly better.
  3. The key point is that these dieters were not told to count calories, just focus on better quality selection of food, and they had successful weight loss and still actually reduced the total amount of calories a day. So this seems to confirm that quality, not quantity, is the key to a healthy diet.

For more articles on a heart-healthy diet, see our Diet page.

New Guidelines for High Blood Pressure

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BW ARA labcoatJust released November 13, 2017, new guidelines for Hypertension, the term for High Blood Pressure, have implications for prevention of heart and vascular disease and stroke. The definition of “high” or elevated blood pressure is now lower, with emphasis on lifestyle changes to prevent progression to hypertension.

The guidelines are written by a group of scientists, researchers, and clinical experts from multiple societies – who review over 900 manuscripts and published research results to include what we know about blood pressure and the effects of uncontrolled blood pressure or hypertension. The guidelines emphasize lifestyle changes that anyone can make to help keep their blood pressure safe.  Lifestyle changes and at times medications can help keep blood pressure in a healthy range and prevent heart disease and stroke.

Why so much focus on high blood pressure? Hypertension is also called ‘the silent killer’ because it may not cause symptoms until heart damage has already happened. Consequences of uncontrolled high blood pressure include stroke, heart failure, erectile dysfunction, vision loss, heart attack, kidney disease/failure. The consequences add up if hypertension combines with other medical problems like diabetes or with lifestyle such as sedentary behavior.

What is blood pressure? It is a measurement of the force of the blood moving through your arteries (arteries are part of the circulation). Blood pressure is made up of two numbers, systolic and diastolic. Arteries exposed to elevated or high blood pressure over time can have changes such as increased size (aneurysm), increased plaque (atherosclerosis), and decreased function (eye blood vessel changes).

What are the new numbers??

The new blood pressure categories define normal as less than 120/80 mmHg, elevated systolic between 120-129 mmHg and diastolic less than 80 mmHg, stage I hypertension as systolic between 130-39 mmHg or diastolic between 80-89 mmHg, stage II hypertension systolic at least 40 or diastolic at least 90 mmHg, and hypertensive crisis is systolic over 180 and/or diastolic over 120 with patients needing prompt changes in medication if there are no other indications of problems or immediate hospitalization if there are signs of organ damage.

The new guidelines lower the level at which doctors will be paying attention to blood pressure. The category of pre-hypertension is eliminated.

How do I know my blood pressure??

How do you check a blood pressure? The new guidelines emphasized the importance of using proper technique to measure blood pressure. Patients can check blood pressure at home. The use of validated devices is recommended ~ a pharmacist can help with BP monitor selection. Be sure to sit with back support, feet on the floor, and arm at heart level (left chest), relax for 5 minutes before checking the blood pressure. Multiple readings are ok.

What affects blood pressure??

What is Lifestyle and how does it impact blood pressure?  Lifestyle refers to how we live, choices we can make on a daily basis, that add up considerably to our overall heart health. Patients often ask how they can reduce or avoid taking medications – it is possible  to use lifestyle ~ depending on the cause of the elevated blood pressure. Getting to goal weight, staying active, avoiding a high sodium diet (read labels, make your own food), liberal amounts of vegetables in the diet, not using tobacco products, managing stress, avoiding excess alcohol, are all great ways to use lifestyle to keep blood pressure < 120/80mmHg.

Really?

Over the counter medications can increase blood pressure. Nonnarcotic analgesics such as non-steroidal anti-inflammatory agents including aspirin, ibuprofen, and naprosyn can increase blood pressure and should be used with intent (not by habit). Pain can raise blood pressure so if the medicine helps reduce pain, that will help but don’t take these medicines ‘just because.’ Medicines such as decongestants, or stimulants for example sometimes found in diet pills, can increase blood pressure. Natural licorice can increase blood pressure levels. Prescription medications such as oral contraceptives, cyclosporin, erythropoietin, or meloxicam can increase blood pressure. Herbal compounds such as ephedra or ma huang can increase blood pressure. Awareness is important when working toward optimal blood pressure.

What does risk for atherosclerotic cardiovascular disease (ASCVD) have to do with blood pressure??

The new blood pressure guidelines focus on the patient’s risk for heart and vascular disease and take into consideration if the patient has already had heart attack or stroke or is at high risk of heart attack or stroke based on age, the presence of diabetes mellitus, chronic kidney disease or calculation of atherosclerotic risk (using the same risk calculator used when evaluating whether or not to treat high cholesterol).

 

Reference: http://www.acc.org/latest-in-cardiology/articles/2017/11/08/11/47/mon-5pm-bp-guideline-aha-2017

 

Where can I get more information??

The Heart Health Docs have covered heart healthy diet and exercise extensively. Lifestyle habits play a powerful role in heart health and in blood pressure management. Simple habits like regular exercise, following the DASH diet, boosting potassium in your  diet, and limiting alcohol are great for getting to goal blood pressure. Keeping a healthy weight will help get to goal blood pressure.

We recommend checking out the American College of Cardiology site, CardioSmart for great information about hypertension.

 

https://hearthealthdocs.com/heart-healthy-diet/

 

https://hearthealthdocs.com/exercise/

 

Really all our site articles are helpful https://hearthealthdocs.com/articles/

 

 

Diet and Heart Disease – What Does the Science Say About What to Eat?

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IMG_8348rt5x7bwIt is so hard to keep up with research on diet and disease prevention, especially with so many conflicting reports in the media. To try to sort through this, some researchers looked comprehensively at all of the high quality research available about diet and prevention of heart disease. They put together this nice summary table showing which foods show evidence of harm, which show evidence of benefit, and which are inconclusive.
It is important to remember that this is addressing heart disease specifically, not general health or general disease prevention.  And they limited their conclusions to the most thorough studies of heart disease outcomes.  For example, I think a diet which is low in wheat-based carbohydrates can be very beneficial for maintaining weight and preventing long-term health complications.
If you, or a family member, suffers from chronic heart disease, this table is a good starting point for a discussion with your physician and other health providers about the optimal diet to prevent future heart issues.

 

ACC food guide

Here are more of our articles on Nutrition and Heart Prevention.

You Really Are (and might die from) What You Eat (. . .or Don’t Eat)!

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IMG_8348rt5x7bwMost of us understand that there is a link between what we eat and our health – but how strong, and how important, is that connection? Heart and circulatory disease is the number one killer of American adults, and we know that certain dietary behaviors can either promote, or reduce, health consequences.

But a new study  just released, shows just how strong that association is between diet and heart disease. These researchers looked at all of the important studies of specific food types and disease associations, then compared this to national surveys of Americans’ eating habits. They then estimated what proportion was due these various dietary habits.

Overeating, or not eating enough, of the 10 foods and nutrients contributes to nearly half of U.S. deaths from heart and circulatory disease, the study suggests.bread

“Good” foods that were under-eaten include: nuts and seeds, seafood rich in omega-3 fats including salmon and sardines; fruits and vegetables; and whole grains.

“Bad” foods or nutrients that were over-eaten include salt and salty foods; processed meats including bacon, bologna and hot dogs; red meat including steaks and hamburgers; and sugary drinks.

Of course, this was a study of populations, and most of us are most concerned about our personal habits and risk of disease (remember, only your doctor or health care provider can give your specific advice about your health care). And most importantly, the fact that certain dietary habits are “associated” with bad health, doesn’t mean those foods “cause” bad health.   But this is an interesting study that helps quantify the most important targets for change in our diet.  (click here to read  the full study)

For more information on Heart Health and Diet, see our overview article here.

 

#GoRedCbus ~ When should you learn about Heart Failure?

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BW ARA labcoatThe American Heart Association’s Go Red for Women event February 23, 2017 gave Columbus information about Heart Health for Women, and provided opportunity to support AHA in advocacy, research, and education.

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Left – right, JS, Dr. Albers, Dr. Basuray

Dr Anup Basuray (photo) presented a breakout session on a complex topic. The name Heart Failure does not in fact mean a heart has stopped working (my engineer/math husband is one of many who question the name Heart Failure – but this has been and remains our wording). The term is broad covering symptoms that occur when the heart is not fully functioning – leading to symptoms including shortness of breath, leg swelling, abdominal swelling, fatigue, and/or weight gain or loss. In his presentation, Prevent. Treat. Recover. : Transforming Heart Failure into a Success Story Dr. Basuray highlighted examples of young women patients he has treated. His case presentations illustrated the different ways people get heart failure; some specific to women, for example in the case of problems associated with pregnancy.

Heart Failure is diverse in cause, outcomes, and treatment. The slide here shows ~ 10 causes of Heart Failure, more recently identified is history of cancer treatment, and also included is ‘unknown‘ or doctor-speak, idiopathic. Heart valve disease, genetics (inherited causes), high blood pressure, drugs and alcohol, infection, coronary artery disease, pregnancy related, and irregular heart rate/rhythm can all be causes of Heart Failure.

Heart Failure results in fluid retention by the kidneys, a problem that is worse with high sodium diet. Western diets have high sodium – top sources are Breads and rolls, cold cuts and cured meats, pizza, poultry, soups, sandwiches, cheese, pasta dishes, meat dishes, SNACKS. Reading labels and being aware of sodium is key to heart health in general and to limiting fluid retention in Heart Failure in particular. Knowledge is power when considering what we eat – see here https://hearthealthdocs.com/heart-healthy-diet/  , and for surprising sources of salt https://hearthealthdocs.com/2016/06/08/surprise-sources-of-salt-in-your-diet/

Dr. Basuray addressed the power of prevention and how to stay healthy by knowing the following KEY modifiable risk factors for heart failure

  • High blood pressure
  • Diabetes
  • Obesity
  • High cholesterol

Know your numbers

  • Blood pressure, cholesterol, diabetes (blood glucose) screen
  • Every 4-6 years, as early as age 20

2013 AHA/ACC Heart Failure Guidelines 

So when should you learn about Heart Failure? Now is good. Same with choosing to live a heart healthier life.

Heart Health Docs recommended resources:

https://www.cardiosmart.org/Heart-Conditions/Heart-Failure

Caffeine and Your Heart -Some New Advice

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IMG_8348rt5x7bwYou may have seen this report in the media regarding the effect of caffeine intake on irregular heartbeats.  As many of you know, irregular heartbeats are common and can be quite bothersome.  The challenge to clinicians is sorting out which are due to a more serious underlying cause, and which are simply a nuisance. Because caffeine is a known stimulant, clinicians have often advised patients who suffer from palpitations and various types of irregular heart rhythms to avoid or minimize their caffeine intake.

This new study attempted to look at the link between caffeine intake and various types of Coffee Cupirregular heartbeats. Interestingly, the researchers found that there seemed to be minimal effect of caffeine intake on the extent of irregular heartbeats.

What can we can conclude? Although this study is limited in that it was a retrospective
review, it does show that caffeine may be just one of many triggers for heart related issues. It may play a role in certain patients but not in others. Some patients may want to experiment with their caffeine intake to see if it affects their symptoms, but it may not be necessary for all patients to eliminate it completely.  As always, you should discuss your specific cardiac symptoms and issues with your healthcare provider to determine the optimal treatment strategy for you.

 

Irregular Heartbeats? Coffee May Not Be So Bad for You

http://nyti.ms/23txNCq via @nytimeswell

 

People with irregular heartbeats are often advised to give up caffeine, but a new study suggests they may not have to forgo their coffee.

Researchers had 1,388 people record their intake of coffee, tea and chocolate over a one-year period, and used Holter monitors to get 24-hour electrocardiograms.

More than 60 percent of the participants reported consuming one or more caffeine-containing foods daily. But the electrocardiograms revealed no differences in premature beats or episodes of accelerated heart rate between caffeine users and abstainers. Thestudy is in the Journal of the American Heart Association.

“There’s no clear evidence that drinking more caffeine increases the risk for early beats,” said the senior author, Dr. Gregory M. Marcus, an associate professor of medicine at the University of California, San Francisco. In fact, evidence from other studies suggests caffeine may even be linked to decreased rates of cardiovascular problems.

“I tell patients that it is very likely that for some people, caffeine is an important trigger” of irregular heartbeats, Dr. Marcus said. “I generally tell them that it’s fine for them to experiment and weigh the pros and cons of caffeine to see how it influences their quality of life. The majority of arrhythmias are not life threatening.”

Top articles from our first 2 years. . .

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IMG_8348rt5x7bwBW ARA labcoatAs we approach the two-year anniversary of our blog, we would like to thank all of our followers for supporting our efforts to promote heart disease prevention.  In 2 years, this site has been viewed over 7,000 times, and in over 70 countries!  We sincerely appreciate your support, as well as your feedback.

As we look back on nearly 50 posted articles, we wanted to share some of the most relevant and important posts. . . . and we look forward to continue promoting heart health in the future! (And remember as always. . . only your doctor can give you specific advice about your health issues).

Here are are our top 10 tips for a heart healthy diet, and also some great online resources about diet.

Is your heart as old (or older) as you? Find out how to calculate your Heart Age.

Here are some useful online resources about high blood pressure, along with a description of the optimal diet.eca284793cc89e389f347e0f41da895a

Here is some insight into the role of wine and heart health.

Here is an overview of CardioSmart, our favorite online resources for heart disease treatment and prevention.

Have you heard conflicting information on saturated fat? Here is some guidance as well as a discussion of low fat and low carb diets.

running shoesCan running be risky for your heart? Here is some information, as well as this article on the right “dose” of exercise heart heart – but maybe even just 5 minutes a day can help! And it even may help your spouse’s heart as well!

If you or a family member suffers from atrial fibrillation, here is a videotaped lecture that addresses the causes and treatment options for this common condition.

Finally, please check out our video blogging site, Vidoyen.com,  where we have posted several videos on heart prevention issues.

Thank you again for all of your support over the past 2 years, and for your interested in Heart Health awareness and prevention!

 

 

 

Heart Health News. . . You Can Use

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IMG_8348rt5x7bwHere are some quick links to useful items in the news recently that reflect new findings on prevention and heart health:

Could drinking alcohol actually affect the way you exercise? Some new research described here suggests that could be the case – and in a positive way. 

The upshot? Because exercise and alcohol intake affect similar “pleasure” centers in our brain, you may actually be tempted to drink more in days you exercise – but people who drink moderate amounts of exercise also tend to exercise more regularly. . . and seem to be healthier. (see our earlier article about wine and heart health).

Is coffee good or bad for you? A new study described here looked at coffee intake and risk of death from various causes.

The upshot? Keep bringing on the java (and consider buying Starbucks stock!)

Can you be “too old” to exercise. . or get its benefits? Not according to new research. 

The upshot? Even in those over age 75, regular walking can reduce your risk of heart attack and stroke. So keep moving!

This article describes research into the link between weekend sleep and weekday sleep.

The upshot? Sleeping in late on weekends may feel good, but may have negative health consequences.

Remember. . only your doctor can give you specific health care advice. . so always check with your health provider if these articles (and the advice they contain) apply to you and your health situation. 

 

A great prescription

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BW ARA labcoatWe have written and posted about the heart health benefits of exercise at HeartHealthDocs – including programs like Cardiac Rehabilitation (Rehab)

heart to start book. In the book Heart to Start, Dr. James Beckerman, a cardiologist who lives in Portland, Oregon, writes a detailed prescription for anyone to use to start living heart healthy. The gut-check forward “What’s your legacy?” written by David Watkins is followed by patient examples, vignettes, and Beckerman’s own personal reasons for the book. The Warm Up, Work Out, Cool Down sections echo a training session, and take the reader through the paces – the what, why, how, for fitness assessment and growth toward heart & circulation health.

The chapter Cardiac Reboot asks “Got Rehab?” and points out the current reality that if you (the patient) don’t bring up cardiac rehab, “it is possible no one else will.” This relates to the low numbers (20-30%) of eligible patients being referred to cardiac rehab, and of those only 40% actually completing this effective treatment regimen.

Beckerman goes on to provide readers a toolkit for being active, while showing how an active lifestyle can be habit forming – and be maintained for years (ie. how not to get injured). The book will get you to your 5K and its finish & beyond, and will teach how nutrition, training, and balance (ie. strength conditioning in addition to walking/running) work together.

Dr. Beckerman gives powerful examples of what motivates him – for the book, and for his practice which includes the PlaySmart heart screening program. The proceeds from the sale of his book will support free heart screenings for kids.  The book will help anyone learn about and apply practical, inspiring information for exercise and heart health. A great way to multitask.

#Heart Health for Women; Start here this Valentine’s Day #LoveYourHeart

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IMG_2641 ara echoWhat better day to talk about the Heart than Valentine’s Day?

More science is showing the benefit of starting early with habits that promote heart health.  Treatments already available & scientifically proven are UNDERUTILIZED: would you think 20% was a good score?! No. But 80% of people eligible for cardiac rehab DON’T take part in this essential treatment / program.

This post covers TWO topics for Women’s Heart Health:

  • A recent study showing the impact of 20 years of healthy choices for young women 
  • A NEW program to promote the established, effective heart treatment Cardiac Rehab.

Heart month is a great time to bring attention to what we know about preventing heart disease as well as what opportunities are available for managing heart risk.

  • A recent study showing the impact of 20 years of healthy choices for young women 

In 2015 we have learned about healthy habits or behaviors that impact RISK for developing heart disease with PRIMARY prevention. A paper published in the Journal of the American College of Cardiology (JACC) in January reports the impact of 6 habits on the risk of heart disease for women. This study,

Healthy Lifestyle in the Primordial Prevention of Cardiovascular Disease Among Young Women

looked at a group of young women ages 27-44 years old and followed them over 20 years. Can you think of what the 6 healthy behaviors might be? We have covered them here on HeartHealthDoctors – like a lot of heart healthy changes they are available to us NOW. So pick one and START living a healthy lifestyle:

A healthy lifestyle was defined as not smoking, a normal body mass index, physical activity ≥ 2.5 h/week, television viewing ≤ 7 h/week, diet in the top 40% of the Alternative Healthy Eating Index–2010, and 0.1 to 14.9 g/day of alcohol.

1) Not smoking

2) Get to GOAL weight which is a normal Body Mass Index (BMI)

3) Move your body through space; physical activity at least 2 1/2 hours per week

4) TV viewing < or equal to 7 hours per week

5) Follow a heart healthy diet 

6) If a woman chooses to drink alcohol, amount of 1 drink per day or 12 oz beer, 4 oz wine, or 1.5 oz liquor correlates to ~14gm

Marlene Busko writes for Medscape about the JACC paper that ” Adoption of six healthy lifestyle behaviors could avert about 73% of coronary heart disease (CHD) cases among women over 20 years, as well as 46% of diabetes, hypertension, and hyperlipidemia, conclude researchers, based on their analysis of about 69 000 participants …”

Key to know with the Nurse’s Health Study findings is that Coronary Heart Disease (CHD) risk was lower for women without AND with heart disease risk factors – BOTH groups showed decreased events with more healthy lifestyle habits/behaviors.

  • A NEW program to promote the established, effective heart treatment Cardiac Rehab.

At OhioHealth we have launched a cardiac rehab program for women to help give every opportunity to succeed at SECONDARY prevention and prevent or slow disease progression. To improve the ‘ low test score of 20%’ participation in Cardiac Rehab the OhioHealth Women’s Heart and Vascular Program launched a program for cardiac rehab designed for women. Education and exercise in the company of other women with heart disease offers a new way to help women who have had a heart event (Chest Pain, Heart Attack, Coronary artery Stent, Heart Valve surgery, Coronary artery bypass surgery) and are starting on their SECONDARY prevention journey.

Read more about Cardiac Rehab here; 10TV News did a great story / coverage of the Women’s Cardiac Rehab program (click text to view story and video).